Cross-sectional Study Research Articles

Sonographic and histopathological findings endometrium among perimenopausal women with abnormal uterine bleeding- A cross sectional study in north Kerala

: AUB makes a perimenopausal woman to seek medical care. This study evaluated and correlated the endometrial thickness obtained by ultrasonography and histopathological findings of endometrium in perimenopausal women with AUB.A hospital based observational cross-sectional study was conducted in Obstetrics and Gynaecology Department, Baby Memorial Hospital, Calicut for a period of 18 months. Histo-pathologic evaluation of endometrial tissue was done and was correlated with endometrial thickness.: The average age of women enrolled was 47.88 years with standard deviation of 3.729. The average endometrial thickness was 12.40mm. Endometrial hyperplasia without atypia was the leading histopathological finding obtained after analysis of endometrium (21.5%). This study shows that there is a significant relationship between histopathology findings of endometrium and age of participant and between endometrial thickness and menorrhagia. There was no relationship between histopathology findings and endometrial thickness. Perimenopausal AUB should be evaluated in a systematic manner, so that endometrial hyperplasia, carcinoma endometrium could be diagnosed in a very early stage and prompt treatment be given at right time reducing morbidity improving the quality of life.

A study on appropriate use and stewardship of proton pump inhibitors

Objective: To analyze the prescribing pattern of use of PPI with respect to “FDA-Approved Indications and Doses for PPI Therapy.” Materials and Methods: After obtaining approval from the Institutional Ethics Committee, a cross-sectional study was carried out among 400 inpatients in a tertiary care hospital in Bangalore. The data were collected from the patient case profile and prescriptions and noted in a self-designed data collection form. The statistical analysis of the collected data was performed using SPSS software and Excel. Results: The study, conducted on 400 patients, revealed a male majority (60%) and a female representation of 40%. Proton Pump Inhibitors (PPIs), mainly Pantoprazole (74.70%), were frequently prescribed, notably in General Medicine (220 patients). PPI use was generally appropriate: indication (99%), dose (97%), frequency (92.8%), and duration (91.8%). However, irrational prescriptions were noted: indication (1%), dose (3%), frequency (7.3%), and duration (8.3%). 139 drug interactions were identified, categorized into Major (39.6%), Moderate (46%), and Minor (14.4%). For example, Ondansetron and tramadol exhibited a major interaction. Among PPI combinations, 93.75% could affect CYP2C19 metabolism, and 6.3% had additive/synergistic toxicity potential.

Identification of learning style preferences among first year MBBS students using VARK questionnaire

Identification of learning style preferences among first year MBBS students using VARK questionnaire

Construction and validation of self-reporting menstrual disorder screening questionnaire for Indian population

Dysmenorrhea is defined as difficulty in menstrual flow and refers to painful cramps during menstruation. There are 2 types of dysmenorrhea, primary and secondary dysmenorrhea respectively. Early diagnosis of these conditions which may be responsible for dysmenorrhea is necessary to curb the rising prevalence of infertility. There are no adequate screening questionnaires available for Indian population which can screen dysmenorrhea and differentiate primary and secondary dysmenorrhea.: The objective of phase-1 of this study comprised of constructing menstrual disorder screening questionnaire and content validating the questionnaire and the objective of phase-2 was to administer the developed questionnaire on the targeted population. This was a cross-sectional study in which a questionnaire was developed and content validated by experts. The expert panel was asked to validate each question on a four-point Likert scale for relevance, clarity, ease of comprehension and the question was represented in participants correct section. A pilot study was carried out on 31 participants. A total of 142 participants were participated in the study.Dysmenorrhea was reported by a total of 129 participants i.e. 90.85% whereas only 9.15% reported of having no pain during menstruation. Dysmenorrhea symptoms experienced only sometimes by 56 participants, but 73 participants reported to experience them with each cycle. The questionnaire developed, and content validated in this study can be used as a self-reporting screening tool to detect menstrual abnormalities in the Indian population

Assessing prescribing practices in a rural hospital: A cross-sectional study using WHO prescribing indicators

This cross-sectional study aims to assess the prescribing practices of physicians at a rural hospital in Western India, focusing on adherence to WHO prescribing indicators. The main research question addressed the extent of alignment with optimal prescribing standards. 1: Evaluate prescribing patterns in a rural hospital using WHO indicators. 2: Assess alignment with WHO standards and identify areas for improvement. 3: Understand demographic influences on prescribing. 4: Provide insights for optimizing rural healthcare delivery.A prospective, descriptive, cross-sectional approach was employed in the outpatient department of the rural hospital. A total of 604 prescriptions were sampled over two months, and data were collected using a random sampling method. The study followed ethical standards, and prescriptions were analyzed for demographic characteristics, prescribing patterns, and adherence to WHO indicators. The average number of drugs per prescription was 3.5, indicating a tendency towards polypharmacy. While 86% of drugs were prescribed generically, the study revealed areas of suboptimal adherence to WHO prescribing indicators, including antibiotic prescriptions (29%) and injectable use (50%). The analysis also highlighted disparities in prescribing patterns based on gender and age. The study provides valuable insights into prescribing practices in a rural healthcare setting, emphasizing the need for interventions to streamline prescriptions and enhance adherence to global standards. The identified areas for improvement include addressing polypharmacy, promoting generic prescribing, and optimizing antibiotic and injectable use.

Retinopathy of prematurity in multiple births versus single births preterm, extremely preterm infants

The purpose of the study was to compare the retinopathy of prematurity in preterm, extremely preterm infants between multiple and single births.It was a hospital – based cross sectional comparative study conducted among preterm 28 - ≤37 weeks of gestational age, extremely preterm ≤ 28 weeks of gestational age at delivery of multiple and single births. Data on Gestational age, birth weight, birth order (single/multiple), Risk factors, Refractive status, and Treatment type were noted. Ophthalmological findings were performed routinely at 4 weeks and repeated later depending upon the severity. 49 infants were involved in this study; 22 were born as singletons and 27 as multiples. Our results show 2.0% of subject in stage 1, 18.4% in stage 2, 8.2% in stage 3, 2.0% in stage 4 substantially corresponds with the severity of retinopathy of prematurity due to lower gestational week and lower birth weight. Multiple birth infants statistically had 6.1% in stage 1, 18.4% in stage 2, 8.2% in stage 3, 2.0% in stage 4 retinopathy of prematurity than single birth infants. Risk factor results indicates necrotizing enterocolitis (33.3% in stage 2), oxygen (35.5% in stage 2 and 16.1% in stage 3), sepsis (37.9%, and 20.7% in stage 3), and continuous positive airway pressure (44.4% in stage 2 and 11.1% in stage 3) Compound hyperopic astigmatism was the most typical refractive error in both births. Laser treatment accounts for 18.1% in both groups. This study showed a significant correlation with ROP development in multiple births.

Conceptual differences about willingness of body donation among southern, eastern, central and northern population of India: Single centered approach

: Cadaveric dissection cannot be compensated by virtue table concepts or computerized learning aids. The present study was aimed to evaluate the conceptual differences and perceptional clarity about willingness of body donation relevant to regional practice among four inter-state population of India. The study objectives focused to assess the understanding level about general and special concepts and attitudes about body donation in Southern, Eastern, Central as well Northern parts of India and to compare differences about the concepts of understanding and willingness about body donation between four inter-state populations.A cross-sectional single center study with a differential rating scale questionnaire was conducted. Four hundred participants equally divided among four medical colleges of Southern, Eastern, Central and Northern India were the samples. All ethical principles for human research were followed. Completing a special course of ethical training and non-willingness to participate in the study were regarded as the criteria of a subject to get excluded from the study.The given questionnaire was completed by various participants from different zones: eastern, western, central and southern. We found significant difference in the educational level of the participants across various zones. Unsurprisingly, most likely due to the literacy rate, participants from the south are much more familiar with ‘body donation’ for research and education compared to participants from other three zones. Provisions to improve the body donation should concentrate on multi-directional tasks.

Influence of sleep quality and other associated factors on glycemic control among diabetic patients: A hospital-based study

The glycemic control of diabetes patients is influenced by a variety of risk factors, some of which are adjustable and others of which are not. Diabetes and sleep quality are most frequently correlated in both directions. To evaluate the quality of sleep and pinpoint the risk factors for inadequate glycemic control in individuals with diabetes. : This cross-sectional study included seventy consecutive patients who met the inclusion criteria. The Pittsburgh Sleep Quality Index (PSQI) scale was used to evaluate the quality of sleep. Siemens- ID 29984, dimension RxL Max, Architect plus ABBOT (ci 4100), completely automatic seven-part cell-counter by Horiba Pentra Dx and Siemens ADVIA Centaur XPT (Immonoassay system) were utilized for the biochemical tests.: Of the 70 participants in the study, 22 patients [31.4%] reported having good sleep quality, while 15 patients [21.4%] had average sleep quality and 33 patients [47.1%] had poor sleep quality. Patients with managed and uncontrolled blood sugar showed varying degrees of sleep quality; 48.4% and 17.9% showed good sleep quality, 29% and 15.4% showed moderate sleep quality, and 22.6% and 66.7% showed poor sleep quality. A statistically significant difference (p<0.001) was seen in the sleep quality of the two groups. : In summary, the results of our study suggested that diabetics with poor sleep quality are more likely to have poor glycemic control. A significant modifiable risk factor for improved glycemic management in diabetic patients is sleep quality.

A study on clinico-demographic and microbiological profile of surgical site infection (SSI) in a tertiary care hospital, Kolkata: An alarming trend

The Centres for Disease Control and Prevention (CDC) estimates surgical site infections SSI is major contributor of healthcare associated infections (HAI). Multidrug resistant (MDR) Gram-negative bacilli are emerging pathogens. This study aimed to determine the magnitude of SSI and identify predominant pathogens with their antimicrobial susceptibility patterns. It is a hospital-based descriptive cross-sectional study including 2070 suspected SSI specimens from 25809 surgeries between 1July 2021 to 30 June 2023. Organisms’ identification and AST was done by both conventional and automated methods. Data was collected and analysed on MS-Excel sheet with various charts and tables. In our study SSI rate was 6.3%, much higher than previous study (2.83%) from this institution. SSI rate was highest in plastic surgery (8.2%). Major pathogens of SSI were Gram-negative bacilli e.g., (26.34%), (25.59%) and (74.69%) was predominant among Gram-positive cocci. Gram-negative bacilli including enterobacterales and non-fermenter and showed resistance to major classes of broad- spectrum antibiotics. Methicillin resistance (MRSA) was 43.9%, which indicates need to improve infection control practices. Our study showed significant higher proportion of SSI as compared to previous studies from the same institute with alarming number of isolated MDR Gram-negative bacilli. So, this study focusses the need of robust infection control practices and strict implementation of antimicrobial stewardship to overcome challenges of antimicrobial resistance.

To study the socio-demographic profile and clinical profile of abnormal uterine bleeding cases attending new civil hospital, Surat, Western India

There are so many concerns and worries about menstruation. With the use of advance method of contraception, women are experiencing more menstrual related problems. Now a days, menstrual related complaints are more common in gynaec clinic. So, we had conducted this study to document the sociodemographic and clinical profile among the attendees of gynaec clinic with menstrual related problem. Observational cross-sectional study carried out in western part of India with 100 patients after their written informed consent. Data were collected on pre-designed semi structured questionnaire which consist of sociodemographic and clinical questions. All data were entered in MS excel spreadsheet and analyzed with the help of SPSS V.20. Current study reported 8% of new Gynaec attendees had problem of abnormal uterine bleeding. Majority of patients were belonging to age group 21 years to 40 years (83%) and most of the patients were multipara (75%). Commonest complains among patients were menorrhagia (80%). Most of the patients were reported haemoglobin of less than 12 mg/dl.: Abnormal uterine bleeding is a distressing problem for women in their reproductive age groups especially in 21 years to 40 years.

Correlation of tumor-associated macrophage density and proportion of M2 subtypes with the pathological stage of colorectal cancer

BACKGROUND Colorectal cancer (CRC) is a prevalent global malignancy with complex prognostic factors. Tumor-associated macrophages (TAMs) have shown paradoxical associations with CRC survival, particularly concerning the M2 subset. AIM We aimed to establish a simplified protocol for quantifying M2-like TAMs and explore their correlation with clinicopathological factors. METHODS A cross-sectional study included histopathological assessment of paraffin-embedded tissue blocks obtained from 43 CRC patients. Using CD68 and CD163 immunohistochemistry, we quantified TAMs in tumor stroma and front, focusing on M2 proportion. Demographic, histopathological, and clinical parameters were collected. RESULTS TAM density was significantly higher at the tumor front, with the M2 proportion three times greater in both zones. The tumor front had a higher M2 proportion, which correlated significantly with advanced tumor stage (P = 0.04), pathological nodal involvement (P = 0.04), and lymphovascular invasion (LVI, P = 0.01). However, no significant association was found between the M2 proportion in the tumor stroma and clinicopathological factors. CONCLUSION Our study introduces a simplified protocol for quantifying M2-like TAMs in CRC tissue samples. We demonstrated a significant correlation between an increased M2 proportion at the tumor front and advanced tumor stage, nodal involvement, and LVI. This suggests that M2-like TAMs might serve as potential indicators of disease progression in CRC, warranting further investigation and potential clinical application.

Prevalence and associated factors of psychiatric comorbidities in epilepsy in the Casablanca-Settat region of Morocco: A cross-sectional study.

To determine the estimated prevalence of anxiety, depression, and anxiety-depression syndrome (ADS) and to identify the associated factors in Moroccan people with epilepsy (PWE). A cross-sectional study was conducted among adult PWE (June 2021-December 2022) in the Casablanca-Settat region. PWE were interviewed by completing a questionnaire collecting sociodemographic and clinical data. Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS). Out of 21 points, a score ≥8 is in favor of considerable anxiety/depression symptoms and a sum of the two scores ≥15 indicates the presence of ADS. Data were analyzed using Statistical Package for Social Sciences (SPSS) 21.0. p-values ≤0.05 were considered statistically significant and logistic regression was performed to determine the associated factors. Among 294 PWE, the median age was 39 years (interquartile range [IQR]: 25.75-54.00). The median anxiety, depression, and ADS scores were 8 (IQR: 5.00-10.00), 7 (IQR: 4.00-10.00), and 15 (IQR: 10.00-20.00), respectively. Anxiety, depression, and ADS were revealed in 51.4%, 44.9%, and 51.0% of PWE, respectively. Depression was the only predictor for anxiety (aOR = 24.20; 95%CI: 12.45-47.01). Antiseizure polytherapy (aOR = 3.35; 95%CI: 1.72-6.54) and anxiety (aOR = 24.04; 95%CI: 12.12-47.67) were the factors associated with depression. The risk of ADS was increased by female gender (aOR = 2.83; 95%CI: 1.68-4.78), antiseizure polytherapy (aOR = 2.75; 95%CI: 1.62-4.65), structural epilepsy (aOR = 1.73; 95%CI: 1.01-2.94), and the presence of concomitant conditions with epilepsy (aOR = 1.96; 95%CI: 1.16-3.31). Our study reports high psychiatric comorbidity prevalence in epilepsy, which supports the bidirectional link hypothesis. Associated factors found are important in the prognosis and prevention. The neural mechanisms underlying epilepsy tend to expose PWE to psychiatric disorders. Our study aims to quantify the rate of psychiatric comorbidities and their predictive factors in Moroccan PWE. The estimated prevalences of significant symptoms of anxiety, depression, and ADS were 51.4%, 44.9%, and 51.0%, respectively. Depression was the predictor of anxiety. Antiseizure polymedication and anxiety were the associated factors with depression. The risk of SAD was increased by female gender, antiseizure polymedication, structural epilepsy, and concomitant diseases with epilepsy. Our results are important for considering the psychiatric aspect of PWE and improving their care and quality of life.

Association between isolated or combined malnutrition and sarcopenia and quality of life in heart failure outpatients: A cross-sectional study.

Heart failure (HF) is a chronic condition with symptoms linked to worse quality of life. Malnutrition and sarcopenia are conditions frequently found in patients with HF. This study aims to evaluate the association between isolated or combined malnutrition and sarcopenia and quality of life in outpatients with HF. This is a cross-sectional study with a sample of outpatients with HF aged ≥18 years. Malnutrition was assessed according to the criteria of the Global Leadership Initiative on Malnutrition, and sarcopenia was evaluated by the European Working Group on Sarcopenia in Older People. Quality of life was assessed using the Minnesota Living with HF questionnaire (MLHFQ). Clinical and sociodemographic data were collected. One hundred and fifty-one patients were included in this study, with a median (interquartile range) age of 58 (48-65) years, 58.9% were adults, and 68.9% were male. A total of 29.5% of the patients were malnourished, and 28.5% and 2.6% were identified with probable sarcopenia and sarcopenia, respectively. Of the total, 15.9% of patients were identified with both conditions. Sarcopenia was associated with higher odds of increase in the MLHFQ total score, indicating worse quality of life (odds ratio [OR] = 3.61; 95% CI, 1.65-7.89). The same was found in the presence of two conditions (OR 3.97; 95% CI, 1.32-11.54), whereas isolated malnutrition was not related to life quality (OR = 1.62; 95% CI, 0.73-3.60). The presence of malnutrition and sarcopenia simultaneously were associated with worse quality of life scores when compared with these isolated conditions.

Impact of mandatory indications for outpatient antibiotic orders on accurate tracking of antibiotic indications.

We sought to evaluate whether implementing mandatory indications for outpatient electronic antibiotic orders or using encounter International Classification of Diseases, Tenth Revision (ICD10) codes more accurately reflected clinicians' charted diagnosis in encounter notes. Secondarily, we examined the appropriateness of antibiotic prescriptions. Cross-sectional study. Mandatory indications were added to all outpatient electronic antibiotic orders on May 18, 2022. A randomly selected convenience sample of 1300 outpatient encounters with antibiotics from walk-in clinics was reviewed. Adjusted logistic regression was used to compare the congruence between encounter ICD10 code and charted diagnosis for encounters from July 15 to September 15, 2021 (pre-implementation period) to the congruence between encounter ICD10 code, charted diagnosis, and mandatory indication for encounters from July 15 to September 15, 2022 (post-implementation period). Antibiotic appropriateness based on charted diagnosis was also evaluated. Among 1300 outpatient encounters, congruence between charted diagnosis and ICD10 code significantly increased in the post-implementation period (87.7% (565/644)) versus pre-implementation (83.3% (540/648), adjusted odds ratio (aOR) 1.52; 95% CI 1.03-2.25). Congruence between charted diagnosis and mandatory indication during post-implementation was 95.2% (613/644) and >5 times more likely to be congruent than charted diagnosis and ICD10 code during pre-implementation (aOR 5.45; 95% CI 3.26-9.11). Antibiotic prescribing based on charted diagnosis was twice as likely to be appropriate in the post-implementation period (aOR1.99; 95% CI 1.32-2.98). Mandatory indications within antibiotic orders show better congruence with charted diagnosis than ICD10 codes and may increase antibiotic appropriateness and congruence between ICD10 code and charted diagnosis.

Prevalence and Clinical Implications of Osteosarcopenia in Patients with Acute Stroke: A Cross-sectional Study.

To investigate the prevalence and risk factors of osteosarcopenia in patients with acute stroke. Overall, 224 patients within 2 weeks of having a stroke were enrolled. Demographic characteristics, National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), modified Barthel Index (MBI), Functional Ambulation Category (FAC), Berg Balance Scale (BBS), and handgrip strength were recorded. Body composition was evaluated using dual-energy X-ray absorptiometry. Patients who met the diagnostic criteria for osteoporosis and sarcopenia were defined as having osteosarcopenia. The overall prevalence of osteoporosis and sarcopenia was 46.9% and 50.9%, respectively. The prevalence of osteoporosis without sarcopenia, sarcopenia without osteoporosis, and osteosarcopenia was 18.3%, 22.3%, and 28.6%, respectively. The proportion of female sex (71.9%), median age, and NIHSS score were significantly higher, and mRS, BBS, MBI, FAC, and grip strength were significantly lower in patients with osteosarcopenia. Older age (≥65-years) (OR, 15.4), female sex (OR, 6.23), and lower BMI (<25 kg/m 2 ) (OR, 43.13) were independently associated with the likelihood of osteosarcopenia. Osteosarcopenia may occur in acute stroke survivors. Patients with osteosarcopenia have a significantly higher stroke severity and disability. A comprehensive diagnostic approach is imperative for osteosarcopenia, thereby facilitating implementation of optimal rehabilitative strategies.

Factors associated with family decision-making self-efficacy among family members of patients with advanced cancer in mainland China.

In Chinese culture, family members are the main decision maker on end-of-life (EoL) issues for patients with advanced cancer. Yet little is known about Chinese families' confidence in making EoL decisions and its associated factors. This study aims to investigate the status and associated factors of Chinese family members' confidence in making EoL decisions for patients with advanced cancer. This cross-sectional study used a convenience sample of 147 family members of patients with stage III or stage IV cancer from a tertiary cancer center in Guangzhou, China. The questionnaires included demographic information of patients and their family members, patients' EoL preferences, and the Chinese version of the Family Decision-Making Self-Efficacy (FDMSE) Scale. A total of145 family members (98.64%) completed the questionnaires. The average score of FDMSE was 3.92 ± 0.53. A multiple regression analysis showed that the factors associated with FDMSE included patients' duration of disease, health insurance, participation in EoL decision-making, the expression of unfilled wishes, and family members' employment status. Chinese family members were not confident enough in making EoL decisions for patients with advanced cancer. It is recommended to develop cultural-tailored advanced care planning models to clarify patient preferences and to enhance the family members' self-efficacy in making EoL decisions with or for patients with advanced cancer.

The impact of socio-environmental factors on doxycycline post-exposure prophylaxis awareness in the US: a cross-sectional study

Background We investigated awareness and use of doxycycline post-exposure prophylaxis (doxyPEP) in the US. DoxyPEP has preventative benefits for bacterial STIs among people assigned male at birth. We considered how individual, interpersonal and social determinants of health, such as state-level LGBTQ equality, impact doxyPEP awareness. Methods We conducted an online snapshot cross-sectional survey in June 2023. Survey questions included demographics, sexual and substance use behaviours, and socio-environmental factors, and provided a short explanation of doxyPEP, with questions regarding prior awareness and use. Results Among a racially diverse sample of 196 participants (median age 33 years), 94% identified as cisgender men, 26% were aware of doxyPEP, whereas only 14 (7%) had ever used it. Factors significantly associated with awareness included being college educated (OR 2.50, 95% CI 1.09–5.74), a past year bacterial STI (OR 4.20, 95% CI 1.97–8.89), having discussed HIV pre-exposure prophylaxis with a health care provider (OR 3.88, 95% CI 1.99–7.57) and having taken HIV pre-exposure prophylaxis (OR 2.29, 95% CI 1.11–4.70). Socio-environmental factors associated with doxyPEP awareness included living in a large urban city (OR 2.14, 95% CI 1.12–4.10) and living in a state with higher levels of LGBTQ policy equality (OR 2.18, 95% CI 1.07–4.44). Conclusions Considering the disproportionate impact of bacterial STIs on men who have sex with men, especially those living in lower LGBTQ equality regions, such as the Southern US, our study emphasises how socio-environmental factors may limit awareness and uptake of novel biomedical approaches that have the potential to prevent morbidity and enhance sexual health.

Funding of Evidence Included Within Public Comments Submitted to Inform Medicare National Coverage Determinations

Abstract The Centers for Medicare &amp; Medicaid Services (CMS) relies on public comments submitted in response to proposed national coverage determinations to assist the agency in determining the coverage of items and services for Medicare beneficiaries. In a cross-sectional study, we characterized the cited evidence and what funding supported the cited evidence submitted in public comments to CMS for all therapeutic medical device national coverage determinations finalized between June 2019 and June 2022. Of 681 public comments, 159 (23%) cited at least one identifiable published scientific journal article. Within these 159 public comments, 198 unique articles were cited, 170 (86%) of which included funding statements or author disclosures. Among these, 96 (56%) disclosed funding from manufacturers that would benefit from Medicare coverage and/or were written by author(s) who received funding from these manufacturers. In summary, most public commenters for national coverage determinations did not cite published scientific journal articles to support their positions. Among those that did, more than half of articles were directly funded by manufacturers that would benefit from coverage. Greater funding of independent, non-industry supported research may help provide unbiased evaluations of benefits and harms to support Medicare coverage decisions.

The interplay between excess weight and hyper-glycemia on NCDs in Italy: results from a cross-sectional study.

To evaluate the prevalence of chronic comorbidities according to BMI classes and assess the interplay between excess body weight and blood glucose abnormalities in increasing the risk of major chronic diseases. The study is based on data from the Health Search/IQVIA Health LPD Longitudinal Patient Database, an Italian general practice registry, with data obtained from electronic clinical records of 800 general practitioners throughout Italy. Data relative to the year 2018 were analyzed. The study population was classified according to BMI (normal weight, overweight, and obesity classes 1, 2 and 3) and glucose metabolism status (normoglycemia-NGT; impaired fasting glucose-IFG; diabetes mellitus-DM). Comorbidities were identified through ICD-9 CM codes. Data relative to 991,917 adults were analyzed. The prevalence of overweight was 39.4%, while the prevalence of obesity was 11.1% (class 1: 7.9%, class 2: 2.3%, class 3: 0.9%). In the whole population, the prevalence of DM and IFG was 8.9% and 4.2%, respectively. Both overweight and obesity were associated with an increasing prevalence of glucose metabolism alterations and a large array of different chronic conditions, including cardio-cerebrovascular diseases, heart failure, chronic kidney disease, osteoarticular diseases, depression, sleep apnea, and neoplasms of the gastrointestinal tract. Within each BMI class, the presence of IFG, and to a greater extent DM, identified subgroups of individuals with a marked increase in the risk of concomitant chronic conditions. Addressing the double burden of excess weight and hyperglycemia represents an important challenge and a healthcare priority.

Sun exposure and protection habits: Self-reported attitudes, knowledge and behaviours.

As exposure to UV radiation is the primary modifiable environmental risk factor associated with skin cancer, it remains the principal focus of most prevention strategies. Numerous sun protection campaigns have been implemented worldwide; however, their impact on the actual incidence and mortality rates of skin cancer seems to be limited. To create successful skin cancer prevention campaigns, it is important to have a comprehensive understanding of individuals' attitudes and behaviours regarding sun protection. The aim of the current study was to determine and report on the prevalence of self-reported attitudes, knowledge and behaviours regarding two of the major sun protection recommendations-avoidance of sun exposure and use of sunscreens-in an international representative sample across five continents. This cross-sectional study was conducted in 20 countries using a web-based online survey. A total of 50,552 individuals, comprising 25,388 men (50.22%) and 25,164 women (49.78%), participated in the survey. Among them, 83.2% reported having been voluntarily exposed to the sun (for sun-basking reasons) at least once in the last 12 months, and 47.96% acknowledged being exposed to the sun between the hours of 10 AM and 4 PM. The primary reason for non-adherence was that these hours were the most convenient times (32.28%). Only 24.05% reported applying sunscreen every 2 h when outdoors. Forgetfulness was the primary reason as provided by 27.79% of participants. Males and older age groups were less likely to adopt sun-protective behaviours around the world. Forgetfulness and the challenges posed by time constraints seem to be the biggest barriers to proper adherence. These findings should prompt the collaboration with health authorities and the manufacturers to enhance adherence by setting reasonable sunscreen prices and creating formulations that make their application less burdensome.