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BACKGROUND: Work-related musculoskeletal disorders (WMSDs) are leading cause of injuries among economically backward workers employed under small scale metal casting units especially in developing countries. In India, most casting unit’s falls under small and medium enterprises having inadequacy of advanced technological equipment’s due to several economic constraints and rely intensively on manual labour. Foundry work is very much prone to WMSDs involving much physical interaction of workers with their jobs which includes several risk factors. OBJECTIVE: The study objectives were to analyse the musculoskeletal risk prevalence among small scale casting workers using ergonomic assessment tools and statistical approach. METHODS: In present study, WMSDs risk prevalence has been examined using Rapid Entire Body Assessment (REBA) and virtual ergonomics. Further, risk evaluations were analysed using Mann–Whitney U test and Taguchi L25 orthogonal array. RESULTS: Results revealed manual handling task as being most vulnerable followed by the fettling section. Statistically significant differences were observed (p-value 0.05) for left side region; and lift-lower task and fettling section (p = 0.230; p > 0.05) for the right side region, where differences were not statistically significant. ANOVA results indicated that workstation height followed by population percentile and object weight were dominant factors significantly affecting the response parameter i.e. L4-L5 spine compression (p-value 0.05) had no significant effect. CONCLUSION: The present study may guide foundry industrialists in analysing the mismatch between the workers’ job profile and redesigning existing workstation layouts in small scale foundries based on minimizing the WMSDs risk severity associated with the work tasks.

Foundry workers are exposed to numerous health hazards, which includes respirable dust exposure as a prominent health issue. Apart from metallic dust, respirable crystalline silica (RCS) is generated during the fettling operation, which is very hazardous and a leading cause for silicosis. Evaluation and control of such hazards deserve particular attention in order to reduce the dust exposure level upto the permissible limits. In present study, an attempt was made to propose a low-cost design control intervention utilizing sensor based intelligence (ATmega328P microcontroller and an optical dust-sensor, SHARP GP2Y1010AU0F) for monitoring the dust exposure, followed by virtual ergonomics approach in CATIAV5R20. The proposed device was tested under several operating conditions. The results indicated that the prototype was sensitive to dust, having higher average dust density values under the dust haze weather condition (arithmetic mean (AM): 0.2590 mg/m3, geometric mean (GM): 0.2350 mg/m3) and fettling work-section (AM: 0.2550 mg/m3, GM: 0.2164 mg/m3) respectively, as compared to other conditions. Also, biomechanics analysis yielded the spine compression values lesser than the recommended limits, validating that the proposed fettling booth models could be considered as suggestive engineering control measures in conjunction with the designed prototype, so as to minimize the respirable dust exposure levels.

BACKGROUND: The hot and humid environment inside the kitchen is a cumulative sign of health impact that deteriorates the well-being and productivity of cooking workers, which could be a barrier to thermal comfort. As the cooking task progresses throughout the day, uncomfortable thermal conditions inside a kitchen work environment may diminish the work quality of the kitchen workers. OBJECTIVE: The objectives of the study were to evaluate the measured environmental factors of thermal comfort during various cooking periods [morning, day, evening, night] and examine the occupant’s perception votes followed by further investigating the worker’s thermal comfort conditions using PMV, PPD, SET, WBGT, and TSI indices. METHODS: The study was carried out inside the kitchen of the university canteen at IIT Guwahati, India. The objective and subjective measurements were accomplished during the summer season, while CBE thermal comfort software was employed for calculating the thermal comfort indices like PMV, PPD, and SET. RESULTS: The results of this study revealed that during entire cooking time, the recorded environmental factors of thermal comfort were found outside the recommended limits as per ASHRAE-55 standard, which indicates very hot prevalent conditions. Also, cook’s perception vote (TSV, TCV) for the existing environment did not follow the central three categories of votes (+1, 0, –1), even the cooking workers were also not satisfied with the prevailing environmental conditions, as 88% subjects responded dissatisfaction with the thermal environment. While, estimated values of thermal comfort indices (PMV, PPD, and SET) designated morning time cooking period slightly comfortable than the other cooking periods, but still not accordance with the ASHRAE-2017 standard. The WBGT index designated day cooking period as hazardous, with rest of cooking periods under severe risk level. In contrast, the TSI index indicated entire cooking periods under “slightly warm” thermal sensation. CONCLUSION: The assessment of this study showed that the existing kitchen environment of the university canteen is not conducive for workers. Improper ventilation design may cause the overheating inside the kitchen, which may increase the dissatisfaction rate of the employed workers and also affects the energy savings in the kitchen environment, which helps maintain thermal comfort. Further studies are required to improve the thermal comfort of the kitchen occupants by providing proper design interventions based on heating and cooling air ventilation systems.

As a systematic ergonomics improvement process has always been prevailing in mankind to maximize the human performance within its body’s capabilities and limitations, by providing it a safe workplace and equipment. In addition to this custom, a scrutinized effort is made to associate worker's strength with the force/torque required to operate the tool/equipment in agrarian society of Haryana state (i.e. northern part of India). Therefore, an isometric hand grip strength for both hands (dominant and other one) base data of 200 male agricultural workers (age 18-60 years) from five districts has been measured with baseline handgrip dynamometer. However 20-50 years age group are found actively involved in arduous agricultural activities. On summarizing the Statistical information for the age group 20-50 years (173 subjects) such as mean, standard deviation (SD), skewness, kurtosis, 5th and 95th percentiles it has been observed that Dominant handgrip strength (46.14±7.13 kg) is significantly different (p

Manual farming tools must match the body characteristics of the workers for their safety and performance. With this objective to serve in the present study, 18 body dimensions were measured including age and mass for 200 male farmers from the five districts of Haryana. Handle design of spade and sickle was suggested following the measured body characteristics. Biomechanical study was conducted to evaluate the compression loading at L4–L5 of five subjects using newly designed spade and pre-existing spade alternately. A similar virtual environment was developed in the CATIA-V5 to examine the compression loading at L4–L5. The results obtained were compared using t test, which show a significant reduction in compression forces at L4–L5 for p

Musculoskeletal disorders (MSDs) are the most common health issues around the globe and a major cause of disability among workers. In developing countries, most casting industries fall under Small and Medium Scale Enterprises (SMEs); SMEs lack modern equipment and often intensively rely on manual labor. As processes are mainly labor intensive, workers employed in the metal casting sector are often at risk of MSDs. The main objective of this study is to investigate the exposure of work-related musculoskeletal symptoms prevalent among male workers employed in small scale gray cast-iron foundries of northern India. The techniques used included the Nordic Musculoskeletal Questionnaire (NMQ), anthropometric measures, work postures analysis based on digital human modeling (DHM), Rapid Upper Limb Assessment/RULA and Biomechanics Single Action Analysis/BSAA ergonomic assessment tools. Based on the measured anthropometric variables and work postures attained during various routine tasks, virtual work manikins were created and analyzed using human activity analysis in CATIA V5R20. Subjective assessment revealed that distal upper extremity regions i.e. wrists/hands followed by lower back, neck and shoulders have higher frequency of reported MSDs symptoms. Higher musculoskeletal risk was observed with most of the analyzed work postures, with fettling and Manual Material Handling (MMH) tasks being the most affected. A regression model was developed to predict the L4-L5 spine compression load on the workers' lumbar regions; a coefficient of determination (R2) value of 0.761 indicates an acceptable model fit (R-value = 0.873). Based on the values of the standardized beta coefficients, findings suggested that trunk angle (β = 0.616), followed by upper arm angle (β = 0.408), were stronger predictors on the dependent variable (i.e. L4-L5 spine compression) than population percentile (β = 0.372), object weight (β = 0.208) and lower arm angle (β = 0.183). The findings suggest that factors like manual work demands, poor work station structure, repetitive actions and awkward postures held for a longer duration may likely be associated with MSDs risk severity. The present study may guide the foundry industrialists in analyzing the mismatch between the workers' job profiles and redesigning the work station layouts in small scale foundries based on minimizing the risk severity associated with the tasks carried out by staff.

Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most significant enzyme defect in India with an incidence ranging from 2% to 27.9% in different communities. Prolonged neonatal jaundice and haemolytic crisis are known to occur in children with G6PD deficiency. Hence, screening of a population for G6PD deficiency is paramount. A Novel water soluble tetrazolium-8 (WST-8) Formazan Method has been used in this study for in-field mass-screening of G6PD in the region of Himachal Pradesh, India. Materials and Methods: In this prospective study, 5652 neonates were screened to assay G6PD activity using WST8/1-methoxy phenazine methosulphate method within the first 48 h of life. Orange colour at the end of the procedure indicated normal G6PD activity while pink or colourless appearance indicated G6PD deficiency. Results: After the screening of 5652 neonates, the prevalence of G6PD deficiency was 12.4%. 45 newborns (6%) had a severe G6PD deficiency. Males were more affected than females (70:30). Furthermore, males had higher prevalence of deficiency than females (64% [n = 29] and 16% [n = 16]). Conclusions: G6PD deficiency assessment by the method used for population screening in the study was easy to do and quite simple. Following this, the high prevalence of this deficiency was noted in Himachal Pradesh. This study highlights the need to do neonatal screening of G6PD deficiency in population so that untowards complications like haemolytic crisis, complications due to neonatal jaundice can be avoided.

Background: The daily risk of mortality in first 4 weeks of life is almost 30-fold higher than post-neonatal period. Late onset sepsis (LONS) and meningitis still continue to be major causes of mortality and morbidity in newborn period. Our study was done to study clinical profile of enrolled newborns with LONS along with incidence of meningitis in them. The objective of this study was to study clinico-bacteriological profile and to determine associated incidence of meningitis in neonates with late onset sepsis (LONS) in a hospital setting in Northern India.Methods: It was a hospital based prospective observational study conducted over a period of 12 months enrolling 122 newborn with >72 hours of age fulfilling inclusion criterias.Results: Out of total 122 enrolled newborn, 37 (30.3%) neonates had meningitis. 71 (58.20%) were of term gestation with majority 61 (50.0%) in age group of 4-7days of life. Incidence of LONS in low birth weight and very low birth weight were 54% and 13.5%. Most commonly seen symptoms in at admission were lethargy, refusal to feed and fever. Blood culture was positive in 45 (36.88%) in neonates with Acinetobacter baumanii, klebsiella pneumonia and Escherichiae coli being most commonly seen organisms. Cerebrospinalfluid (CSF) culture was positive in 4 (10.81%) newborns. Mean duration of hospital stay was 24.75±13.96 days. Mortality in neonatal meningitis was 3 (3.2%).Conclusions: Our study proved that about one third of newborn admitted with LONS also had coexistent meningitis. Thus CSF analysis is a must and it should not be missed as untreated meningitis can be devastating for newborn. Antibiotics must be added as per antibiogram of specified institute.

Background: Infantile tremor syndrome (ITS) is characterized by gradual onset of mental and psychomotor changes, pigmentary disturbances in hairs and skin, pallor, tremors and neuroregression. The aim of study was to determine clinical, haematological and radiological spectrum of children admitted with infantile tremor syndrome.Methods: It was a prospective cross-sectional study done in age group of 6 months to 5 years conducted in department of pediatrics of a tertiary care medical college with duration of 18 months. Clinical, haematological and radiological profile parameters of 36 children admitted during study period with ITS were recorded as per prepared performa and analysed. Microsoft excel was used in creating database while data was analysed by using Statistical Package for Social Sciences (SPSS) version 23.0.Results: Total 36 children were enrolled in study. Mean age was 12.33±3.89 months and mostly were male (55.6%). Most (72.2%) of children belonged to lower socioeconomic status and (83.3%) were exclusively breastfed. Only 11.1% had severe acute malnutrition (SAM). 77.77% had vitamin B12 levels below normal. Progressive paleness (88.9%), delayed development (61.1%) and developmental regression (58.3%) were most common complaints reported. 63.9% had tremors at presentation. In MRI findings, poor myelination with thinning of corpus callosum (16.7%) and uniform thinning of corpus callosum with subtle hypomyelination in bilateral frontal lobes (8.3%) were major findings. In majority of children tremor disappeared in 11-15 days (30.6%) after starting treatment.Conclusions: ITS should to be considered as a differential diagnosis in an infant on exclusive breast feeding with vegetarian mother with poor weaning practices presenting with neuroregression, tremor and malnutrition with skin changes.

In developing countries, workers’ employed under high-heat furnace work environments are exposed to severe heat stress; an ignored occupational health hazard especially under the unorganized work-sectors. During hot summer season, lot of underprivileged workers are strained by harsh thermal work-conditions with subsequent health challenges, declining their productivity and attributes to financial burden. As compared to developed countries, absence of adequate regulatory guidelines and control policies increases the risk-severity under the rampant conditions. The aim of the present study is to gain insights on the prevalence of occupational heat-stress under high-heat furnace work environments with special reference to developing countries. Present review study recognizes the prevalent issues by summarizing the dominant heat-stress factors (environmental, individual, and physiological), suitable assessment strategies, and consequent negative impacts on health and productivity followed by encapsulation of related heat-stress assessment studies particularly from the developing countries. From the assessment studies, it’s evident that the predominant chronic heat-stress adversely impacts the workers’ health and accompanying performance loss. Apart from heat related morbidities, severe health impacts such as immunological suppression, renal/urologic anomalies, and sub-cellular DNA damage are also attributable to this occupational health hazard. The prevalent thermal work-conditions necessitates implementation of adequate preventive measures and control policies to ameliorate the workers’ productive capacity and social well-being. Remedial control interventions like proper ventilation design, installing reflective thermal protective shields, providing cooling spots, optimized cooling vest design, and sensor based intelligence may be considered as an effective control measures with emphasis on ameliorating the heat stress exposure under high-heat furnace work environments.

Foundry industry involves a lot of physical interaction of workers with their jobs. There are several potential hazards that are present in a foundry work environment. In foundry, awkward posture and poor working conditions are one of the major risk factors which contribute to MSDs symptoms and are main cause of workplace injuries among workers. In this study, an ergonomic analysis has been conducted using digital human modeling and simulation module in CATIAV5 software by creating a digital work environment based on the actual working conditions. Various work postures have been examined using RULA analysis tool to evaluate the risk level associated with the work task. An attempt has been made to evaluate the effect of table height, table width, and population percentile on L4–L5 spine compression limit using Taguchi L9 orthogonal array. From the study, work table height was found to be significant, although the other factors selected were not significant.

Background and Aim: Neonatal hyperbilirubinemia continues to be the most common cause of hospital admissions and readmissions in the neonatal population worldwide and this pattern continues despite attempts to identify neonates at risk of pathological hyperbilirubinemia. Therefore, this study aimed to study the risk factors for severe hyperbilirubinemia in neonates. Materials and Methods: An observational prospective study was undertaken for 1 year in neonates with hyperbilirubinemia requiring double volume exchange transfusion in neonatology unit of a tertiary rural health care hospital. Results: Risk factors included ABO incompatibility in 14 (28.5%), Rh incompatibility in 14 (28%). Other risk factors for hyperbilirubinemia were, jaundice in elder sibling, oxytocin use, birth asphyxia, hypothyroidism, ABO along with Rh incompatibility, Glucose-6 phosphate Dehydrogenase deficiency, cephalhematoma, and sepsis in neonates. Ten (20%) neonates were neurologically abnormal with signs of encephalopathy. Significant association of risk factors with neurotoxicity were also found. All neurologically abnormal neonates were small for date and none was appropriate for date (P = 0.05). There were no neurologically abnormal neonates with A+ and O− mothers (P = 0.04). Conclusion: The high rate of exchange transfusion warrants aggressive management of neonatal hyperbilirubinemia by health-care providers by adequate dissemination of information, strict following of hour-based normograms, performing total serum bilirubin assessment in all icteric neonates, and stratification into risk groups thereafter.

Objective: The aim of study was to study morbidity and mortality profile of newborns admitted to Sick Newborn Care Unit (SNCU) and to assess their survival rate over a period of 3 years. Materials and Methods: It was a observational retrospective study done over a span of 3 years from January 2017 to December 2019. The case records of all neonates admitted to SNCU during this period were scrutinized. The birth weight, gestational age at birth, morbidity profile, mortality profile were noted down. Results: Main causes of admission were found to be low birth weight (LBW), Prematurity, birth asphyxia, neonatal sepsis, and neonatal hyperbilirubinemia. Prematurity accounted for 46.3%, 47.42% and 45.34% of NICU admissions over 3 years. LBW newborns accounted for 52.81%, 49.11% and 42.63% of total admissions. Neonatal hyperbillirubinemia accounted for 40.71%, 47.79% and 52.69% of total admissions. Major causes of mortality were found to be sepsis, birth asphyxia and prematurity. Sepsis was observed to be cause of mortality in 33.01%, 37.72% and 23.32% of total deaths. Prematurity and hyaline membrane disease accounted for 30.62%, 23.17% and 33.18% of total deaths. Mortality rates were found to be very high in

Background: As community-based surveys require energy and time, information surveillance of nutrition rehabilitation centers (NRCs) can be used to assess the nature and degree of risk factors for children with severe acute malnutrition (SAM). Therefore, the current study was planned to assess the degree of association of known risk factors for SAM among children admitted in NRC of a tertiary hospital from the northern state of India. Materials and Methods: Case–control study design was adopted where 50 children with SAM (cases) were recruited from NRC and 50 without SAM (controls) were from an immunization clinic of a tertiary center. A pretested structured interviewer-administered questionnaire was used to collect data from cases and controls. Results: Type of house, status of water and sanitation, simple exponential smoothing, method of birth, birth order, initiation and frequency of breastfeeding, colostrum intake, and profile of diarrhea and acute respiratory infection were statistically similar among cases and controls. Logistic regression analysis observed SAM had significantly high odds for risk factors like mean age of mother at birth (1.4, 1.0–1.9), low birth weight (LBW) (8.7, 2.1–35.3), and bottle feeding (6.3, 1.2–14.2), whereas exclusive breastfeeding (0.2, 0.4–0.4) and fully immunization (0.07, 0.5–0.001) had significantly low odds. Conclusion: Advancing age of mother at the time of delivery, LBW, poor rate of exclusive breastfeeding, and high rate of bottle feeding are significant associated factors for SAM in the study area. Reasons for LBW and reasons for bottle feeding need to be targeted in the study area to reduce SAM among children

We describe the prevalence of human metapneumovirus infection in children visiting outpatient department with symptoms of respiratory illness in rural areas of Dibrugarh District of Assam. Human metapneumovirus was observed in 7.2% (20/276) of children aged =5 years with detection of genotypes A2b and B2.

Background: Infantile tremor syndrome (ITS) is characterized by anemia, skin pigmentation, tremors, physical, and mental regression without a defined etiopathogenesis and low incidence. Materials and Methods: We have studied 9 patients over 1 year for the changing clinical and laboratory variables of patients with ITS. Neuroregression and anemia were presented in all followed by tremors in 5 and hypotonia in 2. Result: Sepsis screen was positive in 6 and urine cultures in 2. Antibiotics were required in 6. ITS with changing parameters still significantly contributes to healthcare burden. Conclusion: It is important to screen for urinary infection and septicemia to avoid antibiotic abuse.

We describe profile of 60 children [mean (SD) age, 9.5 (3.8) y] presenting to the department of Pediatrics with snake envenomation. Neurotoxic bites were predominant (53%) and required mean (SD) 21.5 (9.29) antisnake venom vials, while children with neurohemotoxic features required mean (SD) 31.2 (10.8) vials to improve. Duration of hospital stay was median (SD) 4.0 (2.71) days. The commonest complication was respiratory dysfunction; mortality rate was 13.3%.

Context: One of the most important factors of medical education that can revolutionize the learning process in postgraduate students (PGs) is assessment for learning by means of formative assessment (FA). FA is directed at steering and fostering learning of the students by providing feedback to the learner. However, though theoretically well suited to postgraduate training, evidence are emerging that engaging stakeholders in FA in daily clinical practice is quite complex. Aims: To explore perceptions of PGs and teachers (Ts) about factors that determines active engagement in FA. Subjects and Methods: It was a descriptive qualitative study involving focus group discussions (FGDs) with PGs and Ts from Departments of Pediatrics and Orthopedics. FGDs data were processed through points/remarks, data reduction, data display, coding followed by theme generation for content analysis. Results: Four higher order themes emerged: Harsh reality of present summative assessment structure, individual perspectives on feedback, supportiveness of the learning environment, and the credibility of feedback and/or feedback giver. Conclusions: Engaging in FA with a genuine impact on learning is complex and quite a challenge to both students and Ts. Increased acceptability along with the effective implementation of FA structure, individual perspectives on feedback, a supportive learning environment and credibility of feedback are all important in this process. Every one of these should be taken into account when the utility of FA in postgraduate medical training is evaluated.