Modification of the Revised National Institute for Occupational Safety and Health (NIOSH) Lifting Equation to Determine the Individual Manual Lifting Risk in Malaysia's Manufacturing Industry.

INTRODUCTION: The National Institute for Occupational Safety and Health (NIOSH) established the Revised NIOSH Lifting Equation (RNLE) for manual lifting risk assessment. The objectives of this study were to determine the characteristics of physical factors using the RNLE and to explore additional factors to RNLE by modifying it to an Individual Lifting Equation (ILE). METHODS: This cross-sectional study was conducted in the manufacturing industry of three states in Malaysia among manual lifting workers. A questionnaire was administered, which comprised the sociodemographic characteristics and Nordic Musculoskeletal Questionnaire (NMQ) assessing low back pain (LBP). The RNLE dataset includes a load constant and six manual lifting variables collected from observational ergonomic risk assessment. The RNLE was modified to ILE by incorporating age, gender, and BMI. The equations' Lifting Index (LI) computed provides an overall manual lifting risk estimate. RESULTS: There were 165 participants, with a mean age of 28 years, and 108 (65.5%) were male. Most participants had a BMI within the normal range (60 (36.4%)) or were classified as overweight (54 (32.7%)). The lifting horizontal location showed the highest risk estimates, with the lowest mean multiplier value of 0.55. In contrast, age and BMI had the lowest risk estimates, with mean multiplier values of 0.99 and 0.98, respectively. Among the participants, LI values of one or less, indicating very low risk, were observed in 58 (35.1%) for RNLE and 39 (23.6%) for ILE. Additionally, RNLE and ILE showed figures of 11 (6.7%) and 20 (12.1%), respectively, signifying a very high risk of LI exceeding three. CONCLUSION: Studying the lifting factors and equation multipliers from RNLE is critical for evaluating the risk estimates of manual lifting. Exploring the ILE based on individual characteristics is appropriate to support the ergonomic program. Further study is needed to validate the ILE as an accurate screening tool for determining LBP risk estimates.

24-Hour Holter Monitoring for Identification of an Ideal Ventricular Rate for a Better Quality of Life in Atrial Fibrillation Patients.

Introduction Atrial fibrillation (AF) is the most common persistent cardiac arrhythmia. The impact of AF on quality of life (QoL) is significant, and much has related to the achieved resting ventricular rate (VR). Strategies to control VR can improve QoL in AF patients. However, the ideal VR target remains unclear. Therefore, we aimed to identify the ideal VR target by comparing the QoL of AF patients with different VR cut-off means from the 24-hour Holter (Holter). Methods A cross-sectional study was conducted on AF patients in the international normalized ratio (INR) clinic at Hospital Universiti Sains Malaysia. Patients were fixed with a Holter monitor while QoL was measured using the SF-36v2 Health Survey. Patients were repeatedly divided into mean 24-hour Holter VR above and below 60, 70, 80, 90, and 100 beats per minute (bpm). The differences in the total SF-36v2 score and its components were examined. Results A total of 140 patients completed the study. There was a significant difference in physical role, vitality, mental health, mental component summary, and total SF-36v2 scores for VR above and below 90 bpm. The total SF-36v2 score difference was also significant in the covariate analysis, while other VR cut-offs (60, 70, 80, and 100 bpm) did not show significant changes in total SF-36v2 scores. Conclusion Significant differences were observed in the QoL scores among AF patients, with a cut-off VR of 90 bpm favoring patients with the higher rate. Hence, higher VR is better in terms of QoL among stable AF patients.

Prognostic study of using different monitoring modalities in treating severe traumatic brain injury.

OBJECTIVE: To determine whether or not multimodality monitoring technique would result in a better outcome score than single modality monitoring in severely head injured patients. METHODS: This was a prospective randomized study that included all adults with traumatic severe head injury who had a Glasgow Coma Score < 9 and computed tomography scan features that did not reveal significant infratentorial pathology. Subjects were randomized into a multimodality group where they received multiple cerebral monitoring or into a standard single modality group where they received only intracranial pressure monitoring. The outcome was analysed 6 months post treatment using the Barthel Index. RESULTS: The outcome at 6 months post treatment between the two groups was not statistically significant (p < 0.48). However, the percentage of subjects who were independent at 6 months was higher in the multimodality group (21.2%) compared with the single modality group (17.3%). CONCLUSION: Multimodality monitoring for severely head-injured patients has no effect on outcome. However, study with a larger sample size and improvement in groups comparison are required to ascertain the above findings.