Farm Accidents Research Articles

Present status of monetary compensation to the victims of agricultural accidents in Punjab

The Government of Punjab is providing monetary compensation since 1984 to the victims of agricultural accidents through Punjab State Marketing Board. The compensation rate, fixed at 12, 000/-in case of loss of life, was revised regularly to 2, 00, 000 at present. Monetary compensation amounting to about Rupees 8.3 million is being provided to more than 1800 agricultural accidents victims per year of Punjab state. Chaff cutter (34.7 per cent), threshers and harvesters (21.2 per cent), snake bites (7.9 per cent), electrocutions at tube-well motors (6.8 per cent), poisoning due to pesticides (7.0 per cent), tractors (3.0 per cent are involved in agricultural accidents resulting to death (32.1 per cent) or permanent physical injury to the victims (67.9 per cent). All the recorded agricultural accidents related to snake bites, electric motors and pesticides were fatal in nature. All the chaff cutter and thresher related accidents were non-fatal in nature resulting into amputation injuries of fingers (67.5 per cent), hands (18.2 per cent) and arms (10.5 per cent). Interventions are needed for creating awareness and development of safety devices and gadgets so as to reduce agricultural accidents. Similar monetary compensation scheme may be adopted by other states, so that agricultural accidents victims may be rehabilitated.

Rehabilitation and monetary compensation policy for agricultural accidents victims

Estimates of agricultural accidents in states like Punjab, Haryana, Uttar Pradesh, Madhya Pradesh, Tamil Nadu, etc. present a very alarming situation. Punjab State took a lead for rehabilitation of accident victims by providing monetary compensation. Compensation policy was started in 1984 through Punjab State Marketing Board. No insurance premium is collected from anyone covered under the rehabilitation scheme. The monetary relief at the start was fixed at 2, 000 in the case of death and was revised regularly to of 2, 00, 000 at present. About 1900 agricultural accidents victims are provided monetary relief with total expenditure within Rupees 100 million. The application procedure for the victims to avail benefit of this scheme is also simple. This social welfare scheme has been widely appreciated and adopted by a few other states. It is recommended that a similar procedure should be adopted all over the country and also a mechanism should be setup so that the amount of monetary relief depending upon injury level is revised with time.

Replantation of fingers and hand following amputation by fodder (Chara) cutting machine: Our experience of 20 cases

IntroductionFinger amputations in children can occur due to home accidents, agricultural accidents, and road traffic accidents. In rural North India, amputation due to fodder (Chara) cutting machine is very common. Aims and objectivesTo emphasize that, the fodder cutting injury is one of the most common causes of amputation of fingers and hand in children in rural North India and to discuss the demographic aspects, outcomes and preventive measures. To further establish that replantation in fodder cutting amputations is a standard procedure with good functional outcome. ResultsIn a span of 3 years, total numbers of patients who underwent replantation of fingers or hand distal to wrist joint due to fodder cutting machine were 28, out of which 08 patients were lost to follow up. Out of 20 patients, 80% (16) were boys and 20% (4) were girls. Most of the children were from Haryana, Punjab and Uttar Pradesh regions. Successful replantation was achieved in 18 out of 20 cases. After a period of follow up with physiotherapy, all patients regained good functional and cosmetic results. ConclusionChances of success rate is more in replanting a finger cut by fodder cutting machine, as it is a sharp cut, provided it is brought in time and preserved in a proper manner. Educating the children and farmers regarding the precautions, first aid and mode of transporting the amputated part and suggesting guidelines to the machine making industries regarding the prevention would be of great help in avoiding such accidents.

Decreasing HMGB1 levels improves outcome of Pseudomonas aeruginosa keratitis in mice

Pseudomonas (P.) aeruginosa is a Gram negative bacterium widely dispersed in the environment which can cause acute and chronic infections in humans. According to the Centers for Disease Control and Prevention (CDC), the overall incidence of P. aeruginosa infections in USA hospitals averages about 0.4% (4/1000 discharges), and the bacterium is the fourth most commonly-isolated nosocomial pathogen accounting for 10.1% of all hospital-acquired infections. P. aeruginosa keratitis is a severe infection of the eye, progresses rapidly and remains a leading cause of corneal ulcers worldwide. Use of contact lenses is the major risk factor in the USA, while in less industrialized countries, trauma from agricultural accidents are of importance. Animal models of bacterial keratitis are of value in the study of this disease and suggest potential alternative therapeutic targets that are needed urgently due to increasing antibiotic resistance. Recently we have shown success and improved disease outcome after down-regulation of one promising target, high mobility group box1 (HMGB1) using small interfering RNA (siRNA). Testing more clinically relevant approaches are underway to reduce HMGB1 levels in P. aeruginosa keratitis which may hold promise for its treatment.

The CROPS Curriculum Experiment: Evaluating the Farm Safety Knowledge Gained Among Secondary Appalachia Youth

Rural youth in poverty stricken Appalachian communities are the highest at-risk population for tractor rollover accidents (Cole, 2007). The Apprenticeship of Observation theory (Lortie, 1975) concludes that the “apprentice” learns from watching those perceived to be the teacher and their work and so mimic their actions. Thus, farm youth who often overlook safety precautions believe farm accidents are simply a way of life. This project was partially funded through the Southeast Center for Agricultural Health and Injury Prevention. The funds assisted in the development of a Cost-effective Rollover Protective Structure (CROPS) curriculum. A total of 54 (N = 54) secondary agriculture mechanics students, served as the treatment group (n = 31) and control group (n = 23). The treatment group received farm safety instruction from their secondary agriculture teacher through the use of the CROPS curriculum while the control group received their farm safety instruction from their secondary agriculture teacher who taught, only, to reach the required state standards. Results from the quasi-experimental design study revealed a statistically significant gain in farm safety practices from the treatment group as compared to the control group. Recommendations to the participants, future participants, and research are also included.

Banned dinitrophenols still trigger both legal and forensic issues

ABSTRACTNumerous hazardous chemicals from various industrial sources enter the environment daily; some of them can be used both as drugs and as toxins. Many of these compounds, including dinitrophenols, such as 2,4-dinitrophenol (2,4-DNP), 4,6-dinitrocresol (DNOC), and 2-sec-butyl-4,6-dinitrophenol (dinoseb), are widely used pesticides that persist in some contaminated soils. They have been found in groundwater, causing health and environmental hazards, and are subjects of forensic toxicology. Dinitrophenols have multiple biological and noxious effects based on a mechanism of action characteristic to metabolic inhibitors. Although banned, they have pharmaceutical activity and can be purchased on the Internet as ingredients of weight-loss pills. Many death cases have been reported as accidents in agriculture or as overdoses in weight-loss diets. In this article, we discuss legal aspects of dinitrophenol usage, as well as their biological effect and possible mechanisms of toxicity.

농업분야 개인보호구 연구개발을 위한 관련 특허 동향분석

1)ABSTRACTThis study analyzes current technologies in personal protective equipment (PPE) and mechanisms that can be used in the agricultural field to provide data for research and development on PPE for farmers. There is growing awareness of the importance of PP E as part of efforts to reduce agricultural accidents, but data remain rare for developing PPE tailored to the farm work environment. In this regard, patent data on PPE can provide useful insights for facilitating relevant technologies and research. This study examines patents and utility models cl assified under the IPC code in Korea and other countries to analyze patented technologies and recent trends for the period from January 2003 to October 2014. Here Korea, the U.S., Japan, and Europe were considered. The results show that the number of patent applications for PPE remained steady without any sharp fluctuations. KIPO applications accounted for 43.5% of al l cases, reflecting the highest proportion among the countries considered. Domestic applicants accounted for 94% of all cases. In Korea, patent applications were concentrated in safety gear for the face and eyes, indicating a high level of technology. The highest level of competition wa s observed for safety goggles in all countries. Some PPE technologies were dominated by a par ticular manufacturer. The analysis results for farming-related technologies show the current state of technologies and areas lacking technological development. This study analyzes patented technol ogies for PPE in Korea and other countries and recent research trends as part of the effort to d evelop PPE for workers in the farming and livestock industry. This study represents an early- stage effort to develop PPE for workers in the farming and livestock industry, and the results are expected to be useful for tailoring PPE to Korea's farming and livestock environment. Keywords:patent, agricultural accidents, personal protective equipment, farm work environment, IPC Code

Occupational Accidents with Agricultural Machinery in Austria

ABSTRACTThe number of recognized accidents with fatalities during agricultural and forestry work, despite better technology and coordinated prevention and trainings, is still very high in Austria. The accident scenarios in which people are injured are very different on farms. The common causes of accidents in agriculture and forestry are the loss of control of machine, means of transport or handling equipment, hand-held tool, and object or animal, followed by slipping, stumbling and falling, breakage, bursting, splitting, slipping, fall, and collapse of material agent. In the literature, a number of studies of general (machine- and animal-related accidents) and specific (machine-related accidents) agricultural and forestry accident situations can be found that refer to different databases. From the database Data of the Austrian Workers Compensation Board (AUVA) about occupational accidents with different agricultural machinery over the period 2008–2010 in Austria, main characteristics of the accident, the victim, and the employer as well as variables on causes and circumstances by frequency and contexts of parameters were statistically analyzed by employing the chi-square test and odds ratio. The aim of the study was to determine the information content and quality of the European Statistics on Accidents at Work (ESAW) variables to evaluate safety gaps and risks as well as the accidental man-machine interaction.

Development of Mock Control Devices and Data Acquisition Apparatus for Power Tiller Training Simulator

Training power tiller operators in safe farming is necessary to avoid farming accidents. With the continuing progress in computational technology, driving simulators have become increasingly popular for conducting such training. Purpose: The objective of this study is to develop mock control devices and data acquisition apparatus for a tiller simulator. Methods: Except for the stand and tail wheel adjusting levers, the mock control devices were developed using a tiller handle assay. The data acquisition apparatus was realized using an embedded data-logging device and LabVIEW, the system design software. Results: The control devices of a real handle assay were successfully mimicked by the mock operator control devices, which used sensors for the relevant measurements. The data from the mock devices were acquired and transmitted to the main computer at intervals of 10 ms via Wi-Fi. Conclusions: The developed mock control devices operate similar to real power tillers and can be utilized in power tiller training simulators.

Orthopaedic Trauma in the Anabaptist Community: Epidemiology and Hospital Charges

ABSTRACTThis study aims to define the epidemiology of orthopaedic trauma in the rural Anabaptist community and analyze the hospital charges associated with their treatment. The authors performed a retrospective review of 79 Amish and 40 Mennonite patients who had been seen in their rural level I trauma center emergency department for an orthopaedic injury from January 2006 to May 2013. Data collection included baseline demographics, injury mechanism and severity, injury complex, operative interventions, outcomes, and hospital charges. Amish and Mennonite groups were similar except for a higher percentage of males in the Mennonite group. For Amish patients, occupational injuries (52%) and buggy accidents (16%) accounted for the highest percentage of admissions. Eighty-seven percent sustained at least one fracture, most commonly of the hand (11%). Amish patients were statistically more likely to sustain fractures of the spine, and Mennonite patients were more likely to sustain fractures of the foot and femur. Over half of patients required surgery (58%). Total hospital charges did not differ based between the groups. Amish patients completed outpatient follow-up less frequently than Mennonite patients. Anabaptist patients are at risk for a variety of orthopaedic injuries related to their unique lifestyle and vocations. Socioreligious beliefs must be taken into consideration when educating these patients regarding postinjury care, as attendance at outpatient follow-up is low. Understanding the types of injuries that these patients sustain can help create strategies to prevent costly transportation and agricultural accidents within the Anabaptist community.

Off-Road Motorbike and All-Terrain Vehicle/Quadbike Accidents in Rural New South Wales

Objective: To determine the demographics, risk factors, patterns of injuries sustained from off road motor vehicles in rural NSW. Design: A retrospective review. Setting: Dubbo Base Hospital is a major referral base hospital for Western NSW. Participants: All patients admitted to Dubbo Base Hospital with off-road motor vehicle injuries in between years 2009-2011. Main outcome measures: Demographics, referral areas, pattern of injuries sustained from off road motor vehicle accidents. Results: There were total of 57 cases, with 53 being males. Average age for the patient was 13.7. There were 9 quadbike accidents, and 48 off road dirtbike accidents. For quadbike accidents, mechanism of injuries were: collision(5), rollovers (3), fall (1). Four out of nine quadbike accident patients were wearing a helmet. With off road motorbike (dirtbike) accidents, 17 were from motorcross jumps, and 31 were farming accidents. Farming accidents comprised of 19 falls and 12 collisions. Of the 17 involved in motorcross jump related accident, 12 were wearing safety gears. On average, they were travelling at much higher speed, with average of 50 km/hr, and highest of 80 km/hr. The most common injuries were soft tissue injuries and peripheral long bone fractures, however more severe injuries were noted with motocross jump related injuries. Discussion/Conclusion: This study found the vast majority of injuries from off road motor vehicles in rural Australia occur in children. It is of concern that there are currently no enforceable road regulations for off-road motor vehicle use on privately owned properties. There needs to be better education of the younger drivers as well as enforceable regulations to allow safe use of the off road motor vehicles.

Combat-Related Invasive Fungal Wound Infections.

Combat-related invasive fungal (mold) wound infections (IFIs) have emerged as an important and morbid complication following explosive blast injuries among military personnel. Similar to trauma-associated IFI cases among civilian populations, as in agricultural accidents and natural disasters, these infections occur in the setting of penetrating wounds contaminated by environmental debris. Specific risk factors for combat-related IFI include dismounted (patrolling on foot) blast injuries occurring mostly in southern Afghanistan, resulting in above knee amputations requiring resuscitation with large-volume blood transfusions. Diagnosis of IFI is based upon early identification of a recurrently necrotic wound following serial debridement and tissue-based histopathology examination with special stains to detect invasive disease. Fungal culture of affected tissue also provides supportive information. Aggressive surgical debridement of affected tissue is the primary therapy. Empiric antifungal therapy should be considered when there is a strong suspicion for IFI. Both liposomal amphotericin B and voriconazole should be considered initially for treatment since many of the cases involve not only Mucorales species but also Aspergillus or Fusarium spp., with narrowing of regimen based upon clinical mycology findings.

The spectrum of pelvic fracture urethral injuries and posterior urethroplasty in an Italian high-volume centre, from 1980 to 2013

ObjectiveTo describe the emergency and delayed treatment of patients with pelvic fracture urethral injuries (PFUI) presenting to an Italian high-volume centre. Patients and methodsIn a retrospective, observational study we evaluated the spectrum of PFUI and posterior urethroplasty in an Italian high-volume centre, from 1980 to 2013. Patients requiring emergency treatment for PFUI and delayed treatment for pelvic fracture urethral defects (PFUD) were included. Patients with incomplete clinical records were excluded from the study. Descriptive statistical methods were applied. ResultsIn all, 159 male patients (median age 35years) were included in the study. A traffic accident was the most frequent (42.8%) cause of PFUI, and accidents at work were reported as the cause of trauma in 34% of patients. Agricultural accidents decreased from 24.4% to 6.2% over the course of the survey. A suprapubic cystostomy was the most frequent (49%) emergency treatment in patients with PFUI. The use of surgical realignment decreased from 31.7% to 6.2%, and endoscopic realignment increased from 9.7% to 35.3%. A bulbo-prostatic anastomosis was the most frequent (62.9%) delayed treatment in patients with PFUD. The use of the Badenoch pull-through decreased from 19.5% to 2.6%, and endoscopic holmium laser urethrotomy increased from 4.9% to 32.7%. ConclusionsThe spectrum of PFUI and subsequent treatment of PFUD has changed greatly over the last 10years at our centre. These changes involved patient age, aetiology, emergency and delayed treatments, and were found to be related to changes in the economy and lifestyle of the Italian patients.

FROM INJURY TO THE PARALYMPIC PODIUM – A CASE STUDY OF A CROSS-COUNTRY SKIING CHAMPION IN 10-YEAR FOLLOW-UP

BackgroundA rare case of systematic comprehensive assessment of endurance abilities of a multiple Paralympic medalist.ObjectiveTo assess the morpho-functional abilities and health condition of a multiple Paralympic medalist and to design...

Disseminated Infection due to Saksenaea vasiformis Secondary to Cutaneous Mucormycosis

Mucormycosis is an uncommon opportunistic fungal infection caused by Zygomycetes. It usually affects immunocompromised, diabetic and trauma patients with infected wounds. We report a case of disseminated infection secondary to facial cutaneous mucormycosis caused by Saksenaea vasiformis in a diabetic patient who had a farming accident causing him severe head injury. The patient was treated with a combination of surgical debridement and antifungal therapy with liposomal amphotericin B, but he had a slow and fatal outcome. In cases of tissue necrosis following trauma involving wound contact with soil (i.e., potential fungal contamination), testing for the presence of Zygomycetes fungi such as S. vasiformis in both immunocompetent and immunocompromised patients is crucial. The reason is that this infection usually has a rapid progression and may be fatal if appropriate treatment is not administered.

Decision support system for social occupational injury insurance institutions: cost analysis and targeted resource allocation

Occupational injuries are a great burden on health care costs worldwide as they do not only cause costs directly related to the accident but also enormous long-term follow-up costs for individuals, insurance companies, employers, and the economy. We develop a detailed decision support system called “Cost Calculation Tool” for the main Austrian social occupational insurance institution (AUVA) that investigates total direct and main indirect costs of individual injury claims from the time of the incident for all injured individuals up to their death. We discuss policy implications for the occupational injury data of the year 2010. In the first two years after the accident registration, treatment costs account for about 66 %, pension costs for about 12 %, and co-payments for sick leave for about 10 % of the total AUVA costs (117.85 million Euro). An example of an underlying costly case is a middle-aged male who had a traffic-related accident at work and injured his back with lifelong costs of about 4.8 million Euro (pensions, treatment, rehabilitation, prostheses, transportation). However, pension costs are the main cost driver with nearly 50 % of total AUVA costs under a lifelong cost-perspective, while treatment costs only account for less than 15 %. In addition to these total AUVA costs, we also approximate main costs for the employers and the economy. All present and future costs predicted by the “Cost Calculation Tool” are included in the data warehouse of the AUVA and help clustering patients into risk groups according to criteria that most influence related total costs. AUVA decision makers can now optimally target prevention strategies and better plan for prevention budgets. Based on these insights and earlier research projects, the AUVA highly focuses its prevention strategies on injuries on the road to/from/at workplace, accidents at construction sites, as well as accidents in forestry and agriculture.

The occupational safety on the construction sites of the farm production buildings in Finland

The size of farms has increased considerably during Finland's EU membership. The growth has meant big investments in the new production buildings. The buildings have been switched to big industrialhall- like constructions from small-scale ones which have contained own timber and own work contribution. The objective of the project financed by Farmers' Social Insurance Institution was to improve occupational safety on farm building construction and renovation sites by disseminating current safety practices and by developing ways of action which are better than the prevailing ones. The project consisted of a literature review, statistical analysis, as well as a farmer and designer interviews. In the statistical analysis the MATA occupational injuries insurance claims database on farmers’ claims during construction and renovation work for the years 2005 - 2008 was compared with the register of Federation of Accident Insurance Institutions on the construction workers' injuries. In comparing the reasons of the accidents a clear difference was found; poor scaffoldings and ladders are still the main culprits on farm accidents. Farmer interviews were used to assess occupational safety measures on the construction site, occurred injuries and their types, nearmiss situations and the underlying factors which have led to the injuries. Also construction safety deficiencies as well as the direct and indirect costs caused for instance because of the delay in completion of construction project were discussed. Designer interviews aimed to find out how occupational safety and health considerations are taken into account in farm building planning and counseling, and how this experience of the designers should be utilized in order to improve safety at the construction sites on farms. Farmers knew their obligations on occupational safety poorly. The situation was further worsened by the fact that on the site the supervisor tasks were only nominally executed. The designers knew the occupational health and safety legislation better but this did not help the situation on the sites because designers are not generally involved in the actual implementation of the construction project.

Seamless Safe Supervision System of Edible Agricultural Products

In order to resolve the gap in domestic Edible agricultural products safety supervising and decline the probability of Edible agricultural products accidents, this paper puts forward seamless theory and related information sharing theory to construct information sharing platform for seamless supervising of Edible agricultural products safety. Firstly, analyzes the significance of domestic Edible agricultural products safety and the current study situation of Edible agricultural products information platform. Through the analysis of the responsibilities of Edible agricultural products safety supervising department and according to the characteristics of seamless theory and the requirements of information sharing, puts forward the targets and contents of constructing information sharing platform for seamless supervising of Edible agricultural products safety, and designed the functional module and service items of information sharing platform for seamless supervising of Edible agricultural products safety.

Injuries in agriculture – injury severity and mortality

Accidents in agriculture are a problem of global importance. The hazards of working in agriculture are manifold (machines, animals, heights). We therefore assessed injury severity and mortality from accidents in farming. We retrospectively analysed all farming accidents treated over a 12-year period in the emergency department (ED) of our level I trauma centre. Out of 815 patients 96.3% were male and 3.7% female (p <0.0001). A total of 70 patients (8.6%, 70/815) were severely injured. Patients with injuries to the chest were most likely to suffer from severe injuries (odds ratio [OR] 9.45, 95% confidence interval [CI] 5.59-16.00, p <0.0001), followed by patients with injuries to the abdomen (OR 7.06, 95% CI 3.22-15.43, p <0.0001) and patients with injuries to the head (OR 5.03, 95% CI 2.99-8.66, p <0.0001). Hospitalisation was associated with machine- and fall-related injuries (OR 22.39, 95% CI 1.95-4.14, p <0.0001 and OR 2.84 95% CI 1.68-3.41 p <0.001, respectively). Patients suffering from a fall and patients with severe injury were more likely to die than others (OR 3.32, 95% CI 1.07-10.29, p <0.037 and OR 9.17, 95% CI 6.20-13.56, p <0.0001, respectively). Fall height correlated positively with the injury severity score , hospitalisation and mortality (all p <0.0001). Injuries in agriculture are accompanied by substantial morbidity and mortality, and range from minor injuries to severe multiple injuries. Additional prospective studies should be conducted on injury severity, long-term disability and mortality.

Catheter-over-needle method facilitates effective continuous infraclavicular block

To the Editor, We read with great interest the excellent article written by Dr. Lecours et al. which reported an observational cohort study of all ultrasound-guided single-injection infraclavicular blocks (ICBs) performed over a two-year period at their institution. The authors observed that ultrasound-guided ICB performed with a single injection posterior to the axillary artery is a reasonably safe technique associated with a high success rate regardless of the expertise of the anesthesiologist performing the block. Experience within our institution is consistent with this observation, and we would agree strongly that ICB performed by single injection posterior to the axillary artery is safe and effective. Further, this provides an excellent approach for placement of a continuous catheter using a catheter-over-needle technique. Here, with written consent from the patient, we report our recent experience of placing an infraclavicular catheter utilizing a 21G 9 95-mm catheter-over-needle unit (MultiSet UPK NanoLine 21156-40E, Pajunk, Germany) for a planned re-implantation of thumb after a rope-related farming accident. A high-frequency linear ultrasound transducer (13-6 MHz HFL38, M-Turbo ; SonoSite, Bothell, WA, USA) was placed in the deltopectoral grove parasagittally, where the axillary artery and the lateral cord of brachial plexus in its lateral aspect were easily identified (Figure). After raising a local anesthetic wheal, the catheter-over-needle unit was inserted cephalad to the probe and advanced in-plane caudally or inferiorly at approximately 45 to 60 from the ultrasound probe axis, through the pectoral muscles and toward the parasagittal plane between the axillary artery and the lateral cord. Hydrodissection with dextrose 5% in water was used to create sufficient space between the lateral cord and axillary artery to advance the needle/catheter unit into a more advantageous position, posterior to the axillary artery and directly adjacent to the posterior cord. Once the tip of the needle was positioned, and, following negative aspiration of blood or air, 20 mL of local anesthetic was injected to open the perivascular space. The needle was removed from the outer catheter, and a flexible, 20G 9 75-mm inner catheter was inserted through the cannula and Luer-locked onto the 18G catheter sheath such that both catheters were in situ. Before securing the catheter in place with a dressing (e.g., Tegaderm), a further 10 mL of local anesthetic was injected through the catheter to complete the block and confirm the spread. Instead of the planned thumb reimplantation, debridement of the thumb was performed. In the post anesthetic recovery room, a local anesthetic infusion was commenced and continued at 1 mL hr with an 8 mL bolus every hour until the next morning when the infraclavicular catheter was removed and the patient transitioned to oral analgesia. Throughout the infusion, the patient was pain-free, and the catheter remained in place with intact and dry dressings, as was our experience with an interscalene catheter placed using the catheterover-needle method. We have used this approach to place five infraclavicular catheters over the last three months, and in each case, the pain management was excellent. Catheter insertion has been uncomplicated and all have been removed as planned. Editor’s Note: The authors of the article: Can J Anesth 2013; 60: 244-52, respectfully declined an invitation to submit a reply to the above Letter to the Editor.