Use Of Protection Devices Research Articles

Are workers from waste sorting industry really protected by wearing Filtering Respiratory Protective Devices? The gap between the myth and reality

One of the solutions for decreasing the workers' exposure to bioburden is the use of Filtering Respiratory Protective Devices (FRPD). As such it is important to determine whether these devices are fulfilling their protective role. This is the basis of the current study, aimed at characterizing bioburden retained by 120 FRPD (both in interior layers and in exhalation valves) through culture based-methods and molecular tools and also via analysis of antifungal resistance and mycotoxins profile. Our results show that Gram – Bacteria are present at a higher prevalence than total bacteria in both matrixes. Regarding fungal identification, Chrysonilia sitophila presented the highest prevalence on interior layers (55.1% on malt extract agar (MEA) supplemented with chloramphenicol (0.05%); 59.6% on dichloran-glycerol agar (DG18)), whereas on exhalation valves Aspergillus sp. presented the highest prevalence on MEA (6.8%) and C. sitophila on DG18 (36.3%). Among Aspergillus genera, section Fumigati was the one with the highest prevalence in both matrices. Aspergillus sp. was the most prevalent on exhalation valves (75.0% ITRA) in the screening of azole resistance. Fumigati section was the most abundant Aspergillus sp. detected on the interior layers (33.33%, 40 samples out of 120) and on the exhalation valves (1.66%, 2 samples out of 120). The interior layers and exhalation valves from workers with more waste contact showed an increased exposure to bioburden. This study showed that FRPD can have high levels of bioburden, toxigenic fungal strains and Aspergillus sections with reduced susceptibility to the tested azoles and can be used as a passive sampling method since it mimics the results obtained by active methods in previous studies. The gathered information will be useful to prioritize multiple interventions on workers’ education or even on FRPD replacement frequency.

Laser atherectomy and drug‐coated balloons for the treatment of femoropopliteal in‐stent restenosis: 2‐Year outcomes

Femoropopliteal (FP) artery is one of the most anatomically challenging areas for sustained stent patency. The incidence of FP in-stent restenosis (ISR) is estimated at 50% at 24 months. Prior studies have shown that lesion debulking with laser atherectomy (LA) combined with drug coated balloon (DCB) have superior outcomes compared to LA + balloon angioplasty (BA) ISR, but there have not been studies evaluating 2-year outcomes. This was a dual-center retrospective cohort study that compared patients with FP-ISR treated with LA + DCB versus LA + BA. Cox regression analysis was used to examine 2-year outcomes of target lesion revascularization (TLR) and the composite outcome of TLR or restenosis. Multivariable analysis was performed for clinical and statistically significant (in the univariate analysis) variables. One hundred and seventeen consecutive patients with Tosaka II (n = 32) and III (n = 85) ISR were analyzed. Sixty-six patients were treated with LA + DCB and 51 with LA + BA. The LA + DCB group had more lesions with moderate to severe calcification (58% vs. 13%; p < .0001). The LA + DCB group was more likely to be treated with the use of embolic protection devices (64% vs. 23%, p < .001) and cutting balloons (61% vs. 6%, p < .001). Bail-out stenting rates were lower in the LA + DCB group (32% vs. 57%, p = .008). LA + DCB was superior (HR: 0.57; 95% CI: 0.34-0.9, p = .027) for the composite outcome of 2-year TLR or restenosis. The 12-month KM estimates for freedom from TLR or restenosis were 66% in the LA + DCB group versus 46% in the LA + BA group. The 24-month KM estimates were 45% in the LA + DCB group versus 24% in the LA + BA group. The combination of DCB + LA was associated with decreased rates of bail-out stenting and improved 2-year TLR or restenosis rates. Randomized clinical trials examining the DCB + LA combination for FP-ISR are needed.

Determinants of pesticide exposure among workers in floriculture industry in rural Maharashtra

Background: Pesticides are extensively used in floriculture where workers are mostly unskilled and may not have appropriate knowledge about safety. Acute accidents during spraying are reported, chronic exposure goes unnoticed. There are not many Indian studies regarding health risks and safety practices among floriculture workers in India. Hence this study to assess pesticide exposure, to find their determinants and suggest appropriate preventive measures.Methods: Study was cross sectional in Floriculture Park, Talegaon (D), Pune, Maharashtra, India using cluster sampling from February 2018 to July 2019. Prevalence of morbidities being 63% sample size was calculated as 111 (allowable error 15%). Socio-demographic, work and health related variables were recorded using a pretested structured questionnaire. Clinical examination and laboratory investigations were done by medical experts.Results: A total of 118 workers participated. Only half (51.2%) were using personal protective devices. None were following reentry guidelines. 13.3% males and 4.1% females had low serum cholinesterase level which is a biomarker of pesticide exposure. Sprayers had significantly high risk of low serum cholinesterase levels (OR=3.31) as compared to others. With exposed subjects which included both sprayers as well as polyhouse workers the association increased with OR=4.27. However association was not significant when working in polyhouse alone was considered as a risk factor (OR=1.256).Conclusions: Presence of exposure was the only factor that had a statistically significant association with low Serum Cholinesterase levels. Safe occupational practices like use of personal protective devices, rotation of exposed workers, monitoring of serum cholinesterase levels and health education of workers should be undertaken.

Outcomes Following Percutaneous Coronary Intervention in Saphenous Vein Grafts With and Without Embolic Protection Devices

ObjectivesThe aim of this study was to describe the early (inpatient and 30-day) and late (1-year) outcomes of percutaneous coronary intervention (PCI) in saphenous vein grafts (SVGs), with and without the use of embolic protection devices (EPD), in a large, contemporary, unselected national cohort from the database of the British Cardiovascular Intervention Society. BackgroundThere are limited, and discrepant, data on the clinical benefits of the adjunctive use of EPDs during PCI to SVGs in the contemporary era. MethodsA longitudinal cohort of patients (2007 to 2014, n = 20,642) who underwent PCI to SVGs in the British Cardiovascular Intervention Society database was formed. Clinical, demographic, procedural, and outcome data were analyzed by dividing into 2 groups: no EPD (PCI to SVGs without EPDs, n = 17,730) and EPD (PCI to SVGs with EPDs, n = 2,912). ResultsPatients in the EPD group were older, had more comorbidities, and had a higher prevalence of moderate to severe left ventricular systolic dysfunction. Mortality was lower in the EPD group during hospital admission (0.70% vs. 1.29%; p = 0.008) and at 30 days (1.44% vs. 2.01%; p = 0.04) but similar at 1 year (6.22% vs. 6.01%; p = 0.67). Following multivariate analyses, no significant difference in mortality was observed during index admission (odds ratio [OR]: 0.71; 95% confidence interval [CI]: 0.42 to 1.19; p = 0.19), at 30 days (OR: 0.87; 95% CI: 0.60 to 1.25; p = 0.45), and at 1 year (OR: 0.92; 95% CI: 0.77 to 1.11; p = 0.41), along with similar rates of in-hospital major adverse cardiovascular events (OR: 1.16; 95% CI: 0.83 to 1.62; p = 0.39) and stroke (OR: 0.68; 95% CI: 0.20 to 2.35; p = 0.54). In propensity score–matched analyses, lower inpatient mortality was observed in the EPD group (OR: 0.46; 95% CI: 0.13 to 0.80; p = 0.002), although the adjusted risk for the periprocedural no-reflow or slow-flow phenomenon was higher in patients in whom EPDs were used (OR: 2.16; 95% CI: 1.71 to 2.73; p < 0.001). ConclusionsIn this contemporary cohort, EPDs were used more commonly in higher risk patients but were associated with similar clinical outcomes in multivariate analyses. Lower inpatient mortality was observed in the EPD group in univariate and propensity score–matched analyses.

The combined use of proximal and distal protection devices uring carotid stenting: A case report

Despite the development of modern medical technologies, cerebrovascular disease remains a major health and social issue. Among all the cases of ischemic stroke, approximately 20% are attributable to stenotic lesions in the carotid artery. The main drawback of carotid stenting is the risk of embolic complications during the procedure. To resolve this problem, various devices that protect against embolism have been developed. In this clinical case, we describe the ability to minimize the risk of operative stroke through a combined application of the distal and proximal protection systems in carotid stenting.In our patient, a 65-year-old woman, angiography of the carotid arteries revealed an ulcerated atherosclerotic plaque of the right internal carotid artery, with stenosis of the lumen of up to 95%. Considering the high risk of distal embolism, the Mo MaUltra (Italy) proximal protection system was used. When evaluating the installation of the Mo MaUltra system, the preserved blood flow through the superior thyroid artery and, therefore, the antegrade blood flow in the internal carotid artery was revealed. Considering the identified risk and the anatomy of the plaque surface, we decided on the additional use of the distal SpiderFX (USA) protection device.The combined use of proximal protection system and distal protective device for carotid stenting is technically possible and may reduce the risk of embolic complications.Received 23 January 2019. Revised 18 March 2019. Published 23 April 2019.Informed consent: The patient’s informed consent to use the records for medical purposes is obtained.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.

Share of the Lightning Current on Electric Installation Lines Within a Building Considering Equipotential Bonding at Roof Level

The main objective of this paper is to evaluate the maximum share of the lightning current, which enters a building on electric installation lines. The conductors of the power circuit are equipotentially bonded to the air-termination or down-conductor system at roof level. For live conductors, the lightning equipotential bonding is realized by the use of surge protective devices (SPD), which have to withstand the threat of the share of the lightning current. The most important parameter is the maximum transferred charge, which was calculated by the use of the computer code CONCEPT II. The maximum expected charge is about 0.6 C for buildings with metal facades. If the building is additionally equipped with a metal roof, or, if the roof, the ceilings and the pillars/walls consist of reinforced concrete, the maximum expected charge is 0.1 C. For buildings without shielding elements (metal roof, metal facade, reinforced concrete), the charge is much higher, in the range of several coulombs. The values only apply to spark-type SPD and to building up to heights of about 15 m using copper or aluminum for the air-termination and down-conductor system. The transferred charge is significantly higher, if the air-termination and down-conductor system consists of stainless steel.

TCT-24 Clinical Predictors for Procedural Stroke and Implications for Embolic Protection Device During TAVR: Results From the Multicenter TASK (Transcatheter Aortic valve implantation in-hoSpital stroKe) Study

Routine use of embolic protection devices (EPDs) for stroke prevention during transcatheter aortic valve replacement (TAVR) is controversial. Identifying patients at high risk for periprocedural cerebrovascular events (CVEs) may facilitate effective patient selection for EPDs and stroke prevention.

Prevalence of dentofacial injuries among combat sports practitioners: A systematic review and meta-analysis.

Combat sports might result in injuries to the face and teeth. However, it is unclear how often they occur and which sports presents the highest rates. The aim of this study was to investigate the prevalence of dentofacial injuries in combat sports participants. A systematic review was performed. Six main electronic databases and three grey literature databases were searched. Studies were blindly selected by two reviewers based on pre-defined eligibility criteria. Studies that evaluated the prevalence of dentofacial injuries (teeth, alveolar bone, jaw, lips, and/or cheekbones) among combat sports participants were considered eligible. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The software r statistics version was used to perform all meta-analyses. Cumulative evidence of the included articles was evaluated using GRADE criteria (Grading of Recommendations Assessment, Development and Evaluation). From 1104 articles found on all databases, 27 were finally included. Eighteen studies were judged at low, seven at moderate, and two at high risk of bias. The following sports were investigated: boxing, capoeira, fencing, jiu-jitsu, judo, karate, kendo, kickboxing, kung fu, muay thai, sumo, taekwondo, wrestling, and wushu. Results from the meta-analysis suggested a dental pooled prevalence of 25.2% (12.3%-40.8%, i2 =100%) and dentofacial pooled prevalence of 30.3 (18.1%-44.1%, i2 =100%). Considering the sports' categories individually, jiu-jitsu had the highest pooled prevalence of dentofacial injuries (52.9% [37.9%-67.8%, i2 =92%]), while judo was the sport with the lowest pooled prevalence (25.0% [7.6%-48.2%, i2 =98%]). Among Panamerican sports, boxing had the highest prevalence of dental injuries (73.7% [58.7%-86.3%, i2 =0%]). For dentofacial injuries, the GRADE criteria were considered low. Overall pooled prevalence of dentofacial injuries in combat sports was approximately 30%. Raising awareness regarding the frequency of these injuries might encourage the use of protective devices and reduce complications related to these incidents.

Utilization of personal protective equipment among sawmill workers in Ilorin metropolis, north-central Nigeria

Objective: Wood dust becomes a potential health problem when wood particles from processes such as sanding, cutting, drilling, sawing or turning to sap wood becomes airborne. Occupational exposure in sawmills has suggested that workers in sawmills are at risk of developing allergenic disorders, cancers and lung disease. This study assessed the utilization of personal protective equipment among sawmill workers in Ilorin metropolis. Methods: The study was descriptive cross-sectional by design assessing utilization of personal protective devices among sawmill workers in Ilorin metropolis involving 250 sawmill workers that were registered under the Ilorin Plank Sellers' Association. Data was collected using semi-structured, intervieweradministered questionnaires from the participants. The participants were recruited using multistage sampling technique. Data collected from the questionnaire were analyzed using SPSS 16.0 software package. Results: The majority 144 (57.6%) of the respondents own at least one of the personal protective devices while 134 (53.6%) of the respondents utilized at least one of the personal protective devices. Only 54 (21.6%) and 95 (38.0%) of the respondents possess aprons and hand gloves respectively. The least owned PPEs were earmuffs (10.8%) and safety boots (16.8%). Among the 166 respondents who never use PPE, 86 (74.1%) reported inconveniency as the reason for non-utilization of PPE. Conclusion: There is a need to improve the level of knowledge, availability and use of protective devices among the workers through subsequent sensitization and enlightenment on the need to use PPE. Keywords: Sawmill, Utilization, Personal Protective Equipment, PPE, Workers

Strategies for Minimizing Occupational Radiation Exposure in Cardiac Imaging.

Radiation safety has been at the center of interest of both researchers and healthcare institutions. This review will summarize and shed light on the various techniques adapted to reduce staff exposure to ionizing radiation (IR) in the field of cardiac imaging. In the last years, with the advance of awareness and the development of new technologies, there have been several tools and techniques adapted. The breakthrough of several technologies to lower radiation dose and shorten the duration of diagnostic tests associated with IR, the use of protection devices by staff members, and mostly the awareness of exposure to IR are the hallmark of these advances. Using all these measures has led to a significant decrease in staff exposure to IR. Reducing staff exposure to meet the "As Low As Reasonably Achievable" principle is feasible. This review introduces the most important strategies applied in cardiac imaging.

Safety climate, hearing climate and hearing protection device use among transportation road maintainers

It is important to understand workplace factors including safety climate that influence hearing protection device (HPD) use. We sought to investigate the association between HPD use, safety climate, and hearing climate, a new measure specific to hearing. A survey was developed and distributed among transportation "maintainers" who perform road maintenance and repair. A new hearing climate measure was designed by adapting a safety climate measure. HPD use was assessed by asking workers how often they wear HPD while in noise. The differences in safety climate and hearing climate were compared by the frequency of HPD use using analysis of variance. Among 166 maintainers, 54% reported always or almost always wearing HPD while noise exposed. High-frequency HPD users reported a statistically significant higher safety climate (P = 0.004) and hearing climate (P = 0.003). Hearing climate predicts the frequency of HPD use and may be a useful measure when assessing and improving hearing conservation programs.

Impact of a Two-Filter Cerebral Embolic Protection Device on the Complexity and Risk of Transcatheter Aortic Valve Replacement.

There is a growing use of cerebral protection devices in patients undergoing transcatheter aortic valve replacement (TAVR). We aimed to analyze if the use of these devices itself has an impact on the complexity and the risk of TAVR. Between February 2016 and July 2017, 391 patients underwent transfemoral TAVR with Medtronic CoreValve Evolut R (n = 196) or Edwards Sapien 3 (n = 195). In 39 patients, the Claret Sentinel™ embolic protection device (CS-EPD) was used. Prospectively collected data were retrospectively analyzed, comparing fluoroscopy/operation time, amount of contrast used, vascular events, and postprocedural renal function in TAVR patients with (n = 39) and without (n = 352) CS-EPD. The CS-EPD was placed through the right radial (n = 35) or brachial (n = 4) artery. Procedural success rate defined as correct deployment and retraction of both filters was 94.9%. No device-related vascular complications occurred. TAVR patients with CS-EPD showed a significantly higher total operation time, total fluoroscopy time, and amount of used contrast (85.4 ± 39.3 vs. 64 ± 29.8 minutes, p = 0.002; 20.7 ± 9.3 vs. 13.7 ± 7 minutes, p ≤ 0.001; 133.7 ± 42.6 vs. 109.7 ± 44.5 mL, p = 0.001). Comparing the initial third of patients receiving a CS-EPD with the last third of CS-EPD cases, procedural time had decreased significantly (102.5 ± 34.9 vs. 67 ± 11.9; p = 0.002). There were no differences in postprocedural renal failure (p = 0.80). Our data add evidence that the application of the CS-EPD is not associated with an additional risk for the patient. Although procedural time and amount of contrast are still higher when using the CS-EPD, there were no device-related complications or increased incidence of renal failure.

Contemporary Use of Embolic Protection Devices During Saphenous Vein Graft Intervention.

Guidelines recommend use of embolic protection devices during percutaneous coronary intervention of saphenous vein grafts, but the use of these devices in contemporary practice is unclear. We thus sought to evaluate the patient characteristics and clinical outcomes associated with embolic protection device use during contemporary saphenous vein graft percutaneous coronary intervention. We identified patients undergoing isolated saphenous vein graft percutaneous coronary intervention in the Veterans Affairs Healthcare System from January 2008 to June 2017. Patient and procedural characteristics associated with embolic protection device use were assessed, as well as unmeasured site variation. A propensity-matched cohort was constructed to compare outcomes at 30 days, including unsuccessful intervention, periprocedural myocardial infarction, and death. We identified 7266 vein graft interventions, and embolic protection was used in 37.9% of cases, with a significant decline over time ( P=0.001) that was most pronounced from 2014 to 2017 ( P<0.001). There was significant institutional variation in the use of embolic protection, with a 15.50 (95% credible interval, 9.21-29.71)-fold difference in odds of device use by changing facilities independent of patient or procedural factors. Use of embolic protection was associated with reduced risk of unsuccessful intervention (odds ratio, 0.27; 95% credible interval, 0.17-0.42) and 30-day mortality (odds ratio, 0.56; 95% credible interval, 0.36-0.87). Use of embolic protection is decreasing with time and occurs in less than half of vein graft interventions. There is significant site variation in the use of embolic protection independent of patient characteristics, suggesting opportunities for the development of uniform practices to improve outcomes among those undergoing saphenous vein graft percutaneous coronary intervention.

An epidemiological study to evaluate morbidity patterns among wood workers belonging to unorganized sector

Background: Wood workers are predisposed to many occupational diseases. Studying work place environment and its association with the morbidities would provide practical insights to promote the health and prevent disease in wood workers. Present study intends to study the epidemiological determinants of health and morbidity in wood workers.Methods: Quantitative method of research is used. All One hundred and five wood workers in the study area were recruited after taking informed consent. A semi-structured, pre-validated, questionnaire consisting of questions on sociodemographic profile, working pattern, morbidities experienced and working environment was prepared. Data was collected using one to one interview at their workplace. Environmental factors like iIllumination (In LUX) and noise level (in db) at the work place was measured using a Lux meter and sound level meter respectively. Association between different variables were analysed using Chi-square test or t-test wherever applicable.Results: Participants were all male belonging to economically productive age group. They were predominantly Muslims, belonging to lower socioeconomic status. Morbidities experienced by the wood workers were musculoskeletal pain (52%), skin problems (57%), eye problems (57.14%) and ear problems (32.38%). Inadequate illumination (&lt;100 LUX) and noise levels more than 90 db were significantly associated with increased accidents and ear morbidities respectively.Conclusions: Poor working environment and non-compliance with the working standards prescribed by ILO (Indian Labour Organisation) are associated with morbidities among the workers. Environmental modification, use of protective devices, availability of basic minimum facilities for working and continuous monitoring of the workplaces by competent authority would help in decreasing the prevalence of morbidities among woodworkers.

Highlights From the Circulation Family of Journals.

Highlights From the Circulation Family of Journals.

Recent advances in the treatment of carotid artery disease.

Transfemoral carotid stenting has struggled to become a suitable alternative to carotid endarterectomy for the treatment of carotid disease because of higher perioperative stroke risks, even with use of embolic protection devices. To reduce the perioperative stroke rates associated with carotid stenting, several advancements in stent design, embolic protection systems, and technical approaches have been developed. Transcarotid artery revascularization (TCAR) was also recently introduced as a novel carotid artery stenting option which circumvents several of the high embolic-risk maneuvers found in transfemoral carotid stenting and employs a flow reversal system that provides continuous embolic protection throughout the procedure. Early results from this technique have shown low stroke/death rates comparable to carotid endarterectomy while maintaining the minimally invasive benefits of carotid stenting. TCAR has a strong potential to become the preferred method of carotid stenting in the near future and may challenge carotid endarterectomy as the preferred carotid artery revascularization method.

Assessment of the Exposure of Turkey Farmers to Antimicrobial Resistance Associated with Working Practices.

The objective of the present study was the identification of farming practices in the production of turkeys for human consumption, and their ranking in terms of the occupational probability of exposure to antimicrobial resistant (AMR) bacteria, for farm workers. We gathered evidence and data from scientific literature, on risk factors for AMR in farmers, and on the prevalence of those hazards across farming phases. We administered semi-structured interviews to public and private veterinarians in Northern Italy, to obtain detailed information on turkey farming phases, and on working practices. Data were then integrated into a semi-quantitative Failure Modes and Effect Analysis (FMEA). Those working practices, which are characterized by direct contact with numerous animals, and which are carried out frequently, with rare use of personal protection devices resulted as associated with the greatest probability of exposure to AMR. For methicillin resistant Staphylococcus aureus (MRSA), these included vaccination and administration of any individual therapy, and removal and milling of litter, given the exposure of farmers to high dust level. Indeed, levels of occupational exposure to MRSA are enhanced by its transmission routes, which include direct contact with animal, as well as airborne transmission. Level of exposure to extended spectrum beta lactamase (ESBL) is more strictly associated with direct contact and the oral-fecal route. Consequently, exposure to ESBL resulted and associated with the routinely tipping over of poults turned on their back, and with the individual administration of therapies.

Sternal fractures in children: An analysis of the National Trauma Data Bank

PurposeThe purpose of this study was to describe the epidemiology and evaluate the clinical significance of traumatic sternal fractures. MethodsPatients age ≤18 years with sternal fractures in the National Trauma Database research datasets from 2007-2014 were identified. Patient demographics, injuries, procedures, and outcomes were analyzed using descriptive statistics and logistic regression. ResultsThree thousand one hundred sixty patients with sternal fracture were identified. Ninety percent of injuries occurred in patients between 12 and 18 years old. Median injury severity score (ISS) was 17 [9,29]. Exploratory thoracotomy was performed in 1%. Thirty-nine percent were admitted to the intensive care unit (ICU). On multivariate regression, predictors of ICU stay >1 day were increasing ISS, lack of the use of protective devices, decreasing Glasgow Coma Score (GCS), tachycardia, and pulmonary contusion. Median hospital length of stay was 4 [2, 9] days. In-hospital mortality was 8%. Predictors of mortality were lower GCS, increasing ISS, decreasing oxygen saturation, hypotension, and cardiac arrest. Use of protective devices and seat belts did not affect mortality. ConclusionSternal fractures in patients increase in incidence with age, and poor outcomes are impacted by associated injuries and complications. The presence of a sternal fracture should trigger a careful diagnostic evaluation. Level of EvidenceIII Study TypeTreatment Study

Drug-Eluting Stents Versus Bare-Metal Stents for Saphenous Vein Grafts Lesions

A best-evidence topic was written according to a structured protocol addressing the question “For patients with saphenous vein graft (SVG) lesions requiring percutaneous coronary intervention, do long-term clinical outcomes differ between drug-eluting stents (DES) or bare-metal stents (BMS)?” Altogether, 1,466 papers were found using the reported search, of which eight represented the best evidence to answer the clinical question. Randomised data are conflicting. “DIVA,” a major recent neutral randomised trial, has superior methodology in terms of sample size, blinding, allocation concealment, angiographic follow-up, and use of embolic protection devices. Four earlier randomised trials showed significant benefit with DES, driven by a reduction in target vessel revascularisation (TVR); however, reductions in myocardial infarction (MI) and stent thrombosis rates were also demonstrated in DES groups. The validity of these earlier trials is hampered by small sample size, lack of blinding, and inconsistent use of embolic protection devices. Both observational trials included favoured DES. Outcome measures at follow-up for DES and BMS groups were 2%–55% versus 5.6%–77% for major adverse cardiac events, 4.9%–37% versus 11%–49% for TVR, 2%–17% versus 6%–46% for MI. Mortality did not differ between groups. We conclude that in the management of SVG lesions, DES should continue to be standard of care as the weight of evidence points toward benefit, in particular rates of target lesion or target-vessel revascularisation. In light of the recent neutral trial, we postulate that with modern techniques and improved patient selection, BMS may be non-inferior to DES; however, further research is needed before changing routine practice.

Knowledge and Perception of Farmers Regarding Pesticide Usage in a Rural Farming Village, Southern India.

Background:Farmers are extensively using pesticides for pest control in agriculture. Their precarious handling practices may lead to higher exposure resulting in adverse health effects.Aim:Current study was aimed to evaluate the knowledge, attitude and practices regarding pesticide usage and its toxic effects by farmers.Settings and Design:Cross sectional,Study Setting:Rural village in south Karnataka.Materials and Methods:Sample size: 171 farmers, Data collection: face to face standardized validated questionnaire.Statistical Analysis:Chi-square test.Results:A total of 118 males and 53 females participated in this study with median age of 40 years. About 61% of the farmers knew the harmful effects of pesticides. However, 22% of them were mixing the pesticides using their bare hands and 26% were not wearing any protective clothing during spraying pesticides. Around 67% were carelessly disposing the leftover pesticides in the open fields. Skin problems and neurological system disturbances were the most common pesticide related health symptoms. Equipment washing practices (P < 0.05) and protective clothing (P < 0.03) were significant predictors of health related problems. Significant associations were found between the occurrence of headache and equipment washing practices (P < 0.03), storage of pesticide remains (P < 0.02) and protective clothing (P < 0.01).Conclusion:These findings showed that knowledge level is adequate among farmers but this did not reflect in their practice. There is a need for continuous pesticide safety education along with training to the farmers regarding use of personal protective devices, personal hygiene and sanitation practices during and after application of pesticides.