exudates and Musculoskeletal-Pain

The use of intranasal fentanyl as an alternative type of analgesia has been shown to be effective in paediatric populations and prehospital settings. There are a limited number of studies on the use of intranasal fentanyl in adult patients in emergency settings.. An open-label study was conducted to evaluate the effectiveness of the addition of 1.5 mcg/kg intranasal fentanyl to 2 mg/kg intravenous tramadol (fentanyl + tramadol arm, n = 10) as compared to the administration of 2 mg/kg intravenous tramadol alone (tramadol-only arm, n = 10) in adult patients with moderate to severe pain due to acute musculoskeletal injuries.. When analysed using the independent t-test, the difference between the mean visual analogue scale scores pre-intervention and ten minutes post-intervention was 29.8 ± 8.4 mm in the fentanyl + tramadol arm and 19.6 ± 9.7 mm in the tramadol-only arm (t[18] = 2.515, p = 0.022, 95% confidence interval 1.68-18.72 mm). A statistically significant, albeit transient, reduction in the ten-minute post-intervention mean arterial pressure was noted in the fentanyl + tramadol arm as compared to the tramadol-only arm (13.35 mmHg vs. 7.65 mmHg; using Mann-Whitney U test with U-value 21.5, p = 0.029, r = 0.48). There was a higher incidence of transient dizziness ten minutes after intervention among the patients in the fentanyl + tramadol arm.. Although effective, intranasal fentanyl may not be appropriate for routine use in adult patients, as it could result in a significant reduction in blood pressure.

Topics: Administration, Intranasal; Administration, Intravenous; Adolescent; Adult; Aged; Analgesics, Opioid; Bone and Bones; Dizziness; Female; Fentanyl; Humans; Malaysia; Male; Middle Aged; Muscles; Musculoskeletal Pain; Pain Management; Pain Measurement; Prospective Studies; Tertiary Care Centers; Tramadol; Treatment Outcome; Young Adult

This study was conducted to determine the prevalence and severity of menopausal symptoms and their associated risk factors among postmenopausal breast cancer patients receiving adjuvant endocrine therapy.. Postmenopausal breast cancer patients on endocrine therapy were recruited at three hospitals in Malaysia. Presence and severity of menopausal symptoms were determined using the Menopause Rating Scale. Sociodemographic and clinical data were collected from medical records.. A total of 192 patients participated in this study. Commonly reported symptoms were musculoskeletal pain (59.9%), physical and mental exhaustion (59.4%), and hot flushes (41.1%). Multivariate analyses indicated that increasing number of years after menopause until the start of endocrine therapy was significantly associated with less likelihood of reporting menopausal symptoms and musculoskeletal pain. Patients with primary or secondary education levels reported significantly less menopausal urogenital symptoms compared to patients with a tertiary education level. Patients using aromatase inhibitors were twice as likely to experience musculoskeletal pain compared to patients using tamoxifen (odds ratio, 2.18; 95% confidence interval, 1.06-4.50; p < 0.05).. Menopausal symptoms and musculoskeletal pain are common problems encountered by postmenopausal breast cancer patients receiving adjuvant endocrine therapy and should be closely monitored for successful treatment.

Topics: Aged; Antineoplastic Agents, Hormonal; Aromatase Inhibitors; Breast Neoplasms; Chemotherapy, Adjuvant; Cross-Sectional Studies; Fatigue; Female; Hot Flashes; Humans; Malaysia; Mental Fatigue; Middle Aged; Musculoskeletal Pain; Postmenopause; Tamoxifen

Obesity leads to the increase of pain at different parts of the body and it is a potential marker for complications of chronic diseases. This paper aims to assess changes in the body pain among overweight and obese housewives who participated in the My Body is Fit and Fabulous at home (MyBFF@home) study.. Housewives aged 18 to 59 years old from the MyBFF@home study were selected and pain was measured using the Visual Analogue Scale (VAS) questionnaire. VAS measured the pain intensity at different parts of the body (score of 0-10). Data were collected at base line, 3 months and 6 months among the housewives in both the control and intervention group. Pain scores and other variables (age, Body Mass Index (BMI) and waist circumference) were analysed using SPSS version 22.. A total of 328 housewives completed the VAS questionnaires at baseline, while 185 (56.4%) of housewives completed the VAS at 3 months and 6 months. A decreasing trend of mean pain score in both groups after 6 months was observed. However, the intervention group showed a consistent decreasing trend of pain score mainly for back pain. In the control group, there was a slight increment of score in back pain from baseline towards the 6 months period. Older housewives in both groups (aged 50 years and above) had a higher mean score of leg pain (2.86, SD: 2.82) compared to the other age group. Higher BMI was significantly associated with pain score in both groups.. There were some changes in the level of body pain among the housewives before and after the intervention. Older obese women had a higher pain score compared to younger obese women. Pain was associated with BMI and change in BMI appears to be beneficial in reducing body pain among overweight and obese individuals.

Topics: Adolescent; Adult; Body Mass Index; Chronic Pain; Female; Humans; Malaysia; Male; Middle Aged; Musculoskeletal Pain; Obesity; Overweight; Surveys and Questionnaires; Waist Circumference; Young Adult

Purpose Workers with musculoskeletal pain (MSP) often continue to work despite their condition. Understanding the factors that enable them to remain at work provides insights into the development of appropriate workplace accommodations. This qualitative study aims to explore the strategies utilised by female Malaysian office workers with MSP to maintain productive employment. Methods A qualitative approach using thematic analysis was used. Individual semi-structured interviews were conducted with 13 female Malaysian office workers with MSP. Initial codes were identified and refined through iterative discussion to further develop the emerging codes and modify the coding framework. A further stage of coding was undertaken to eliminate redundant codes and establish analytic connections between distinct themes. Results Two major themes were identified: managing the demands of work and maintaining employment with persistent musculoskeletal pain. Participants reported developing strategies to assist them to remain at work, but most focused on individually initiated adaptations or peer support, rather than systemic changes to work systems or practices. A combination of the patriarchal and hierarchical cultural occupational context emerged as a critical factor in the finding of individual or peer based adaptations rather than organizational accommodations. Conclusions It is recommended that supervisors be educated in the benefits of maintaining and retaining employees with MSP, and encouraged to challenge cultural norms and develop appropriate flexible workplace accommodations through consultation and negotiation with these workers.

Topics: Adaptation, Psychological; Adult; Chronic Pain; Cultural Characteristics; Disclosure; Employment; Female; Humans; Interviews as Topic; Malaysia; Middle Aged; Musculoskeletal Pain; Qualitative Research; Sex Factors; Social Support; Women, Working; Workplace

Prevalence and predictors associated with musculoskeletal disorders (MSDs) vary considerably between countries. It is plausible that socio-cultural contexts may contribute to these differences. We conducted a cross-sectional survey with 1184 Malaysian and Australian office workers with the aim to examine predictors associated with MSD discomfort. The 6-month period prevalence of self-reported MSD discomfort for Malaysian office workers was 92.8% and 71.2% among Australian workers. In Malaysia, a model regressing level of musculoskeletal discomfort against possible risk factors was significant overall (F [6, 370] = 17.35; p < 0.001) and explained 22% (r = 0.46) of its variance. MSD discomfort was significantly associated with predictors that included gender (β = 14), physical (β = 0.38) and psychosocial hazards (β = -0.10), and work-life balance (β = -0.13). In Australia, the regression model is also significant (F [6, 539] = 16.47; p < 0.001) with the model explaining 15.5% (r = 0.39) of the variance in MSD discomfort. Predictors such as gender (β = 0.14), physical (β = 24) and psychosocial hazards (β = -0.17), were associated with MSD discomfort in Australian office workers. Predictors associated with MSD discomfort were similar, but their relative importance differed. Work-life balance was significantly associated with increased MSD discomfort for the Malaysian population only. Design and implementation of MSD risk management needs to take into account the work practices and culture of the target population.

Topics: Adult; Australia; Cross-Cultural Comparison; Cross-Sectional Studies; Female; Humans; Interpersonal Relations; Lifting; Malaysia; Male; Middle Aged; Musculoskeletal Pain; Physical Exertion; Posture; Prevalence; Risk Factors; Sex Factors; Work-Life Balance; Workplace; Young Adult

Musculoskeletal pain is common among teachers. Work-related psychosocial factors are found to be associated with the development of musculoskeletal pain, however psychological distress may also play an important role.. To assess the prevalence of self-reported low back pain (LBP), and neck and/or shoulder pain (NSP) among secondary school teachers; and to evaluate the association of LBP and NSP with psychological distress and work-related psychosocial factors.. This was a cross-sectional study conducted among teachers in the state of Penang, Malaysia. The participants were recruited via a two stage sampling method. Information on demographic, psychological distress, work-related psychosocial factors, and musculoskeletal pain (LBP and NSP) in the past 12 months was collected using a self-administered questionnaire. Poisson regression was used to estimate the prevalence ratio (PR) for the associations between psychological distress and work-related psychosocial factors with LBP and NSP.. The prevalence of self-reported LBP and NSP among 1482 teachers in the past 12 months was 48.0% (95% Confidence Interval (CI) 45.2%, 50.9%) and 60.1% (95% CI 57.4%, 62.9%) respectively. From the multivariate analysis, self-reported LBP was associated with teachers who reported severe to extremely severe depression (PR: 1.71, 95% CI 1.25, 2.32), severe to extremely severe anxiety (1.46, 95% CI 1.22, 1.75), high psychological job demand (1.29, 95% CI 1.06, 1.57), low skill discretion (1.28, 95% CI 1.13, 1.47) and poorer mental health (0.98, 95% CI 0.97, 0.99). Self-reported NSP was associated with mild to moderate anxiety (1.18, 95% CI 1.06, 1.33), severe to extremely severe anxiety (1.25, 95% CI 1.09, 1.43), low supervisory support (1.13, 95% CI 1.03, 1.25) and poorer mental health (0.98, 95% CI 0.97, 0.99).. Self-reported LBP and NSP were common among secondary school teachers. Interventions targeting psychological distress and work-related psychosocial characteristics may reduce musculoskeletal pain among school teachers.

Topics: Adult; Anthropometry; Cross-Sectional Studies; Female; Humans; Low Back Pain; Malaysia; Male; Middle Aged; Musculoskeletal Pain; Occupational Diseases; Poisson Distribution; Prevalence; Psychology; Regression Analysis; School Teachers; Schools; Self Report; Shoulder Pain; Stress, Psychological; Surveys and Questionnaires; Teaching

Musculoskeletal disorders (MSDs) are a major occupational health issue for workers in developed and developing countries, including Malaysia. Most research related to MSDs has been undertaken in developed countries; given the different regulatory and cultural practices it is plausible that contributions of hazard and risk factors may be different. A population of Malaysian public service office workers were surveyed (N = 417, 65.5% response rate) to determine prevalence and associated predictors of MSD discomfort. The 6-month period prevalence of MSD discomfort was 92.8% (95%CI = 90.2-95.2%). Akaike's Information Criterion (AIC) analyses was used to compare a range of models and determine a model of best fit. Contributions associated with MSD discomfort in the final model consisted of physical demands (61%), workload (14%), gender (13%), work-home balance (9%) and psychosocial factors (3%). Factors associated with MSD discomfort were similar in developed and developing countries but the relative contribution of factors was different, providing insight into future development of risk management strategies.

Topics: Adult; Cross-Sectional Studies; Developing Countries; Female; Government Agencies; Humans; Malaysia; Male; Middle Aged; Musculoskeletal Pain; Occupational Diseases; Physical Exertion; Prevalence; Risk Factors; Sex Factors; Surveys and Questionnaires; Workload; Workplace; Young Adult

The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was developed to assess the level of musculoskeletal discomfort among office workers related to their ergonomic situation.. The primary objective of this initial study is to analyze the validity and dependability of the Malay translation of the Cornell Musculoskeletal Discomfort Questionnaire.. The questionnaire was self-administered two times, with an interval of two weeks in order to evaluate the accuracy of the original findings with a retest. The study involved 115 participants.. The range of Cronbach Alpha coefficient showed a considerable consistency of the items for each sub-scale (Cronbach's a > 0.95). The range of Kappa coefficients was between (ICC = 0.690-0.949, p < 0.001), (ICC = 0.801-0.979, p < 0.001) and (ICC = 0.778-0.944, p < 0.001) for frequency, severity and interference scales.. This research, introduced the Malay-language version of the CMDQ (CMDQ-M) as the first formal validation of the CMDQ, and confirmed a high reliability and validity for the evaluation of musculoskeletal discomfort among the study population.

Topics: Adult; Ergonomics; Female; Humans; Malaysia; Male; Middle Aged; Musculoskeletal Pain; Occupational Diseases; Reproducibility of Results; Surveys and Questionnaires; Translations

Performance injuries among musicians have been widely discussed for decades. However, despite the growing number of classical pianists, this is still a new issue in Malaysia. Therefore, this study aimed to investigate the level of knowledge of playing-related musculoskeletal disorders (PRMDs) among tertiary music students in Malaysia. A survey was conducted among classical piano students at tertiary institutions of Kuala Lumpur and Selangor. Out of 192 respondents, 76% knew that piano playing can cause PRMDs. Slightly over three-quarters of respondents (77.1%) learned about PRMDs from music educators. The survey revealed that the belief in "no pain, no gain" was still ingrained in their minds, as 50.5% respondents believed that pain experienced while playing the piano was normal and 51.6% of them considered that pain must be experienced to improve their piano skill. The respondents were also scored on questions on terminologies of pianist injury and specific PRMD examples: 7.8% of respondents scored high in the questions on the general terminology, while 99.5% of them scored low in the questions on the specific examples of PRMDs. This finding indicated a lack of knowledge of specific musicians' injuries among classical piano students. The attitudes to pain and the level of understanding of the significance of potential injuries indicate that increasing PRMD awareness and introducing courses on PRMD prevention at tertiary institutions are warranted.

Topics: Adolescent; Adult; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Humans; Malaysia; Male; Musculoskeletal Diseases; Musculoskeletal Pain; Music; Occupational Diseases; Students; Surveys and Questionnaires; Young Adult

Workstyle can be defined as an individual pattern of cognitions, behaviours and physiological reactivity that can occur while performing job tasks. Workstyle has been associated with the development of musculoskeletal disorders (MSDs) amongst office workers in developed countries. However, little is known about the contribution of workstyle on MSDs in developing countries such as Malaysia. The objective of this cross-sectional study was to examine the relationship between workstyle and musculoskeletal discomfort in a sample of office workers in Malaysia.. Office workers (N = 417; response rate 65.5 %) from four organisations completed a survey measuring physical and psychosocial hazards, job satisfaction, work-life balance, workstyle, and MSD discomfort levels. Hierarchical regression analyses were undertaken to examine predictors associated with self-reported musculoskeletal discomfort, and more specifically the relationship between workstyle and MSD discomfort.. Musculoskeletal discomfort was significantly associated with working through pain, mental health, physical demands, gender and work-life balance (R (2) = 50.2, adjusted R (2) = 0.48; F (13, 324) = 25.09, p = 0.001). Working through pain is the strongest risk factor associated with MSD discomfort (ß = 0.49, p = 0.001) compared to other potential risk factors.. Working through pain is influenced by work, social culture and religious beliefs. Workplace MSDs interventions that focus on the impact of physical and psychosocial hazards with emphasis on addressing adverse workstyles should take into account aspects related to work and social culture of the target population. Changes are recommended at both employee and management levels such as better communications and understanding concerning workplace problems with regards to minimizing MSDs at work.

Topics: Adult; Cross-Sectional Studies; Developing Countries; Female; Humans; Job Satisfaction; Malaysia; Male; Mental Processes; Middle Aged; Musculoskeletal Pain; Occupational Diseases; Public Sector; Rest; Risk Factors; Sex Factors; Stress, Psychological; Surveys and Questionnaires; Work; Workload; Workplace; Young Adult

Topics: Adult; Female; Humans; Industry; Malaysia; Male; Musculoskeletal Pain; Occupational Diseases; Prevalence; Transients and Migrants; Young Adult

GeoSentinel (the surveillance program of the International Society of Travel Medicine and CDC) has identified 32 cases of suspected acute muscular sarcocystosis in travelers returning from Tioman Island off the east coast of peninsular Malaysia. All the patients traveled to Tioman Island during the summer of 2011. Within days or weeks of returning home, all experienced fever and muscle pain, often severe and prolonged. All had peripheral eosinophilia, and most had elevated serum creatinine phosphokinase levels. Most were tested for acute trichinosis and toxoplasmosis by serology, and all of these tests were negative. Approximately half of the patients were identified in Germany; others were reported elsewhere in Europe, and in North America and Asia. Muscle biopsy from two patients demonstrated organisms consistent with sarcocystosis, one from a group of five ill travelers and one from a group of three.

Topics: Acute Disease; Biopsy; Disease Outbreaks; Fever; Food Contamination; Humans; Malaysia; Muscle, Skeletal; Musculoskeletal Pain; Sarcocystis; Sarcocystosis; Sentinel Surveillance; Travel; Water Supply

The objective of this study is to compare the evaluation of postural analysis between a self-report questionnaire and physical assessments methods for students aged 13 to 15 years old in school workshop. 336 students were volunteered as participants to fill in the questionnaire and being observed in the workshop. Total of 104 positions were selected and analyzed while students performing their tasks. Questionnaire data was examined to specify the prevalence of postural stress symptoms. The relationship of postural stress by physical assessment methods (RULA and REBA methods) was defined to identify the risk level of students' working posture. From the results, comparison of four factors categorized from total of 22 questions among ages, the mean values were lower for 13 years old students meaning that they were faced higher posture problems while using the workstation. The obtained results from both physical assessment methods and questionnaire analysis have identified 13 years old students faced higher risk exposure. Analysis results emphasized the fact that self-reports questionnaire method has almost accurate as postural evaluation methods to identify physical risks in workplace. The result also shows that an intervention is needed to overcome the posture problems.

Topics: Adolescent; Ergonomics; Humans; Malaysia; Musculoskeletal Pain; Posture; Risk Assessment; Schools; Self Report; Task Performance and Analysis

The aim of this study was to investigate the work-related musculoskeletal disorders (WMSDs) among workers in wall plastering jobs within the construction industry.. A total of 43 workers within three workplaces participated in the study.. Subjects were interviewed using self-report charts. During the task duration, observation of the workplace was carried out using a Workplace Ergonomic Risk Assessment (WERA) method.. An analysis of WERA assessment, the wrist score for WERA body part was >4 in 86% of workers, while wrist pain or discomfort was reported by 86%, yielding a significant association between WERA body part score and self-reported pain (χ(2)=16.12; p=0.000). The WERA body part score for the shoulder regions during wall plastering job yielded a score > 4 in 93% and caused shoulder pain or discomfort in 91%, the association being significant (χ(2)=12.58; p=0.000). The back regions for WERA body part score was >4 in 91% of workers, with 98% reporting pain or back discomfort, with a significant association (χ(2)=9.98; p=0.002).. These results showed that statistically significance for the wrist, shoulder and back regions of the individual WERA body part scores were affecting the worker and lead to the development of pain or discomfort among workers in wall plastering jobs.

Topics: Adult; Construction Industry; Ergonomics; Female; Humans; Interviews as Topic; Logistic Models; Low Back Pain; Malaysia; Male; Musculoskeletal Diseases; Musculoskeletal Pain; Occupational Diseases; Occupational Health; Prevalence; Random Allocation; Reproducibility of Results; Risk Assessment; Self Report; Shoulder Pain; Surveys and Questionnaires; Task Performance and Analysis; Young Adult

As of 4 November, 2012, 100 patients with an acute muscular Sarcocystis-like illness associated with travel to Tioman Island, Malaysia, have been identified. Thirty-five travelled there mostly during July and August 2011 and 65 mostly during July and August 2012, suggesting an ongoing outbreak. Epidemiological investigations are ongoing. Public health agencies and practicing clinicians should be aware of this rarely-reported disease in humans and consider it as differential diagnosis in travellers returning from Tioman Island.

Topics: Blotting, Western; Creatine Kinase; Disease Outbreaks; Eosinophils; Fever; Humans; Malaysia; Muscle, Skeletal; Musculoskeletal Pain; Sarcocystis; Sarcocystosis; Sentinel Surveillance; Serologic Tests; Travel