Efficacy of platelet-rich fibrin and tacrolimus on facial nerve regeneration: an animal study.

This study was performed to investigate the effect of platelet-rich fibrin membrane (PRFM), alone and with topical tacrolimus application, on regeneration of the crushed facial nerve (FN). Thirty healthy 7-week-old albino rats were used. The left FN was damaged by crushing in all rats. Three random groups of rats were formed: group 1, untreated; group 2, treated with PRFM; group 3, treated with PRFM plus topical tacrolimus. Functional recovery and histological and immunohistochemical evaluations were performed 4 and 8 weeks later. Anti-S100 was used to detect myelin sheath. At 4 weeks, blinking reflex recovery was more rapid in group 3 than in groups 2 and 1 (4.30 ± 0.48, 3.40 ± 0.52, and 2.20 ± 0.42, respectively); the difference was statistically significant (P = 0.001). Histologically, group 3 showed more apparent normal FN structures than the other groups. Immunohistochemical caspase-3 evaluation of the axon area revealed a significant difference between group 2 (PRFM alone; 8.67 ± 0.029) and group 3 (PRFM plus topical tacrolimus; 4.42 ± 0.028) (P = 0.001). Group 3 showed the greatest positive staining in the myelin sheath. Based on the results of this animal study, clinical studies should be performed to determine whether the combination of PRF and tacrolimus also improves the outcome of nerve regeneration in humans.

Psycho-behavioural risks of low back pain in railway workers.

BACKGROUND: Low back pain (LBP) is the most costly ailment in the work force. Risky work behaviour and psychological stress are established risk factors. AIMS: To explore the associations between workplace risk factors, psychological stress and LBP among Malaysian railway workers. METHODS: A cross-sectional study was carried out on railway workers in Malaysia. Socio-demographics, workplace risk factors for LBP, perceived psychological stress and history of LBP over the previous month were obtained by direct interviews using a structured closed-ended questionnaire. Descriptive, bivariate and logistic regression analyses were conducted. RESULTS: There were 513 study participants (70% response rate). The prevalence of LBP in the previous month was 69%. Multivariate analysis yielded four significant predictors of LBP: employment of ≥ 10 years, lifting and lowering heavy loads, prolonged standing posture and psychological stress. CONCLUSIONS: The high prevalence of LBP and its significant associations with physical and psychological stress factors in railway workers points to an urgent need for preventive measures, particularly among workers in high-risk occupations.

Medical professionalism from a socio-cultural perspective: evaluating medical residents communicative attitudes during the medical encounter in malaysia.

CONTEXT: The practice of medicine requires good communication skills to foster excellent rapport in doctor patient relationship. Reports on communication skills learning attitude among medical professionals are key essentials toward improving patient safety and quality of care. AIMS: We aimed to determine factors affecting communication skills learning attitudes among medical residents in Malaysia. SETTINGS AND DESIGN: Cross-sectional survey, in a Malaysian public health hospital. MATERIALS AND METHODS: A total of 191 medical residents across medical and surgical based rotations were included. We assessed the validated communication skills attitude scale among medical residents from different rotations. STATISTICAL ANALYSIS: Statistical Package of Social Sciences (SPSS®) (version 16.0, IBM, Armonk, NY) was used. Cronbach's alpha was used to test the internal consistency of the scale. Descriptive analysis was conducted for all variables. Bivariate analysis was employed across the socio-demographic variables. RESULTS: Majority of the residents believed that communication skills training should be made compulsory in Malaysia (78.5%). Medical residents agreed that acquiring good communication skills is essential to be a good doctor. However, the majority cited time pressures for not being able to learn communication skills. Significant differences in communication skills learning attitude scores were found between Malays and Chinese. CONCLUSION: The majority of medical residents had a positive attitude toward communication skills learning. Socio-demographic factors influenced communication skills learning attitude among medical residents. Incorporating communicative skills modules during hospital Continuous Medical Education for medical residents is essential to cultivate communicative skills attitudes for effective doctor-patient relationship during the routine medical encounters.