Prevalence of Musculoskeletal Pain and Its Relation With Weight of Backpacks in School-Going Children in Eastern India

Background: Recently, heavy school backpacks have become a significant concern among parents and health professionals, as well as the media, but evidence for the same is limited in the Indian context.Aim: To find the prevalence of musculoskeletal pain among school-going children and its relationship with backpack weight.Design: Cross-sectional study.Method: This study was carried out among school-going children from grade 6 to 10 with age of 10 to 16 years from an urban and rural location. Schools were selected randomly from all enlisted schools in the district of Khurdha, Odisha state of India. A structured questionnaire was administered to assess symptoms of musculoskeletal pain. Anthropometric measurements along with backpack weight were taken.Statistical Analysis: Chi-square test was performed for categorical variables and Student's t-test for continuous variables. Multivariate regression analysis was performed to identify factors with maximum effect on musculoskeletal pain.Results: The prevalence of musculoskeletal pain was 18.8% in the preceding year. Backpacks weights were higher among children of urban schools as compared with rural areas. Children from urban schools were more likely to have pain than those from rural schools (OR 1.88, 95% CI 1.41–2.49). Those children with a backpack weight more than 10% of body weight had almost twice the risk of musculoskeletal pain compared to backpack weight less than 10% (OR 1.91, 95% CI 1.4–2.6) in univariate analysis where as no significant association was found on multivariate analysis.Conclusion: The prevalence of musculoskeletal pain was high in school-going children. In children, carrying higher backpack weight, and a higher percentage of the backpack to bodyweight had a significant association with musculoskeletal pain. Gender, height, body mass index, and backpack weight to body weight > 10% had no association with musculoskeletal pain.

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Quality of life based on level of physical activity among elderly residents of urban and rural areas

Revista Brasileira de Geriatria e Gerontologia ◽

10.1590/1981-22562017020.160110 ◽

2017 ◽

Vol 20 (3) ◽

pp. 330-339 ◽

Cited By ~ 5

Author(s):

Cezar Grontowski Ribeiro ◽

Fátima Ferretti ◽

Clodoaldo Antônio de Sá

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Rural Areas ◽

The Elderly ◽

Categorical Variables ◽

Elderly Persons ◽

Continuous Variables ◽

Place Of Residence ◽

Cross Sectional

Abstract Objective: To analyze quality of life (QOL) according to level of physical activity among elderly persons living in rural (RA) and urban (UA) areas. Method: A descriptive cross-sectional study, analyzing 358 elderly residents of RA and 139 of UA, in the municipal region of Palmas, Paraná, Brazil was performed. Quality of life, level of physical activity and economic condition were evaluated. For the analysis of the continuous variables, the student’s t-test or the Mann-Whitney test were used, based on the normality or otherwise of the data. Pearson's chi-squared or Fischer’s exact test were used to analyze the categorical variables. Results: The general perception of QOL reported in RA was better than in UA (p<0.05). The analysis of the level of physical activity according to place of residence showed that the elderly are more physically active in RA (p<0.05), whereas insufficiently active or sedentary subjects prevail in UA. The variables age and gender were not associated with QOL (p>0.05), irrespective of place of residence, and active elderly persons had better QOL scores than insufficiently active or sedentary individuals, again irrespective of place of residence (p<0.05). Conclusion: The present study provides evidence that QOL is positively influenced by both maintaining satisfactory levels of physical activity and by residing in RA. It is important to establish public policies aimed at ensuring a more active and independent old age, thus generating greater health and quality of life.

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Diagnostic Dilemmas: A Multi-Institutional Retrospective Analysis of Adrenal Incidentaloma Pathology Based on Radiographic Size

10.21203/rs.3.rs-1150325/v1 ◽

2021 ◽

Author(s):

David Zekan ◽

Robert Scott King ◽

Ali Hajiran ◽

Apexa Patel ◽

Samuel Deem ◽

...

Keyword(s):

Ct Scan ◽

Imaging Modality ◽

Univariate Analysis ◽

Adrenal Incidentaloma ◽

Categorical Variables ◽

Continuous Variables ◽

Chi Square ◽

Cross Sectional ◽

Adrenal Cortical Adenoma ◽

Simple Logistic

Abstract Introduction/Background Adrenal incidentalomas (AIs) are masses >1 cm found incidentally during radiographic imaging. They are present in up to 4.4% of patients undergoing CT scan, and incidence is increasing with usage and sensitivity of cross-sectional imaging. Most result in diagnosis of adrenal cortical adenoma, questioning guidelines recommending removal of all AIs with negative functional workup. This retrospective study analyzes histological outcome based on size of non-functional adrenal masses. Material and Methods 10 years of data was analyzed from two academic institutions. Exclusion criteria included patients with positive functional workups, those who underwent adrenalectomy during nephrectomy, <18 years, and incomplete records. AI radiologic and histologic size, histologic outcome, laterality, imaging modality, gender, and age were collected. T-test was used for comparison of continuous variables, and the two-sided Fisher’s exact or chi-square test were used to determine differences for categorical variables. Univariate analysis of each independent variable was performed using simple logistic regression. Results 73 adrenalectomies met the above inclusion criteria. 60 were detected on CT scan, 12 on MRI, and one on ultrasound. Eight of 73 cases resulted in malignant pathology, 3 of which were adrenocortical carcinoma (ACC). Each ACC measured >6 cm, with mean radiologic and pathologic sizes of 11.2 cm and 11.3 cm. Both radiologic and pathologic size were significant predictors of malignancy (p=0.008 and 0.011). Conclusions Our results question the generally-accepted 4 cm cutoff for excision of metabolically-silent AIs. They suggest a 6 cm threshold would suffice to avoid removal of benign lesions while maintaining sensitivity for ACC.

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Association of Backpack Weight with Musculoskeletal Status among Adolescents

Journal of Nepal Health Research Council ◽

10.33314/jnhrc.v18i3.1708 ◽

2020 ◽

Vol 18 (3) ◽

pp. 535-540

Author(s):

Sristy Kafle

Keyword(s):

Body Weight ◽

Musculoskeletal Pain ◽

Management Strategies ◽

Cross Sectional Study ◽

Government Schools ◽

Musculoskeletal Discomfort ◽

Cross Sectional ◽

Musculoskeletal Development ◽

Perceived Weight ◽

Backpack Weight

Background: Adolescence period is a critical stage of musculoskeletal development and carrying heavy backpack to school daily puts them at risk of musculoskeletal discomfort. This study aims to find out the association of backpack weight with musculoskeletal status among adolescents. Methods: A descriptive cross-sectional study was conducted among 291 grade 4 to 8 students from three government schools of Lalitpur. Data was analyzed using descriptive and inferential statistics. Results: Around 68% of the adolescents carried schoolbag of weight greater than 10% of their body weight. Similarly, 66.7% perceived musculoskeletal pain of which 29.9% had ever missed school due to pain, 70.1% felt tired while carrying their schoolbag and 23.4% adopted forward/sideways leaning posture while carrying their schoolbag. Age (p< 0.001), backpack percentage to body weight (p< 0.001) and perceived weight of schoolbag (p= 0.006) were significantly associated with musculoskeletal pain. Similarly, age (p= 0.023), sex (p= 0.005), grade (p= 0.030) and perceived weight of schoolbag (p= 0.007) were significantly associated with tiredness while carrying schoolbag. Also, backpack percentage to body weight (p= 0.008), duration of carrying schoolbag (p= 0.010) and perceived weight of schoolbag (p= 0.001) were significantly associated with posture assumed while carrying schoolbag. Conclusions: Students carrying backpack weight more than recommended limit are more likely to develop musculoskeletal pain and change in posture while carrying their schoolbag. Thus, necessary steps must be taken to further analyze the situation and develop management strategies on reducing backpack weight and its possible effect on adolescents. Keywords: Adolescents; backpack weight; musculoskeletal pain; tiredness, fatigue

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Characteristics of Confidence and Preparedness in Paramedics in Metropolitan, Regional, and Rural Australia to Manage Mental-Health-Related Presentations: A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041882 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1882

Author(s):

Kate Emond ◽

Melanie Bish ◽

Michael Savic ◽

Dan I. Lubman ◽

Terence McCann ◽

...

Keyword(s):

Mental Health ◽

Rural Areas ◽

Cross Sectional Study ◽

Categorical Variables ◽

Considerable Proportion ◽

Sectional Study ◽

Cross Sectional ◽

Health Related ◽

Manage Mental ◽

Manage Mental Health

Mental-health-related presentations account for a considerable proportion of the paramedic’s workload in prehospital care. This cross-sectional study aimed to examine the perceived confidence and preparedness of paramedics in Australian metropolitan and rural areas to manage mental-health-related presentations. Overall, 1140 paramedics were surveyed. Pearson chi-square and Fisher exact tests were used to compare categorical variables by sex and location of practice; continuous variables were compared using the non-parametric Mann–Whitney and Kruskal–Wallis tests. Perceived confidence and preparedness were each modelled in multivariable ordinal regressions. Female paramedics were younger with higher qualifications but were less experienced than their male counterparts. Compared to paramedics working in metropolitan regions, those working in rural and regional areas were generally older with fewer qualifications and were significantly less confident and less prepared to manage mental health presentations (p = 0.001). Compared to male paramedics, females were less confident (p = 0.003), although equally prepared (p = 0.1) to manage mental health presentations. These results suggest that higher qualifications from the tertiary sector may not be adequately preparing paramedics to manage mental health presentations, which signifies a disparity between education provided and workforce preparedness. Further work is required to address the education and training requirements of paramedics in regional and rural areas to increase confidence and preparedness in managing mental health presentations.

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Epilepsy as a Comorbidity in Polymyositis and Dermatomyositis—A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18083983 ◽

2021 ◽

Vol 18 (8) ◽

pp. 3983

Author(s):

Ella Nissan ◽

Abdulla Watad ◽

Arnon D. Cohen ◽

Kassem Sharif ◽

Johnatan Nissan ◽

...

Keyword(s):

Proportional Hazards ◽

Cross Sectional Study ◽

Cox Proportional Hazards ◽

Categorical Variables ◽

Rank Test ◽

Control Group ◽

Multivariable Logistic Regression Analysis ◽

Positive Trend ◽

Continuous Variables ◽

Cross Sectional

Polymyositis (PM) and dermatomyositis (DM) are autoimmune-mediated multisystemic myopathies, characterized mainly by proximal muscle weakness. A connection between epilepsy and PM/DM has not been reported previously. Our study aim is to evaluate this association. A case–control study was conducted, enrolling a total of 12,278 patients with 2085 cases (17.0%) and 10,193 subjects in the control group (83.0%). Student’s t-test was used to evaluate continuous variables, while the chi-square test was applied for the distribution of categorical variables. Log-rank test, Kaplan–Meier curves and multivariate Cox proportional hazards method were performed for the analysis regarding survival. Of the studied 2085 cases, 1475 subjects (70.7%) were diagnosed with DM, and 610 patients (29.3%) with PM. Participants enrolled as cases had a significantly higher rate of epilepsy (n = 48 [2.3%]) as compared to controls (n = 141 [1.4%], p < 0.0005). Using multivariable logistic regression analysis, PM was found only to be significantly associated with epilepsy (OR 2.2 [95%CI 1.36 to 3.55], p = 0.0014), whereas a non-significant positive trend was noted in DM (OR 1.51 [95%CI 0.99 to 2.30], p = 0.0547). Our data suggest that PM is associated with a higher rate of epilepsy compared to controls. Physicians should be aware of this comorbidity in patients with immune-mediated myopathies.

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Association between Short Hours of Sleep and Overweight/Obesity in Mexican Adolescent Population: A School-Based Cross-Sectional Study

Healthcare ◽

10.3390/healthcare9080939 ◽

2021 ◽

Vol 9 (8) ◽

pp. 939

Author(s):

Ana Fresan ◽

Alma Delia Genis-Mendoza ◽

María Lilia López-Narváez ◽

Tania Guadalupe Gómez-Peralta ◽

Daniela Georgina Aguilar-Velázquez ◽

...

Keyword(s):

Cross Sectional Study ◽

The Body ◽

Categorical Variables ◽

Continuous Variables ◽

Sectional Study ◽

Cross Sectional ◽

Obese Adolescent ◽

School Based ◽

Prevalence Of Obesity ◽

Mexican Adolescents

Background/Aim: Obesity in adolescents is increasing; as such, the aim of this study was to determine the prevalence of obesity in Mexican adolescents and examine its possible association with hours of sleep. Methods: A school-based cross-sectional study was carried out. This study included 863 adolescents aged between 11 and 16 years. The prevalence of obesity was estimated using the body mass index (BMI). The duration of sleep (and other information) was assessed by a self-reported questionnaire. The Cochran–Mantel–Hansel test for categorical variables and a general linear model for continuous variables were used to evaluate the interaction effect of BMI and sex with respect to sleeping and assessed activity conditions. Results: It was found that 47.6% of the adolescents were overweight/obese. Men were more frequently overweight/obese than women (52.6% vs. 41.8%, p = 0.002). Moreover, overweight/obese adolescents were younger and spent fewer daily hours watching television (p < 0.05). Men practiced sports more hours per week than women (p = 0.04). However, women spent more daily time on the internet (p = 0.05), and overweight/obese adolescent women slept fewer hours than overweight/obese men and adolescents with normal weight (p = 0.008). Conclusions: The development of strategies for the prevention of overweight/obesity and the improvement of sleep duration should include a gender perspective to improve health habits in Mexican adolescents.

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Testing telediagnostic obstetric ultrasound in Peru: a new horizon in expanding access to prenatal ultrasound

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03720-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Marika Toscano ◽

Thomas J. Marini ◽

Kathryn Drennan ◽

Timothy M. Baran ◽

Jonah Kan ◽

...

Keyword(s):

Excellent Agreement ◽

Rural Areas ◽

Intraclass Correlation ◽

Standard Of Care ◽

The United States ◽

Categorical Variables ◽

Continuous Variables ◽

Second Trimester ◽

Obstetric Ultrasound ◽

Biometric Measurements

Abstract Background Ninety-four percent of all maternal deaths occur in low- and middle-income countries, and the majority are preventable. Access to quality Obstetric ultrasound can identify some complications leading to maternal and neonatal/perinatal mortality or morbidity and may allow timely referral to higher-resource centers. However, there are significant global inequalities in access to imaging and many challenges to deploying ultrasound to rural areas. In this study, we tested a novel, innovative Obstetric telediagnostic ultrasound system in which the imaging acquisitions are obtained by an operator without prior ultrasound experience using simple scan protocols based only on external body landmarks and uploaded using low-bandwidth internet for asynchronous remote interpretation by an off-site specialist. Methods This is a single-center pilot study. A nurse and care technician underwent 8 h of training on the telediagnostic system. Subsequently, 126 patients (68 second trimester and 58 third trimester) were recruited at a health center in Lima, Peru and scanned by these ultrasound-naïve operators. The imaging acquisitions were uploaded by the telemedicine platform and interpreted remotely in the United States. Comparison of telediagnostic imaging was made to a concurrently performed standard of care ultrasound obtained and interpreted by an experienced attending radiologist. Cohen’s Kappa was used to test agreement between categorical variables. Intraclass correlation and Bland-Altman plots were used to test agreement between continuous variables. Results Obstetric ultrasound telediagnosis showed excellent agreement with standard of care ultrasound allowing the identification of number of fetuses (100% agreement), fetal presentation (95.8% agreement, κ =0.78 (p < 0.0001)), placental location (85.6% agreement, κ =0.74 (p < 0.0001)), and assessment of normal/abnormal amniotic fluid volume (99.2% agreement) with sensitivity and specificity > 95% for all variables. Intraclass correlation was good or excellent for all fetal biometric measurements (0.81–0.95). The majority (88.5%) of second trimester ultrasound exam biometry measurements produced dating within 14 days of standard of care ultrasound. Conclusion This Obstetric ultrasound telediagnostic system is a promising means to increase access to diagnostic Obstetric ultrasound in low-resource settings. The telediagnostic system demonstrated excellent agreement with standard of care ultrasound. Fetal biometric measurements were acceptable for use in the detection of gross discrepancies in fetal size requiring further follow up.

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Prevalence and factors related to second hand smoking exposure, knowledge and response among adolescents in rural Puducherry

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2019-0014 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Kalaiselvy Arikrishnan ◽

Gokul Sarveswaran ◽

Yuvaraj Krishnamoorthy ◽

Manikandanesan Sakthivel ◽

Marie Gilbert Majella ◽

...

Keyword(s):

Environmental Assessment ◽

Nuclear Family ◽

Economic Status ◽

Cross Sectional Study ◽

Categorical Variables ◽

Continuous Variables ◽

Public Place ◽

Cross Sectional ◽

Adequate Knowledge ◽

Second Hand Smoking

AbstractObjectivesTo determine the prevalence of Second Hand Smoking (SHS) and assess the factors related to exposure, knowledge and response to SHS among adolescents in rural Puducherry, South India.MethodsA community based cross-sectional study was conducted among adolescents during March and April 2018. Two out of four villages were selected randomly and all the adolescents were contacted through household visit and questionnaire was administered. Semi structured questionnaire contained three sections: sociodemographic details, environmental assessment and third section contained knowledge about SHS, COTPA and response towards being exposed to SHS, as well as exposure history. Continuous variables like age were summarized as mean (SD). Categorical variables such as awareness, attitude and practise towards SHS were summarized as proportions with 95% confidence interval.ResultsTotal number of adolescents interviewed was 789. The mean age of the study participants were 14.1 (2.4) years and majority, 440 (55.8%) were boys and 684 (86.7%) belonged to nuclear family. More than one fourth, 210 (26.6%) belonged to middle class of socio-economic status. Environmental assessment of household showed more than half, 456 (57.8%) were staying in pucca house and majority 642 (81.4%) had adequate cross ventilation. It was found that about 70.1% had adequate knowledge about SHS and its harmful effects. Prevalence of exposure to SHS was 49%. Majority (40.5%) told that they will scold or advice the family member to stop smoking if they are exposed to SHS in the living place. However, almost 80% of adolescents mentioned that they will no’t react if they see someone smoking in a public place.ConclusionsCurrent study found that almost half of the adolescents were exposed to SHS. Even though, almost three fourth had adequate knowledge, attitude towards preventing SHS in public place was found to be poor. Hence, adolescents need to be motivated enough to address the problem in the public place through motivational counselling in adolescent clinics by health care workers.

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Ultrasound Employed to Detect Breast Lumps among Symptomatic Patients in Tertiary Care Hospital

Journal of Bahria University Medical and Dental College ◽

10.51985/jbumdc2020032 ◽

2020 ◽

Vol 10 (4) ◽

pp. 296-300

Author(s):

Ameet Jesrani ◽

Pari Gul ◽

Nida Khan ◽

Seema Nayab ◽

Fahmida Naheed

Keyword(s):

Predictive Value ◽

Imaging Modality ◽

Tertiary Care ◽

Ultra Sound ◽

Categorical Variables ◽

Breast Lesions ◽

Care Hospital ◽

Continuous Variables ◽

Cross Sectional ◽

Breast Lumps

Objective: To assess different pathological breast lesions in ultra sound in a subgroup of population. Study design and setting: It was a cross sectional study conducted at Bolan Medical Complex Hospital Quetta, Pakistan from June 2018 to January 2019. Methodology: Total 103 patients with breast swelling, pain and discharge were targeted. Gray scale and Doppler Ultrasound of breast followed by FNAC/biopsy of breast lesion was performed. Data presented as mean ± standard deviation for continuous variables and frequency with percentages for categorical variables. Results: Out of 48 clinically palpable lumps US detected all of 48 lumps and additionally 12 clinically non palpable masses were detected on US examination. Thus, overall sensitivity of ultrasound in detecting breast lumps was 100%. Fibroadenoma of the breast was diagnosed accurately in 80.3% of women. Ultrasound reliably differentiated cystic from solid breast masses (100%). The sensitivity of ultrasound for detecting breast carcinoma was 63.4% with a positive predictive value of 87.5%, a negative predictive value of 99.5% and accuracy of 58.33%. US findings most suggestive of benign lesions were oval or round shape in 88.3%, well defined margin in 84%, absent lobulation in 86.04% and wider than taller ratio in 90.69% of the cases.US findings of most predictive for malignancy were of irregular shape in 81.8%, ill-defined margin in 90.9% and length to height ratio in 63.6% of cases. Conclusion: Ultrasound is simple, cheap, safe and relatively accessible imaging modality for evaluation of breast pathologies. Due to its high sensitivity in diagnosing benign breast lesions particularly cystic lesions and fibroadenoma unnecessary interventions can be avoided

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MO775CONTROL OF BONE DISEASE ASSOCIATED WITH CHRONIC KIDNEY DISEASE AS A PREDICTOR OF PRIMARY PERMEABILITY AFTER THE CREATION OF THE VASCULAR ACCESS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab103.0013 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Luis Guillermo Piccone Saponara ◽

Maria Paz Castro Fernández ◽

Nancy Giovanna Uribe Heredia ◽

Agustin Carreno ◽

Sara Anaya Fernandez ◽

...

Keyword(s):

Antiplatelet Therapy ◽

Vascular Access ◽

Statistical Significance ◽

Univariate Analysis ◽

Primary Patency ◽

Categorical Variables ◽

Cross Sectional ◽

High Phosphorus ◽

The Creation ◽

Phosphorus Levels

Abstract Background and Aims Clinical practice guidelines recommend an arteriovenous fistula (AVF) as the preferred vascular access for hemodialysis. Patency of the arteriovenous access is important for effective hemodialysis. However, maintaining the patency of the AVF remains a challenge. We determined those independent prognostic factors for the patency of the AVF at the time of its creation. Method Cross-sectional study; We include all AVFs performed at the HGUCR in the last 2 decades. Demographic variables (age, sex), etiology of CKD and associated comorbidity were collected. We determine the factors involved in the primary patency of AVFs. Statistical analysis with SPSS 25.0. Categorical variables are expressed as percentages and are compared using the Chi2 test. Quantitative variables are expressed as mean ± standard deviation and the Mann Whitney Student-T/U was used to compare them. Statistical significance for a value of p <0.05. Results 622 AVFs performed in 482 patients were reviewed. 86.8% were autologous. The mean age was 65.4±14 years; 66.6% were male. The most frequent etiologies of CKD were diabetic nephropathy (30.2%), unknown (18%), and glomerulonephritis (16.6%). 91.2% had arterial hypertension (HBP) and diabetes mellitus (DM) 47.9%. 48.7% received antiplatelet therapy and 15.6% anticoagulation prior to the creation of the AVF. 27% presented primary failure. The univariate analysis showed statistical significance for the qualitative variables HTA (p=0.002), treatment with statins (p<0.01) and antiplatelet (p<0.01), and for the quantitative variables fibrinogen (p=0.048), serum phosphorus (p=0.001), CRP (p=0.004), triglycerides (p=0.05), ferritin (p=0.006) and age (p=0.05). When performing a multivariate analysis using logistic regression, HTA (OR: 0.46 95% CI 0.22-0.95 p = 0.036), high phosphorus levels (OR: 1.22 95% CI 1.08-1, 49 p = 0.004) and statin treatment (OR: 0.58 95% CI 0.36-0.96 p = 0.004) are predictors of primary VA failure. Conclusion In our study, HTA and antiplatelet therapy prior to the creation of the VA behave as protective factors for primary failure, with high phosphorus levels being an independent factor for primary failure of AVFs.

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