64-year Age Group Research Articles

OVERVIEW OF CAREER MANAGEMENT IN DENTISTRY: CHALLENGES AND TRENDS FOR THE FUTURE FROM THE STUDENTS' PERSPECTIVE

Career management has faced several innovations, due to the economy, politics and social contexts. Such changes are justified by technological advances, globalization, communication processes, outsourcing, and unemployment (PEREZ, 2021). It is relevant to reflect and outline a career plan, in order to find a way to put it into practice, to have the attitude of moving towards the achievement of both personal and professional goals. To describe the perception of career management, as seen by students in the health area at a private university in Belo Horizonte. This is a quantitative research, with the purpose of obtaining results that answer the guiding problem of this study. All dentistry students from Brazilian public and private universities were included, who answered a semi-structured questionnaire, reaching the following results: Gender 76.9% of the interviewees are female and 23.1% male; Age 58% of the students are in the 25-year age group; working in the area represent 38%; 79.3% of these students are studying their first undergraduate degree; 20.7% are in their second degree. Regarding the income profile, 37.9% receive between 1 and 2 thousand reais per month, and 50.7% have a salaried employment relationship, and 70.9% have never taken a vocational test to choose dentistry. Therefore, it is possible to conclude that in the current times, important changes in the work scenario are visible. Having achieved the objectives of this study, evidencing the commitment of dentistry students, however, contrary to expectations, it was noted that the individual initiative to develop the career is unsatisfactory, as well as there is no promotion by the HEIs due to the lack of disciplines on clinical career management and offices during the course.

Ocular biometry parameters in mobile cataract surgery camp: a large-scale report from Nigeria

Background: Humanitarian missions and mobile camp surgeries have pivotal roles in cataract surgery in areas with limited resources. Ocular biometry is an important preoperative evaluation tool for cataract surgery candidates. Herein, we report the distributions of ocular biometric values among cataract surgery candidates in camp settings in southern Nigeria. Methods: In this cross-sectional study, we retrieved data from consecutive patients scheduled for cataract surgery. All patients underwent a full ophthalmic examination using a slit-lamp biomicroscope. Age, sex, and preoperative biometric values, including anterior chamber depth (ACD), lens thickness (LT), vitreous chamber depth (VCD), and axial length (AL), together with intraocular lens (IOL) power, were documented. Biometric values were obtained using A-mode ultrasonography. Results: Records of 567 patients with a mean (standard deviation) age of 66.0 (13.4) years revealed a male-to-female sex ratio of 1:1.24. Most participants were in the 66–70-year age group. Mean IOL power was significantly different between males and females (P < 0.001). However, the biometric values were comparable between sexes (all P > 0.05). There were significant differences in the mean IOL power (P < 0.001) and ACD (P < 0.05) between the age groups, indicating a decrease in ACD with age. However, the other biometric parameters were comparable between the age groups (all P > 0.05). ACD had a significant weak negative correlation with LT (r = - 0.16; P < 0.001) and IOL power (r = - 0.22; P < 0.001) and a positive correlation with AL (r = + 0.24; P < 0.001). LT had a significant weak negative correlation with VCD (r = - 0.16; P < 0.001) and a positive correlation with AL (r = + 0.09; P < 0.05). VCD had significant moderate positive and negative correlations with AL (r = + 0.39; P < 0.001) and IOL power (r = - 0.34; P < 0.001), respectively. AL had a significant strong negative correlation with IOL power (r = - 0.78; P < 0.001). Conclusions: This study presents the mean distributions of ocular biometric parameters among cataract surgery candidates in camp settings in southern Nigeria. Age and sex were important determinants of IOL power and should be considered when planning eye camp supplies. AL had a strong inverse correlation with IOL power. Further multicenter national studies are required to verify these preliminary findings.

Endoscopic Sinus Surgery in the Management of Inflammatory Sinonasal Disease

Background: Inflammation of the nose and paranasal sinus is a clinical problem frequently encountered in the practice of otolaryngology in our country. Endoscopic sinus surgery is a minimally invasive technique for the evaluation and treatment of inflammatory sinonasal disease. Endoscopic sinus surgery is used to restore sinus ventilation and normal function of sinuses.Objectives: To see the outcome of endoscopic sinus surgery associated with inflammatory sinonasal diseases.Materials and Methods: It is a prospective observational study carried out in ENT &Head Neck Surgery of Shaheed Suhrawardy Medical College Hospital Dhaka from April 2016 to September 2016.Fifty(50) patients were enrolled in this study. Data was collected by Structural Questionnaire.Result: The majority of patients were 21-30years age group. The mean age group was 35.32 years, Male: male-to-female ratio was 1.3:1. The Majority of cases were antrochoanal polyps followed by an ethmoidal polyp, chronic maxillary sinusitis, and fungal rhinosinusitis. The majority of patients came with nasal obstruction and nasal discharge. Polyp was found in the majority of cases. A major complication was found in hemorrhage. Symptomatic improvement was found following endoscopic sinus surgery. KYAMC Journal Volume: 14, No: 04, January 2024: 226-233.

Comparative analysis of unnatural deaths in Faisalabad during 2018-2022 – A raising trend.

Objective: To assess the pattern of unnatural deaths in Faisalabad during the last five years, to determine the gender and age group mostly affected and to explore the increasing trend if any. Study Design: Retrospective Cross-sectional Descriptive study. Setting: Department of Forensic Medicine and Toxicology, Punjab Medical College, Faisalabad. Period: January 2018 to December 2022. Methods: Subjects of the study were victims of unnatural death in areas covered by Police stations where the postmortem was performed in the Mortuary of Punjab Medical College / Faisalabad Medical University. Data was collected from respective official Police records, FIRs and Postmortem reports and recorded on pre-structured proformas. It was categorized on the basis of manner of death, type of weapon involved, age groups involved and gender. Results: Out of a total of 1340 autopsies conducted, 1024(76.4%) were males and 316(23.6%) were females. The male to female ratio was 3.2:1. Majority of the victims belonged to the 30–39-year age group i.e. 338 (25.2%) followed by the 20-29-year age group with 333 (24.8%) cases. The manner of death was homicidal in 896(67%) cases followed by 320(24%) accidental and 77(6%) of suicide. Firearm was the most commonly used weapon claiming 490 (36.6%) lives followed by RTA with 254 (19%) cases. September was the month in which maximum cases were reported (140,10.4%). Conclusion: Males are the major victims of unnatural deaths, with firearm weapons claiming the majority of lives. There is a rising trend in the number of unnatural deaths as the years go by and strict measures need to be implemented to keep a check and balance on the availability and easy access to firearms and strict traffic rules should be implemented.

To Study the Knowledge, Attitude, and Practice about COVID-19 Pandemic among Health-care Workers in a Tertiary Care Hospital of Northern India

Abstract Background: As the primary carers, the health-care workers (HCWs) are interacting directly with the patients and are consequently more susceptible to infection. By enhancing their knowledge, attitudes, and practices (KAP) about COVID-19, the HCWs can prevent or significantly minimize their risk of contracting it. Objective: This research was carried out to assess KAP about various aspects of the COVID-19 infection among HCWs and their association vis-à-vis different sociodemographic variables. Methodology: The study used a prospective cross-sectional design and the participants were the HCWs working in the department of obstetrics and gynecology at a tertiary care referral and academic hospital. A pretested questionnaire comprised 35 items, with 14 items about knowledge, 13 about attitude, and 8 about practices adopted by HCWs. Statistical Analysis: For the analysis, we used descriptive statistics, analysis of variance (ANOVA), and Pearson Chi-square tests. Results: The study involved a cohort of 209 HCWs. Based on the results of descriptive statistical analysis, the participants had an average knowledge score of 9.59 with a standard deviation (SD) of 2.07. The observed scores ranged from 2.00 to 14.00. On further subgroup analysis, the mean knowledge was highest among the 19–25-year age group (mean: 9.97, minimum: 4.00, and maximum: 14.00; SD: 2.13), MBBS students (mean: 10.69, minimum: 8.00, and maximum: 14.00; SD 1.74), male participants (mean: 9.97, minimum: 5.00, and maximum: 13.00; SD: 1.62), and unmarried respondents (mean: 9.77, minimum: 2.00, and maximum: 14.00; SD 2.24). Conclusions: It is vital to evaluate the present KAP of health-care professionals regarding COVID-19 in the global fight against the pandemic. The study identified a few gaps in the KAP of HCWs.

Nostalgia-based marketing campaigns and sport participation

PurposeFramed by nostalgia marketing, this research draws upon lessons from ParticipACTION, a Canadian non-profit health promotion organization, to examine one of their most well-known campaigns, Body Break with ParticipACTION, in order to assess the potential role for nostalgia-based marketing campaigns in sport participation across generational cohorts.Design/methodology/approachExploratory sequential mixed methods involving two studies were completed on behalf of ParticipACTION, with the authors developing the research instruments and the collection of the data undertaken by research agencies. Study 1 was the secondary analysis of qualitative data from five focus groups with different demographic compositions that followed a common question guide. Study 2 was a secondary data analysis of a pan-Canadian online survey with a sample (n = 1,475) representative of the overall adult population that assessed awareness of, and attitudes toward, ParticipACTION, Body Break, physical activity and sport participation. Path analysis tested a proposed model that was based on previous research on attitudes, brand and loyalty. Further, multi-group path analyses were conducted to compare younger generations with older ones.FindingsThe results provide direction and understanding of the importance of nostalgia in marketing sport participation programs across generational cohorts. For instance, in the four parent-adult focus groups, unaided references as well as frequent and detailed comments regarding Body Break were observed. Similarly, Millennials reported that Body Break was memorable, Canadian and nostalgic, with a mix of positive and negative comments. The importance of nostalgia was supported sequentially via results from the national survey. For example, while 54.1% of the 40–54 age-group associated ParticipACTION positively with Body Break, so did 49.8% of the 25–39-year age group, most of whom were not born when the promotion ran. Further, brand resonance was found to explain 4% more variance in moderate-to-vigorous physical activity (MVPA), the proxy for sport participation, for younger people compared to older people.Practical implicationsResults provide direction to brands, properties and agencies around the use of nostalgia in sport marketing campaigns and sponsorship efforts. For brands seeking to sponsor sport properties to alter their image with potential consumers in a new market, associating with a sport property that many view as nostalgic could improve the impact of the campaign. On the sport property side, event managers and marketers should both identify existing assets that members or fans are nostalgic about, as well as consider building nostalgia into current and new properties they develop.Originality/valueThis research is valuable to the sport marketing and sponsorship literature through several contributions. First, the use of nostalgia marketing, and nostalgia in general, is novel in the sport marketing and sponsorship literature, with future research in nostalgia and sponsorship recommended. Second, the potential to adopt or adapt Body Break to other sport participation and physical activity properties is empirically supported. Finally, the finding that very effective promotions can have a long-lasting effect, both on those who experienced the campaigns as well as younger populations who only heard about it, is notable.

Impact of age on the prevalence of poor-quality dietary variety, associated lifestyle factors, and body composition profile (low body muscle mass and high body fat mass) in older people residing in Colombo district, Sri Lanka

AimsTo assess the impact of age on the prevalence of poor-quality dietary variety, associated lifestyle factors, and body composition profile (low body muscle mass and high-fat mass) in older Sri Lankans. MethodsIn this population-based cross-sectional study, older people of 60 years or above were selected using a multistage cluster sampling technique probability proportionate to the size. They were classified into 3 groups; 60–64, 65–69 and > 70-years. The poor-quality dietary variety was defined based on food variety, dietary diversity and dietary serving scores assessed using 24-h dietary recall. Body composition was measured using bio-electrical impedance. The impact of age on determinants of poor-quality dietary variety and being at risk of low muscle mass and high-fat mass were assessed by using multivariable logistic regression models. ResultsEight hundred older participants with a mean (SD) 68.1(5.8) years were included. There were 28.4%(n = 227), 36.2%(n = 290) and 35.4%(n = 283) in the 60–64, 65–69 and ≥ 70-year age groups, respectively. The prevalence of poor-quality dietary variety was similar across age groups. The urban living environment, and getting nutritional advice from the GP/hospital were found to have a significant negative association only in the 60–64 age group. A poor-quality dietary variety was significantly associated with no education or up to the primary level in the 65–69 age group and having diabetes or hypertension in the ≥70-year group. Odds of low muscle mass and high-fat mass were 2.43(1.46–4.03) and 2.17(1.30–3.63) respectively among the≥70-year age group compared to the 60-64-year group, after controlling for confounders. ConclusionsThe prevalence of poor-quality dietary variety was similarly high in all age groups. Increasing age was associated with higher odds of low body muscle and high body fat mass despite similar dietary variety, indicating the need for special dietary attention.

Profile of Five Types of Gynecological Bleeding Cases at UKI Hospital

This study provides an overview of cases of gynecological bleeding that occurred at RSU UKI from 01 January 2012 to 31 December 2014. The method used in the research was a descriptive study with a retrospective, exploratory, and cross-sectional approach. To simplify the research process, the author only examined five types of cases that occurred at RSU UKI, namely uterine myoma, adenomyosis, polyps, cervical cancer, and endometrial cancer. Gynecological bleeding is a disease that is very often encountered today. The study's results based on the period found 69 cases of gynecological bleeding. Around 66.7% (46 cases) were sufferers of uterine myoma, 13.0% (9 cases) had adenomyosis, 11.6% (8 cases) had polyps, 7.2% (5 cases) had cervical cancer, and 1.4% (1 case) had endometrial cancer. Until now, the number of incidents has been increasing from year to year, and this is very likely based on a person's risk factors for the occurrence of a disease. Of these gynecological bleeding disorders, it was found that the highest incidence was in the 40 - 44-year age group. From the results of laboratory examinations, there is a close relationship between gynecological bleeding and the frequency of anemia; it was found that 56.5% of patients with gynecological bleeding disorders experienced anemia. The author recommends routine examination of the uterine organs to detect them as early as possible. Keywords: Gynecological bleeding, uterine myoma, adenomyosis, cervical cancer, polyps, endometrial cancer

Burden of depressive disorders in Vietnam from 1990 to 2019: A secondary analysis of the Global Burden of Disease Study 2019

Depressive disorders are among the leading causes of disability globally. However, information on the burden of depressive disorders in Vietnam is limited. We aimed to analyse the burden of depressive disorders in Vietnam from 1990 to 2019. Using data from the Global Burden of Disease Study 2019, prevalence and disability-adjusted life-years (DALYs) were used as indicators to analyse the burden of depressive disorders by age and sex. In 2019 in Vietnam, depressive disorders comprised 2629.1 thousand (95% uncertainty interval (UI): 2233.3–3155.9) estimated cases and 380.6 thousand (95% UI: 258.9–533.8) estimated DALYs. The crude prevalence rate of depressive disorders was higher among females than among males. The DALYs of depressive disorder accounted for a higher percentage of the total all-cause DALYs in the 10–64-year age group than in other age groups. Major depressive disorder was the largest contributor to the burden of depressive disorders. From 1990 to 2019, the crude prevalence and DALY rates per 100 000 population due to depressive disorders increased significantly, whereas age-standardised rates of prevalence and DALYs decreased significantly; the respective average annual percent changes were 0.88% (95% confidence interval: 0.87 to 0.89), 0.68% (0.66 to 0.70), −0.20% (−0.21 to −0.19), and −0.27% (−0.28 to −0.25). Although the age-standardised prevalence rate was lower than that seen globally, depressive disorders were considerable mental health issues in Vietnam. This study will help governments and policymakers to establish appropriate strategies to reduce the burden of these disorders by identifying the priority areas and individuals.

A novel approach to quantifying individual's biological aging using Korea’s national health screening program toward precision public health

Accurate prediction of biological age can inform public health measures to extend healthy lifespans and reduce chronic conditions. Multiple theoretical models and methods have been developed; however, their applicability and accuracy are still not extensive. Here, we report Differential Aging and Health Index (DAnHI), a novel measure of age deviation, developed using physical and serum biomarkers from four million individuals in Korea's National Health Screening Program. Participants were grouped into aging statuses (< 26 vs. ≥ 26, < 27 vs. ≥ 27, …, < 75 vs. ≥ 75 years) as response variables in a binary logistic regression model with thirteen biomarkers as independent variables. DAnHI for each individual was calculated as the weighted mean of their relative probabilities of being classified into each older age status, based on model ages ranging from 26 to 75. DAnHI in our large study population showed a steady increase with the increase in age and was positively associated with death after adjusting for chronological age. However, the effect size of DAnHI on the risk of death varied according to the age group and sex. The hazard ratio was highest in the 50–59-year age group and then decreased as the individuals aged. This study demonstrates that routine health check-up biomarkers can be integrated into a quantitative measure for predicting aging-related health status and death via appropriate statistical models and methodology. Our DAnHI-based results suggest that the same level of aging-related health status does not indicate the same degree of risk for death.

Specialize Early and Select Late: Performance Trajectories of World-Class Finalists and International- and National-Class Swimmers.

To investigate performance progression from early-junior to peak performance age and compare variety in race distances and swimming strokes between swimmers of various performance levels. Using a longitudinal data analysis and between-groups comparisons 306,165 annual best times of male swimmers (N = 3897) were used to establish a ranking based on annual best times at peak performance age. Individual performance trajectories were retrospectively analyzed to compare distance and stroke variety. Performances of world-class finalistsand international- and national-class swimmers (swimming points: 886 [30], 793 [28], and 698 [28], respectively) were compared across 5 age groups-13-14, 15-16, 17-18, 19-20, and 21+years-using a 2-way analysis of variance with repeated measures. World-class finalists are not significantly faster than international-class swimmers up to the 17- to 18-year age group (F2|774 = 65, P < .001, ηp2=.14) but specialize in short- or long-distance races at a younger age. World-class breaststroke finalists show faster breaststroke times compared to their performance in other swimming strokes from an early age (P < .05), while world-class freestyle and individual medley finalists show less significant differences to their performance in other swimming strokes. While federation officials should aim for late talent selection, that is, not before the 17- to 18-year age group, coaches should aim to identify swimmers' preferred race distances early on. However, the required stroke variety seems to be specific for each swimming stroke. Breaststroke swimmers could aim for early and strong specialization, while freestyle and individual medley swimmers could maintain large and very large stroke variety, respectively.

Oral cavity cancer incidence and survival trends: A population-based study.

The present study aimed to calculate the burden of oral cavity cancer (OCC) including incidence, mortality rate, survival rate, and influence of predictive factors such as clinicopathological, demographic findings, and treatment modalities. Data in this retrospective study were collected from India's population-based cancer registry (PBCR) from 2010 to 2016. A total of 1051 cases of OCC were noted. Incidence and mortality rates were calculated. The cumulative survival outcome was calculated using Kaplan-Meier (KM) method. Prognostic factors were estimated using the Cox proportional hazard regression model. The age-standardized incidence rates (ASR), and mortality rate (ASMR), of overall OCC cases were 10.1 and 8.4 per 100 thousand population, respectively. Five-year overall survival (OS) was 32.3%. Survival outcome was significantly associated with the given treatment (Chi-square value = 58.17, P = 0.0001) and anatomical site (Chi-square value = 26.70, P = 0.0001). 17.6% of cases in males were <39-year age group. The hazard ratio (HR) in the age group of >50 years was 2.065 (95% CI 1.34-3.18, P = 0.001). Combination therapy had an HR of 2.630 (95% CI 1.91-3.63, P value 0.000). Tonsillar carcinoma (C09) (95% CI 1.04-3.12) had 1.8 times more chances of death than lip carcinoma (C00). OCC cases are increasing in the younger population, and overall, cases show higher mortality rates with reduced survival outcomes. Prognostic factors such as age >50 years, single modality treatment, and alveolar and tonsillar malignancy are associated with poor survival. OCC robust screening by a trained health professional can improve early detection and increases awareness and lower mortality of the disease.

THE EFFECT OF MUSIC THERAPY AND POSITIVE AFFIRMATIONS (TEMATIVE) ON REDUCING DEPRESSION LEVELS IN ELDERLY FAMILIES WITH SRTOKE

Introduction: In Indonesia, the problem of stroke is becoming increasingly important to pay attention to because the incidence of stroke in Indonesia is the highest in the Asian region. Stroke sufferers in Indonesia have increased according to 2018 Basic Health Research (RISKESDAS) data based on age groups. Stroke incidents are more common in the 55–64-year age group. Stroke in the elderly is a complex problem because it has an impact on the family. Apart from physical factors, there are psychological problems and illnesses such as chronic disease, poverty, successive failures, prolonged stress, or conflict with family or children. Living conditions like this can trigger depression. Depression can affect anyone, but people with chronic illnesses such as stroke are at higher risk. One method to reduce depression levels is music therapy. The aim of this research is to determine the effect of music therapy on reducing levels of depression. The methodology used is "Quasi experimental pre-post-test wit control group". With the intervention package providing music therapy to the intervention group. Meanwhile, the control group was not given intervention, only given direction. The population in this study were elderly people in the PKM Cipayung work area. Analysis results the results of statistical tests in the control group obtained a p value = 0.254. which means there is no significant difference in the average pre and post-depression levels in the control group. The results of statistical tests in the intervention group showed a p value = 0.058, meaning that there was a significant difference in the average level of anxiety in the pre and post intervention groups.

Effect of fluoxetine on serum sodium levels in patients with depression

Background: One common selective serotonin reuptake inhibitor (SSRI) used to treat depression and other mood disorders is fluoxetine. Hyponatremia, or low serum sodium levels, is one of the side effects of fluoxetine and other selective serotonin reuptake inhibitors (SSRIs), despite their effectiveness in reducing depressed symptoms. Regular monitoring of serum sodium levels is essential to prevent and manage these side effects. Aim and Objectives: The objective of this study was to evaluate and compare the changes in serum sodium levels in patients with depression taking fluoxetine in different age groups (18–45, 46–70 years) and to evaluate the adverse effects between the two age groups. Materials and Methods: This prospective observational study involved 110 depressed patients who were divided into two age groups, 18–45 and 46–70 years old, and who attended a psychiatric outpatient department at a tertiary care hospital. Before starting fluoxetine therapy as well as in the first and third weeks afterward, serum sodium levels were tested, and adverse effects were noted. Between the two age groups, serum sodium level changes and other side effects were compared. Results: The serum sodium levels in the 46–70-year-old age group significantly dropped at the first and third weeks following therapy, whereas in the 18–45 year-old age group, the decrease in serum sodium levels occurred only after the 3rd week of therapy (P = 0.0005). At the 3rd week of therapy, 46–70-year-old serum sodium levels were substantially lower than those of 18–45-year-old patients (136.6 vs. 140.5, P = 0.0005), and only older patients had hyponatremia after the 1st and 3rd weeks of therapy. The P value is highly statistically significant (&lt; 0.01). Conclusions: Fluoxetine can lower serum sodium levels, which are more common and clinically evident in the 46–70-year age group than in the 18–45-year age group. In the first few weeks of fluoxetine medication, monitoring serum sodium levels is advised, especially for patients in the 46–70 age group.

Clinicopathological study of benign breast diseases in Bundelkhand regions

Background: Benign breast diseases are a neglected entity despite the fact that it constitutes the majority of breast complaints and that the vast majority of the lesions that occur in the breast are benign. Aims and Objectives: The aims and objectives of the study are to analyze the percentage of incidence, age distribution, and other associated factors of benign breast diseases. Materials and Methods: The prospective study was conducted on 100 cases of benign breast diseases in Maharani Laxmi Bai Medical College, Jhansi, between January 2021 and June 2022. Results: Lump was found in all participants (100%) in which incidence of painless and painful lump was for 94% and 6%, respectively. 6% lump was found to be associated with non-cyclical mastalgia and 2% lump had having association with discharge. Milky discharge (1%) was found in the case of galactocele and serous discharge (1%) was found in duct ectasia. Benign breast diseases were found most commonly in premenopausal women (97%) in comparison to post-menopausal women (3%). Breast lump was investigated by fine needle aspiration cytology which was consistent with a lump of fibroadenoma and fibroadenosis in 95% of cases. Rest 5% of breast lumps were non-consistent. 90% of cases were found of fibroadenoma. All patients underwent surgical line of management except for fibroadenosis which was managed conservatively. Cases of breast abscess, fibroadenoma, duct ectasia, and galactocele admitted in hospital, for which mean hospital stay was 4.28 plus or minus 6.21 days. Conclusion: The most common benign breast disease encountered in clinical practice is fibroadenoma followed by fibroadenosis. They are most common in 15–25-year age group and its presentation is found to be more in married woman.

Trends in Infective Endocarditis Mortality in the United States: 1999 to 2020: A Cause for Alarm.

Data on national trends in mortality due to infective endocarditis (IE) in the United States are limited. Utilizing the multiple causes of death data from the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research database from 1999 to 2020, IE and substance use were identified using the International Classification of Diseases, Tenth Revision, Clinical Modification codes. Between 1999 and 2020, the IE-related age-adjusted mortality rates declined. IE-related crude mortality accelerated significantly in the age groups 25-34 years (average annual percentage change, 5.4 [95% CI, 3.1-7.7]; P<0.001) and 35-44 years (average annual percentage change, 2.3 [95% CI, 1.3-3.3]; P<0.001), but remained stagnant in those aged 45-54 years (average annual percentage change, 0.5 [95% CI, -1.9 to 3]; P=0.684), and showed a significant decline in those aged ≥55 years. A concomitant substance use disorder as multiple causes of death in those with IE increased drastically in the 25-44 years age group (P<0.001). The states of Kentucky, Tennessee, and West Virginia showed an acceleration in age-adjusted mortality rates in contrast to other states, where there was predominantly a decline or static trend for IE. Age-adjusted mortality rates due to IE in the overall population have declined. The marked acceleration in mortality in the 25- to 44-year age group is a cause for alarm. Regional differences with acceleration in IE mortality rates were noted in Kentucky, Tennessee, and West Virginia. We speculate that this acceleration was likely due mainly to the opioid crisis that has engulfed several states and involved principally younger adults.

Younger Patients Undergoing Total Ankle Arthroplasty Experience Higher Complication Rates and Worse Functional Outcomes.

Although many patients with posttraumatic ankle arthritis are of a younger age, studies evaluating the impact of age on outcomes of primary total ankle arthroplasty (TAA) have revealed heterogenous results. The purpose of the present study was to determine the effect of age on complication rates and patient-reported outcomes after TAA. We retrospectively reviewed the records of 1,115 patients who had undergone primary TAA. The patients were divided into 3 age cohorts: <55 years (n = 196), 55 to 70 years (n = 657), and >70 years (n = 262). Demographic characteristics, intraoperative variables, postoperative complications, and patient-reported outcome measures were compared among groups with use of univariable analyses. Competing-risk regression analysis with adjustment for patient and implant characteristics was performed to assess the risk of implant failure by age group. The mean duration of follow-up was 5.6 years. Compared with the patients who were 55 to 70 years of age and >70 years of age, those who were <55 years of age had the highest rates of any reoperation (19.9%, 11.7%, and 6.5% for the <55, 55 to 70, and >70-year age groups, respectively; p < 0.001), implant failure (5.6%, 2.9%, and 1.1% for the <55, 55 to 70, and >70-year age groups, respectively; p = 0.019), and polyethylene exchange (7.7%, 4.3%, and 2.3% for the <55, 55 to 70, and >70-year age groups, respectively; p = 0.021). Competing-risk regression revealed a decreased risk of implant failure for patients who were >70 of age compared with those who were <55 years of age (hazard ratio [HR], 0.21 [95% confidence interval (CI), 0.05 to 0.80]; p = 0.023) and for patients who were 55 to 70 years of age compared with those who were <55 years of age (HR, 0.35 [95% CI, 0.16 to 0.77]; p = 0.009). For all subscales of the Foot and Ankle Outcome Score (FAOS) measure except activities of daily living, patients who were <55 years of age reported the lowest (worst) mean preoperative and postoperative scores compared with those who were 55 to 70 years of age and >70 years of age (p ≤ 0.001). Patients who were <55 years of age had the highest mean numerical pain score at the time of the latest follow-up (23.6, 14.4, 12.9 for the <55, 55 to 70, and >70-year age groups, respectively; p < 0.001). Studies involving large sample sizes with intermediate to long-term follow-up are critical to reveal age-related impacts on outcomes after TAA. In the present study, which we believe to be the largest single-institution series to date evaluating the effect of age on outcomes after TAA, younger patients had higher rates of complications and implant failure and fared worse on patient-reported outcome measures. Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.

Assessment of Farmer Knowledge Level about Recommended Production Technology in Maize (Zea mays) Crop

The present research work was conducted in the Darbhanga and Bhagalpur district of Bihar to assess the knowledge level of farmers about recommended maize production technology. The ex-post facto research design was used. Three villages are purposefully chosen for each district and a total of 210 respondents were selected randomly. Results shown that the majority of respondents (40.5%) fall into the 40–54-year age group followed by most the respondents have educational background up to the level of senior secondary. It was observed that most the respondents have farming experience range of 9 -14 years followed by BAO (Block Agriculture Officer) is the most preferred extension exposure by the respondents, most of the respondents had the membership of panchayat. The average knowledge level of respondents is determined by knowledge test which contains question regarding different cultivation practices of maize further data from result revealed that the average knowledge level in planting time, soil and land preparation, method of sowing, seed rate and spacing, irrigation management, insect- pest management is higher in Bhagalpur respondents compare to Darbhanga district respondents. Average knowledge level in insect -pest management is low in both districts compare to other cultivation practices.

A Morphometric Study Analyzing the Anterior Epidural Space Volume Throughout Childhood

BACKGROUND: Following disc herniations, fragments migrate into the anterior epidural space within the lumbar spine. Although the volume of this area has been previously described in the adult population, the volume is relatively unknown within children. OBJECTIVES: Investigate the relative volume in the lumbar anterior epidural space within the growing spine by using imaging studies. STUDY DESIGN: Retrospective chart review. SETTING: University Medical Center in Lubbock Texas. A teaching hospital affiliated with Texas Tech University Health Sciences Center. METHODS: We conducted a retrospective review of the charts of pediatric patients seen at our institution from 2018 through 2020. Charts chosen for our investigation contained computed tomography imaging of the lumber spine, showing no deformities. Thirty patients were stratified equally among 3 age groups, 2-5 years old, 10-12 years old, and 16-18 years old. The anterior epidural space was measured in each patient 3 times using the previously reported method used by Teske et al (1). Results were compared with a combination of analysis of variance (ANOVA) and single tail paired t test. RESULTS: There was a statistically significant difference in the anterior epidural space size among age groups at all levels of the lumbar spine. When comparing only 2 groups together, the younger age group had anterior epidural space sizes significantly smaller than the other age group for all levels of the lumbar spine. The 10-12 age group had a significantly smaller space in the anterior epidural space than the 16–18-year olds only at the level of L2, L4, and L5 (P = 0.048,0.039, and 0.031, respectively). Within the 16–18-year age group, the anterior epidural space was significantly different between L4 and L3 and L2 and L3 (P &lt; 0.001 and P = 0.019, respectively). LIMITATIONS: Our study is limited by its retrospective nature and the sample size of the patient groups. Furthermore, the use of computed tomography imaging and not making physical measurements limits our accuracy. CONCLUSION: The volume of the anterior epidural space is smaller in the pediatric population than the adult population. The inability of herniated discs to fit within the epidural space in children and adolescents could potentially be the cause of the increased failure of conservative treatment for pediatric lumbar disc herniations. KEY WORDS: Anterior epidural space, lumbar herniated disc, low back pain, fossa corporis vertebralis dorsalis, free disc fragment, lumbar spine anatomy

The prevalence of vitamin D deficiency and the factors affecting vitamin D levels in children admitted to the outpatient clinic of pediatric endocrinology in Bolu Province

BackgroundThe present study aimed to determine the rate of vitamin D deficiency in children who presented to the pediatric endocrinology outpatient clinic in Bolu and to investigate the factors affecting vitamin D levels. MethodsVitamin D levels of 1008 children and adolescents were retrospectively analyzed according to age group (0–1, 1–10, and 10–18 years), gender, season, month, obesity and other diseases, and deficiency category. Moreover, calcium, phosphorus, alkaline phosphatase, and parathyroid hormone levels were evaluated. Comparisons and correlation analyses between related groups were performed. ResultsThe mean vitamin D level of the patients was 16.35±9.56 ng/mL and was lower in girls (14.90±9.56 ng/mL) than in boys (18.68±9.63 ng/mL, p<0.001). Overall, 18.3% of the children and adolescents had vitamin D insufficiency, 52.3% had vitamin D deficiency, and 3.5% had severe vitamin D deficiency. Vitamin D levels were lower in 10–18-year age group than in the other age groups (p<0.001), and levels were higher in summer and autumn than in winter and spring (p<0.001). Vitamin D levels of participants with obesity (14.3 ± 8.3 ng/mL) were significantly lower than normal-weight participants with no health problems (15.9 ± 8.3 ng/mL, p = 0.004). There was a negative correlation between vitamin D, alkaline phosphatase, and parathyroid hormone levels in the 1–10-year age group, but a positive correlation between vitamin D, alkaline phosphatase, and calcium levels in the 10–18-year age group. ConclusionThe rate of vitamin D deficiency is high among children and adolescents who presented to the endocrine outpatient clinic in Bolu. The season appears to be an important factor affecting vitamin D levels as well as the relationship between vitamin D and parathyroid hormone. Obese children and adolescents living in this region may be advised to take vitamin D supplements in winter and spring.