Elderly Age Group Research Articles

Application of Endoprosthetic Replacement in Old Patients with Isolated Proximal Femoral Bone Metastases.

Due to radical resection, endoprosthetic reconstruction (EPR) is more invasive and increases the risk of dislocation. Therefore, the suitability of EPR for elderly patients with metastatic tumor needs further investigation. Seventy-one adult patients with isolated proximal femoral bone metastases who underwent EPR were retrospectively analyzed and stratified into two groups: elderly age group (≥60years, n=31) and younger age group (<60 years, n=40). The effect of age on prognosis was analyzed to determine whether EPR is beneficial in elderly patients with proximal femoral metastatic tumor. Cox regression modeling was used to evaluate the effect of different factors on postoperative survival outcomes. Ten (32.26%) and 9 (22.50%) cases of perioperative complications were recorded in the elderly and younger age groups, respectively, with median survival times of 22.00±4.61 months and 23.00±2.85 months, respectively; a log-rank test showed that the difference was not statistically significant (p=0.657). A Cox regression model was established with patient age as the covariable to evaluate whether it affected postoperative survival. The risk of death due to age was not significant (p=0.649), but malignancy and femoral metastasis type were significantly associated with postoperative survival (p=0.001 and p=0.019). Although older patients have a slightly higher incidence of postoperative complications than younger patients, they do not experience severe adverse consequences. With rigorous selection and careful preparation, EPR is appropriate for the treatment of proximal femoral metastases in older patients, including those with Harrington type I-II acetabular invasion.

A STUDY TO COMPARE THE CLINICO- EPIDEMIOLOGIC PROFILE OF OSTEOARTHRITIS OF KNEE OF MIDDLE AGED WITH ELDERLY PERSONS IN JODHPUR CITY

Osteoarthritis (OA) is the most prevalent form of arthritis in India, affecting over 15 million adults every year. One in two adults will develop symptoms of knee OA, while one in four adults will development symptoms of hip OA by the age 85 and one in 12 people above 60 years or older have hand OA. Although OA occurs in people of all ages, osteoarthritis is most common in people older than 65. The prevalence of knee osteoarthritis is 22% - 32% in India; commonly females are more affected than males as the age progress. 5 More than half of those with arthritis are under 65 years of age. OA knee increases with age (older than 50 years), especially in women. According to a survey, anywhere from 6% to over 13% of men, but between 7% and 19% of women, resulting in a 45% less risk of incidence in men. According to Kallgren Lawrence scale, knee joints symptoms, it states that middle-aged individual feel less pain as compared to elderly age individual and knee joint examination shows inflammation, swelling, scar, shape alteration, muscle wasting present in lesser individual among middle age group as compared to elderly age group. Lastly 15% of middle age screened participants were having hypokalaemia(&lt;6.7%mg/dl), as compared to 18% of elderly age group and 42% of middle- aged participants were having vit. D3 deficiency as compared to 45% of elderly age group participants, which shows that as the age progresses the participants of hypokalaemia increased and with the age increase, vit. D3 deficiency also increases, and which play major role in severity and complication of OA. 411 patients (&lt;60 year = 201; &gt;60 year = 210) were studied for osteoarthritis of knee joint symptoms, signs, investigation at Shri Shivram Nathu Ji Tak Government Satellite Hospital Mandore, AGH: Dr S N Medical Collage, Jodhpur (Raj.) during January 2019 to October 2019. Osteoarthritis is more prevalent in females (58%). Osteoarthritis is more common in active physical worker, especially in females due to their job profile like prolong standing and squatting (for doing household moping etc).Vitamin D3 level and deficiency not significantly similar in both groups due to the regular supplementation. Left knee of both age group was found more common, we cannot find any explanation for this, further studies to be done upon this

Basic Tenets of Sandhigatavata w.s.r. Osteoarthritis and Assessment of Pharmacological Basis of Trayodasanga Guggulu: A Classical and Contemporary Overview

Sandhigatavāta is comparable to osteoarthritis of modern medicine. It is a kind of articular degenerative disorders that can affect any joints but generally observed weight bearing joints. It is prevalent since antiquity and commonly exists among elderly age group. Osteoarthritis is the second most common rheumatologic problem and it is the most frequent joint disease with a prevalence of 22% to 39% in India. It is predominant in females as compared to male. Variety of herbal and herbo-mineral formulations are mentioned in Ayurvedic lexicons for its management, Trayodaśāṇga guggulu is one of them. In this concern, we have laid down an emphasis in brief on Sandhigatavaāta and trying to explore the classical and contemporary pharmacological aspects of Trayodaśāṇga guggulu for its management.

Treatment of Inherited Retinal Dystrophies with Somatic Cell Therapy Medicinal Product: A Review.

Inherited retinal dystrophies and retinal degenerations related to more common diseases (i.e., age-related macular dystrophy) are a major issue and one of the main causes of low vision in pediatric and elderly age groups. Advancement and understanding in molecular biology and the possibilities raised by gene-editing techniques opened a new era for clinicians and patients due to feasible possibilities of treating disabling diseases and the reduction in their complications burden. The scope of this review is to focus on the state-of-the-art in somatic cell therapy medicinal products as the basis of new insights and possibilities to use this approach to treat rare eye diseases.

MO118: A Study on Renal Involvement in COVID-19 Patients with or without Preexisting Kidney Disease and Outcome: Acha Single-Centre Retrospective Study

BACKGROUND AND AIMSChronic kidney disease (CKD) patients and renal allograft recipients (RARs) are at increased risk for severe coronavirus disease 2019 (COVID-19). Acute kidney injury (AKI) can develop in a patient with COVID-19 infection. Data regarding the outcome of COVID-19 patients affected with renal disease are scarce, especially from northeastern part of India.METHODWe conducted a single-centre, retrospective, observational study, involving hospitalized COVID-19 affected patients with renal disease in Gauhati Medical College, Guwahati between 1 July 2020 and 30 June 2021. Patients with various forms of kidney disease including AKI, CKD, RAR and glomerulonephritis were included. The main aim of the study was to describe the outcome (in-hospital mortality) in this group of patients.RESULTSThe study included a total of 384 patients with most patients in the elderly age group (73.7% above 45 years). Most of the patients were male (n = 288, 75%). Those with renal disease were grouped under AKI, CKD, RAR, systemic lupus erythematosus with lupus nephritis (LN) and rapidly progressive GN (RPGN) (20.3%, 75%, 3.4%, 1% and 0.3%, respectively). The mean duration of stay at the hospital was 8.1 days with maximum duration for RAR patients with a mean of 11.2 days. A total of 199 patients (51.8%) died. Mortality data were not available for 19 patients who got transferred to various other departments after recovering from COVID-19. Mortality rates for AKI, CKD, RAR and LN were 37.2%, 55.2%, 53.8% and 75%, respectively. One patient with RPGN also died.CONCLUSIONCOVID-19 affects patients of all age and sex. CKD patients and those on immunosuppressive agents are at higher risk for mortality.FIGURE 1:Diagnosis.Table 1.Mortality based on diagnosisDiagnosisTotal cases(A)No of death cases (B)% of total cases (A/B *100)% of total death cases (B/199 *100)AKI782937.214.6CKD28815955.279.9RAR13753.83.5SLE/LN4375.01.5RPGN11100.00.5Total38419951.8100Chi square test value and P value458.814,P < .001, S

Fungal sinusitis in debilitated patients with poor oral health

Background: Fungal sinusitis is a sinus infection that results from fungus. It occurs mostly in uncontrolled diabetes, debilitated patients and in patients on immuno-suppressants, antibiotics or steroids. There are several types of fungus sinus infections. Some types can cause serious health problems and death. Debilitated patients have a higher risk of complications from fungal sinusitis. Aim: To study the incidence and clinical profile of fungal sinusitis in debilitated patients with poor oral health. Material and methods: This was a prospective study in which 50 patients with fungal sinusitis who underwent treatment in School of medical science and research over 1 year were randomized into the study. So patients were selected from which 25 patients were male and 25 patients were female in age group of 45-70 years .Various examinations were conducted at different times which included microscopic, serological diagnosis and histopathological examination. Results: Fungal sinusitis was more common in the elderly age groups with debilitated diseases and poor oral health. Fungal sinusitis was comparatively more common among immunocompressant individuals(3). Surgery with chemotherapy offered better treatment outcome as compared to single modality.

Corrected and Republished: Breast Cancer in Young Women: Experience from a Tertiary Care Hospital of Coastal India

International Journal of Medicine and Public Health,2022,12,2,91-95.DOI:10.5530/ijmedph.2022.2.18Published:April 2022Type:Original ArticleCorrected and Republished: Breast Cancer in Young Women: Experience from a Tertiary Care Hospital of Coastal IndiaShazima Sheereen, Pradipta Das, Pradipta Kishore Khuntia, Flora D Lobo, Waseemoddin Patel, Rajashree Das, and Abhishek Singh Nayyar Shazima Sheereen1, Pradipta Das2, Pradipta Kishore Khuntia2, Flora D Lobo1, Waseemoddin Patel3, Rajashree Das4, Abhishek Singh Nayyar5 1Department of Pathology, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, Karnataka, INDIA. 2Department of Surgery, Kalinga Institute of Medical Sciences, Patia, Bhubaneswar, Odisha, INDIA. 3Department of Pediatrics and Neonatology, McMaster University, Hamilton, Ontario, CANADA. 4Former- Assistant Surgeon, Capital Hospital, Bhubaneswar, Odisha, INDIA. 5Department of Oral Medicine and Radiology, Saraswati-Dhanwantari Dental College and Hospital and Postgraduate Research Institute, Parbhani, Maharashtra, INDIA. Abstract:Background and Aim: Breast cancers are relatively rare among young women amounting up to 6% of all breast carcinoma cases reported in that age group. In younger age groups, breast cancers, though, have a more aggressive behavior and poorer outcome in comparison to patients in the elderly age groups. The aim of the present study was to evaluate the histopathological characteristics of breast carcinomas reported in patients lesser than 40 years of age. Materials and Methods: Surgical specimens of carcinoma breast received at the Department of Pathology in a tertiary care hospital for a period of 2 years from January 2014 to December 2015 were included in the study. The histo-pathological slides were reviewed and clinical data was collected from the archival records and compared. Statistical analysis was done using IBM SPSS statistics 17 (Chicago, USA). Various tumor characteristics were correlated with the morphological features and the other clinico-pathologic data using Chi-square value (c2), paired t-test and Fischer’s test. p<0.05 was considered to be statistically significant. Results: Infiltrating Ductal Carcinoma-Not otherwise specified (IDC-NOS) was found to be the most common variant of breast carcinoma in both the younger and the elderly age groups followed by the invasive lobular carcinoma and mucinous carcinoma in the younger and invasive lobular carcinoma and mucinous carcinoma and papillary carcinoma in the elderly age groups. Also, stage II followed by stage III were the commonest stages reported in the younger and elderly age groups based on their prevalence as against stage I and IV (p=0.006). Conclusion: Breast cancers diagnosed in younger age groups present with an aggressive behavior and poorer outcome in comparison to patients in the elderly age groups. Also, such cancers often tend to present with advanced stages of the disease process and high grades of tumor with lymph nodal involvement and metastasis at the time they are first diagnosed conferring an inferior prognosis illustrating the need for more clinical trials to be conducted on younger patients with breast cancers with an aim to improve the overall outcome in this age group. Keywords:Breast cancers, Histo-pathology, Tertiary care settings, TNM staging, Younger age groupsView:PDF (297.49 KB)

Association of Left Ventricular Hypertrophy on Echocardiography with Hemorrhagic and Non-Hemorrhagic Stroke

Introduction: Left ventricular hypertrophy (LVH) is related to increased risk of stroke. However, very few studies analyzed association of LVH assessed by Echocardiography (Echo) in ischemic and hemorrhagic stroke separately.&#x0D; Aims &amp; Objectives: To determine the association of left ventricular hypertrophy on echocardiography with hemorrhagic or non-hemorrhagic stroke.&#x0D; Place &amp; Duration of Study: Study was done in Department of Cardiology Shaikh Zayed Hospital Lahore for six months from 01-01-2019 to 30-06-2019.&#x0D; Material &amp; Methods: Total 190 patients, fulfilling inclusion and exclusion criteria were selected. All patients underwent for echo and LVH was noted. Left ventricular posterior wall (PW) and inter ventricular septum (IVS) thickness&gt;11mm in males and &gt;10mm in females labeled as LVH.&#x0D; Results: Results of this study showed that risk of LVH was 1.66 times higher among patients who presented with Hemorrhagic: 57.9% vs Non-hemorrhagic stroke: 34.7%. Elderly age group patients (RR: 1.85), female patients (RR:2.53), overweight patients (RR:2.38), longer duration of stroke (RR:2.42) and diabetic patients had higher association with LVH in hemorrhagic stroke.&#x0D; Conclusion: It was observed in this study that patients having hemorrhagic stroke had higher association of left ventricular hypertrophy (LVH) as compared to Non- Hemorrhagic stroke. Further studies are needed in this domain to address the association between LVH and hemorrhagic stroke.

A comparative study to assess the effect of multiple Kirschner wiring versus plating in the management and functional outcome of proximal humerus fractures

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Proximal humerus fractures constitute 5% of all appendicular skeletal injuries and are mainly a menace of the elderly, after hip fractures and distal radial fractures. According to the NEER’S classification, the decision regarding the treatment of such fractures is dependent on whether the four anatomical segments of the proximal humerus are fractured or displaced.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 50 patients admitted in orthopaedics ward satisfying the inclusion criteria were randomly divided in 2 groups with 25 patients in each group for PHILOS plating and Kirschner wiring management. Groups were compared with respect to their improvement in physical function, pain, quality of life, complications and re-operation rates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Out of the total 50 cases, 20% were type I, 22% type II, 36% were type III fractures while 22% were type IV fractures. Mean DASH questionnaire was comparable between two groups at 1 month after surgery (p=0.56). During immediate post-op period and at subsequent follow ups, DASH questionnaire was better in plating group as compared to K-wiring. At 3 months and 6 months follow up, functional outcome as calculated by DASH questionnaire was comparable between two groups (p=0.17 and 0.45). Excellent to good outcome was seen in all cases of either group. No difference was observed between study groups with respect to associated complications. K-wire loosening was observed in 2 cases (8%). Plating was associated with infections (8%) and screw break out (4%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; After comparing both the techniques, we recommend PHILOS plating for young adults and percutaneous K wire fixation for the elderly age group.&lt;/p&gt;

Comparison of Cycle Threshold and Clinical Status Among Different Age Groups of COVID-19 Cases.

IntroductionThe COVID-19 pandemic has shaken the entire world ever since its emergence in March 2020. The disease manifestation of COVID-19 has been more severe, with a high degree of mortality in the elderly than in the young population. The cycle threshold (Ct ) value obtained in the real-time polymerase chain reaction (RT-PCR) has been used as the surrogate marker of viral load. Therefore, assessing Ct value and clinical status among different age groups with SARS-CoV-2 infection is required to understand the viral kinetics and to assess the transmission potential of that particular age group.PurposeThe aim of this study was to compare the viral load and clinical status among different age groups with COVID-19 infection.Methods and materialsA retrospective cross-sectional study was carried out to analyze the Ct values of SARS-CoV-2 positive samples reported from April 2020 till May 2021. The results of 13,820 RT-PCR (reverse transcriptase-polymerase chain reaction) positive samples were included for analysis of Ct values. Ct values of confirmatory genes were taken into consideration, and Ct values below 25, >25 to 30, and >30 were categorized as high, moderate, and low viral load, respectively. Age group was stratified into ≤18 years (young), 18-60 years (adult), and >60 years (elderly). The data were analyzed using SPSS Windows Version 25.0.ResultsThe mean Ct values were 27.9, 26, and 26.2 in the young, adult, and elderly age groups, respectively. The mean Ct values of young patients were significantly higher as compared to adult and elderly patients (p<0.05). The percentage of high viral load (Ct<25) was found to be significantly higher in adults and elderly (44.6% & 43.7%) as compared to young (32.2%) (p<0.001). Majority of the COVID-19 positive cases younger than 18 years (75.9%) were asymptomatic as compared to 64.5% and 59.7% in the adult and elderly age groups, respectively.ConclusionThis study observed a significantly high proportion of viral load in the adult and elderly population, which plays a substantial contribution to SARS-CoV-2 transmission, whereas the majority of the young population being asymptomatic plays a major role as silent transmitters. The study reemphasizes the need for strict adherence to COVID-appropriate behaviors.

Age-Dependent Outcome of First-Line Endovascular and Surgical Revascularization Strategies in Chronic Limb-Threatening Ischemia

Chronic limb-threatening ischemia (CLTI) has a high mortality and amputation risk even after revascularization. Owing to an aging population the incidence of peripheral arterial disease is rising. However, the current age distribution in patients with CLTI and the impact of age on outcomes remains unclear. For this reason we performed an age-dependent analysis of mortality, morbidity, and amputation-free survival after open surgical revascularization (OSR) and endovascular revascularization therapy (ERT) with identification of risk factors for mortality. Standardized mortality ratios (SMR) were calculated, comparing observed deaths in the study population to expected deaths based on age and gender specific mortality rates of the overall Dutch population. Patients revascularized for the first episode of CLTI between 2013 and 2018 were included in this multicenter retrospective cohort study. The cohort was divided into 2 treatment groups (OSR and ERT) who were each stratified in 3 age groups: early age group < 65 years (G1), middle age group 65-74 years (G2), and elderly age group ≥ 75 years (G3). During the study period 274 limbs (43.9%) were treated with OSR and 350 limbs (56.1%) with ERT. The young population (G1) is only a small part of the whole CLTI population, namely for OSR 22% and ERT 18%. The risk profile of the early age group was characterized by male gender and smoking, whereas the elderly age group was characterized by poor arterial runoff, tissue loss, hypertension, hypercholesterolemia, chronic kidney disease, history of heart disease, chronic obstructive pulmonary disease, and cerebrovascular disease. One year amputation rates were similar between the age groups. However, significantly higher one-year mortality rates were observed in patients ≥ 75 years in comparison to the low mortality rates in patients < 75 years (OSR: G3 19.8% vs. G2 7.1% and G1 6.7%, P = 0.006; ERT: G3 30.7% vs. G2 12.7% and G1 7.8%, P = 0.001). The SMR in this elderly group equaled 3.72 after OSR and 4.04 after ERT. Independent risk factors for mortality after OSR were age, hazard ratio (HR) 1.03 (95% confidence interval [CI] 1.01-1.06; P = 0.006), preoperative hemoglobin level (HR 0.79; 95% CI 0.67-0.92; P = 0.003), tissue loss (HR 1.85; 95% CI 1.22-2.79; P = 0.004), cardiac history (HR 1.56; 95% CI 1.06-2.30; P = 0.024), and development of postoperative delirium (HR 2.75; 95% CI 1.61-4.71; P < 0.001). After ERT we identified age, HR 1.06 (95% CI 1.04-1.08; P < 0.001); preoperative hemoglobin level, HR 0.75 (95% CI 0.65-0.87; P < 0.001); tissue loss, HR 1.71 (95% CI 1.15-2.53; P = 0.008); history of chronic obstructive pulmonary disease, HR 1.99 (95% CI 1.43-1.79; P < 0.001); history of cerebrovascular accident (CVA), HR 1.55 (95% CI 1.09-2.21; P = 0.015); the development of postoperative pneumonia, HR 2.27 (95% CI 1.24-4.16; P = 0.008); postoperative acute kidney injury (AKI), HR 2.42 (95% CI 1.29-4.54; P = 0.006); and postoperative CVA, HR 8.17 (95% CI 1.96-34.15; P = 0.004) as risk factors. The current CLTI population consists mostly of elderly patients and only a small part is younger than 65 years. This shift in the population is important because increasing age is associated with considerable higher one-year mortality rates regardless of the method of revascularization in patients with CLTI. The mortality rates in the elderly group are 3 to 4 times larger than expected in the general population. In relation to the high mortality of the elderly patient, we assume that interventions to prevent postoperative delirium and correct preoperative anemia may be warranted as they appear to be independent risk factors for mortality.

Pelican Crossing System for Control a Green Man Light with Predicted Age

Traffic lights are generally used to regulate the control flow of traffic at an intersection from all directions, including a pelican crossing system with traffic signals for pedestrians. There are two facilities for walker crossing, namely using a pedestrian bridge and a zebra cross. In general, the traffic signals of the pelican crossing system are a fixed time, whereas other pedestrians need "green man" traffic lights with duration time arrangement. Our research proposes a prototype intelligent pelican crossing system for somebody who crosses the road at zebra crossings, but the risk of falling while crossing is not expected, especially in the elderly age group or pedestrians who are pregnant or carrying children. On the other hand, the problem is that the average step length or stride length (distance in centimeter), cadence or walking rate (in steps per minute), and the possibility of accidents are very high for pedestrians to make sure do crossing during the lights “green man”. The new idea of our research aims to set the adaptive time arrangement on the pelican crossing intelligent system of the traffic lights “green man” based on the age of the pedestrians with artificial intelligence using two combined methods of the FaceNet and AgeNet. The resulting measure can predict the age of pedestrians of the training dataset of 66.67% and testing prototype in real-time with participants on the pelican crossing system of 73% (single face) and 76% (multi faces).

Evaluation of Anemia as a Risk Factor for Lower Respiratory Tract Infection in Children

Background: Acute lower respiratory tract infection being a leading cause of death n children less than five years of age and anemia is the commonest cofactor in these patients seeking medical advice, particularly in developing countries. Aim: To determine the association of anemia with lower respiratory tract infection in children by evaluating the frequency of anemia in children with and without LRTI. Methods: A Case Control Study was carried out at department of Pediatrics, Children hospital Lahore, Institute of child health from 20-1-18 to 20-7-19. Blood was drawn by phlebotomist from each patient included in this study by using disposable and sterile syringes and accurate tubes. Blood samples were used to estimate hemoglobin level by using automatic blood cell counter. Anemia was defined as per operational definition. Children were managed as per standard protocol. Results: In this study risk of anemia was significantly higher among cases i.e. Cases: 54% &amp; Controls: 22%, OR= 4.162, p-value=0.001. Although in all age groups frequency as well as risk of anemia was higher in cases. But children among cases in the elder age group showed statistically significant risk for anemia as compared to children in control group i.e. 31-45 Months. OR= 14.00, p-value=0.013 &amp; 46-60 months: 5.60, p-value=0.027. Conclusion: Children presenting with LRTI possesses significant risk for anemia. Thus, early and accurate diagnosis of anemia in children and treatment of anemia will have a positive effect decreasing pneumonia in children. Keywords: Anemia, Lower respiratory tract infection, Children, association, odds ratio

The Prevalence and Associated Risk Factors of Fear of Fall in the Elderly: A Hospital-Based, Cross-Sectional Study.

BackgroundFalls are one of the most common but serious health issues faced by the elderly population. Falls-related injuries not only add to the morbidity and economic burden they also have a significant negative impact on psychological health and the quality of life of the elderly. In this study, we assess the prevalence of fear of falling among the geriatric population and the risk factors associated with fear of falling.MethodologyThis prospective, cross-sectional study was conducted among geriatric patients aged more than 60 years attending the medical outpatient department of a tertiary care hospital in Uttarakhand, India. This study aimed to determine the prevalence of fear of falling among the geriatric population and compare various demographic and clinical parameters in elderly patients with and without fear of falling. Fear of fall was assessed using a questionnaire by asking the elderly if they had fear of falling, how often they had fear of falling, and under which circumstances did they have fear of falling. Information regarding demographics, history of daily activities, and chronic diseases was collected and assessed from all geriatric patients with and without fear of falls.ResultsAlmost half (334; 42%) of the geriatric population had a history of fear of falling. Demographic parameters such as age over 80 years, female gender, living alone, and rural background were significantly associated with fear of falling. Similarly, a history of chronic diseases such as stroke, hypertension, and history of visual and motility impairment was significantly related to fear of falls among geriatric patients. Around 70% (571) of geriatric patients aged over 60 years had associated health problems.ConclusionsThis study reinstates that fear of falls is a significant health issue in the elderly age group. It also highlights multiple risk factors related to fear of falling which if controlled can significantly improve the quality of life of the geriatric population.

Assessment of the emotional intelligence and its dimensions of students at beginning of their medical profession education

Background: Medicine involves not only prescriptions but also a well-developed emotional intelligence (EI). The assessment of EI of students at their entry to medical professional training may identify weaknesses, if any, so as to be taken care during the course. Thus, it may be relevant to explore it and its dimensions because it is still a nascent field of research, hence this study was planned.Methods: Objectives were to assess the EI and its dimensions of first year MBBS students. Study design was a descriptive and cross-sectional study. Study sample were 150 first year MBBS students. Ethical approval from institutional ethics committee and informed written consent from participants obtained; administered a questionnaire based EI test. Data obtained was analysed by ANOVA. Results: The 53.1 % participants were females and 46.9% males. The 73.1% were 17-18 years of age and 26.9% were 19-21 years old. The mean total EI score was 353.01. Among the emotional dimensions sensitivity was significantly low (p=0.047) in males (87.35±15.34) than females (92.49±9.071). The emotional competency was significantly low (p=0.055) in the elder group (153.59±26.99) than the younger one (160.61±15.762).Conclusions: The study identified certain gender and age differences in the EI and some weaknesses among first year medical students. Emotional sensitivity was significantly low in males and emotional competency was significantly low in the elder age group.

Differences in fixation to young and elderly quadrilateral surfaces with anatomic quadrilateral surface plate (AQSP) based on cortical thickness morphological results

AimsWith relatively thinner cortical thickness, the management of acetabulum osteoporotic fractures in elderly patients is difficult. The aim of the research was to compare and present the morphological characteristics of the quadrilateral plate in young and elderly age groups, such as the area, and position distribution of the thin cortical thickness region, fracture lines maps, and propose a revised design plate for elderly patients based on these anatomic information.MethodsAs a retrospective research, acetabular fracture with one normal hemipelvises, including 110 men and 39 women, were collected to present the morphological characteristics of the quadrilateral region. The subjects were divided into three different age groups: Group I = 18–40 years (31.3 ± 6.6 years), Group II = 41–60 years (49.9 ± 5.3 years), and Group III ≥ 61 years (68.7 ± 6.8 years). The area of the quadrilateral surface, the area and position distribution of the thin cortical thickness region, the ratio and fracture lines maps were calculated and compared with Mimics in different groups.ResultsThe thin cortical thickness/width region area (TCWRA) was significantly increased in Group III compared with Group I and Group II. The ratio of TCWRA accounted for in the quadrilateral region was also significantly increased in Group III (≥ 61 years) compared with Group I (P = 0.01) and Group II (P = 0.011). None of the subjects had a component involving the “A” zone, thirty-three thin cortical thickness regions were located in the “B” zone, and one hundred and sixteen involved both zones of the quadrilateral plate (“A + B” zone). Furthermore, there were a significant differences in the fracture line distributions in three age groups. More fracture lines of elderly patients were located at anterior part (B zone) compared with Group I and Group II.ConclusionsIt was identified the area of thin cortical thickness region increased as age grown, and fracture lines were inclined to be more distributed in “B” zone in elderly patients. To meet the demands of acetabular fixation in different age groups, cortical thickness changes in young and elderly individuals should be given special attention when the quadrilateral surface plate is designed.Level of evidence Level IV, observational study.

Incidence of COVID-19 infection and its variation with demographic and clinical profile: lessons learned at a COVID-19 RT-PCR laboratory in Nagpur, India.

Introduction. The coronavirus disease 2019 (COVID-19) pandemic emerged as a global health crisis in 2020. The first case in India was reported on 30 January 2020 and the disease spread throughout the country within months. Old persons, immunocompromised patients and persons with co-morbidities, especially of the respiratory system, have a more severe and often fatal outcome to the disease. In this study we have analysed the socio-demographic trend of the COVID-19 outbreak in Nagpur and adjoining districts. Methods. The study was conducted from April to December 2020. Nasopharyngeal and oropharyngeal swabs collected from suspected cases of COVID-19 were tested using reverse-transcription polymerase chain reaction (RT-PCR) at a diagnostic molecular laboratory at a tertiary care hospital in central India. Patient-related data on demographic profile and indication for testing were obtained from laboratory requisition forms. The results of the inconclusive repeat samples were also noted. The data were analysed using SPSS v24.0. Results. A total of 46 898 samples were received from April to December 2020, of which 41 410 were included in the study; 90.6 % of samples belonged to adults and 9.4 % belonged to children. The overall positivity rate in the samples was 19.3 %, although it varied over the period. The yield was significantly high in the elderly age group (25.5 %) and symptomatic patients (22.6 %). On repeat testing of patients whose first test was inconclusive, 17.1% were positive. There was a steady increase of both the number of tests and the rate of positivity in the initial period of the study, followed by a sharp decline. Conclusion. We can conclude that rigorous contact tracing and COVID-appropriate behaviour (wearing a mask, social distancing and hand hygiene) are required to break the chain of transmission. Elderly people are more susceptible to infection and should follow stringent precautions. It is also important to perform repeat testing of those individuals whose tests are inconclusive with fresh samples so that no positive cases are missed. Understanding of demographics is crucial for better management of this crisis and proper allocation of resources.

Comparison of Cycle Threshold and Clinical Status Among Different Age Groups of COVID-19 Cases

PurposeAim of the study was to compare the viral load and clinical status among different age groups with COVID-19 infectionMethods & MaterialsA retrospective cross-sectional study was carried out to analyse the Ct values of positive samples reported during April 2020 till May 2021. Result of 13,820 number of RT-PCR positive samples were included for analysis of Ct values. Ct values of confirmatory genes were taken into consideration and Ct values below 25, >25 to 30 and >30 was categorized as high, moderate and low viral load respectively. Age group was stratified into ≤18 years, 18-60 and >60 years as young, adult and elderly respectively. The data was analysed using SPSS windows version 25.0.ResultsThe Mean Ct value was 27.9, 26, and 26.2 in young, adult and elderly age group respectively. Mean Ct value of young patients were significantly higher as compared to adult and elderly patients (p<0.05). The percentage of high viral load (Ct<25) was found to be significantly higher in adults and elderly (44.6% & 43.7%) as compared to young (32.2%) (p<0.001). Majority of the covid 19 positive cases belonging to <18 years age (75.9%) were asymptomatic as compared to 64.5% and 59.7% in adult and elderly age groups respectively.ConclusionPresent study observed a significantly high proportion of viral load in the adult and elderly population which plays a substantial contribution to SARS CoV-2 transmission, whereas the majority of the young population being asymptomatic play major role as silent transmitters. The study reemphasizes the need for strict adherence to COVID appropriate behaviours.

Spectrum of neurological diseases in patients presenting to a tertiary care hospital of Peshawar.

Objective: The aim of our study was to note the spectrum of neurological diseases in Out Patient department of hospital. Study Design: Observational Cross Sectional study. Setting: Rehman Medical Institute, Peshawar. Period: Jan 2019 to June 2019. Material &amp; Methods: All the patients presenting/referred to neurology OPD were included. There demographic characteristics, level of disability and diagnosis was noted on proforma. The diagnosis was made by neurologist and the neurological diseases were grouped according to International Classification of Disease in different categories. Data was entered and analyzed on SPSS 22. Results: Out of 455 patients, 54.7% (n=249) were female. Mean age was 42.92±17.69. 54.7% (n=249) belong to urban area. Psychiatric illness was the most common group of illness accounted for 29.5% (n=134) followed by nerve disorders 23.3 %( n=106) and Headaches 23.10 %( n=105), muscular disorders 14.70% (n=67), vascular diseases 13.40% (n=61) and epilepsy 5.9% (n=27).Vascular diseases were significantly more in males (P value &lt; 0.05). Female predominance was observed in nerve and psychiatric disorders (P value &lt; 0.05). Vascular diseases, movement disorders and dementia was observed in elder age group. (P-value &lt; 0.05). Epilepsy effected pediatric, headache and psychiatric illness were seen in young age and nerve disorder were common in middle aged people mostly. (P value &lt;0.05). Conclusion: Psychiatric disorder was the top most diagnosis followed by nerve disorder and headache. Most of the disorders were significantly more in specific age groups and few were gender specific.

Optimum Radiation Fractionation Schedule in Advanced Cancer Cervix; A Study from Low Resource North Indian Cancer Center

Introduction: Cervical cancer is the fourth most commonly occurring lethal cancer among women worldwide. The primary curative treatment option for women suffering from locally advanced cervical cancer includes external beam radiotherapy (EBRT) with concurrent weekly platinum-based radiosensitizing chemotherapy and brachytherapy (BT) to obtain finest treatment outcomes. Aim: The purpose of this study is to assess tumor response following HDRBT preceded by EBRT and to identify optimum radiation fractionation schedule for better response with tolerable radiation toxicity. Material and methods: 91 patients diagnosed with carcinoma of uterine cervix were screened for inclusion in the study. Patients were categorized according to FIGO Staging system The patient was put in lithotomy position and given anesthesia and fletcher suit applicator was applied to the patient push the bladder and rectum and finally shifted to the HDR treatment unit. All the associations were tested by using chi square test. Results: In our study it was found that majority (44%) of the cases were aged 51-60 years. Vaginal bleeding and squamous cell carcinoma was found in most of the cases. The acute radiation toxicities were more in elderly age group and the association was found to be statistically significant (p&lt;0.05) except Genitourinary – cystitis. Age group 51-60 years was significantly associated with response (p=0.034) with lower risk of partial response (OR=0.31 (0.10-0.95), while the symptom Backache/Pain in abdomen had significantly higher risk of partial response (p=0.002, OR=16.24 (1.7-154.8). Conclusion: When compared to traditional techniques, HDR can achieve very high rates of local control while lowering morbidity.