Displaying publications 61 - 80 of 184 in total

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  1. Sanjeevan R, Prabu S, Azizul A, Abdul-Halim Y
    Malays Orthop J, 2018 Jul;12(2):56-58.
    PMID: 30112131 MyJurnal DOI: 10.5704/MOJ.1807.011
    Being a rare clinical entity, discal cyst presents indistinguishably from other causes of lower back pain and radiculopathy. It is an extremely rare pathology with unclear pathogenesis, indeterminate natural history with no consensus on the ideal management of the condition. We report a rare case of discal cyst in a patient who presented to our centre with localised low back pain and subsequently left sided radicular pain. With the aid of MRI and with clear surgical indication we proceeded with endoscopic removal of the cyst and intraoperatively confirmed its origin from the adjacent disc. The patient had immediate relief of his symptoms and no postoperative complications. We recommend that endoscopic surgery can be an effective alternative to conventional open surgery for discal cyst of the lumbar spine.
    Matched MeSH terms: Low Back Pain
  2. Mohd. Yusof Hj. Othman, Faridah Hussain, Kamaruzzman Sopian, Baharuddin Yatim, Hafidz Ruslan
    Sains Malaysiana, 2013;42:1319-1325.
    Three different designs of heat exchanger, V-groove, honeycomb and stainless steel wool had been tested to study their effectiveness in improving the overall performance of a photovoltaic/thermal (PV/T) air base solar collector. Heat exchangers were installed horizontally into the channel located at the back side of the PV module. The system was tested at irradiance of 828 W/m2 with mass flow rate spanning from 0.02 kg/s to 0.13 kg/s. It was observed that at mass flow rate of 0.11 kg/s, the maximum thermal efficiency of the system with V-groove is 71%, stainless steel wool is 86% and honeycomb is 87%. The electrical efficiency of the systems is 7.04%, 6.88% and 7.13%, respectively. The experimental results showed that honeycomb design is the most efficient design as heat exchanger. The design which is simple and compact is suitable for building integration.
    Matched MeSH terms: Back
  3. Nur Dina, A., Shalimar, A.
    JUMMEC, 2013;21(2):71-73.
    MyJurnal
    We report a case of a 59-year-old gentleman with complete left brachial plexus injury. He presented with
    chronic pain over the dorsum of his left hand since the injury eight years ago. Medical treatment had been
    optimised but the pain still persist. End-to-side nerve transfer was done involving superficial sensory radial
    nerve and median nerve to alleviate the pain. The surgery was considered successful as the patient claimed
    that the pain score had reduced a few weeks postoperatively. However, there was no sensory recovery and
    functionally no improvement was observed.
    Matched MeSH terms: Back
  4. Kato T, Chinzei N, Katayama N, Hirota S, Takahashi M
    Malays Orthop J, 2020 Mar;14(1):92-95.
    PMID: 32296490 DOI: 10.5704/MOJ.2003.016
    A traumatic iliacus hematoma is rare and usually occurs in patients after a fall involving a lower back injury. Although the hematoma may compress the femoral nerve causing femoral nerve palsy, the gold standard treatment for this condition has not been established. Here we report transcatheter arterial embolisation as a useful treatment strategy for a traumatic iliacus hematoma.
    Matched MeSH terms: Back Injuries
  5. Doraisamy MA, Anshul
    Physiother Can, 2011;63(4):405-9.
    PMID: 22942517 DOI: 10.3138/ptc.2010-27
    PURPOSE: The purpose of this article was to determine whether strength is altered in the upper trapezius in the presence of latent myofascial trigger points (MTrP).

    METHODS: This study was case controlled and used convenience sampling. The sample recruited was homogeneous with respect to age, sex, height, and body mass. Participants were assessed for the presence of latent MTrP in the upper trapezius and placed into two groups: an experimental group that had latent MTrP in the upper trapezius and a control group that did not. Eighteen women (mean age 21.4 y, SD 1.89; mean height 156.9 cm, SD 4.03; and mean body mass 51.7 kg, SD 5.84) made up the experimental group, and 19 women (mean age 20.3 y, SD 1.86; mean height 158.6 cm, SD 3.14; and mean body mass 53.2 kg, SD 5.17) made up the control group. We obtained strength measurements of the non-dominant arm using a handheld dynamometer and compared them between the two groups.

    RESULTS: The difference in the strength measurements between the two groups was not statistically significant (p=0.59).

    CONCLUSIONS: The presence of latent MTrPs may not affect the strength of the upper trapezius.

    Matched MeSH terms: Superficial Back Muscles
  6. Adeyemi AJ, Rohani JM, Abdul Rani MR
    Appl Ergon, 2017 Jan;58:573-582.
    PMID: 27132042 DOI: 10.1016/j.apergo.2016.04.009
    The study analysed backpack-related back pain in school children by investigating the possibility of multiple interactions among causative factors, which may be responsible for the non-conclusive findings on the issue. Using data from 444 prepubescent schoolchildren, a mixed method design combining survey, observation and direct measurement strategies was implemented. Using a multivariate structural equation modelling approach, the study investigated interactions among anthropometry, posture, backpack volume, rating and back pain constructs, with each construct made of 2-4 indicators. Additionally, regression analysis was used to determine the feasibility of considering the two additional factors of age and body mass index along with the globally accepted recommendation of a load of 10-15% of body weight. Our model demonstrated an acceptable model fit and revealed direct and indirect effects of the factors. Obese children were recommended to carry a one-third lighter load than other children. The application of systematic/multiple strategies provided an explanation for some of the issues associated with school children's backpack-related back pain.
    Matched MeSH terms: Back Pain/etiology*; Back Pain/prevention & control*
  7. Chan ST
    Med J Malaysia, 1995 Sep;50(3):241-5.
    PMID: 8926902
    This prospective survey attempt to study the incidence of post-operative back pain after lumbar epidural anesthesia for non-obstetric patterns and the correlation of this symptom with various contributing factors. One hundred and five patients who were given lumbar epidural anaesthesia as the sole anaesthesia for non-obstetric surgery were studied. The choice of equipment, number of attempts at giving the injection, duration of surgery and position of patient during surgery were documented. One week post-operatively, the patients were asked whether they recalled any back pain. The nature, duration and severity of the back pain was documented. Statistical analysis was achieved by using Chi-squared test. Twenty-eight patients recalled "injection site tenderness" post-operatively. The pain was mild to moderate in severity and lasted up to 4 days. None of the studied patients had post-operative "backache". The pain showed no significant correlation with needle size, technique of injection, use of epidural catheter, patient's position during surgery, duration and number of attempts made during epidural injection.
    Matched MeSH terms: Back Pain/etiology; Back Pain/epidemiology*
  8. Coggon D, Ntani G, Walker-Bone K, Palmer KT, Felli VE, Harari R, et al.
    Spine (Phila Pa 1976), 2017 May 15;42(10):740-747.
    PMID: 27820794 DOI: 10.1097/BRS.0000000000001956
    STUDY DESIGN: A cross-sectional survey with a longitudinal follow-up.

    OBJECTIVES: The aim of this study was to test the hypothesis that pain, which is localized to the low back, differs epidemiologically from that which occurs simultaneously or close in time to pain at other anatomical sites SUMMARY OF BACKGROUND DATA.: Low back pain (LBP) often occurs in combination with other regional pain, with which it shares similar psychological and psychosocial risk factors. However, few previous epidemiological studies of LBP have distinguished pain that is confined to the low back from that which occurs as part of a wider distribution of pain.

    METHODS: We analyzed data from CUPID, a cohort study that used baseline and follow-up questionnaires to collect information about musculoskeletal pain, associated disability, and potential risk factors, in 47 occupational groups (office workers, nurses, and others) from 18 countries.

    RESULTS: Among 12,197 subjects at baseline, 609 (4.9%) reported localized LBP in the past month, and 3820 (31.3%) nonlocalized LBP. Nonlocalized LBP was more frequently associated with sciatica in the past month (48.1% vs. 30.0% of cases), occurred on more days in the past month and past year, was more often disabling for everyday activities (64.1% vs. 47.3% of cases), and had more frequently led to medical consultation and sickness absence from work. It was also more often persistent when participants were followed up after a mean of 14 months (65.6% vs. 54.1% of cases). In adjusted Poisson regression analyses, nonlocalized LBP was differentially associated with risk factors, particularly female sex, older age, and somatizing tendency. There were also marked differences in the relative prevalence of localized and nonlocalized LBP by occupational group.

    CONCLUSION: Future epidemiological studies should distinguish where possible between pain that is limited to the low back and LBP that occurs in association with pain at other anatomical locations.

    LEVEL OF EVIDENCE: 2.

    Matched MeSH terms: Low Back Pain/diagnosis; Low Back Pain/epidemiology*
  9. Hoang T, Kieu H, Nguyen V, Tran T, Ngee T, Duong H
    PMID: 39230213
    BACKGROUND: To evaluate the treatment outcomes of lateral interbody bone graft surgery and posterior percutaneous screws for lumbar spinal stenosis Methods: This is a cross-sectional descriptive study. There were 27 patients with 30 segments of surgery diagnosed with lumbar spinal stenosis that were surgically treated with the XLIF method. Clinical outcomes measured included VAS scores for lower back pain and leg pain, ODI, and JOA scores. Magnetic resonance imaging of the lumbar spine after surgery was used to evaluate indirect decompression. X-ray or CT scan to evaluate bone fusion after 6 months of surgery. Differences were determined by independent T-test.

    RESULTS: There were 27 patients with 30 segments of surgery. They were 12 males and 15 females with an average age of 58.81±8.1. There was significant improvement in VAS for lower back pain from 7.11±1.31 to 3.67±1.3, VAS for leg pain from 6.81±2.19 to 1.59±1.89, ODI from 26.41±8.95 to 13.69±8.34, and JOA score from 7.63±2.87 to 13.5±1.73. A-P diameter increased 134%, lateral diameter increased 120%, lateral recess depth increased 166%, disc height increased 126%, foraminal height increased 124%, spinal canal area increased 30%. The p-values were all <0.001. The average hospital stay was 6.79±3.01 days. Complications included 1 pedicle screw malformation, 1 ALL avulsion fracture, 1 abdominal herniation, 1 venous damage, 1 failure.

    CONCLUSION: XLIF surgery presents a favorable option for patients with lumbar spinal stenosis. This is a minimally invasive surgical method that reduces pain, reduces bleeding, and is effective in indirectly decompressing the spinal canal both clinal and imaging.

    Matched MeSH terms: Low Back Pain/etiology; Low Back Pain/surgery
  10. Rozali A, Rampal KG, Shamsul Bahri MT, Mohd Sidik S, Shamsul Azhar S, Khairuddin H, et al.
    Med J Malaysia, 2009 Sep;64(3):197-204.
    PMID: 20527267 MyJurnal
    A cross sectional study was conducted among military armoured vehicle drivers in the two largest mechanized battalions with the objective to determine the prevalence of low back pain (LBP), and its association with whole body vibration (WBV) and other associated factors. A self-administered questionnaire and Human Vibration Meter were used in this study. A total of 159 respondents participated in this study and 102 (64.2%) of them were subjected to WBV measurement. One-hundred-and-seventeen respondents complained of LBP for the past 12 months giving a prevalence of 73.6%. The prevalence of LBP among tracked armoured vehicle drivers was higher (81.7%) as compared to wheeled armoured vehicle drivers (67.0%). The mean acceleration at Z-axis in tracked armoured vehicles (1.09 +/- 0.26 ms(-2)) and wheeled armoured vehicles (0.33 +/- 0.07 ms) were the dominant vibration directions. The mean estimated vibration dose value (eVDV) for eight-hour daily exposure at Z-axis (19.86 +/- 4.72 ms(-1.75)) in tracked armoured vehicles showed the highest estimation. Based on the European Vibration Directive (2002), the mean eVDV at Z-axis in tracked armoured vehicles exceeded exposure action value (EAV) (> 9.1 ms(-1.75), but did not exceed exposure limit value (ELV) (<21.0 ms(-1.75)). Logistic regression analysis revealed that only driving in forward bending sitting posture (OR = 3.63, 95% CI 1.06-12.42) and WBV exposure at X-axis (OR = 1.94, 95% CI 1.02-3.69) were significant risk factors to LBP. Preventive measures should be implemented to minimize risk of WBV and to improve ergonomic postures among drivers.
    Matched MeSH terms: Low Back Pain/etiology*; Low Back Pain/epidemiology
  11. Shariat A, Cardoso JR, Cleland JA, Danaee M, Ansari NN, Kargarfard M, et al.
    Work, 2018;60(2):191-199.
    PMID: 29865103 DOI: 10.3233/WOR-182738
    BACKGROUND: Malaysian office workers often experience Musculoskeletal Discomfort (MSD) which is typically related to the low back, shoulders, and neck.

    OBJECTIVES: The objective of this study was to examine the occurrence of lower back, shoulder, and neck pain among Malaysian office workers.

    METHODS: 752 subjects (478 women and 274 men) were randomly selected from the Malaysian office workers population of 10,000 individuals. The participants were aged between 20-50 years and had at least one year of work experience. All participants completed the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). Instructions to complete the questinnaire were given to the participants under the researchers supervision in the morning before they started a day of work. The participants were then classified into four categories based on body mas index (BMI) (BMI:≤18.4, 18.5-24.99, 25-29.99, ≥30) and age (Age: 20-29, 30-39, 40-49, ≥50).

    RESULTS: There was a significant association between pain severity in gender and right (p = 0.046) and left (p = 0.041) sides of the shoulders. There was also a significant association between BMI and severity of pain in the lower back area (p = 0.047). It was revealed that total pain score in the shoulders was significantly associated with age (p = 0.041).

    CONCLUSIONS: The results of this study demonstrated that a significant correlation existed between pain servity for gender in both right and left shoulder. These findings require further scientific investigation as do the identification of effective preventative stratgies.

    Matched MeSH terms: Back Pain/complications; Back Pain/epidemiology*
  12. Kew Y, Tan CY, Ng CJ, Thang SS, Tan LH, Khoo YK, et al.
    Rheumatol Int, 2017 Apr;37(4):633-639.
    PMID: 28013358 DOI: 10.1007/s00296-016-3633-x
    The prevalence of neuropathic low back pain differs in different ethnic populations. The aims of the study are to determine its frequency and associations in a multi-ethnic cohort of Asian low back pain patients. This was a cross-sectional study of low back patients seen at the University of Malaya Medical Centre, Kuala Lumpur, Malaysia. Neuropathic low back pain patients were identified using the painDETECT questionnaire and compared with non-neuropathic (unclear or nociceptive) low back pain patients, in terms of socio-demographic and clinical factors, pain severity (numerical pain rating scale, NPRS), disability (Roland Morris Disability Questionnaire, RMDQ), as well as anxiety and depression (Hospital Anxiety and Depression Scale, HADS). Of 210 patients, 26 (12.4%) have neuropathic low back pain. Neuropathic pain is associated with non-Chinese ethnicity, higher body mass index and pain radiation below the knee. Patients with neuropathic pain have significantly higher NPRS and RMDQ scores, and there are more subjects with anxiety on HADS. However, there are no differences between the groups in age, gender, pain duration or underlying diagnosis of low back pain. The prevalence of neuropathic low back pain in a multi-ethnic Malaysian cohort is lower than previously reported in other populations with possible differences between ethnic groups. It is associated with greater pain severity, disability and anxiety.
    Study site: Spine Clinic, University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Low Back Pain/epidemiology*; Low Back Pain/psychology
  13. Zamri EN, Hoe VCW, Moy FM
    Ind Health, 2020 Jun 09;58(3):254-264.
    PMID: 31666460 DOI: 10.2486/indhealth.2019-0106
    Low back pain (LBP) is prevalent among workers both in developed and developing countries. School teachers represent a high proportion of the working population in Malaysia. However, there is a lack of longitudinal study on predictors and course of LBP among teachers. Therefore, this study aimed to determine the predictors and course of LBP among secondary school teachers. Longitudinal data of 701 teachers in Selangor, Malaysia were collected from May 2015 to October 2016. Associations between predictors and LBP were analysed using logistic regression and reported as odds ratio (OR) and 95% confidence interval (CI). At 12-month of follow-up, 44% (95%CI: 40.6%, 48.0%) of the participants reported having LBP. In the regression model that included all risk factors, only LBP at baseline (OR 10.43, 95%CI: 6.19, 17.58) was associated with LBP at 12-month follow-up. When LBP at baseline was removed from the model, anxiety symptom (OR 2.51, 95%CI: 1.19, 5.30) and lifting heavy weights (OR 4.16, 95%CI: 1.40, 12.30) were found to be significantly associated with LBP at 12-month follow-up. In conclusion, issues on anxiety and lifting heavy weights should be addressed to reduce the occurrence of LBP despite the presence of health condition itself (LBP at baseline).
    Matched MeSH terms: Low Back Pain/epidemiology*; Low Back Pain/psychology
  14. Ariffin M, Lloyd S, Rhani S, Kamalnizat, Baharudin A
    Malays Orthop J, 2014 Jul;8(2):40-2.
    PMID: 25279091 DOI: 10.5704/MOJ.1407.001
    The management of post-radiation wound breakdown over the posterior cervico thoracic region can be a challenging task for a surgeon. The aim of the treatment is to produce a well vascularized and a low tensile flap which will close a large defect. We describe the use of the lower trapezius flap to reconstruct the wound breakdown and to obtain stable tissue coverage in a patient with postradiation necrosis. This flap minimizes the disruption of the scapula-thoracic function while preserving the range of movement over the shoulder. From the literature review, it was noted that the dorsal scapular artery (DSA) and transverse cervical artery (TCA) aid in the blood supply to the trapezius muscle and prevent local necrosis during rotation of the flap. The trapezius flap is widely accepted because of the minor donor site morbidity, large arc of rotation and adequate blood supply.
    Matched MeSH terms: Superficial Back Muscles
  15. Ganasegeran K, Perianayagam W, Nagaraj P, Al-Dubai SA
    Occup Med (Lond), 2014 Jul;64(5):372-5.
    PMID: 24727561 DOI: 10.1093/occmed/kqu039
    BACKGROUND:
    Low back pain (LBP) is the most costly ailment in the work force. Risky work behaviour and psychological stress are established risk factors.

    AIMS:
    To explore the associations between workplace risk factors, psychological stress and LBP among Malaysian railway workers.

    METHODS:
    A cross-sectional study was carried out on railway workers in Malaysia. Socio-demographics, workplace risk factors for LBP, perceived psychological stress and history of LBP over the previous month were obtained by direct interviews using a structured closed-ended questionnaire. Descriptive, bivariate and logistic regression analyses were conducted.

    RESULTS:
    There were 513 study participants (70% response rate). The prevalence of LBP in the previous month was 69%. Multivariate analysis yielded four significant predictors of LBP: employment of ≥ 10 years, lifting and lowering heavy loads, prolonged standing posture and psychological stress.

    CONCLUSIONS:
    The high prevalence of LBP and its significant associations with physical and psychological stress factors in railway workers points to an urgent need for preventive measures, particularly among workers in high-risk occupations.
    Matched MeSH terms: Low Back Pain/etiology*; Low Back Pain/epidemiology; Low Back Pain/psychology
  16. 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
  17. Nazli Z, Norizal MN, Noor Kaslina MK, Abdul Fattah AW
    Med J Malaysia, 2015 Apr;70(2):98-9.
    PMID: 26162385 MyJurnal
    Hibernoma is a slow growing, rare benign tumour, which derived from brown adipose tissue. This tumour is usually found in the area where foetal fat persists such as back, axilla, retro peritoneum and thorax. Hibernoma rarely occurs in the retro pharynx. We report a case of retropharyngeal hibernoma in a 44-year-old male. He presented with obstructive symptoms for six months and a retropharyngeal mass upon examination. His CT scan findings showed a mass in the prevertebral region from level of C2 until C5 causing narrowing of upper aero digestive tract. Histopathological examination reported as hibernoma.
    Matched MeSH terms: Back
  18. Mohan V, Paungmali A, Sitilertpisan P, Henry LJ, Omar FA, Azhar FZ
    J Bodyw Mov Ther, 2020 Oct;24(4):196-202.
    PMID: 33218511 DOI: 10.1016/j.jbmt.2020.07.007
    BACKGROUND: Studies have shown the involvement of respiratory characteristics and their relationship with impairments in non-specific low back pain (NS-LBP). The effects of core stability with a combined ball and balloon exercise (CBB) on respiratory variables had not been investigated.

    OBJECTIVE: To evaluate the effectiveness of CBB on respiratory variables among NS-LBP patients.

    STUDY DESIGN: pre- and post-experimental study.

    PARTICIPANTS: Forty participants were assigned to an experimental group (EG) [n = 20] and control group (CG) [n = 20] based on the study criteria.

    INTERVENTIONS: The EG received CBB together with routine physiotherapy and the CG received routine physiotherapy over a period of 8 weeks. Participants were instructed to carry out the exercises for 3 days per week. The training was evaluated once a week and the exercises progressed based on the level of pain.

    OUTCOME MEASURES: Primary outcomes were maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP) and maximum voluntary ventilation (MVV). The secondary outcomes were measured in the numeric rating scale (NRS), total faulty breathing scale (TFBS), cloth tape measure (CTM) and lumbo-pelvic stability.

    RESULTS: The MIP increased significantly among the EG when compared with that in the CG (p > 0.05).The EG showed a significant increase in MVV (p = 0.04) when compared to the CG (p = 0.0001). There was a significant reduction in pain for both groups. The MEP, TFBS, chest expansion and core stability showed no changes in either group.

    CONCLUSION: CBB was effective in improving respiratory variables among NS-LBP patients.

    Matched MeSH terms: Low Back Pain
  19. Wan SA, Teh CL, Jobli AT, Cheong YK, Chin WV, Tan BB
    J Med Case Rep, 2019 Jan 08;13(1):8.
    PMID: 30626451 DOI: 10.1186/s13256-018-1940-4
    BACKGROUND: Gout is a monosodium urate deposition disease which is prevalent worldwide. The usual manifestations are crystal arthropathy and tophi deposition in the soft tissues. Spinal tophi may also occur and are rarely reported, resulting in various clinical manifestations such as back pain, spinal cord compression, radiculopathy, and even mimicking epidural abscess and spondylodiscitis.

    CASE PRESENTATION: We report a case of a 42-year-old Chinese man with underlying gout who presented with back pain and radiculopathy. The diagnosis of spinal tophi was unsuspected and he was initially treated for epidural abscess and spondylodiscitis. He underwent a laminectomy and posterolateral fusion during which tophus material was discovered. He recovered and medications for gout were started.

    CONCLUSION: Spinal tophi are rare. The diagnosis is difficult and spinal tophi may be mistaken for epidural abscess, spondylodiscitis, or neoplasm.
    Matched MeSH terms: Back Pain/drug therapy; Back Pain/etiology*; Back Pain/physiopathology
  20. Tam, Jenn Zhueng, Sharifa Ezat Wan Putih, Noor Hassim
    MyJurnal
    The study objective is to examine the effects of the identified attributes (i.e. employee characteristics and ergonomics) that influences the chronic back pain disabilities acquired and benefits awarded via the recognition of workplace relatedness. As these factors are considered in work- related chronic back pain, we hypothesized that the ascertainment of work relatedness would depend on employees’ workplace conditions (poor ergonomic practices) and innate personal conditions (excellent pre-existing medical health). Two set of data was collected from a registry owned by a social security organization in 2012. Factor analysis and structural equation modeling (SEM) was used to analyze the data. As predicted, workplace conditions and employees’ pre- existing medical health status mediated occupational back pain to develop disability and monetary benefit relationships. In conclusion, the results support the importance of obtaining workplace evidence and employees’ pre- existing medical health status that produces stronger relationship in terms of the amount of benefits to be given compared to the lesser effects on disability. Both models with different samples showed consistent SEM results. The proposed model would be applicable in the heterogenous Asian setting and that occupational back pain consensus is the key element in providing effective social security protection.
    Matched MeSH terms: Back Pain
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