Diagnostic Value of Clinical Findings in Evaluation of Thoracolumbar Blunt Traumas

Introduction: Necessity of imaging for symptom-free conscious patients presented to emergency department (ED) following traumatic thoracolumbar spine injuries has been a matter of debate. The present study was aimed to evaluate the diagnostic value of clinical findings in prediction of traumatic thoracolumbar injuries compared tocomputed tomography (CT) scan. Methods: The present diagnostic value study was carried out using non-random convenience sampling during the time between October 2013 and March 2014. All trauma patients > 15 years old underwent thoracolumbar CT scan were included. Correlation between clinical and CT findings was measured using SPSS 21.0 and screening performance characteristics of clinical findings in prediction of thoracolumbar fracture were calculated. Results: 169 patients with mean age of 37.8 ± 17.3 years (rage: 15-86) were evaluated (69.8% male). All fracture patients had at least 1 positive finding in history and physical examination. The fracture was confirmed in only 24.6% of the patients with positive findings in history or physical examination. In 37.5% of patients the location of fracture, matched the area of positive physical examinations. Sensitivity, specificity, PPV, NPV, PLR, and NLR of clinical findings in comparison to thoracolumbar CT scan were 100 (95% CI: 89 - 100), 1.5 (95% CI: 0.2-6), 24.5 (95% CI: 18.3-31.9), 100 (95% CI: 19.7-100), 32.5 (95% CI: 24.6-43.03), and infinite, respectively. Conclusion: The results of the present study, show the excellent screening performance characteristics of clinical findings in prediction of traumatic thoracolumbar fracture (100% sensitivity). It could be concluded that in conscious patients with stable hemodynamic, who have no distracting pain and are not intoxicated, probability of thoracolumbar fracture is very low and near to zero in case of no positive clinical finding

Evaluating Musculoskeletal Disorders and Their Ergonomic Risk Factors among Office Workers of a Large Public Hospital in Iran

Aims: Musculoskeletal disorders (MSDs) are injuries in the musculoskeletal system which is also named as “repetitive stress injury” or “overuse injury”. Inattention to the principles of ergonomics at work is associated with different MSDs. This study evaluated MSDs and their ergonomic risk factors among office workers in a large public hospital in Iran. Materials and Methods: This cross-sectional study was conducted in 2019. Participants were 111 office workers of Shahid Beheshti Hospital, Kashan, Iran. Data were collected using the Cornell Musculoskeletal Discomfort Questionnaire and the Rapid Office Strain Assessment. The SPSS software (v. 20) and the STATA software were used for data analysis, using t-test and linear regression. Results: Most participants were female (55.9%) and had experienced MSDs during the past week (76%). Subject analysis revealed significant differences in vertebral column's MSDs versus limbs and right-sided limbs versus left ones (P < 0.001). The most common MSDs among participants were in the neck (67.6%), lower back (59.5%), and upper back (55%). MSDs among females were significantly more than males (P < 0.05). MSDs in the lower back among overweight and obese participants were significantly more than others (P < 0.05). Respecting the chair-related ergonomic risk factors for MSDs, 24% of participants were at high risk and 75% of them were at moderate risk. Conclusion: Office workers were at moderate risk for MSDs. Providing education about the principles of ergonomics can reduce their MSDs