Nutritional Status And Its Impact On The Occurance Of Complications In Children With Acute Lymbhoblastic Leukemia During 1Stinduction Chemotherapy: The Experience At Bp Koirala Memorial Cancer Hospital

Malnutrition is a common problem in cancer patients. It has been recognized as an important component to influence on tolerance to treatment, increased morbidity, poor prognosis, decreased quality of life and increased health care costs. Acute leukemia is the most common malignancy in children of which acute lymphoblastic leukemia accounts for majority of the cases (75%). Chemotherapy is the main treatment modality for acute lymphoblastic leukemia(ALL). Under nutrition can contribute to the incidence and severity of treatment side effects and increases the risk of infection, thereby reducing the chances of survival. Objectives: To evaluate pretreatment nutritional status (BMI) in children with ALL and its effects during first induction chemotherapy. Methodology: This observational study included sixty-two consecutive children with acute lymphoblastic leukemia, admitted in Haemato-Oncology Ward of BPKMCH over a period of 27 months (15thy May, 2015 to 15th July, 2017) were measured for height and weight to calculate BMI for assessing nutritional status at presentation. Children were grouped into 2 group: normal weight and underweight usingCDC BMI percentile chart by World Health Organization(WHO). Day to day observation and documentation were maintained to identify any side effects and complications over a period of first induction chemotherapy. Findings of the study: Among 62 cases, majority were male (66%). Three forth of the cases were B-cell ALL. More than 34 percent of the cases (27) had under- weight (BMI< 5thpercentile). Effects like very severe neutropenia, febrile neutropenia, infections, musculoskeletal problems, severe pancytopenia, G/I problems were noted mostly in children with underweight. Conclusion: Baseline nutritional status negatively influences in the occurrence of complications during induction chemotherapy in children with ALL. The nutritional support has to be personalized according to the nutritional status of the single patient.

Extra Burden on Urology Outdoor Due to Non Urology Flank Pain

Background: Flank pain is one of common urological emergency. It can be result of various causes. Most commonly results from one of three causes: urinary tract infection (UTI), kidney stones, and musculoskeletal problems like a muscle strain or pinched nerve. Objective: Determine frequency of none urological flank pain burden in urology outdoors. Methods: This was prospective descriptive case study conducted at department of urology and transplantation at Jinnah Postgraduate Medical Center Karachi from September 2020 to December 2020. All patients with flank pain, who visited in urology outdoor, were included in study. All patients had detailed history and physical examination. Urinalysis and ultrasound abdomen were done in all patients. CT KUB was also done in patients who had abnormal ultrasound finding of kidney ureter and bladder. Results: Total 100 patients were included in this study, 41 (41%) male while 59 (59%) patients were females. 45 patients had right sided pain, 34 had left sided while remaining 21 patients had bilateral flank pain and six patients had also lower urinary tract symptoms along with pain. 13 patients had positive renal punch on examination, 23 patients had positive straight leg rising sign and rest of the 64 patients’ examination was unremarkable. 55 patients had urology related pathology on ultrasound, in 9 patients had non urological pathology and rest 36 patients it was unremarkable. CT KUB was done in all 55 patients who had positive findings on ultrasound showing pathology in kidney and ureter in which 47 patients CT scan had confirmed the diagnosis while in 8 patients it was in remarkable. Conclusion: flank pain is not always secondary to renal origin. It has wide spectrum of alternative significant causes also. Keywords: Flank pain, none urological, CT KUB

Epidemiology of Musculoskeletal Disorders in Musicians - Systematic Review

Musicians performing over an instrument demands repetitive, awkward postures and postural stress from prolonged sitting or standing. Musicians are found to be more prone to the development of Playing-Related Musculoskeletal Disorders (PRMDs) due to these factors. PRMDs are defined as ‘pain, weakness, numbness, tingling or other symptoms that interfere with their ability to play an instrument’. There is an increasing interest seen in the medical issues faced by the musicians performing over an instrument. There are different type of musicians playing different instruments which means different instrumentalists face different musculoskeletal disorders depending upon many factors. There are intrinsic and extrinsic factors involved which contribute to the development of PRMDs in musicians. Development of PRMDs is seen to be a cause of early termination of musician’s career. The purpose of study is to review the epidemiology of musculoskeletal disorders in musicians. Key words: Musculoskeletal disorders, Musculoskeletal problems, Prevalence of musculoskeletal injuries, Postural disorders, Playing-related strain in instrumentalists and musicians.

Digging deeper: exploring chiropractors online claims about non-musculoskeletal disorders

Background Some chiropractors suggest that chiropractic treatment is appropriate for health issues other than musculoskeletal problems. The prevalence of such claims on individual clinic websites has previously been reported as approximately one-in-four in Denmark. The underlying rationales for such claims may reflect convictions about traditional chiropractic subluxations paradigms, but are not self-evident and has not previously been studied. Methods An exploratory qualitative case interview study of Danish chiropractors with websites which contain claims about chiropractic efficacy in the treatment of non-musculoskeletal disorders. Websites were identified from a nation wide random sample (57%) of all chiropractic clinic websites. Results Of the original 139 websites, 36 were identified as mentioning non-MSK conditions. When revisited, 19 of those clinic websites still mentioned non-MSK disorders and were contacted. Eleven (11) declined our invitation to participate. Interviews were conducted with the responsible chiropractor from each of the remaining 8 clinics. Five distinct themes were identified in the rationales for treating non-musculoskeletal disorders: ‘Positive side-effects,’ ‘Experience,’ ‘Web page,’ ‘Communication’ and ‘Conviction.’ Conclusions A minority of Danish chiropractic websites suggest that non-musculoskeletal disorders are within the chiropractic scope of practice. Those that do, do so for varying reasons—poor communication and website maintenance were commonly cited problems. An explicitly stated adherence to traditional chiropractic subluxations concepts was uncommon. By contrast, a more tempered rationale that suggested a potential beneficial side-effect of chiropractic on non-musculoskeletal health issues were more common and was typically presented in softer-language and/or with some reservations.

Prevalence of Playing-Related Musculoskeletal Problems Among Professional Orchestra Musicians in South Africa: A Study Using the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM)

BACKGROUND: The prevalence of playing-related musculoskeletal problems (PRMPs) in professional musicians is well documented in the literature, but few studies have been done on South African professional musicians. OBJECTIVE: The present study aimed to evaluate the prevalence of PRMPs, pain intensity, and pain interference among full-time and part-time orchestral musicians, using a validated self-report instrument specifically designed for musicians. METHODS: Seventy-nine full-time and part-time professional orchestral musicians took part in the study and completed the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM). RESULTS: A lifetime prevalence of PRMPs was 76% and point prevalence 30%. Of the PRMP group, 30% experienced current pain that interfered with their ability to play. Upper strings players reported the most PRMPs. The most commonly reported pain locations were right and left upper limb, neck, forearm, and elbow. The mean pain intensity score for the PRMP group was 16.3 (SD 6.62) (out of 40) and the mean pain interference score was 21.2 (9.98) (out of 50). Female musicians reported experiencing pain more frequently and intensely and also reported more pain sites than males. CONCLUSIONS: This study, the first to make use of a validated self-report instrument, shows that musculoskeletal problems are common among full-time and part-time professional orchestral musicians in South Africa.

Effects of Kinesio Taping in Supraspinatus Tendinitis

Background: Shoulder pain is one of the most commonly reported musculoskeletal problems after low back pain. One common reason for the shoulder pain is supraspinatus tendinitis that is often associated with impingement syndrome. Objective: To find the effects of kinesio taping in reducing pain and disability in subjects with supraspinatus tendinitis. Methodology: In this study, patients were randomly allocated the treatment using a set of predefined inclusion and exclusion criteria. Subjects were managed with kinesio taping. Pre- and post-evaluation of the patients was done using Numerical Pain Rating Scale (NPRS) and Disability of Arm Shoulder & Hand Questionnaire (DASH) score and the data gathered was entered and analyzed using SPSS version 23. Results: Mean difference of 2.65 was reported between the pretreatment and post treatment values of NPRS in KT taping group which was significant (P < 0.05). Mean difference of 27.25 was reported between the pre-treatment and post-treatment values of DASH score in KT taping group which was significant (P < 0.05). Conclusion: Kinesio taping is an effective Program in management of supraspinatus tendinitis.

Analyzing the Vibration Exposure to the Safety and Health at Workplace: A Case in the Urea Granulation Unit of the Fertilizer Factory

This study aims to evaluate the vibration exposure experienced by workers in the Urea Granulation Screen Unit (UGSU) at the fertilizer factory in Aceh, Indonesia. This study involved 30 labors in charge as operators, mechanical maintenance officers, electrical maintenance officers, instrument maintenance officers, and inspectors. The measurement of vibration was carried out using a Triaxial Accelerometer with Integral Magnet and shows that the vibration exposure on the factory floor of the urea granulation screen unit occurs vertically with a minimum value of 0.298 m/s2 and a maximum of 1.630 m/s2. According to ISO 2631-1:1997, the maximum vibration values that occur are categorized as a likely health risk zone and result in uncomfortable reactions to the workers. Furthermore, this study analyzes the effect of vibrations on musculoskeletal problems using a Nordic Body Map (NBM) questionnaire. It reveals that the average score of musculoskeletal complaints is 71.6, which defines a high degree of pain. The results of the NBM questionnaire also showed that the vulnerable part of the body which experienced musculoskeletal complaints is the knee. The result of vibration exposure on this body part shows the highest value of 3.437 m/s2. To minimize occupational diseases and accidents, it is necessary to manage a working system that takes into account legal standards, ideal working time, and working shifts in the work area.

Prevalence of Musculoskeletal Pain in Bio-Pharmaceutical Industry Workers

The purpose of this study was to identify the prevalence of musculoskeletal problems in bio-pharmaceutical industry workers. A cross sectional survey was conducted on 33 bio-pharmaceutical industry workers by administering the Extended Nordic Musculoskeletal Questionnaire to quantify the musculoskeletal pain and activity limitation in 9 body regions. The Rapid Office Strain Assessment was used to assess the work-related postures and ergonomics of the computer operators in this industry. A Self-Designed Questionnaire was administered to obtain data regarding the various musculoskeletal problems faced by Bio-pharmaceutical industrial workers, work-related risk factors and various postures attained throughout the day. Out of the 33 workers investigated, 21 workers (63%) of the workers experienced musculoskeletal pain. Isolated spine pain was the commonest, and was reported in 8 out of 21 individuals (38%). Spine with upper and lower limb pain was the next most common, and was reported in 5 out of 21 individuals (24%). 4 out of 21 individuals had spine and lower limb pain (19%). The Rapid Office Strain Assessment scores of all the workers was above 5 indicating “high risk” which implied that immediate ergonomic change was necessary. This study concluded that there was 63% prevalence of musculoskeletal pain. The most common site of pain were the spine, followed by pain in the spine with both upper and lower extremities. All the workers were exposed to different ergonomic risk factors. The study concluded that implementation of ergonomic interventions may minimize the risks of work related musculoskeletal pain. Key words: Work-related musculoskeletal disorders, Extended Nordic Musculoskeletal Questionnaire, Rapid Office Strain Assessment, Ergonomic hazards.