Prevalence of Musculoskeletal Disorders among Dentists in Iran: A Systematic Review.

INTRODUCTION: Musculoskeletal disorders (MSD) have become significant problems for all health care workers especially dentists. This systematic review provides prevalence of MSD in dentists of Iran. MATERIAL AND METHODS: In this study all published literatures about MSD in Iranian dentists were selected without any time limits or other restrictions. However, it was found that the studies about MSD among Iranian dentist are very low. RESULTS: The results of literatures investigations show that the prevalence was between 0.5% and 70%. The prevalence of pain in different regions includes; neck pain (0.7- 0.15), back pain (0.08 - 0.55), wrist pain (0.005-0.48), shoulder pain (0.08-0.5), knee pain (0.03- 0.25) and elbow pain (0.01- 0.2). The gender has no influence on the prevalence. Compare the results with other similar studies shows that the prevalence of MSD is an important issue in other area too. CONCLUSION: Results show that the prevalence of musculoskeletal problems is high in Iran. Therefore it is necessary conduct reliable and comprehensive epidemiological studies in this field to determine the causes of the problem more consciously; and propose appropriate solutions.

Prevalence of Low Back Pain in Health Care Workers and Comparison with Other Occupational Categories in Iran: A Systematic Review.

BACKGROUND: There are few research studies evaluating the significance of low back pain (LBP) in Iran, even though the majority of locally published surveys are written in the Persian language. In the present review study, we aimed at appraising published articles related to the burden of LBP and its divergence among different jobs. METHODS: A comprehensive search was conducted in all accessible national and international electronic databases from 1948 to mid-2012. The international electronic databases were MEDLINE (PubMed), Web of Sciences, Google Scholar, Scopus, CINAHL, and the Iranian equivalents were SID, IRANDOC, IranMedex, and Magiran. The main search terms were musculoskeletal disorders, musculoskeletal symptoms, low back pain, back pain, and Iran. All keywords were searched electronically by three Boolean operators. The inclusion criteria were age ≥10 years, study focus on LBP prevalence, inclusion of both genders, and no limitation to the study design. A dedicated STROBE questionnaire was developed as a critical appraisal tool and the quality of the identified literature was examined according to the 5-point Linker scale. Articles scoring ≥3 on the Linker scale were appraised. Each literature was screened by four reviewers independently and possible disagreements were streamlined in a joint review meeting. The extracted data were entered into a dedicated table using Microsoft Office Excel program. Data were analyzed for homogeneity using the STATA software (version 11). RESULTS: Of the 51 articles that were included in the present review study, 35 articles reported 1-year LBP with Nordic questionnaire and 3 articles reported point prevalence of LBP. The calculated global prevalence of 1-year LBP in workers was 25% and LBP was the most prevalent issue among health care workers. There was no association between the prevalence of LBP and job classification among workers. CONCLUSION: LBP is the most common issue among health care workers. It is recommended that future research should focus on this job category for investigating LBP prevalence. This allows parameters that increase the frequency of LBP to be assessed and subsequently permits the reduction or elimination of such factors.

Increased carotid intima-media thickness in scuba divers.

BACKGROUND: Scuba divers work in high pressure conditions which may cause some changes in physiological status to adapt to this situation. In this study, the carotid intima-media thickness (CIMT) was assessed in divers as a risk factor of cerebrovascular and cardiovascular disorders. METHODS: This historical cohort study was performed on 16 male professional scuba divers as case group and 30 healthy people as controls with age range of 26-66 years. CIMT of both carotids of supine participants was measured by a 10 MHz linear ultrasonic probe quantitatively. Relationship between experience of diving and carotid IMT was evaluated. RESULTS: All the participants were males (mean age 42.9 ± 10.58. and for the control group was (47.05 ± 12.31 years). The mean right CIMT in divers and control group was 524.31 ± 149.40 and 443.66 ± 59.62 micrometer, respectively. Furthermore, the mean left CIMT in divers and control group was 624.57 ± 116.15 and 458.44 ± 49.56 micrometer, respectively. CONCLUSION: The findings demonstrated that long-term occupational diving leads to increased intima-media thickness in scuba divers.

Effect of scuba-diving on optic nerve and sheath diameters.

BACKGROUND: There is not any data available about the effect of high bar pressure condition on intracranial pressure. In this study, the effect of diving on the optic nerve and sheath diameters as non-invasive markers of intracranial pressure has been investigated. METHODS: Twenty professional male divers from twenty one volunteers were chosen for this cross-sectional study. Only one person who had a history of barotraumas was excluded. Each diver then completed a questionnaire on demographic data, medical and diving history. Nineteen other volunteers were selected to represent a control group. A 10-MHz linear ultrasonic probe was used to measure the optic nerve sheath diameters of both eyes in closed and supine position and its relationship with diving history of divers was determined. RESULTS: It was found that divers have a higher mean optic nerve sheath diameter compared to the normal population as previously reported by other studies. The mean diameter of the left and right optic nerve sheaths were 6.4±0.7, 6.5±0.9 mm respectively and a significant relationship between optic nerve sheath diameter and diving history was found. CONCLUSION: RESULTS showed that divers have a higher optic nerve diameter than the general population. However, our result cannot yet be considered as a marker of intracranial pressure in divers as it was conducted on an limited number of subjects and so a bigger study should be undertaken for this purpose.

Effect of Air Pollutant Markers on Multiple Sclerosis Relapses.

BACKGROUND: Multiple Sclerosis (MS) is one of the autoimmune diseases with an unknown cause. The aim of this study was to explore the link between air quality and MS relapses in patients who suffer from MS. METHODS: This time-series study was conducted on patients registered at the Iranian Multiple Sclerosis Society in 2011-2012. They were randomly selected from patients lived in Tehran in the last five years, and had at least one relapse in the last three years. The link between monthly mean air pollutant levels and the relapses of MS in the participants was studied. RESULTS: Among the registered 160 participants, at least 150 had one attack during 2009 and 2012. Most air pollutants such as NO2, NO and CO are in high levels in the rainy season. Others like Pm10 and Nox are in high levels in the dry season. The correlation between NO2 levels of all markers of air quality and MS relapses (P=0.03, r=0.27) is weak. Best ARIMA model (p,d,q; 1,0,1) was determined between number of monthly relapses and living place, although this model was not significant (P=0.3) (AR; P=0.000, MA;P=0.4). CONCLUSIONS: Air pollutants might be regarded as a risk factor for MS relapse.

Health related quality of life and pain characteristics among Iranian patients suffering non-malignant chronic pain.

BACKGROUND: Chronic pain is a frequent disability that negatively affects patient's quality of life. Understanding of the possible relation between sociodemographic and medical variables with Health Related Quality of Life (HRQL) may help identifying the multidimensionality of pain and risk factors that limit physical and psychological adjustment of the patients. The present study was done to find these possible relationships, based on using Medical Outcomes Survey-Short Form (SF-36). METHODS: Among the patients who were referred to pain clinic of Iranian Pain Society, 101 consecutive outpatients were select based on the defined inclusion and exclusion criteria. All the participants in this study orally satisfied and were fully informed by a check list and SF-36 questionnaire. The possible impact of demographic variables, characteristics, diagnosis, analgesic use, smoking and opium addiction were collected as the first part of a routine pretreatment evaluation. RESULTS: Our findings showed significant relation between HRQL and gender (P < 0.05), the rate of chronic pain in female was higher than male, and same results found for elderly patients compared to younger ones. Our findings also showed significant relation between employment and intensity of pain (p = 0.001) as, employed patients showed less physical and psychotic problems than unemployed ones. The mean average of intensity of pain in these patients was 7.5±2.2; few patients used alcohol (4%), opium (1%) and cigarette (10%). Large number of participants used analgesic (%78.2). No significant difference between sociodemographic features with pain duration and quality of life was found. In contrast our data showed significant difference between pain intensity and quality of life (p < 0.001). CONCLUSION: Based on our findings it could be concluded that chronic pain in Iranian patients certainly leads to poor HRQL, the state is more serious in the elderly and female patients. Thus, in order to re-socialize the patients suffering chronic pain and decrease the impact of their pain on their life, these findings should be considered in any kind of pain relief therapy.