Knowledge, Attitude and Practice of Preventing the Occurrence of Work-Related Musculoskeletal Disorders Among Doctors in University of Port-Harcourt Teaching Hospital

Background: Musculoskeletal disorders affecting medical personnel should never be treated lightly. It has thus become necessary to strictly infuse ergonomics in medical practice in order to tackle the occurrence of musculoskeletal system disorders. This would ensure better productivity among the medical personnel. This research was conducted to determine the knowledge, attitude and practice of the prevention of work-related musculoskeletal disorders among doctors working at the University of Port-Harcourt Teaching Hospital.Methods: A descriptive, cross-sectional study design was employed in carrying out this study among doctors working at the University of Port Harcourt Teaching Hospital. Multistage sampling was utilized in selecting a sample population of 223 doctors for this study. Data collection was done using a semi-structured self-administered questionnaire. Ethical approval to conduct this study was gotten from the University of Port-Harcourt research ethics committee. Consent, confidentiality, privacy and beneficence were ensured in this study. For test of associations, statistical significance was set at 0.05.Results: Majority of the respondents had good knowledge and attitude towards musculoskeletal disorders’ prevention at work. The practice of ergonomic principles was however not satisfactory. Occurrence of work-related musculoskeletal disorders among study respondents was significantly associated with the knowledge and practice of ergonomic principles required to prevent the occurrence of these disorders.Conclusion: Despite the significant proportion of doctors in this study having good knowledge and attitude towards prevention of musculoskeletal system disorders at work, only few of these doctors satisfactorily practiced the necessary preventive measures necessary to prevent these disorders. This inadvertently resulted in the high prevalence of these disorders found in this study. It is recommended that a re-orientation of doctors to be more involved in the actual application of ergonomics while working no matter the compulsion or desire to get the work done should be done

Immunoprotective role of indoleamine 2,3-dioxygenase in engraftment of allogenic skin substitute in wound healing

Delayed wound healing can significantly impact survival of patients who suffer from severe thermal injury. In general, the use of a wound coverage, particularly with those of bilayer skin substitute, would be ideal to promote healing and prevent infection and fluid loss. Although the use of an autologous skin substitute is desirable, its preparation is time consuming and its immediate availability is impossible. To overcome this difficulty, the authors have previously demonstrated that the expression of indoleamine 2,3 dioxygenase (IDO) could function as a local immune suppressive factor in protecting allogenic fibroblasts and keratinocytes without using any immunosuppressive medication in a wound healing animal model. IDO, which is naturally expressed in the placenta by trophoblast cells during pregnancy, plays an essential role in maternal tolerance toward the fetus. The potent and selective local immunosuppressive function of IDO makes this enzyme a very promising tool for engineering a nonrejectable skin allograft. Here, the authors reviewed and discussed how the expression of IDO by the primary cells of our skin substitute can serve as a source of IDO enzyme activity and generate a tryptophan-deficient environment. Under this condition, only skin cells but not immune cells (CD4+ and CD8+ cells) would survive and protect engraftment of this engineered and shelf-ready skin substitute to be used not only as wound coverage but also as a rich source of wound healing promoting factors. Therefore, this review summarizes the body of work on immunoprotective role of IDO in engraftment of allogenic skin substitute in wound healing, which has recently been reported by the authors' research group and others. Copyright © 2012 by the American Burn Association

Fibroblast cell-based therapy prevents induction of alopecia areata in an experimental model

YesAlopecia areata (AA) is an autoimmune hair loss disease with infiltration of proinflammatory cells into hair follicles. Current therapeutic regimens are unsatisfactory mainly because of the potential for side effects and/or limited efficacy. Here we report that cultured, transduced fibroblasts, which express the immunomodulatory molecule indoleamine 2,3-dioxygenase (IDO), can be applied to prevent hair loss in an experimental AA model. A single intraperitoneal (IP) injection of IDO-expressing primary dermal fibroblasts was given to C3H/HeJ mice at the time of AA induction. While 60–70% of mice that received either control fibroblasts or vehicle injections developed extensive AA, none of the IDO-expressing fibroblast-treated mice showed new hair loss up to 20 weeks post injection. IDO cell therapy significantly reduced infiltration of CD4+ and CD8+ T cells into hair follicles and resulted in decreased expression of TNF-α, IFN-γ and IL-17 in the skin. Skin draining lymph nodes of IDO fibroblast-treated mice were significantly smaller, with more CD4+ CD25+ FoxP3+ regulatory T cells and fewer Th17 cells than those of control fibroblast and vehicle-injected mice. These findings indicate that IP injected IDO-expressing dermal fibroblasts can control inflammation and thereby prevent AA hair loss.Canadian Institutes of Health Researches (Funding Reference Number: 134214 and 136945)

Novel, Blended Polymeric Microspheres for the Controlled Release of Methotrexate: Characterization and In Vivo Antifibrotic Studies

Low dose methotrexate (MTX) is known to effectively decrease type I collagen production in dermal fibroblasts, while increasing the matrix metalloproteinase-1 (MMP-1) production in vitro. For in vivo use as an antifibrotic agent on wounds, a linear and extended controlled release formulation of MTX is required. The objective of this study was to optimize the fabrication of MTX-loaded polymeric microspheres with such properties, and to test the efficacy for the prevention of fibrosis in vivo. Poly lactic-co-glycolic acid (PLGA), Poly (L-lactic acid) (PLLA) and the diblock copolymer, methoxypolyethylene glycol-block-poly (D, L-lactide) (MePEG-b-PDLLA), were used to fabricate microspheres, which were then characterized in terms of size, drug encapsulation efficiency, and in vitro release profiles. The optimized formulation (PLGA with diblock copolymer) showed high drug encapsulation efficiency (>80%), low burst release (~10%) and a gradual release of MTX. The amphipathic diblock copolymer is known to render the microsphere surface more biocompatible. In vivo, these microspheres were effective in reducing fibrotic tissue which was confirmed by quantitative measurement of type I collagen and α-smooth muscle actin expression, demonstrating that MTX can be efficiently encapsulated in PLGA microspheres to provide a delayed, gradual release in wound beds to reduce fibrosis in vivo

Control System Design for Telescope Point Spread Function Stability Maintenance

Clearly imaging distant celestial structures from the ground can be difficult due to interference of the atmosphere, and doing so from space is often incredibly expensive. However, there is a third option: using a balloon in order to lift the imaging system to a height devoid of most atmospheric aberrations. This paper will review pertinent aspects of the design of a balloon-borne imaging telescope which will be used in order to measure the masses of certain galaxy clusters via gravitational lensing. Following this, details of the preliminary steps in the design of a quasi-static control system for the stability maintenance of the point spread function (PSF) of the telescope will be described. In order to design the control system, we first derived a linear mapping between a lower dimensional proxy for PSFs and the positions of the mirrors. We then tested this mapping using two simulations, and the results suggest that the linear mapping is only slightly better than a random model. This prompted us to explore more sophisticated regression models

Efficacy of kynurenic acid and methotrexate in prevention of fibrosis

In postnatal life, tissue injuries with sufficient intensity, such as surgical procedures, elicit a repair process rather than regeneration. Hypertrophic scaring, capsular contracture around implants and peritendinous adhesions are common fibroproliferative reactions observed following surgery. These complications not only adversely affect the patients’ quality of life but also impose a significant economic burden on health care system. Despite recent advances in knowledge, refinements of techniques, and various therapeutic methods, the management of post- surgical fibrosis remains a challenge. Recently, Kynurenic acid (KynA), an end product of tryptophan metabolism, has been found to have an anti-fibrotic effect both in vitro and in vivo through suppression of type 1 collagen and enhancement of the matrix metalloproteinase 1 (MMP-1) expression in dermal fibroblasts. Another potential anti-fibrotic molecule is methotrexate (MTX). Systemic low dose MTX, which is a popular first line drug in the management of early and established rheumatoid arthritis (RA), has also been reported to be effective in prevention and treatment of keloid in few case reports. Since fibroproliferative disorders usually appear after the wound is healed, the intact skin can be an obstacle to effective delivery of topical KynA or MTX, and serious side effects limit the systemic use of MTX. In this dissertation, it is hypothesized that localized controlled release of anti-fibrosis agents from biodegradable, biocompatible polymer microspheres, embedded within the wound bed before skin closure, will reduce fibrotic scar formation following surgical procedures. To test this hypothesis, three specific objectives were employed: (1) Developing and validating a suitable animal model for in vivo studies, (2) Fabricating controlled release microspheres loaded with KynA and evaluating the efficacy of fabricated microspheres in vivo and (3) Determining the anti-fibrotic effect of MTX in vitro and evaluating the efficacy of fabricated MTX microspheres in vivo. The findings of these specific objectives demonstrated that the implantation of the controlled release polymer microspheres containing MTX and/or KynA efficiently reduces the fibrotic tissue formation in the PVA sponge-implant model of fibrosis, supporting our hypothesis that controlled local delivery of small anti-fibrosis agents to the wound bed is a feasible method for prevention of post surgical fibrosis.Medicine, Faculty ofExperimental Medicine, Division ofMedicine, Department ofGraduat

Localized Controlled Release of Kynurenic Acid Encapsulated in Synthetic Polymer Reduces Implant—Induced Dermal Fibrosis

Excessive fibrosis following surgical procedures is a challenging condition with serious consequences and no effective preventive or therapeutic option. Our group has previously shown the anti-fibrotic effect of kynurenic acid (KynA) in vitro and as topical cream formulations or nanofiber dressings in open wounds. Here, we hypothesized that the implantation of a controlled release drug delivery system loaded with KynA in a wound bed can prevent fibrosis in a closed wound. Poly (lactic-co-glycolic acid) (PLGA), and a diblock copolymer, methoxy polyethylene glycol-block-poly (D, L-lactide) (MePEG-b-PDLLA), were used for the fabrication of microspheres which were evaluated for their characteristics, encapsulation efficiency, in vitro release profile, and in vivo efficacy for reduction of fibrosis. The optimized formulation exhibited high encapsulation efficiency (>80%), low initial burst release (~10%), and a delayed, gradual release of KynA. In vivo evaluation of the fabricated microspheres in the PVA model of wound healing revealed that KynA microspheres effectively reduced collagen deposition inside and around PVA sponges and α-smooth muscle actin expression after 66 days. Our results showed that KynA can be efficiently encapsulated in PLGA microspheres and its controlled release in vivo reduces fibrotic tissue formation, suggesting a novel therapeutic option for the prevention or treatment of post-surgical fibrosis.Pharmaceutical Sciences, Faculty ofNon UBCReviewedFacultyResearche