Neck Disorders Research Articles

Clinical recognition of the role of the cervical spine in signs and symptoms of altered sensorimotor control

Together with visual and vestibular input the cervical spine is vital for sensorimotor control of head and eye movement control, general body postural stability adjustments and co-ordination.Altered cervical input in persons with neck disorders can lead to signs and symptoms of impaired sensorimotor control across and within several domains. Clinical assessment for differential diagnosis and to direct management of cervical related altered sensorimotor control is clearly required in many patients. This applies not only to patients with neck disorders but also in patients with, for example vestibular disorders or concussion, presenting with signs and symptoms of altered sensorimotor control where the cervical spine may have a role to play.This paper explores the research and current knowledge in relation to clinical measures of cervical related sensorimotor control. The feasibility, responsiveness, comparison to gold standards and potential of clinical measures of cervical related sensorimotor control to assist in differential diagnosis are considered where relevant. Future research directions should examine the full complement of psychometric properties of tests and consideration of any relationships of these measures to pain, dizziness, trauma and functional implications. Development of other measures as well as use in assessing response post management are also important directions.These clinical measures, along with a skilled interview and cervical musculoskeletal examination will enable clinicians to recognise and manage impaired cervical sensorimotor control in patients with neck disorders as well as determine the role of the cervical spine in many patients presenting with signs and symptoms of altered sensorimotor control.

Prevalence of ENT, Neck and Face Diseases in Children Aged 0-14 Years in the ENT Department of the Center Hospitalier Universitaire Gabriel Toure in Bamako

ENT, neck and face disorders are usually benign, but can often be grafted to complications with after-effects that affect the child's psychomotor development, with serious school and social consequences. The aim of the present study is to determine the prevalence of ENT, neck and face disorders in children aged 0 to 14 in the ENT department of the Gabriel Touré University Hospital Centre (UHC) in Bamako. This was a prospective descriptive study conducted from September 1 to November 30, 2021. The results show that the prevalence of ENT, neck and face disorders in children aged 0 to 14 years was 14.53% of department consultations during our study period. Males predominated with 53.07% of cases, a sex ratio of 1.6. The 0-4 age group was best represented, with 49.01% of cases. Otalgia was the most frequent reason for consultation, accounting for 38.60% of cases. Acute otitis media (AOM) was the most common pathology with 24.30% of cases, followed by nasopharyngitis with 17.40%. Otological conditions accounted for the majority, with 58.29% of cases. Otological conditions were followed by naso-sinus conditions with 26.57% of cases, and pharyngolaryngeal conditions with 14% of cases. ENT, neck and face infections are frequent in children. This frequency, linked to immune learning, has repercussions on social and school life. Early treatment can help reduce the morbidity of these conditions.

Explainable machine learning framework to predict the risk of work-related neck and shoulder musculoskeletal disorders among healthcare professionals.

This study aims to develop risk prediction models for neck and shoulder musculoskeletal disorders among healthcare professionals. A stratified sampling method was employed to select employees from medical institutions in Nanning City, yielding 617 samples. The Boruta algorithm was used for feature selection, and various models, including Tree-Based Models, Single Hidden-Layer Neural Network Models (MLP), Elastic Net Models (ENet), and Support Vector Machines (SVM), were applied to predict the selected variables, utilizing SHAP algorithms for individual-level local explanations. The SVM model excels in both Mean Absolute Error (MAE) and Root Mean Square Error (RMSE) and exhibits more stable performance when generalizing to unseen data. The Random Forest model exhibited relatively high overall performance on the training set. The MLP model emerges as the most consistent and accurate in predicting shoulder musculoskeletal disorders, while the SVM model shows strong fitting capabilities during the training phase, with occupational factors identified as the main contributors to WMSDs. This study successfully constructs work-related musculoskeletal disorder risk prediction models for healthcare professionals, enabling a quantitative analysis of the impact of occupational factors. This advancement is beneficial for future economical and convenient work-related musculoskeletal disorder screening in healthcare professions.

Ultrasound-guided caudal cervical articular process arthrocentesis is accurate in live horses with and without arthropathy.

Cervical articular process joint (CAPJ) therapy is advocated for horses with neck disorders. Several ultrasound-guided CAPJ techniques have been described in cadaver studies with 72%-89% intra-articular injection accuracy; however, the CAPJ injection accuracy in clinical equine practice has not been extensively reported. To describe a modified cranial approach for ultrasound-guided caudal CAPJ injections, to investigate the accuracy of this CAPJ injection technique in live horses, and to assess the effect of CAPJ injection location, laterality, operator, and radiographic CAPJ enlargement on injection accuracy. Retrospective case study. Medical records of adult horses in which ultrasound-guided caudal (C4-T1) CAPJ injections were performed using a modified cranial approach between November 2006 and December 2020 were reviewed. Radiographic images of caudal cervical vertebrae were assessed by a blinded radiologist and the degree of CAPJ enlargement was graded using a previously described grading system (Rgrade 1-5b). Ultrasound-guided caudal CAPJ injection accuracy was determined by synovial fluid retrieval during an individual CAPJ injection. Statistical analysis was performed using mixed-effects multivariable logistic model to evaluate the association of CAPJ injection accuracy and the CAPJ injection location, Rgrade, laterality (right, left), and operator. The study included 149 horses with 177 hospital admissions. Synovial fluid was obtained from 586/658 (89.1%) caudal CAPJs using modified cranial ultrasound-guided approach for CAPJ injections. C6-C7 CAPJ injections had 7-fold higher likelihood (OR = 6.78, 95% CI: 1.67-27.52; p = 0.007) of synovial fluid retrieval compared with C4-C5 CAPJ injections. Operator, CAPJ injection side (left, right), and degree of radiographic CAPJ enlargement did not have significant effects on the success of synovial fluid retrieval from ultrasound-guided caudal CAPJ injections. Retrospective study design. Intra-articular ultrasound-guided caudal CAPJ injections using a modified cranial approach can be performed accurately in live horses with and without CAPJ arthropathy.

Routine Physical Therapy with and without Neural Mobilization in Chronic Musculoskeletal Neck Disorders with Nerve-Related Symptoms: Systematic Review and Meta-Analysis.

No previous study has evaluated the effectiveness of routine physical therapy with and without neural mobilization for patients with chronic musculoskeletal neck disorders and cervical radiculopathy. The objective is to evaluate the effectiveness of routine physical therapy with and without neural mobilization on pain and mobility in patients with chronic musculoskeletal neck disorders and cervical radiculopathy. A systematic review with meta-analysis of randomized clinical trials involving the use of neural mobilization techniques for the treatment of chronic musculoskeletal neck disorders and cervical radiculopathy was conducted. Methodological quality was assessed by the Cochrane Risk of Bias Tool and PEDro scale. Data were pooled and a meta-analysis was performed using a random effects model with Review Manager 5 software. Seven articles were included in our review. Significant differences were found in mobility but not in pain in favor of using routine physical therapy with neural mobilization for the treatment of chronic musculoskeletal neck disorders and cervical radiculopathy. Our results show that routine physical therapy accompanied by neural mobilization is superior for improving mobility in comparison with routine physical therapy alone in patients with musculoskeletal neck disorders and cervical radiculopathy.

Hyperbaric Oxygen in Otorhinolaryngology: Current Concepts in Management and Therapy

Background: In otorhinolaryngology and head and neck surgery, oxygen is a therapeutic tool used for various pathologies. Oxidative stress is the imbalance between the production of free radicals (ROS) and the antioxidant capacity of the body, which can represent the pathogenesis of several pathologies or contribute to their worsening. This narrative review aims to analyze the benefits, indications, and side effects of hyperbaric oxygen therapy (HBOT) in different head and neck disorders. Methods: The search was carried out on multiple electronic databases such as PubMed and Google Scholar, and prospective, randomized, and reviewed studies were analyzed from January 1982 to February 2024. Results and Conclusions: The most common tools used to manage oxidative stress in the ear, nose, and throat (ENT) field are continuous positive airway pressure (CPAP) and HBOT. A common ENT pathology, while the latter can be used for osteoradionecrosis treatment in head and neck cancer patients, infections, malignant external otitis, head and neck reconstruction, facial cosmetic surgery, and among patients with sudden sensorineural hearing loss. From our analysis, it emerged that HBOT is a currently used effective therapy in various ENT pathologies’ treatment, alone or in association with other treatments; it can guarantee functional recovery and healing depending on the type of pathology for which it is used and on its severity.

The potential role of Hypericum perforatum in wound healing: A literature review on the phytochemicals, pharmacological approaches, and mechanistic perspectives.

St. John's Wort, commonly known as Hypericum perforatum L., is a flowering plant in the Clusiaceae family that traditionally been employed for treating anxiety, depression, wounds, burns, sunburn, irritation, and stomach ailments. This review provides a synopsis of H. perforatum L. phytoconstituents and their biological effects, highlighting its beneficial therapeutic properties for dermatological indications, as well as its antioxidant, antimicrobial, anti-inflammatory, and anti-angiogenic activity in various applications including wound healing and skin conditions such as eczema, sun burn and minor burns also spastic paralysis, stiff neck and mood disorders as anti-depressant and nerve pains such as neuralgia. The data were collected from several databases as Web of Science PubMed, ScienceDirect, Scopus and Google Scholar using the terms: "H. perforatum L.", "H. perforatum L. /phytochemistry," and "H. perforatum extracts/wound healing" collected from 1994 to 2023. The findings suggest H. perforatum L. acts through various mechanisms and plays a role in each phase of the wound healing process, including re-epithelialization, angiogenesis, wound contraction, and connective tissue regeneration. H. perforatum L. enhances collagen deposition, decreases inflammation, inhibits fibroblast migration, and promotes epithelialization by increasing the number of fibroblasts with polygonal shape and the number of collagen fibers within fibroblasts. H. Perforatum L. extracts modulate the immune response and reduce inflammation were found to accelerate the wound healing process via inhibition of inflammatory mediators' production like interleukin-6, tumor necrosis factor-α, cyclooxygenase-2 gene expression, and inducible nitric oxide synthase. Thus, H. perforatum L. represents a potential remedy for a wide range of dermatological problems, owing to its constituents with beneficial therapeutic properties. H. perforatum L. could be utilized in the development of novel wound healing therapies.

Burden of neck pain in general population of China, 1990-2019: An analysis for the Global Burden of Disease Study 2019.

Neck pain has become very common in China and has greatly affected individuals, families, and society in general. In this study, we aimed to report on the rates and trends of the prevalence, incidence, and years lived with disability (YLDs) caused by neck pain in the general population of China from 1990 to 2019. We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) study to estimate the number and age standardised rates per 100 000 population of neck pain point prevalence, annual incidence, and YLDs in 33 provinces/municipalities/autonomous regions of China, stratified by age, sex, and sociodemographic index (SDI) from 1990 to 2019. We then compared these estimates with other G20 countries. There were 6.80 × 107 patients with neck pain in 2019, presenting an increase from 3.79 × 107 in 1990. Likewise, the national age-standardised point prevalence increased slightly from 3.53% in 1990 to 3.57% in 2019. The YLDs increased by 78.08%, from 3814 × 103 in 1990 to 6792 × 103 in 2019. The age-standardised YLDs rate increased 1.50% from 352.84 in 1990 to 358.10 in 2019. The point prevalence of neck pain in 2019 was higher in females compared with males. These estimates were all above the global average level and increased more rapidly among G20 countries from 1990 to 2019. We generally observed a positive association between age-standardised YLD rates for neck pain and SDI, suggesting the burden is higher at higher sociodemographic indices. Neck pain is a serious public health problem in the general population in China, especially in its central and western regions, with an overall increasing trend in the last three decades. This is possibly related to changes of people's lifestyles and work patterns due to improvements in societal well-being and technology. Raising awareness of risk factors for neck pain in the general population and establishing effective preventive and treatment strategies could help reduce the future burden of neck disorders.

Neck Pain, Mental Status, and Associated Factors Among Hospital Secretaries: A Cross-Sectional Study From Turkey.

Neck disorders occur in the presence of various risk factors. Determining the cause-effect relationship is highly important in treating existing health problems. Our study aimed to determine the relationship between neck pain and mental status and the factors affecting them in hospital secretaries. The study was cross-sectional. A total of 427 people who had been working as hospital secretaries at Gazi University Medical Faculty Hospital for at least one year were included in the study. Sociodemographic characteristics, working conditions, psychopathology levels, and the presence of neck pain were questioned. The study was conducted with 354 (82.9%) people. 34.3% of the hospital secretaries had neck pain, and 26.3% required psychiatric evaluation. There was a statistically significant (p<0.001) difference in neck pain according to gender, adjustability of the chair, accessibility of the tools, and the need for psychiatric evaluation. Data was collected during November 2022. Those who did neck exercises during the study period had lower mean scores on the General Health Questionnaire-12 than those who did not, and the difference was statistically significant (p<0.001). According to the General Health Questionnaire-12 scores and the Bournemouth Neck Pain Questionnaire Scale, there is a significant (p<0.001), positive, and moderate (r=0.481) correlation between the frequency of mental problems and neck pain disability levels. The relationship between the need for psychiatric status evaluation and neck pain is striking. A significant proportion of hospital secretaries complain of neck pain, work in non-ergonomic conditions, and need psychiatric evaluation. The study's results underline the necessity of targeted workplace interventions and wellness procedures, highlighting the need to implement ergonomic improvements, promote regular exercise regimes, and provide psychosocial support services to improve the general well-being of hospital secretaries and develop a better working environment.

Cascading defenses: A multifaceted narrative of immune responses in head and neck physiology

This scholarly investigation provides an exhaustive exploration of the intricate landscape governing immune responses within the physiology of the head and neck, with a specific emphasis on the concept of cascading defenses. The introduction underscores the paramount significance of comprehending immune responses within this distinctive anatomical context, illuminating the multifaceted nature of the immune system. The initial section scrupulously examines the primary line of defense, elucidating the pivotal role of physical and chemical barriers, including the skin, mucous membranes, and antimicrobial secretions. Transitioning to the subsequent section, the study delves into the realm of innate immune responses, offering insights into the activation mechanisms of phagocytes, the release of inflammatory mediators, and the functioning of the complement system. The third section provides a closer examination of adaptive immune responses, furnishing detailed insights into the activation processes of B and T cells, as well as the establishment of immunological memory. The intricate interplay between the innate and adaptive immune systems is thoroughly explored in the fifth section, with a particular emphasis on the coordination, communication, and feedback loops characterizing their dynamic relationships. To address the unique challenges posed by the distinctive anatomical features of the head and neck, including the presence of specialized immune structures, the sixth section contributes valuable insights. The article further ventures into the realm of immunopathology in head and neck disorders in the subsequent section, shedding light on potential dysregulation, autoimmune implications, and prospective immunotherapy approaches. Section eight extends its focus to future perspectives and research directions, encompassing emerging technologies, therapeutic interventions, and implications for personalized medicine. In conclusion, this study successfully recapitulates the multifaceted narrative surrounding immune responses in head and neck physiology, underscoring the ongoing significance of research in advancing clinical approaches. The dynamic and interconnected nature of immune defenses in this anatomical context serves as a foundation for future investigations and holds promising applications in the field of clinical medicine.

A systematic review of work-related musculoskeletal disorders and risk factors among computer users

IntroductionRapid technological developments, especially in the use of electronic devices, have affected workers. MSDs are a major burden for both employees and employers, and in contemporary society. Millions of computer workers suffer musculoskeletal diseases and it is the most common cause of occupational illness in the USA and result in medical costs and absenteeism that cost the sector between $45 and $54 billion annually. A single review was done about WMSDs, however it only investigated neck and upper extremities disorders. Therefore, this study aimed to review epidemiological evidence about the prevalence and risk factors of overall WMSDs among computer user bankers and office workers. MethodsAn extensive literature search was undertaken in the PubMed, Web of Sciences, Google Scholar, and Scopus databases. Articles published in peer-reviewed English-language journals were considered for inclusion criteria. Articles published in conference proceedings, reports, abstracts, and not full text were excluded. After a thorough search of databases, a total of 90 articles were discovered, and finally, 25 of them met the inclusion criteria and were investigated in detail. ResultThe magnitude of WMSDs ranged from 33.8 to 95.3 %. The lower back, neck, upper back, and shoulder were the most affected body parts, and the elbow, hip/thigh, knee, wrist/hand, and ankle/feet were the least affected body parts. Prolonged computer use, being older, repetitive moments, female sex, working in awkward posture, low educational status, a lack of physical exercise, and ergonomics training were significantly affected by MSDs. Conclusionand recommendation: The prevalence of WMSDS was very high, and as a result, an interventional study should be conducted. Reducing prolonged use of computers and working in the right posture will reduce the magnitude of MSD among computer users.

Changes in Neck and Shoulder Muscles Fatigue Threshold When Using a Passive Head/Neck Supporting Exoskeleton During Repetitive Overhead Tasks.

This study aimed to investigate the effects of a head/neck supporting exoskeleton (HNSE) on the electromyographic fatigue threshold (EMGFT) of the neck and shoulder muscles during a simulated overhead work task. Overhead work is a well-known risk factor for neck and shoulder musculoskeletal disorders due to the excessive strain imposed on the muscles and joints in these regions. Fourteen healthy males performed a repetitive overhead nut fastening/unfastening task to exhaustion while wearing and not wearing the HNSE at two neck extension angles (40% and 80% of neck maximum range of motion). Electromyographic signals were continuously recorded from the right and left sternocleidomastoid (SCMR, SCML), splenius capitis (SCR, SCL), upper trapezius (UTR, UTL), and anterior deltoid (ADR, ADL) muscles. The normalized electromyographic amplitude (nEMG) data was time normalized, and a bisegmental linear regression was applied to determine the muscle fatigue break point. The results showed a significant increase in fatigue threshold time in the SCMR (p < .001), SCML (p = .002), and UTR (p = .037) muscles when the HNSE was used. However, the EMGFT times for the right and left deltoid and left trapezius muscles showed a nonsignificant reduction due to the head/neck support exoskeleton use. In addition, the neck extension angle did not reveal a significant effect on muscles' EMGFT time. Overall, the findings confirmed a significant delay in fatigue onset in sternocleidomastoid muscles, as measured by the electromyographic fatigue threshold. This finding suggests that the HNSE can be an effective ergonomic intervention for reducing the risk of musculoskeletal disorders in overhead workers. However, further studies are needed to investigate the effect of the HNSE at other neck extension angles and more realistic tasks to ensure the generalizability of our results. The present findings emphasize the application of the fatigue onset time to evaluate the effectiveness of ergonomic interventions, including exoskeletons, which can subsequently be utilized to alleviate postural demands and reduce the risk of musculoskeletal disorders.

A Study of 45 Patients with Chronic Neck Pain to Compare the Effects on Pain and Disability of 4 Weeks of Physical Therapy with the Active Release Technique and Strain-Counterstrain Manipulation with Massage Alone, Before and After Treatment.

BACKGROUND Active release technique (ART) and strain-counterstrain (SCS) have been reported to be beneficial for patients with trigger point pain. Therefore, this study of 45 patients with chronic neck pain aimed to compare the effects of 4 weeks of physical therapy with the ART and SCS manipulation with massage alone, evaluated before and after treatment, using the visual analog scale (VAS) for pain, the neck disability index (NDI), and the pressure pain threshold (PPT). MATERIAL AND METHODS The participants were 45 adults with neck pain lasting >12 weeks, divided into the ART group (n=15), SCS group (n=15), and control group (n=15). All groups received clinical massage (CM) for 15 min twice a week for 4 weeks. The control group received only CM, the ART group received CM and ART for 15 min twice a week for 4 weeks, and the SCS group received CM and SCS for 15 min twice a week for 4 weeks. VAS, NDI, and PPT were measured before and after the interventions. RESULTS In all groups, there were significant changes in VAS, NDI, and PPT after the interventions (P<0.05), and there was a significant difference among groups in the difference before and after intervention (P<0.05). VAS and NDI showed the greatest difference among before and after intervention in the ART group (VAS pre-post 3.38±0.76, NDI pre-post 5.69±2.78). PPT showed the greatest difference among before and after intervention in the SCS group (PPT pre-post 1.75±0.62). CONCLUSIONS The ART technique and the SCS technique effectively reduced neck pain and neck disorders in adults with chronic neck pain.

The effectiveness of Allen Carr's method for smoking cessation: A systematic review.

Allen Carr's (AC) method is a pharmacotherapy-free approach to quit smoking that is delivered through seminars, online courses, or in the form of a book. It has gained popularity, but its effectiveness remains controversial due to a lack of scientific evidence. This systematic review aims to provide an updated overview of the current evidence on the effectiveness of the AC method. We conducted a systematic literature review of all epidemiological studies evaluating the effectiveness of the AC method for smoking cessation, published in PubMed/MEDLINE and Embase up to March 2023. Among 34 original studies identified through the literature search, six met the inclusion criteria. These studies were published between 2006 and 2020, with sample sizes ranging from 92 to 620 participants. Of the six studies, two did not have a comparison group while four, including two randomized control led trials (RCT), had a comparison group. The included studies showed cessation rates for people who attended the seminars from 19% to 51%. An observational study found an odds ratio (OR) of abstinence for those attending AC single-session seminars of 6.52 (95% confidence interval, CI: 3.10-13.72) compared with controls with no treatment. One RCT found higher quit rates for AC single-session seminars compared with the online Irish National service (OR=2.26; 95% CI: 1.22-4.21). Another RCT reported no significant difference between AC single-session seminars and a specialist stopsmoking service. One single study on patients with head and neck disorders analyzed the effectiveness of reading the AC book, showing no significant results. The AC seminar may be an effective intervention for smoking cessation. This approach deserves further RCTs with large sample sizes to strengthen the evidence. Scant data are available on the effectiveness of reading the AC book.

Clinimetric properties of a smartphone application to measure the craniovertebral angle in different age groups and positions

BackgroundCraniovertebral angle (CVA) alteration is a causative factor for the neck, shoulder, and temporomandibular joints disorders. Therefore, as an outcome measure for therapeutic intervention, measuring the craniovertebral angle with the Surgimap smartphone app is a cost-effective, easily accessible, and reliable tool. This study's objective was to assess the clinimetric properties of the Surgimap smartphone application with Surgimap system software to measure the Craniovertebral Angle in different age groups and positions. MethodNinety subjects with neck pain were randomly allocated to aged between 18 and 30 years (Group A; n = 45) and 45–60 years (Group B; n = 45). Using the Surgimap smartphone application and Surgimap system software, the craniovertebral angle was measured objectively in the sagittal plane. Intraclass correlation coefficients were used to determine validity and reliability. Receiver operating characteristic (ROC) curves and the area under the curves (AUC) were determined to distinguish participants with and without forward head posture. ResultThe result of this study shows that Smartphone Surgimap Application and Surgimap System Software correlate 0.95 and have p-values of 0.01 for diverse positions and ages. CVA measurement in the sitting position was significantly lower than in the standing position, regardless of methodology or age. Both positions demonstrated high intra-rater reliability, as evidenced by Intraclass Correlation Coefficients (ICC) between 0.972 and 0.991. The minimum detectable change (MDC) values ranged from 1.3 to 1.733, indicating high measurement accuracy. The smartphone application demonstrated outstanding diagnostic sensitivity (100.00% for Group A standing) and specificity (93.55% for Group B standing). ConclusionThe Surgimap smartphone application is a reliable and accurate method for craniovertebral angle measurement and is useful for measuring outcomes. Also standing posture was found to be better than sitting posture while measuring the CVA.

Acupuncture Treatment of Neck Pain in Cold Wind Pathogen Syndrome

Introduction: Neck pain is one of the health problems that exist in modern society. Neck pain is one of the main musculoskeletal disorders in the adult population, where the prevalence in the world ranges from 16.7% to 75.1%. In Indonesia, every year, around 16.6% of the adult population complains of neck disorders, of which 0.6% start with discomfort in the neck and progress to severe neck pain. Objective: This study aims to provide an in-depth description of the role of acupuncture in specific neck pain cases caused by cold-weather pathogens. Method: The research design used a qualitative approach with a case study type and was conducted in March–AApril 2023. Result and Discussion: The acupuncture points used were Feng Chi (GB 20), Tian Zhu (BL 10), Jianjing (GB 21), Dazhu (BL 11), Extra Xinshe, and Jianzhongshu (SI 15). The results of this study showed that participants felt pain at the beginning on a scale of 8 before changing to a scale of 1 and 5, and the neck and shoulders no longer felt stiff. Conclusion: And the participants can sleep comfortably and are not disturbed by pain because the complaints they feel have improved.

Evaluation of the physical condition and the amount of musculoskeletal disorders in Ganjovian using the REBA and ROSA methods Dezful hospital employees

Introduction: The most common occupational diseases are musculoskeletal disorders that happen with improper body posture while performing job duties. The present study aimed to determine the prevalence of musculoskeletal disorders and evaluate the physical condition of hospital employees using REBA and ROSA methods.&#x0D; Materials and methods: This descriptive-analytical study was conducted on 125 employees of Dezful teaching hospital, selected by stratified random sampling method. Musculoskeletal disorders were assessed using the Nordic questionnaire, and Rapid Entire Body Assessment (REBA)، and Rapid Office Strain Assessment (ROSA) methods were used to assess physical condition. The normality of the data was checked using Kolmogorov-Smirnov test. Statistical analysis was done with SPSS version 23 software.&#x0D; Results: The average age and work experience were 36.49±8.26 and 7.33±11.8 years, respectively. The highest prevalence of musculoskeletal disorders was related to the neck (47.7%) and wrist (40.4%), and the lowest was the elbow (7.8%). According to the REBA score, 18.3% of posture workers needed immediate corrections, and 37.8% needed corrections as soon as possible. According to the ROSA score, in 75.8% of the tasks, the work environment should be re-evaluated. There was a significant relationship (P-value&lt;0.05) between wrist, shoulder, and neck disorders with gender, height, age, work history, and posture.&#x0D; Conclusion: Considering the prevalence of musculoskeletal disorders and the high level of risk among employees, it is recommended to modify the workstation and train employees.

Etiology and Risk Factors of Ischemic Stroke in Young Adults: A Mongolian Two-Center Study

Introduction: Young adults experiencing ischemic stroke often present with distinct risk factors and underlying causes that are less prevalent or different compared to older individuals. However, the existing classifications may not fully capture the unique risk and etiological factors specific to young adults. In this study, we utilized a modified risk factor categorization derived from the International Pediatric Stroke Study (IPSS) to analyze the risk factor profiles of Mongolian young patients diagnosed with ischemic stroke. Methods: This study is a retrospective analysis conducted at two medical centers. We included patients between the ages of 18 and 49 years who were admitted to the First and Third Central Hospitals of Ulaanbaatar for their first-ever ischemic stroke during the period from 2018 to 2021. The study aimed to consecutively collect and analyze the risk factors of these patients, which were subsequently categorized into 10 groups based on the modified IPSS criteria. We also examined the potential differences in risk factor distribution based on both sex and age, thereby exploring any notable variations among these patient subgroups. Results: The study included a total of 306 patients, with a median age of 42 years, and 60.5% of the participants were men. Among all patients, at least one IPSS risk factor category was identified in 91.5% of the cases. The most common IPSS subtype observed was atherosclerosis-related risk factors, accounting for 81% of the cases followed by cardiac disorders (16%), chronic systemic conditions (13.1%), arteriopathy (11.4%), and chronic head and neck disorders (6.2%). The prevalence of chronic systemic conditions was higher in patients aged below 35 years (16.7% vs. 11.4%) and in women (21.5% vs. 7.6%, p &lt; 0.05). Atherosclerosis-related risk factors were more dominant in patients aged 35 years and older (87.1% vs. 67.7%, p &lt; 0.0001) and in men (93.0% vs. 62.8%, p &lt; 0.0001). Conclusions: The IPSS classification has the potential to serve as an effective tool in identifying the risk factors associated with ischemic stroke in young adults

Investigating the Relationship Between Medical History and General Health Status of Bank Workers With Voice Handicap Index and Vocal Fatigue Index

Background and Objectives: The present study examined the relationship between the total score of the voice handicap index (VHI) and the total score and scores of the three factors of the vocal fatigue index (VFI) with the medical history of Melli bank workers working in Tehran and Kurdistan privences. Methods: The research is a descriptive-analytical cross-sectional study that was conducted on 444 clerks of Melli Bank branches in Iran (76% male and 24% female with a mean age of 42.3). A demographic questionnaire, the medical history checklist, and the Persian version of VHI and VFI were used to collect data. Results: The voice handicap index had a significant relationship with a history of neurological (P=0.030) and head and neck (P=0.048) disorders, speech and language disorders (P=0.001), and reflux (P=0.041). Regarding vocal fatigue index, the total score had a significant relationship with head and neck (P=0.006) and speech and language disorders (P&lt;0.001); the first factor with diseases of the head and neck (P=0.018), pharynx and larynx (P=0.005) and speech and language disorders (P=0.001), the second factor with neurological (P=0.020), head and neck (P=0.006), and speech and language disorders (P&lt;0.001), and allergies (P=0.032), and finally, the third factor with neurological (0.044), pharynx and larynx (P=0.031), speech and language disorders (P=0.044), and reflux (P=0.021). Conclusion: Regardless of the respiratory system, suffering from diseases of the speech and language system can have a significant effect on the scores of the VHI and VFI indices. Meanwhile, the history of speech and language problems and head and neck disorders affect the total score of most factors of the VFI.

Postures of the Head, Upper, and Lower Neck in Forward Head Posture: Static and Quasi-static Analyses

Background: Abnormal head and neck postures play a significant role in developing cervical spine dysfunction. Forward head posture (FHP) is one of the most common findings in individuals who experience head and neck disorders. Objectives: This study used a photographic method to analyze the head, upper neck, and lower neck postures in forward head posture in both static and quasi-static states. Since timely diagnosis and appropriate treatment are important in preventing further complications of this kinematic chain disorder, the postural variables of the head and neck were evaluated by focusing on their separate parts in both static and quasi-static states. Methods: This observational-analytical case-control study included 175 individuals with no history of neck pain in the past 6 months, 138 with FHP, and 37 with non-FHP. The postural angles, including the upper cervical, lower cervical, craniovertebral, head posture, and head tilt angles, were measured through photography in both the static state (with the head and neck in a neutral position) and the quasi-static state (while moving the head and neck in the sagittal plane) in a sitting position. The measurements were taken in two groups (FHP and non-FHP). Results: In a static state, the upper cervical angle was higher in the FHP group than in the non-FHP group. The lower cervical measurements were higher in the non-FHP group than in the FHP group. In the quasi-static state, significant differences existed in the changes of the upper cervical, lower cervical, craniovertebral, head postural, and head tilt angles between the two groups (P-value &lt; 0.05). Conclusions: During full flexion to full extension of the neck, subjects with FHP exhibited reduced mobility in the cervical spine, particularly in the lower cervical region. Additionally, the position of the head relative to the neck remained unchanged in this group.