POSTURE RELATED MUSCULOSKELETAL DISORDERS AMONG NURSING STAFF IN A TERTIARY CARE HOSPITAL

Background: Work-related musculoskeletal disorders are the most common occupational health problems in developing countries. The present study was conducted with an aim to study prevalence and cause of musculoskeletal disorders in nurses. Method: It was a cross sectional study. 103 nurses were included in the study. and were asked to answer a well-equipped questionnaire so as to obtain information about their postural habits and other daily activities. Results: Among the nurses, 86% were found to be suffering from MSDs, low back pain and leg pain being the commonest problems. 30% of the nurses took medications for the pain. 52% required work related weight lifting activity. Out of those requiring weight lifting activity, only 48% of the nurses acquired proper posture (squatting without bending forward) while lifting weight. Mere 26% of the nurses acquired proper erect posture while sitting. Only 20% of them supported the lower back while sitting. 66% of the nurses did not perform any physical activity during the break. 56% of the nurses had not attended any workshop on good postural habits and had no idea about the ergonomically correct postures. However, no association was found between the postural habits of nurses and prevalence of Musculoskeletal disorders. Conclsuion: In view of high prevalence and insufficient knowledge and practice of ergonomics, it is the need of the hour to educate the nurses about the ergonomically correct postural habits and further complications. KEY WORDS: Ergonomics; Musculoskeletal disorders; Nursing staff; Posture

POSTURE RELATED MUSCULOSKELETAL DISORDERS AMONG NURSING STAFF IN A TERTIARY CARE HOSPITAL

Background: Work-related musculoskeletal disorders are the most common occupational health problems in developing countries. The present study was conducted with an aim to study prevalence and cause of musculoskeletal disorders in nurses. Method: It was a cross sectional study. 103 nurses were included in the study. and were asked to answer a well-equipped questionnaire so as to obtain information about their postural habits and other daily activities. Results: Among the nurses, 86% were found to be suffering from MSDs, low back pain and leg pain being the commonest problems. 30% of the nurses took medications for the pain. 52% required work related weight lifting activity. Out of those requiring weight lifting activity, only 48% of the nurses acquired proper posture (squatting without bending forward) while lifting weight. Mere 26% of the nurses acquired proper erect posture while sitting. Only 20% of them supported the lower back while sitting. 66% of the nurses did not perform any physical activity during the break. 56% of the nurses had not attended any workshop on good postural habits and had no idea about the ergonomically correct postures. However, no association was found between the postural habits of nurses and prevalence of Musculoskeletal disorders. Conclsuion: In view of high prevalence and insufficient knowledge and practice of ergonomics, it is the need of the hour to educate the nurses about the ergonomically correct postural habits and further complications. KEY WORDS: Ergonomics; Musculoskeletal disorders; Nursing staff; Posture

Evaluation of Effect of Melatonin on Hematological Parameters in Patients of Periodontitis

Introduction: Considering the immunity enhancing property of melatonin, a study on the evaluation of the effect of melatonin on the hematological parameters in patients suffering from Periodontitis.  Methods: This study was conducted in the Department of Periodontics, Rural Dental College, Loni. Patients of chronic Periodontitis, of age between 18 to 65 years of either gender ready to give informed consent to participate in the study were included. Postoperative patients, patients having night duties, drivers and those using heavy machinery, pregnant women, lactating mothers, patients with any clinically significant systemic disease and patients on any other drugs were excluded from the study. Patients were divided into two Groups. Group B received scaling and root planning (SRP) and melatonin 3 mg per day were compared to Group A which received SRP only. The Total Leukocyte count, Differential Leukocyte count and Erythrocyte sedimentation rate of each patient was studied at a baseline, 1st (30 days) visit, 2nd (60 days) visit and 3rd (90 days) visit. Results: Both the groups consisted of 80 subjects each. Group A consisted of 71.25% male and 28.75% female patients. There were 56.25% male and 43.75% female patients in Group B. With respect to visit 3, the TLC was statistically lower in Group B. The neutrophil count of Group B was significantly lower during visit 3 as compared to Group A. The lymphocyte count of Group B was significantly lower than that of Group A during the visit 1, and also significantly higher during visit 3 on comparison with Group A. There was no statistically significant difference in the groups with respect to eosinophil and basophil count. The Monocyte count of Group B was statistically lower when compared to that of Group A. There was no statistically significant difference between ESR of Group A & Group B.  Conclusions: It can be concluded that melatonin has a positive effect on TLC and differential count of patients of periodontitis, conferring a new facet to the management of periodontitis and an attempt to impede the disease progression. Keywords: Melatonin; Hematological parameters; Periodontitis; Total Leukocyte count; Differential Leukocyte count; Erythrocyte sedimentation rate; Scaling and Root Planning

Evaluation of antioxidant potential of melatonin in periodontitis: a prospective clinic-biochemical study

Background: The present study was done with an objective to evaluate the effect of melatonin as an antioxidant in patients suffering from periodontitis.Methods: This study was conducted in the Department of Periodontics, Rural Dental College, Loni. Patients of chronic periodontitis, of age between 18 to 65 years of either gender ready to give informed consent to participate in the study were included. Postoperative patients, patients having night duties, drivers and those using heavy machinery, pregnant women, lactating mothers, patients with any clinically significant systemic disease and patients on any other drugs were excluded from the study. Patients were divided into three Groups. Group A included patients who underwent SRP (Scaling and Root Planning) alone, Group B included patients who underwent SRP & supplemented with Vitamin E 200 IU daily at night for 4 weeks. Group C included patients who underwent SRP & supplemented with tablet melatonin 3 mg daily at night for 4 weeks. Estimation of Malondialdehyde (MDA) for serum lipid peroxidation8, Superoxide dismutase (SOD) and Glutathione peroxidase (GPx) was done on day 0, day 30, day 60 and day 90.Results: A total 240 patients were enrolled in the study. It was demonstrated that there was considerable oxidative stress in periodontitis patients, as established by high serum MDA levels, which was reduced significantly by melatonin reflecting its antioxidant potential. Pretreatment levels of SOD and GPx also were low, which were improved with the treatment of melatonin far better than with vitamin E.Conclusions: Melatonin acts as an antioxidant in the patients of periodontitis which has positive effect on biochemical parameters of periodontitis, conferring a new facet to the management of periodontitis and an attempt to impede the disease progression

Lessons learned from performance of students of Pharmacology in self coded surprise test with negative marking.

Introduction: The present study aims to find the effect of instruction of negative marking in a self-coded MCQ examination on the performance of students in the subject of Pharmacology with respect to the raw score, correct score and negative score. Material and methods: This longitudinal study was conducted in the Department of Pharmacology, Rural Medical College, Loni. The Second MBBS students were exposed to a self-coded MCQ test twice by surprise. The first test (T1) was given without instructions of negative marking, while during the second test (T2) instructions for negative marking were given. The parameters of the raw score, negative score, corrected score and number of students who did not attempt respective MCQs were calculated. The number of students passing with modified Minimum Passing Level was calculated was compared with conventional Minimum Passing Level. Results: Sixty-seven students participated in the study. There was a statistically significant decrease in the raw score in the T2, while the increase in the negative score when compared with T1. The number of non-attempted questions was increased in T2. There was a statistically significant difference in the number of students passed with respect to raw score in T1 and T2, while no such difference was seen with respect to Negative score and Corrected score. Conclusion: The Corrected score and Negative score are not affected by the minimum passing level, indicating a better parameter of scoring than the raw score. Hence, the use of Negative score or Corrected score should be encouraged than the use of conventional Raw score. Keywords: Minimum Passing Level, Negative Marking, MCQ, Corrected score, Pharmacology, Formative assessment, surprise test, self-coded test

Evaluation of Effect of Melatonin on Hematological Parameters in Patients of Periodontitis

Introduction: Considering the immunity enhancing property of melatonin, a study on the evaluation of the effect of melatonin on the hematological parameters in patients suffering from Periodontitis.  Methods: This study was conducted in the Department of Periodontics, Rural Dental College, Loni. Patients of chronic Periodontitis, of age between 18 to 65 years of either gender ready to give informed consent to participate in the study were included. Postoperative patients, patients having night duties, drivers and those using heavy machinery, pregnant women, lactating mothers, patients with any clinically significant systemic disease and patients on any other drugs were excluded from the study. Patients were divided into two Groups. Group B received scaling and root planning (SRP) and melatonin 3 mg per day were compared to Group A which received SRP only. The Total Leukocyte count, Differential Leukocyte count and Erythrocyte sedimentation rate of each patient was studied at a baseline, 1st (30 days) visit, 2nd (60 days) visit and 3rd (90 days) visit. Results: Both the groups consisted of 80 subjects each. Group A consisted of 71.25% male and 28.75% female patients. There were 56.25% male and 43.75% female patients in Group B. With respect to visit 3, the TLC was statistically lower in Group B. The neutrophil count of Group B was significantly lower during visit 3 as compared to Group A. The lymphocyte count of Group B was significantly lower than that of Group A during the visit 1, and also significantly higher during visit 3 on comparison with Group A. There was no statistically significant difference in the groups with respect to eosinophil and basophil count. The Monocyte count of Group B was statistically lower when compared to that of Group A. There was no statistically significant difference between ESR of Group A & Group B.  Conclusions: It can be concluded that melatonin has a positive effect on TLC and differential count of patients of periodontitis, conferring a new facet to the management of periodontitis and an attempt to impede the disease progression. Keywords: Melatonin; Hematological parameters; Periodontitis; Total Leukocyte count; Differential Leukocyte count; Erythrocyte sedimentation rate; Scaling and Root Planning

Adverse drug reaction profile of anticancer agents in a tertiary care centre of rural Maharashtra: a cross-sectional study

Background: The present study was undertaken to analyse the clinical spectrum, pattern of ADR reported, most common suspected drugs, timing of reporting of suspected ADR, outcome, severity and causality assessment of adverse drug reactions among oncology patients reported at our ADR monitoring Centre. Methods: The descriptive cross-sectional study was carried out for two months in the oncology department of a tertiary care rural hospital. ADR reporting form Version 2.4 was used for recording information of all patients of any gender and age who were suspected cases of adverse drug reactions receiving chemotherapy. Results: Total 83 ADRs were reported within the duration of two months. The number of males and females were 21 and 62, respectively with mean age 56.9±11.6 years for males and 59.6±8.8 years for females. The age group most commonly reported with suspected ADR was 61-70 years (28.9%). Of the 83 ADR reported, the most common suspected drug was Paclitaxel (47, 56.6%). The most common indications for the use of these anticancer drugs was reported to be CA breast (43, 51.8%). Most of the ADRs (38, 45.8%) were reported immediately. On applying Naranjo’s Causality Assessment Scale, 61 and 22 ADRs fell in the category of Probable and Possible, respectively. Conclusions: The occurrence of ADR among patients on chemotherapy is high. The reported ADR were common and predictable. Hence diligent monitoring in ADR may help manage and prevent morbidity associated with anti-cancer drugs

Effect of Various Concentrations of Lignocaine & Adrenaline Combination as Local Anesthetic on ECG Parameters of Patients Undergoing Dental Procedures

Background: Systemic absorption of local anesthetics occurs due to its local vasodilator effects. This leads to inhibitory action on the heart which is represented in the form of a decrease in conduction rate, the excitability of myocardium and force of contraction. The aim of the present study was to evaluate the effects of Lignocaine and adrenaline combinations on electrocardiogram undergoing dental procedures. Methods: This was a prospective, observational clinical study done in collaboration with the Department of Oral & Maxillofacial Surgery. All patients scheduled for oral surgeries under local anesthesia with Lignocaine 2% and adrenaline (1:80000 or 1:200000) combination of age 18 years or above 150 patients were included in the study. Patients with a history of hepatic, renal, cardiovascular and thyroid disorders were excluded from the study. A standard 12-lead ECG (25 mm/s) was recorded for each patient before administration of drugs (Basal), during the dental procedure (Intraoperative) and immediately after completion of surgical procedure. Results: There was no statistically significant difference seen between the Group A (Lignocaine 2% with 1:80000 adrenaline) and B (Lignocaine 2% with 1:200000 adrenaline) when the age, gender, PR interval, RR interval, mean QT & QTc dispersion, and heart rate were compared. Statistically significant difference was seen in comparing the mean QT & QTc interval, which was higher in Group A. ECG parameters in Group A and B showed a statistically significant decrease in PR interval, RR interval, QT interval, QTc interval, QT dispersion and QTc dispersion, with the basal, was compared with intraoperative and postoperative findings. The increase in heart rate although was statistically significant in both the groups, it was always within normal limits suggestive of no clinical significance. There was a statistically significant decrease in QT and QTc interval, QT and QTc dispersion. The change in all these parameters was within the physiologic range. All these relevant parameters for cardiac arrhythmias did not show any arrhythmogenic potential of lignocaine-adrenaline combination in both the groups. Both the combinations are comparable with each other in terms of ECG parameters with changes more with group A suggesting the effect of increased concentration of adrenaline. The change in the heart rate and ECG parameters in both the study group might be attributed to the presence of adrenaline in the combination. No cardiovascular morbidities were observed except palpitation. Conclusion: Thus it can be very well concluded that the effects of lignocaine-adrenaline combinations on electrocardiographic parameters are minimal and clinically irrelevant. Both the combination appears to be safe to use in healthy individuals. Keywords: Adrenaline; Lignocaine; ECG parameters; Dental procedures