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  1. The Use of Methylphenidate for Physical and Psychological Symptoms in Cancer Patients: A Review
    Andrew BN, Guan NC, Jaafar NRN
    Curr Drug Targets, 2018;19(8):877-887.
    PMID: 28322161 DOI: 10.2174/1389450118666170317162603
    BACKGROUND: One of the goals of cancer treatment is symptoms management especially at the end stage. The common symptoms in cancer include pain, fatigue, depression and cognitive dysfunction. The available treatment options for symptom management are limited. Methylphenidate, a psychostimulant, may be of benefit for these patients. In this report, we review the use of methylphenidate for symptoms control in cancer patients.

    METHOD: Electronic literature search on PubMed was conducted using the following keywords: methylphenidate, cancer, carcinoma, oncology, oncological and tumour. We identified forty two relevant studies and publications on the use of methylphenidate in cancer patients to be included in this review.

    RESULTS: Methylphenidate was found to have some evidence in reducing opioid-induced sedation, improving cognitive symptoms and reduction of fatigue in cancer patients. Nevertheless, the results were inconsistent due to variations in the study populations, study design and outcome measures, among others. There was minimal evidence on its use in treating depression. Otherwise, methylphenidate was generally well-tolerated by patients.

    CONCLUSION: This review potentially supports the use of methylphenidate for opioid-induced sedation, cognitive decline and fatigue in cancer patients. Further placebo-controlled trials would help in strengthening the evidence for this treatment.

    Matched MeSH terms: Cancer Pain/drug therapy
  2. Association between painful physical symptoms and clinical outcomes in East Asian patients with major depressive disorder: a 3-month prospective observational study
    Ang QQ, Wing YK, He Y, Sulaiman AH, Chiu NY, Shen YC, et al.
    Int J Clin Pract, 2009 Jul;63(7):1041-9.
    PMID: 19570122 DOI: 10.1111/j.1742-1241.2009.02107.x
    Reports from non-Asian populations indicate that painful physical symptoms (PPS) are associated with poorer clinical and functional outcomes in major depressive disorder (MDD). The purpose of this study is to report comparative changes in disease severity, treatment patterns and quality of life observed in East Asian patients with MDD, with and without PPS, as assessed prospectively over a 3-month observation period.
    Matched MeSH terms: Pain/ethnology; Pain/psychology*; Pain Measurement
  3. Fulltext Contact lens related Elizabethkingia meningoseptica keratitis-a first Southeast ASEAN case report & literature review
    Ang, Wen-Jeat, Embong Zunaina, Raja Omar Raja Norliza, Abdul Jalil Fadzillah
    Journal of Biomedical and Clinical Sciences, 2017;2(1):1-4.
    MyJurnal
    We describe the first clinical case of contact lens related corneal ulcer caused by Elizabethkingia meningosepticaregistered in Southeast Asia. A 20-year-old female student who wasa regular soft contact lens wearer, presented with pain, photophobia and blurring of vision of the right eye for 3 days. On slit lamp examination, there was a small paracentral anterior stromal infiltrate with an overlying epithelial defect. Microbiological cultures from corneal scrapings, contact lens and its casing were positive for E.meningoseptica. Due to high likelihood of contact lens contamination causing keratitis, topical fortified gentamicin0.9% and ceftazidime 5% were administered empirically. Topical vancomycin 5% was later added tailoring to the culture and sensitivity of the organism. After 8 weeks of treatment, the keratitis subsided and corneal epithelial defect completely healed with residual corneal opacity. Even though uncommon, contact lens related E.meningosepticakeratitis can occur in healthy immunocompetent individuals with no ocular comorbidities.
    Matched MeSH terms: Pain
  4. Fulltext More than meets the naked eye: an unusual psoriatic arthritis mimicry and the important role of dermoscopic examination
    Anne LJ, Rahim MJC, Ghazali WSW, Ahmed WAW, Isa SAM
    BMC Rheumatol, 2021 Apr 12;5(1):10.
    PMID: 33840385 DOI: 10.1186/s41927-021-00182-7
    BACKGROUND: Psoriatic arthritis (PsA) can manifest in various forms. This includes mimicry of other diseases. We describe an unusual mimicry of PsA.

    CASE PRESENTATION: We report a case of a middle-aged lady who presented with severe pain and morning stiffness over the small joints of the left hand for 3 months and painless deformity of the affected joints 1 year before. She was under treatment for pruritic rash over her ankles and knees for the past 1 year as well. Physical examination revealed a fixed flexion deformity, swelling and tenderness of the left ring and little fingers' distal interphalangeal (DIP) joints. Left hand radiograph showed sclerotic joint margin, narrowed joint space and marginal osteophytes of the affected DIP joints. Dermoscopic examination showed red- violaceous, flat-topped papules and plaques with minimal scales on both ankles; hyperpigmented scaly plaques over both knees and vertical fingernail ridges. Serum autoimmune screening and inflammatory markers were unremarkable. Left ankle skin biopsy showed features consistent of psoriasis. PsA was diagnosed. Weekly titrated oral methotrexate and topical steroid were started. The patient showed significant improvement after 1 month of treatment.

    CONCLUSION: PsA is a great mimicker. Dermoscopy is an accessible and valuable tool to assess skin lesions in greater detail. Clinicians should be aware of coexisting diseases or misdiagnosis when patients do not respond to treatment.

    Matched MeSH terms: Pain
  5. Fulltext Kajian sakit belakang dan faktor-faktor yang mempengaruhinya di kalangan pekerja pemasangan industri automotif
    Annuar, I., Nurulakhmar, A.S., Mazruras, S., Azhar, A.H.
    Malaysian Journal of Community Health, 2010;16(2):10-16.
    MyJurnal
    Introduction: Back pain associated with sense of pain and less comfort in back part of the body especially at the lower back area. Back pain is an occupational health problem with significant impact to productivity of workers.
    Methodology: A cross sectional study was conducted to study the prevalence of back pain towards individual, physical and psychosocial factors associated among body shop’s operators at national Automotive Manufacturers.
    Result: A total of 32 operators were involved in this study. Nordic Musculoskeletal questionnaire has been used in this study and body position assessment was done by using Ovako Working Posture Analyzing System (OWAS) method. Study showed the prevalence of back pain among operators throughout their work and in the last 12 months was 93.8% and 87.5% respectively. There are significant association (p0.05) between prevalence of back pain with another individual, physical and psychosocial factor.
    Conclusion: This study shows that back pain prevalence were influenced by types of activity and body posture during working at assembling division among workers. Attention should be given to ergonomics factors to prevent back pain incident among automotive industry assembly workers.
    Matched MeSH terms: Back Pain
  6. Fulltext Occupational risk factors for carpal tunnel syndrome among nurses in medical
    Anuar Ithnin, Kong, Dinnee, Venkataraman, Saraswathy
    Int J Public Health Res, 2012;2(2):137-143.
    MyJurnal
    Carpal tunnel syndrome (CTS) is a hand disorder which indicates the presence of symptoms such as pain, numbness, and muscle weakness among the patient. CTS is an occupational related disorder which can occur in any profession. However, it can be prevented and managed. The aims of the research were to determine the prevalence of acquiring CTS among nurses who worked in the wards and occupational risk factors involving the upper limbs during nursing tasks performance. The specific aims were to determine the relationship between the prevalence of acquiring CTS and individual factors (age, gender, race, educational level, duration of work and medical history), relationship between the prevalence of acquiring CTS and occupational risk factors in nursing tasks. Nurses profession was chosen as they are performing multitask involving upper limbs especially the wrist joints. Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) was used to determine the level of severity in CTS. Occupational risk factors were assessed by using the Rapid Upper Limb Assessment (RULA). This research was a cross sectional mode which was carried out at a government university medical centre from November through December 2010. Eighty nurses were involved in the research. The respondents were required to fill in the socio-demographic information sheet. Those having CTS were required to fill in the BCTQ. Assessments were performed by observing of the job activity through RULA. The results showed that the prevalence for nurses acquiring CTS is 7.5%. The RULA assessment also indicated that the risk factor was in the highest level with a score of 7. No relationship was shown between the prevalence of CTS and race, gender, educational level and medical history. Significant relationship was indicated by the prevalence of CTS and occupational risk factors. In conclusion, a significant prevalence of CTS related to age of more than 30 years old, Malay races compared to Indian, working experience of more than 10 years and respondents with right hand dominant. Occupational risk factors also indicated among the active nurses. Therefore, it is important for us to modify the work environment, work flow, work methodology and ergonomic factors in order to prevent the nurses from acquiring CTS. Furthermore, education about the condition of CTS should be implemented and reinforced especially among the higher risk nurses.
    Matched MeSH terms: Pain
  7. Fulltext Plunging epidermoid cyst of the floor of the mouth mimicking a ranula
    Anusha Balasubramanian, Irfan Mohamad, Purushotman Ramasamy, Avatar Singh Mohan Singh, Lina Ling Chooi, Ferdinand Jesudian Kovilpillai
    Malaysian Journal of Medicine and Health Sciences, 2016;12(1):67-69.
    MyJurnal
    Plunging epidermoid cyst of the floor of mouth is indeed an uncommon entity. A 34-year old Malay
    gentleman had presented to our centre with a floor of mouth lesion that extended into the submental
    region. Clinical findings and imaging studies pointed towards the impression of a plunging ranula.
    Histopathological examination of a completely excised mass via intraoral approach, confirmed the
    diagnosis of an epidermoid cyst. He was well on follow up with no subsequent recurrence. We discuss
    the nature of epidermoid cyst and its surgical management.
    Matched MeSH terms: Pain Management
  8. Anomalous aortic origin of a coronary artery (AAOCA): A case report
    Anwar A, Chan KMJ, Awang Y, Ping DC
    Med J Malaysia, 2019 Oct;74(5):436-438.
    PMID: 31649223
    Anomalous Aortic Origin of a Coronary Artery (AAOCA) is a rare anomaly of the coronary artery with a considerable risk of sudden cardiac death due to ischaemia of the heart. Symptoms may include chest pain on exertion, breathlessness or dizziness. We encountered a case of a 46- year-old female who complained of exertional chest pain with a positive-stress test and subsequently diagnosed with AAOCA through CT angiography (CTA). She successfully underwent a coronary artery bypass graft (CABG) surgery using a saphenous vein graft with uneventful recovery. Right internal mammary artery (RIMA) was not used as it was flimsy and the flow was very poor.
    Matched MeSH terms: Chest Pain
  9. Fulltext A child with coated tonsils
    Appannan VR, Mohamad I, Ramli RR, Johan KB
    Malays Fam Physician, 2018;13(1):55-56.
    PMID: 29796214 MyJurnal
    A 5-year-old girl presented with a history of
    fever for four days associated with odynophagia.
    She was treated with amoxycillin prescribed
    by a general practitioner for 3 days prior to
    presentation. However, the symptoms were
    worsening and associated with drooling of
    saliva and poor oral intake. There was history
    of recurrent acute tonsillitis in the past two
    years, with 5 to 6 episodes per year. The child
    had completed regular immunizations up to her
    current age. There was no similar presentation
    amongst family members and friends. (Copied from article).
    Matched MeSH terms: Pain
  10. Fulltext The levels of depression, anxiety, stress on pre and post knee Arthroplasty patients
    Ardilla Hanim Abdul Razak, Ahmad Hafiz Zulkifly, Ramli Musa, Mohd Shukrimi Awang, Goh, Kian Liang
    International Medical Journal Malaysia, 2017;16(11):39-39.
    MyJurnal
    Total knee arthroplasty represents a major advance in the treatment of
    degenerative joint disease. It provides excellent restoration of joint function and pain
    relief. The primary indication for total knee arthroplasty is to relieve pain caused by
    severe arthritis, with or without significant deformity. This study is to assess
    psychological impact pre and post arthroplasty. (Copied from article).
    Matched MeSH terms: Pain
  11. Fulltext Comparison of Core Stabilisation Exercise and Proprioceptive Neuromuscular Facilitation Training on Pain-related and Neuromuscular Response Outcomes for Chronic Low Back Pain: A Randomised Controlled Trial
    Areeudomwong P, Buttagat V
    Malays J Med Sci, 2019 Nov;26(6):77-89.
    PMID: 31908589 DOI: 10.21315/mjms2019.26.6.8
    Background: Existing literature offers little guidance for therapists who provide core stabilisation exercise (CSE) and proprioceptive neuromuscular facilitation (PNF) training to treat chronic low back pain (CLBP). Studies conducting a head-to-head comparison of CSE and PNF training for CLBP are needed.

    Objective: To compare the effects of CSE and PNF training on pain-related outcomes and trunk muscle activity in CLBP patients.

    Methods: Forty-five CLBP patients, ranging from 18 to 50 years of age, were randomly divided and assigned to either a four-week CSE, four-week PNF training, or control group. Pain-related outcomes, including pain intensity, functional disability and patient satisfaction, as well as superficial and deep trunk muscle activity were assessed before and after the four-week intervention, and at a three-month follow-up.

    Results: Compared to the control group, those in the CSE and PNF training groups showed significant improvements in all pain-related outcomes after the four-week intervention and at three-month follow-up (P < 0.01). Following the four-week intervention, both CSE and PNF training groups demonstrated significant improvement in deep trunk muscle activity, including the transversus abdominis (TrA) and superficial fibres of lumbar multifidus (LM), compared to the control group (P < 0.05).

    Conclusion: Four-week CSE and PNF training provided short-term and long-term effects on pain-related outcomes, along with increased deep trunk muscle activity in CLBP patients.

    Matched MeSH terms: Low Back Pain
  12. Beyond the study of pain: the evolving role of the International Association for the Study of Pain in global advocacy
    Arendt Nielsen L, Belton J, Cardosa M
    Pain, 2023 Nov 01;164(11S):S22-S26.
    PMID: 37831956 DOI: 10.1097/j.pain.0000000000003064
    Although founded on the basis of the study of pain, the International Association for the Study of Pain (IASP) has actively advocated for improving pain relief and access to pain management in a variety of ways. The Global Year was launched in 2004 and has continued with a different theme each year, and "Pain Awareness Month" is held every September. The Declaration of Montreal (2010) emphasized that access to pain management is a fundamental human right as a result from the IASP-hosted International Pain Summit. The IASP has continued to publish timely statements related to pain and pain management. The work of IASP on the 11th version of the International Classification of Disease has ensured that chronic pain is recognized as a disease in its own right, and the establishment of the Global Alliance of Partners for Pain Advocacy Task Force recognizes the importance of engaging people with lived experience of pain in accomplishing IASP's mission. The Working Group on Global Advocacy now spearheads IASP's global efforts in capacity building to ensure that pain advocacy activities will continue to grow.
    Matched MeSH terms: Chronic Pain*; Pain Management
  13. Revision of total hip arthroplasty using an anterior cortical window, extensive strut allografts, and an impaction graft: follow-up study
    Arif M, Sivananthan S, Choon DS
    J Orthop Surg (Hong Kong), 2004 Jun;12(1):25-30.
    PMID: 15237118
    To report the outcome of revised total hip arthroplasty procedures involving an anterior cortical window, extensive strut allografts, and an Exeter impaction graft.
    Matched MeSH terms: Pain Measurement
  14. Fulltext Recognizing life-threatening features of dengue in children and health seeking behavior in dengue emergency amongst parents and carers: A cross-sectional study in Gombak district, Malaysia
    Ariffin F, Ramli AS, Naim N, Selamat MI, Syed-Jamal SJ
    Med J Malaysia, 2014 Oct;69(5):210-5.
    PMID: 25638233
    Dengue is life-threatening and the paediatric population is highly susceptible to complications. Deterioration can occur rapidly and ability to recognise early warning signs is crucial. This study aims to determine the knowledge and awareness of parents and carers and to predict their ability in recognising life-threatening symptoms and signs of dengue in children and to assess their health-seeking behaviour in dengue emergency. Methods This is a crosssectional study involving parents and carers of children ≤ 12 years old in schools and kindergartens in the Gombak district. Demographic details, knowledge on life-threatening symptoms and signs of dengue and health-seeking behaviour were collected using a self-administered questionnaire and knowledge scoring was done. The questionnaire was pilot tested with a Cronbach alpha of 0.82. The results were analysed using SPSS version 20.0. Results Total respondents were 866 with 44.8% men and 55.2% women. The mean age was 40.3 years (SD ± 5.7). Knowledge score of dengue life threatening features among respondents were good (30.0%) to average (56.8%). Respondents were able to recognise fever (98.5%), petechial rash (97.1%) and bleeding (65.2%) but were less able to recognise abdominal pain (22.3%) and passing less urine (28.2%) as life threatening dengue features. However, the ability to recognise fever is a poor predictor in recognising life threatening dengue in children compared to all other symptoms which were good predictors. A respondent that recognise stomach pain or neck stiffness were five times more likely to recognise life-threatening dengue. Respondents preferred to bring their children to the clinic (50.8%) or hospital (37.8%) themselves Instead of calling for ambulance. Worryingly, some would give antipyretics (3.6%) or wait for improvements (7.8%). Conclusion Concerted efforts by the schools, healthcare professionals and health authorities are required to educate parents and carers to identify life-threatening features of dengue and to improve their health seeking-behaviour.
    Matched MeSH terms: Abdominal Pain
  15. Fulltext Retained intraspinal bullet: a rare case in a visitor to malaysia - a case report
    Ariffin M, Noreen F, Nor Hamdan Y, Shaharuddin AR, Azmi B
    Malays Orthop J, 2012 Nov;6(3):45-7.
    PMID: 25279057 MyJurnal DOI: 10.5704/MOJ.1207.005
    Firearm injuries to the spine commonly present with acute neurology caused by direct penetration or indirectly from concussive effects of bullet impact on the vertebral column. We report a case of delayed neurologic presentation of retained intra-spinal bullet in a 42 year-old African who had chronic low back pain and sciatica with a past history of gunshot injury to the spine and radiograph revealed a bullet at the L4-5 disc level. Intra-operative exploration showed a fibrous mass around the bullet compressing on the L4 existing nerve root and L5 traversing nerve root. Removal of the retained bullet resulted in a good clinical outcome with complete resolution of symptoms.
    Matched MeSH terms: Low Back Pain
  16. Fulltext Persistent Shoulder Pain in Young Male: Osteosarcoma
    Arinima P, Ishak A
    Korean J Fam Med, 2018 Jul;39(4):266-269.
    PMID: 29972896 DOI: 10.4082/kjfm.17.0117
    A 16-year-old Malay boy presented to Kota Bharu Health Care Centre, Kelantan, with left shoulder pain after sustaining a fall. On further history taking, it was noted that the pain preceded the fall by 1 month. The early changes of osteosarcoma were visible on an X-ray during the initial presentation; however, this was missed by the primary care doctors. Three months later, the patient presented with persistent pain in the left shoulder and was diagnosed with osteosarcoma.
    Matched MeSH terms: Shoulder Pain
  17. Effect of Low-level Laser Therapy on Postoperative Pain after Root Canal Retreatment: A Preliminary Placebo-controlled, Triple-blind, Randomized Clinical Trial
    Arslan H, Doğanay E, Karataş E, Ünlü MA, Ahmed HMA
    J Endod, 2017 Nov;43(11):1765-1769.
    PMID: 28967495 DOI: 10.1016/j.joen.2017.06.028
    INTRODUCTION: Low-level laser therapy (LLLT) is a practical, nonpharmacologic technique for reducing pain. This study evaluated the effect of LLLT on postoperative pain after root canal retreatment (RCR).

    METHODS: This study enrolled patients (N = 36) who required root canal retreatment (RCR) on mandibular molar teeth, presented with periapical lesions with periapical index scores of 2 or 3, and had a pain visual analog scale (VAS) <50 and a percussion pain VAS <50. The participants were divided into 2 groups: (1) patients scheduled for RCR followed by LLLT (n = 18) and (2) patients scheduled for RCR followed by a mock LLLT (placebo) (n = 18). Postoperative pain was assessed using the VAS. Data were collected and statistically analyzed with the chi-square test, the independent sample t test, and the Mann-Whitney U test (P = .05).

    RESULTS: On the first 4 days, postoperative pain significantly reduced in the LLLT group compared with the placebo group (P pain were found between the 2 groups after 5 and 7 days (P > .05). The number of patients who needed analgesics was lower in the LLLT group than in the placebo group (P pain during LLLT application.

    CONCLUSIONS: LLLT may reduce postoperative pain after RCR of mandibular molars.

    Matched MeSH terms: Pain Measurement; Pain, Postoperative/prevention & control*
  18. Fulltext Chronic Back Pain in a Young Female Patient: A Case of Ependymoma Originating from the Conus Medullaris
    Asahar SF, Malek KA, Zohdi WNWM, Peter AB
    Korean J Fam Med, 2020 Jan;41(1):68-72.
    PMID: 31902199 DOI: 10.4082/kjfm.18.0157
    We present the case of a 14-year-old Malay girl with an ependymoma of the conus medullaris who presented to multiple general practitioner clinics with a 24-month history of chronic low back pain. The pain was symptomatically managed as a simple musculoskeletal pain and sciatica. Further imaging to aid diagnosis was delayed until the appearance of severe pain with neurological deficits. Magnetic resonance imaging revealed an enhancing spinal mass at L1 through L3, and histopathological investigations confirmed the grade II ependymoma according to the World Health Organization classification. She underwent gross resection of the tumor. After the surgery, she developed neurogenic urinary bladder and bowel, which required intermittent self-catheterization, intermittent enema use, and intensive physical therapy.
    Matched MeSH terms: Low Back Pain; Musculoskeletal Pain
  19. Systematic review and meta-analysis of perioperative outcomes of peroral endoscopic myotomy (POEM) and laparoscopic Heller myotomy (LHM) for achalasia
    Awaiz A, Yunus RM, Khan S, Memon B, Memon MA
    Surg Laparosc Endosc Percutan Tech, 2017 Jun;27(3):123-131.
    PMID: 28472017 DOI: 10.1097/SLE.0000000000000402
    AIMS AND OBJECTIVES: Laparoscopic Heller myotomy (LHM) is the preferred surgical method for treating achalasia. However, peroral endoscopic myotomy (POEM) is providing good short-term results. The objective of this systematic review and meta-analysis was to compare the safety and efficacy of LHM and POEM.

    MATERIALS AND METHODS: A search of PubMed, Cochrane database, Medline, Embase, Science Citation Index, and current contents for English-language articles comparing LHM and POEM between 2007 and 2016 was performed. Variables analyzed included prior endoscopic treatment, prior medical treatment, prior Heller myotomy, operative time, overall complications rate, postoperative gastroesophageal reflux disease (GERD), length of hospital stay, postoperative pain score, and long-term GERD.

    RESULTS: Seven trials consisting of 483 (LHM=250, POEM=233) patients were analyzed. Preoperative variables, for example, prior endoscopic treatment [odds ratio (OR), 1.32; 95% confidence interval (CI), 0.23-4.61; P=0.96], prior medical treatment [weighted mean difference (WMD), 1.22; 95% CI, 0.52-2.88; P=0.65], and prior Heller myotomy (WMD, 0.47; 95% CI, 0.13-1.67; P=0.25) were comparable. Operative time was 26.28 minutes, nonsignificantly longer for LHM (WMD, 26.28; 95% CI, -11.20 to 63.70; P=0.17). There was a comparable overall complication rate (OR, 1.25; 95% CI, 0.56-2.77; P=0.59), postoperative GERD rate (OR, 1.27; 95% CI, 0.70-2.30; P=0.44), length of hospital stay (WMD, 0.30; 95% CI, -0.24 to 0.85; P=0.28), postoperative pain score (WMD, -0.26; 95% CI, -1.58 to 1.06; P=0.70), and long-term GERD (WMD, 1.06; 95% CI, 0.27-4.1; P=0.08) for both procedures. There was a significantly higher short-term clinical treatment failure rate for LHM (OR, 9.82; 95% CI, 2.06-46.80; P<0.01).

    CONCLUSIONS: POEM compares favorably to LHM for achalasia treatment in short-term perioperative outcomes. However, there was a significantly higher clinical treatment failure rate for LHM on short-term postoperative follow-up. Presently long-term postoperative follow-up data for POEM beyond 1 year are unavailable and eagerly awaited.
    Matched MeSH terms: Pain, Postoperative/etiology
  20. Lower back pain and its association with whole-body vibration and manual materials handling among commercial drivers in Sabah
    Awang Lukman K, Jeffree MS, Rampal KG
    Int J Occup Saf Ergon, 2019 Mar;25(1):8-16.
    PMID: 28978270 DOI: 10.1080/10803548.2017.1388571
    A cross-sectional study was undertaken to determine the prevalence of lower back pain (LBP) and its association with whole-body vibration (WBV) and manual materials handling (MMH). We studied 110 commercial vehicle drivers using a self-administered questionnaire and the VI-400Pro human vibration monitor. Prevalence of LBP was 66.4%. The percentage of drivers who had frequent manual handling of heavy loads was 45.5% and those who handled heavy loads in awkward postures accounted for 86.4%. Daily vibration A(8) averaged on the z axis was 0.25 (0.06) m·s-2 and at vector sum was 0.29 (0.07) m·s-2. Daily vibration exposures on the z axis, frequent manual handling of heavy loads and awkward posture during MMH were significantly associated with LBP. Drivers who are exposed to WBV and frequently handle heavy loads manually and with awkward postures probably have more LBP than drivers who are exposed to only one of these risk factors.
    Matched MeSH terms: Low Back Pain/epidemiology*
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