A study conducted between 1998-2001 on the semiconductor industry in Penang and Selangor found that irregular menstruation, dysmenorrhea and stress were identified as the three leading health problems by women workers from a checklist of 16 health problems. After adjusting for confounding factors, including age, working duration in current factory, and marital status, in a multiple logistic regression model, wafer polishing workers were found to experience significantly higher odds of experiencing irregular menstruation. Dysmenorrhea was found to be significantly associated with chemical usage and poor ventilation, while stress was found to be related to poor ventilation, noise and low temperatures.
Malaysia ; *Occupational Exposure ; *Occupational Health ; *Semiconductors ; *Women, Working

Current available implants for total knee replacement are based on the mormphometry of the Caucasian knee. We believe there are significant morphometric differences in the Asian knee that will be relevant in future implant designs. Sixty nine consecutive patients (80 knees) underwent computer navigated primary total knee arthroplasty. The anterior posterior (AP) length, and the medial lateral (ML) width of the distal femur, were analyzed, with respect to the final sizing details of four implants (femoral component) commonly used locally. The mean AP length was 59.9 (SD 4.8) mm, and the mean ML width was 65.0 (SD 5.0) mm. The overall mean aspect ratio (ML/AP) was 1.09 (SD 0.07). The mean aspect ratio for females was 1.08 (SD 0.07). Both were smaller than the aspect ratio of the implants which ranged from 1.11 to 1.13. All four implants tend to overhang at the medial lateral width of the distal femur. This is more obvious in females. Future implant designs should provide more ML wdth sizes for a given AP length, in addition to gender differences, for ths population.
Orthopaedic

A total of 486 Malaysian women electronics workers participated in a study of reproductive health knowledge and cancer screening. The practice of Breast Self Examination (BSE) was found to be related to educational attainment; while ever having had a Pap smear was found to be related to being older than 30 years old, being ever married, living with family or relatives, and not staying in hostels. Knowledge on reproductive health was found to be higher for older women, married women, living with family or relatives, not staying in hostels, ever having done BSE and ever having had a Pap smear.
*Breast Self-Examination ; Electronics ; *Health Knowledge, Attitudes, Practice ; Malaysia ; *Vaginal Smears ; *Women, Working

INTRODUCTIONWhile opioids are effective in carefully selected patients with chronic non-cancer pain (CNCP), they are associated with potential risks. Therefore, treatment recommendations for the safe and effective use of opioids in this patient population are needed.

MATERIALS AND METHODSA multidisciplinary expert panel was convened by the Pain Association of Singapore to develop practical evidence-based recommendations on the use of opioids in the management of CNCP in the local population. This article discusses specific recommendations for various common CNCP conditions.

RESULTSAvailable data demonstrate weak evidence for the long-term use of opioids. There is moderate evidence for the short-term benefit of opioids in certain CNCP conditions. Patients should be carefully screened and assessed prior to starting opioids. An opioid treatment agreement must be established, and urine drug testing may form part of this agreement. A trial duration of up to 2 months is necessary to determine efficacy, not only in terms of pain relief, but also to document improvement in function and quality of life. Regular reviews are essential with appropriate dose adjustments, if necessary, and routine assessment of analgesic efficacy, aberrant behaviour and adverse effects. The reasons for discontinuation of opioid therapy include side effects, lack of efficacy and aberrant drug behaviour.

CONCLUSIONDue to insufficient evidence, the task force does not recommend the use of opioids as first-line treatment for various CNCP. They can be used as secondor third-line treatment, preferably as part of a multimodal approach. Additional studies conducted over extended periods are required.

Analgesics, Opioid ; therapeutic use ; Chronic Pain ; drug therapy ; etiology ; Evidence-Based Medicine ; Humans