Extreme Age Groups Research Articles

Prevalence and associated factors of norovirus infections among patients with diarrhea in the Amhara national regional state, Ethiopia

BackgroundNoroviruses (NoVs) are the leading cause of diarrheal disease among all age groups worldwide, with an increased burden in developing countries. As there is no surveillance, epidemiological data is limited in Ethiopia. Hence, this study aimed to investigate the prevalence and associated factors of NoV infection among patients with diarrhea in the Amhara National Regional State, Ethiopia.MethodsA prospective health facility-based cross-sectional study was conducted from May 2021 to November 2021. A total of 550 study participants of all age groups with symptoms of diarrhea were proportionately assigned to the four study areas, area with three health facilities. Study participants were systematically sampled in each health facility. A fecal sample from each case was collected. The RNA was extracted and tested for NoV by one-step RT-PCR. Sociodemographic and other variables were gathered using a pre-tested questionnaire. A descriptive analysis was performed. Both binary and multiple logistic regressions were utilized to identify factors associated with NoV infection. Variables with a p-value < 0.05 in the final model were considered statistically significant.ResultsFive hundred nineteen out of 550 samples were analyzed (94.4% response rate). The overall prevalence of NoV was 8.9% (46/519). The positivity rates were higher among the elderly (33.3%) and under-5 children (12.5%). Both genogroup I and genogroup II (GII) were identified, with GII being the predominant, at 82.6% (38/46). Of all participants, only 20% reported a history of vomiting. Norovirus infection was more prevalent among participants from Debre Tabor (AOR = 4, 95%CI: 1.2–14) and Bahir Dar areas (AOR = 3.6, 95%CI: 1.04–11) compared to Debre Markos. Additionally, older adults (AOR = 7, 95% CI: 2–24) and under-5 children (AOR = 3.5, 95% CI: 2.8–12) were disproportionately affected compared to adults. The previous history of diarrhea (AOR = 3.6, 95% CI: 1.7–7) was a significant factor contributing to NoV infections. Moreover, the odds of NoV infection were higher among individuals with a high frequency of diarrhea (AOR = 15.3, 95%CI: 7.6–43) and vomiting (AOR = 3.5, 95%CI: 1.5-8).ConclusionsThe prevalence of NoV was considerably high, with the predominance of NoV-GII. The positivity rate was higher among the extreme age groups and varied across the study areas. To obtain a comprehensive understanding of the virus`s epidemiology and its genetic diversity, further research is warranted.

Pattern of Adverse Drug Reactions in Extremes of Age Group Reported to a Tertiary Care Hospital

ABSTRACT Background: The World Health Organization (WHO), defined adverse drug reactions (ADRs) as “any noxious and unintended response to a drug, which occurs at doses normally used in humans for prophylaxis, diagnosis and treatment of the disease or for the modification of physiological functions.” Pediatrics (≤12 years) and geriatrics (≥65 years) are the extreme age groups that are more vulnerable for ADRs. Aim and Objectives: To determine ADRs time-plausible relationship, clinical spectrum, causality, and severity in extreme age group patients. Materials and Methods: All the ADRs reported to ADR monitoring center among geriatrics and pediatrics patients after Institutional Ethics Committee approval were collected from January 2015 to July 2022. The collected reports were analyzed for ADR pattern, drug groups, Causality (as per WHO-Uppsala Monitoring Centre scale) and severity (Modified Hartwig scale). Results: Out of 4705 ADRs, 176 (3.74%) were reported in geriatric and 181 (3.84%) in pediatric patients. In geriatric patients, anti-neoplastic drugs followed by cardiovascular drugs were the most commonly implicated drugs, erythematous rash and dyspnea were the most common ADRs. Erythematous rash and diarrhea were the most commonly ADRs and immunological agents followed by antimicrobials were implicated drugs in pediatric patients. In geriatric patients 84.1% were mild, 14.8% moderate, and 1.1% severe reactions whereas in pediatric group 91.2% were mild, 8.3% moderate, and 0.5% severe ADRs. Two cases of toxic epidermal necrolysis and one case of Steven–Johnson syndrome were reported in geriatric and pediatric patients respectively. Causality assessment of the majority of ADRs in geriatric age group was possible (79.5%) and in pediatric age group it was probable (61.3%). Conclusion: Extreme age group populations are more vulnerable to ADRs due to comorbidities, polypharmacy and drug interactions in elderly people and immature hepatobiliary and renal systems in pediatric age. Hence, active surveillance of drugs and education of prescribers will help to minimize the risk of ADRs in this susceptible population.

Changes in the Functional Classification of Spirometry Using the New Interpretation Standard 2022: A Multicenter Study

IntroductionPulmonary function tests are vital for diagnosing lung diseases, assessing treatment responses, and monitoring respiratory health. Recent updates to interpretive standards by the European Respiratory and American Thoracic Societies (ERS/ATS) in 2022 introduced significant changes compared to the 2005 standards. They include incorporating lung volume measurements, non-specific and mixed disorders, introducing z-scores for functional abnormality assessment, reducing severity categories from five to three, and revising criteria for positive bronchodilator responses. MethodsWe conducted a retrospective, multi-center study across four centers using spirometric data spanning from 2002 to 2022. We categorized spirometry results using both the 2005 and 2022 ATS/ERS standards and calculated predicted values following the GLI 2012 equation (Caucasian subset). ResultsAmong 79,039 subjects, we observed that 23% shifted from an obstructive diagnosis under the 2005 standard to a mixed pattern diagnosis under the 2022 standard, necessitating lung volume assessments. In the evaluation of bronchodilator responses among 59,203 tests, 12.3% of those initially classified as responders were reclassified as non-responders with the new standards. We found variations in severity categorization across age groups, with older patients tending to receive milder severity classifications and younger individuals receiving greater severity classifications under the 2022 standards. ConclusionsThe 2022 document emphasizes early lung volume assessment, potentially leading to increased utilization of more complex tests. Furthermore, the bronchodilator response was predominant in extreme age groups and among individuals with milder spirometric impairments. This shift may impact treatment decisions, potentially initiating medication in milder cases and de-escalating treatment in more severe cases.

Antibiotic prescriptions associated with a diagnosis of acute nasopharyngitis by GPs in France: a retrospective study.

Nasopharyngitis is a common viral infection that has led to an overuse of prescription drugs, in particular antibiotics, which are not indicated for this condition. The purpose of this study was to describe drug prescriptions for patients with a diagnosis of acute rhinopharyngitis in general practices in France. Retrospective study of 1 067 403 prescriptions for a diagnosis of nasopharyngitis issued by 2637 physicians to 754 476 patients living in metropolitan France. The data were sourced from the prescription software, Cegedim, for the period 1 January 2018 to 31 December 2021 and analysed according to patients' and physicians' ages. A total of 2 591 584 medications were prescribed by GPs, with a median of three medications per patient. A total of 171 540 courses of antibiotics were prescribed (16% prescription rates), with amoxicillin being the most frequently prescribed (102 089 prescriptions; 59.5% of antibiotic prescriptions). Amoxicillin prescription increased in extreme age groups (18.2% of visits in those aged 9 years and under, and 10.0% of visits in those aged over 80 years, while patients aged 20-29-years were prescribed amoxicillin in just 2.9% of visits), and more prescriptions are issued by older doctors (GPs older than 70 years prescribed antibiotics in 26.4% of visits versus 3.2% of visits by GPs aged under 29 years). Nasopharyngitis is frequently a cause of therapeutic over-prescriptions including antibiotics, with an antibiotic prescription rate of 16%. Additional research is required to enhance our understanding of factors linked to drug prescriptions.

#466 Comparison of CKDEPI vs EKFC equations in estimating glomerular filtration rate in kidney transplant recipients

Abstract Background and Aims In 2020, European Kidney Function Consortium (EKFC) proposed a new equation that estimates glomerular filtration rate (GFR) in European population. Using creatinine and age, as well as CKDEPI, EKFC gives an estimation which has been demonstrated to correlate better to measured GFR, particularly at extreme ages. CKDEPI equation is the most common equation used in our clinical practice. Few studies have compared EKFC with CKDEPI, particularly in kidney transplant (KT) recipients. Our objective is to compare estimation of GFR with EKFC and CKDEPI in KT patients. Method We conduct a retrospective observational study including all consecutive KT performed at our centre from 1993 to 2022 with survival greater than one year, and laboratory tests at third month and one-year post-transplant. Using Creatinine and Age we calculate estimated GFR (eGFR) by CKDEPI and EKFC equations. We compare both results in terms of correlation and agreement in the global sample and classifying by subgroups according to a) Sex, b) Age by 10-year sections, c) Body Mass Index (BMI) as WHO classification and d) presence or absence of Diabetes Mellitus (DM). We use SPSS as statistics program. Results We include 968 KT, depicted in Table 1. CKDEPI and EKFC at 3rd month and EKFC at one-year have a non-normal distribution (Kolmogorov-Smirnov test with p = 0.003, p = 0.035 and p = 0.002, respectively), contrary to normality in CKDEPI at one year (p = 0.058). Levene test for homogeneity of variances shows no differences (3rd month p = 0.102, one year p = 0.165), as well as in subgroups. We perform, besides Mann-Whitney, Student's T-test despite limitations over means without significant differences in any subgroup. Mean global difference at 3rd month is 0.23 ml/min greater by CKDEPI. There are no relevant differences between subgroups related to DM and BMI. We can describe a difference between women (0.85 ml/min) and men (0.05 ml/min), and it is larger in 20-30 years group (3.4 ml/min) and in 70-80 years (2.74 ml/min). As measure of agreement, Intraclass Correlation Coefficient (ICC) shows excellent correlation in all subdivisions (Cronbach's Alpha statistic (CA) &amp;gt; 0.99), without significant decrease in any subgroup; minimum ICC = 0.987 is in 20-30 years group, and maximum ICC = 0.999 in 40-60 years. Bland-Altman plot is shown in Fig. 1, where we appreciate a negative bias in low eGFR against a positive in higher values. Mean global difference at one-year eGFR is 0.25 ml/min greater by CKDEPI. We observe a difference between women (0.75 ml/min) and men (0.04 ml/min), larger in 20-30 years group (2.94 ml/min) and 70-80 years (2.27 ml/min) without significance. ICC shows excellent correlation without significant decrease in any subgroup; minimum ICC = 0.992 is in 20-30 years group, and maximum ICC = 0.999 in 50-60 years. Conclusion We find no significant differences between means in eGFR by CKDEPI and EKFC. We observe a tendency to a greater estimation in women than in men. Both CKDEPI and EKFC equations for eGFR show an excellent concordance in our cohort of KT but differences in scatter analysis in Bland-Altman plot, greater in higher values of eGFR. ICC and CA are both slightly minor in the extreme age groups of our cohort. It matches what described in major studies; these differences may be not clinically relevant in this age range group but are probably greater in patients beyond this range.

Epidemiology, Seasonal Variability, and Factors Associated with Increased Mortality in Patients with Acute Appendicitis in Thailand: A Study Using Data from the National Health Security Office

Objective: The study aimed to study the spatiotemporal distribution of acute appendicitis in Thailand, using a reimbursement dataset from the National Health Security Office, and also analyze for mortality and factors associated with mortality after an appendectomy.Material and Methods: The study used data mining to analyze a reimbursement data set from the Thailand National Health Security Office (NHSO), focusing on the diagnosis of acute appendicitis (K35.2-K35.9). The analysis looked for the incidence trend and seasonal variation of the incidence. The study also analyzed mortality and factors associated with the mortality. A prediction model for mortality was constructed using a decision tree. Results: During the 4 fiscal years of the study period, from October 2016 - September 2020, a total of 287,449 individuals were diagnosed with acute appendicitis, and 272,850 appendectomies were performed, which gave an annual incidence (AI) of 10.8/10,000 person-years. The peak age incidence was in the second decade of life, which had an age-specific AI of 28.4/10,000 person-years. Using a multiplicative model of time series detrending and a decomposition model and a seasonal variation of acute appendicitis, with the highest incidence from May to October, linear regression showed a significant correlation between the incidence of appendicitis and precipitation (r2=0.28, p-value&lt;0.001). The AI of appendicitis was declining and showed an especially large decline in the year 2020, when the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic began. The overall mortality was 2.3%. A significantly higher mortality rate was found in cases with extreme age (pediatric or geriatric), those with co-morbidities (diabetes, hypertension, dyslipidemia, chronic pulmonary disease, chronic kidney disease), and those with complications, especially generalized peritonitis, sepsis, and acute kidney injury. A decision-tree prediction model suggested that sepsis and renal complication were key nodes determining mortality risk in pediatric and geriatric appendicitis. Conclusion: A mortality risk from appendicitis remains in Thai patients, especially the elderly with co-morbidities and those with generalized peritonitis, sepsis, or renal complications. Early diagnosis and improvement in perioperative care in the extreme age groups might improve the mortality figure.

Gaze data of 4243 participants shows link between leftward and superior attention biases and age.

Healthy individuals typically show more attention to the left than to the right (known as pseudoneglect), and to the upper than to the lower visual field (known as altitudinal pseudoneglect). These biases are thought to reflect asymmetries in neural processes. Attention biases have been used to investigate how these neural asymmetries change with age. However, inconsistent results have been reported regarding the presence and direction of age-related effects on horizontal and vertical attention biases. The observed inconsistencies may be due to insensitive measures and small sample sizes, that usually only feature extreme age groups. We investigated whether spatial attention biases, as indexed by gaze position during free viewing of a single image, are influenced by age. We analysed free-viewing data from 4,243 participants aged 5-65 years and found that attention biases shifted to the right and superior directions with increasing age. These findings are consistent with the idea of developing cerebral asymmetries with age and support the hypothesis of the origin of the leftward bias. Age modulations were found only for the first seven fixations, corresponding to the time window in which an absolute leftward bias in free viewing was previously observed. We interpret this as evidence that the horizontal and vertical attention biases are primarily present when orienting attention to a novel stimulus - and that age modulations of attention orienting are not global modulations of spatial attention. Taken together, our results suggest that attention orienting may be modulated by age and that cortical asymmetries may change with age.

Age-related disparities in the severity course of COVID-19

COVID-19 demonstrates a different clinical severity of course in different age groups. In the present study, we present a comparative analysis regarding the risk of hospitalization and in-hospital mortality between two extreme age groups – children and young adults (0-39 years) and elderly patients (≥70 years). For the period from January to June 2022, nasopharyngeal samples of 1,611 patients at MHAT Uni Hospital (Panagyurishte, Bulgaria) were examined by PCR analysis, of which 486 had a positive result for SARS-CoV-2. From the first target group with a laboratory-confirmed diagnosis of COVID-19, there were 158 patients with an average age of 27.5 years, and only one of them was hospitalized (a 30-year-old man, unvaccinated, with bilateral pneumonia and concomitant arterial hypertension). The average age of the patients from the second target group (n=40) was 75.6 years, 29 of them were outpatients and 11 were hospitalized, among whom 5 men with an average age of 77.6 years died. The average hospital stay of the only hospitalized patient from the young age group was 6 bed days, while for patients ≥70 years of age it was 10.1 bed days. Age is among the determinants of risk of hospitalization and in-hospital mortality associated with COVID-19.

Acute kidney injury requiring dialysis in children: a multicentric, emerging country perspective.

Acute kidney injury (AKI) is a life-threatening condition, especially in extreme age groups and when kidney replacement therapy (KRT) is necessary. Studies worldwide report mortality rates of 10-63% in pediatric patients undergoing KRT. Over 13years, this multicenter study analyzed data from 693 patients with AKI, all receiving KRT, across 74 hospitals and medical facilities in Rio de Janeiro, Brazil. The majority were male (59.5%), under one year old (55.6%), and treated in private hospitals (76.5%). Sixty-six percent had comorbidities. Pneumonia and congenital heart disease were the most common admission diagnoses (21.5% and 20.2%, respectively). The mortality rate was 65.2%, with lower rates in patients over 12years (50%). Older age was protective (HR: 2.35, IQR [1.52-3.62] for neonates), and primary kidney disease had a three-fold lower mortality rate. ICU team experience (HR: 0.74, IQR [0.60-0.91]) correlated with lower mortality, particularly in hospitals treating 20 or more patients. Among the deceased, 40% died within 48h of KRT initiation, suggesting possible late referral or treatment futility. This study confirms the high mortality in pediatric dialytic AKI in middle-income countries, underlining early mortality and offering critical insights for improving outcomes.

FACTOR ASSOCIATED WITH UNFAVOURABLE TREATMENT OUTCOME AMONG ADULT TUBERCULOSIS PATIENTS IN AGRA: A CROSS-SECTIONAL STUDY

Background: Tuberculosis has remained a disease of public health importance since ages and is known to inflict large quantum of socioeconomic cost on the society. Risk of TB is high among population living in poverty, low socioeconomic groups, low income, immune-suppressed, and extreme age groups, certain ethnicity, migrants, and those exposed to animals.1,2Factors that delay diagnosis similarly increase the length of exposure to an infectious TB patient. Malnutrition increases the susceptibility to disease3,4. Aims and Objectives: In our study we identified the sociodemographic factor, knowledge and perception of the subjects about the disease that will cause the unfavourable treatment outcome. Material and Methods:The study was cross sectional study and conducted at designated microscopic centre of Sarojni Naidu medical college Agra.Total number of patients registered during the period of July to September 2017 were taken. Two follow up were done during the course of treatment. Result: The overall success rate (cure plus completed) in our study was 80.0%. The subjects who had no knowledge regarding curability have more unfavourable treatment outcome (43.7%) as compare to those subjects who had knowledge of curability (15.73%) (p value=0 .009). Conclusion: Symptomatic relief by medicine, side effect and forgetfulness of medicine directly affected the treatment outcome.

AGE DIFFERENCES IN SOCIAL DISCOUNTING AND CHARITABLE GIVING IN A US SAMPLE

Abstract Social discounting describes the tendency to show less generosity to more socially distant recipients. With respect to age differences, prior studies (Pornpattananangkul et al., 2019; Lin &amp; Zhang, 2020) found that older adults showed more generosity to distant others (i.e., lower social discounting rates) than younger adults. However, prior research relied on small samples, compared extreme age groups, and focused on Asian countries. To examine generalizability, this pre-registered study examined social discounting and charitable giving in a U.S. adult life-span sample (N = 426, age 18-96, Mage = 50.93, SDage = 19.51, 51% female, 61% non-Hispanic White). The social discounting measure was adapted from Jones and Rachlin (2006) and involved five social distances (1, 5, 10, 50, 100) on a 100-point scale (0 = closest, 100 = most distant). For each social distance, participants were asked how much of $100 they would allocate to themselves versus a person at that distance. They made the same decision for their favorite charity. Contrary to previous findings and our predictions, results revealed a significant positive association between age and social discounting rates (p&amp;lt; .01), such that older adults’ generosity declined more with increasing social distance. Age differences remained robust after controlling for demographics. There were no significant age differences in average giving across social distances and in charitable giving, but, regardless of age, charitable giving was higher among those with lower social discounting rates (p&amp;lt; .001). Findings suggest that age differences in social discounting may be sensitive to cultural context.

Intestinal helminth and the predisposing factors in Fufore LGA of Adamawa state

Background &amp; Objective: Helminths have plagued humans since the era of our earliest recorded history. A large part of the world's population are infected with one or more of helminthes infection (WHO, 2016). Helminthes are endemic and have been a major problem in rural settlements in Nigeria this is as a result of poor socio- economic status and lack of basic amenities such as pipe borne water and other sanitary facilities (Okon and Okun, 2001). They also have detrimental effects on animal survival (Silva et al., 2009) and these parasites have the potential of being transmitted to human (Batchelor et al., 2008). To provide information on the prevalence, intensity and predisposing factors of intestinal helminth among School-aged children in relation to their age and gender in Fufore. Methods: A cross sectional study was carried out to determine the prevalence of intestinal helminth and the predisposing factors in Fofure LGA of Adamawa State between October and November 2022 where five Schools were sampled for the study. 300 Students between the ages 0-15 years were randomly selected and grouped into three age groups (0-5, 6-10, 11-15). 300 stool samples were obtained from the students and examined. Each were issued a structured questionnaire so as to obtain their demographic characteristics and to examine the possible risk factors associated with this infection. Result: out of the 300 Students examined, 17(5.7%) were positive for intestinal helminth and the Males (6.7%) had significantly higher prevalence (P &lt; 0.05) than the Females (4.4%). In respect to age, the age group 0-5 (11.5%) were significantly more infected (P &lt; 0.05) followed by the age group 6-10 (7.9%) than the extreme age group 11-15 (1.5%) examined. Three parasites namely Schistosoma mansoni, Ascaris lumbricoides and Trichiuris trichiura were recovered. The most common of these parasites were Schistosoma mansoni and Ascaris lumbricoides which occurred in high intensity in most of the positive samples. Interpretation and Conclusion: The result of this study revealed that, poverty, ignorance, socio-cultural practice, poor hygienic practices, inadequate sanitary/ toiletry facility to be the driving forces of this infection in the study area. Intervention needed to curtail the effect and further transmission of this infection include; massive treating and health education, provision of portable drinking water and provision of good sanitary/ toilet facility.

To study clinical profile and correlation of EEG and CT findings in diagnosis of focal seizures in children at medical institution in mid – Karnataka region

Focal-onset seizures account for approximately 40% of seizures in children. Focal seizures are most commonly associated with underlying brain pathology in extreme age groups. Clinical correlation and localizing the site of the lesion play an important role in the early diagnosis and proper management of focal seizures in children. Objectives: To study the clinical profile and correlation of EEG and CT findings in children admitted to the paediatric ward of Medical College.A prospective study on the correlation of focal seizures, CT brain, and EEG studies was carried out in children in the age group of 1 month–14 years admitted to the Department of Pediatrics at Medical College &amp; Hospital, Karnataka. Among the (n=50) study subjects, the majority of the children with focal seizures were in the age group of 6–10 years, with a slight male preponderance.(n=22) (44% of the children) presented with focal-aware seizures. The most common brain lesions detected were calcified disc lesions and cysticercosis ring lesions (52%).45% of children with focal seizures had epileptiform discharges. We also observed that complementary to CT brain scans in correlating with the clinical history. It was noted that44% of children with focal seizures had normal CT brain scans and normal EEG studies. A good clinical history is crucial in the diagnosis of focal seizures. Most focal seizures are associated with underlying organic brain lesions. A CT brain scan plays an important role in the detection of brain lesions in children with focal seizures. The EEG study complements history and CT scan of the brain in defining and correlating the lesions precisely.

Role of Education and Physical Activity in Executive Function Performance of Adult Population.

Executive function performance has been extensively studied in extreme age groups, but the middle age population, where a decline could begin, is still under investigation. The role of factors like education and physical activity that might influence cognitive performance is not well understood. The study aimed to examine the influence of age, education, and physical activity on executive function performance and the interaction effects between these factors on two subpopulations of adults, i.e., young adults and middle-aged adults. 92 adults, 46 young adults (N = 24.4 ± 2.7 years, 25 postgraduates and 21 PhDs) and 46 middle-aged adults (N = 48.08 ± 5.79 years, 28 postgraduates and 18 PhDs), were included. Each subject performed Delayed Matching of Sample (DMS), Spatial Working Memory (SWM), and Multitasking (MTT) test on CANTAB. Physical activity levels were reported through IPAQ. Results indicated age to have a major influence on DMS, SWM, and MTT performance; however, education was only found to influence SWM. MTT and SWM performance was found to be lower in middle-aged adults in comparison to young adults. On comparison of test scores between highly active and moderately active groups of middle-aged adults, no differences were found; however, in young adults, MTT correct scores (p < 0.05) were significantly higher in the highly active group in comparison to their counterparts. Interaction between age and level of education revealed better retrieval in middle-aged adults with higher education in comparison to their counterparts. In comparison to younger counterparts, executive function performance deteriorated around the middle ages. Education was found to play a protective role in executive abilities slowing during middle age. Also, physical activity may play some role in executive function performance.

Clinicopathological Profile of Colorectal Cancers in a Tertiary Care Hospital of Central, Nepal

IntroductionThere is an increasing incidence of colorectal carcinoma (CRC) in developing countries like Nepal. The objective of this research is to study the CRC its demography, mode of presentation, type of surgery, complications and Histopathological evaluation (HPE) after surgery.MethodsThis was a retrospective descriptive observational study at College of Medical Sciences, Bharatpur, Nepal. Patients diagnosed with colorectal cancer admitted to gastrointestinal surgery department from July 2019 to June 2022 (3 years) were included. Data of patients were retrieved from hospital records. Pre-operative, intra-operative and post-operative diagnosis of CRC on HPE were also included in the study.ResultsOut of 52 CRC, males were 30 (57.7%) and females were 22 (42.3%), mean age was 52.7 years. Overall, left colon was affected in 33 (63.5%) and right in 19 (36.5%). More than one quarter of patients 14 (26.9%), had disease recurrence by 6 months follow-up. HPE revealed half of the disease condition as adenocarcinoma, moderately differentiated in (50%) cases.ConclusionsColorectal cancer is predominant in male patients and older age group. Incidence is high in younger people &lt;40 years and low in extreme age group &gt;80 years. Meticulous surgery is the only proven cure for malignancy.

Time trends, projections, and spatial distribution of low birthweight in Australia, 2009-2030: Evidence from the National Perinatal Data Collection.

Infants with low birthweight (LBW, birthweight <2500 g) have increased in many high-resource countries over the past two decades. This study aimed to investigate the time trends, projections, and spatial distribution of LBW in Australia, 2009-2030. We used standard aggregate data on 3 346 808 births from 2009 to 2019 from Australia's National Perinatal Data Collection. Bayesian linear regression model was used to estimate the trends in the prevalence of LBW in Australia. Wefound that the prevalence of LBW was 6.18% in 2009, which has increased to 6.64% in 2019 (average annual rate of change, AARC=+0.76%). If the national trend remains the same, the projected prevalence of LBW in Australia will increase to 7.34% (95% uncertainty interval, UI=6.99, 7.68) in 2030. Observing AARC across different subpopulations, the trend of LBW was stable among Indigenous mothers, whereas it increased among non-Indigenous mothers (AARC=+0.81%). There is also an increase among the most disadvantaged mothers (AARC=+1.08%), birthing people in either of two extreme age groups (AARC=+1.99% and +1.53% for <20 years and ≥40 years, respectively), and mothers who smoked during pregnancy (AARC=+1.52%). Spatiotemporal maps showed that some of the Statistical Area level 3 (SA3) in Northern Territory and Queensland had consistently higher prevalence for LBW than the national average from 2014 to 2019. Overall, the prevalence of LBW has increased in Australia during 2009-2019; however, the trends vary across different subpopulations. If trends persist, Australia will not achieve the Sustainable Development Goals (SDGs) target of a 30% reduction in LBW by 2030. Centering and supporting the most vulnerable subpopulations is vital to progress the SDGs and improves perinatal and infant health in Australia.

A Rare Case of Anti-N-Methyl-D-Aspartate Receptor Encephalitis in an Infant Presenting with Regression and Movement Disorder.

A Rare Case of Anti-N-Methyl-D-Aspartate Receptor Encephalitis in an Infant Presenting with Regression and Movement Disorder.

Impact of COVID-19 pandemic on medication use in the older Italian population.

This study aims to analyse the impact of the pandemic on the amount of use and new medication dispensation for chronic diseases in the Italian population aged 65years and older (almost 14 million inhabitants). The "Pharmaceutical Prescriptions database", which gathers data on medications, reimbursed by the National Health Service and dispensed by community pharmacies, was employed. Data were analysed as amount of use (defined daily dose-DDD per 1000 inhabitants); variation in DDD between 2020 and 2019 was calculated for the 30 categories with major consumption in 2020. Trends in prevalence and incidence of dispensations between 2020 and 2019 were calculated for four categories: antidiabetics, antihypertensives, antidepressants and drugs for respiratory diseases. All medications showed a negative variation in DDD/1000 inhabitants between 2020 and 2019 except for anticoagulants (+ 5%). The percentage variation ranged from -27.7% for antibiotics to -6.4% for antipsychotics in 85 + year-old persons, but increased for most classes in the youngest (65-69years). On the other hand, a decrease of the dispensation incidence of antidiabetics, antihypertensives, antidepressants and drugs for pulmonary disease was high, especially in the two extreme age groups, the youngest and the oldest one. Great variation in medication use between 2020 and 2019 was observed probably reflecting the low rate of infectious diseases due to the widespread use of protective devices and self-isolation, reduced healthcare access because of the lockdowns and the fear of going to hospital, and the reduction of screening and diagnostics due to health-care system overload.

Assessment Clinical Association of Thyroid Function in Women of Reproductive Age Group with Abnormal Uterine Bleeding

Background: Abnormal Uterine Bleeding occurs when the frequency and quantity of menstrual bleeding in females is significantly altered. It is the most prevalent clinical presentation in gynecology, affecting more than 20% of the female population, and is characterized by variations from normal menstruation in terms of irregularity in periods, frequency, duration of blood flow, amount of blood loss, and cyclicity. Thyroid hormones had significant effects on the female reproductive system, such as delayed puberty, infertility, premature menopause, recurrent abortions, and AUB. The AUB is significantly associated with thyroid secretions, and any patient who complains of AUB or irregular menstruation must have thyrotoxicosis ruled out. Objectives: This study was conducted at the Department of Obstetrics and Gynecology, Nishtar Hospital, Multan, Pakistan, (2021-22) in order to evaluate the clinical association between thyroid function and AUB in women of different reproductive age groups. Methods: This cross-sectional study was conducted in the outpatient department of Obstetrics &amp; Gynecology, Nishtar Hospital, Multan, from 1st December 2021 to 31st May 2022. 320 patients participated in the study and were examined clinic-pathologically and were allocated into three groups based on their thyroid profile (euthyroid, hyperthyroid and hypothyroid, respectively) and further predisposition risk factors were recorded and analyzed. Results: It was discovered that extreme age groups of adolescence and pre-menopause phase significantly (p&lt;0.05) increased the incidence of AUB. The incidence of AUB was also elevated (p&lt;0.05) among patients with an abnormal BMI, women with multiple pregnancies, and married women. The menstrual bleeding pattern was also studied in females, with polymenorrhea (131/320) being the most prevalent (p&lt;0.05), followed by menorrhagia (79/320), metrorrhagia (59/320), oligomenorrhea (42/320), and amenorrhea (9/320) having a significantly lower incidence (p&lt;0.05). The incidence rate of thyroid disorders was 28.12% (90/320), with hypothyroidism affecting 77(24.06%) and hyperthyroidism affecting 13(4.06%) patients (p&lt;0.05). Practical implication: AUB is significantly associated (p&lt;0.05) with thyroid hormones, therefore for early diagnosis of the underlying etiology and treatment of the patients by preventing hysterectomy and other serious surgical interventions, all patients presenting to OPD clinics with the complaint of AUB or irregular menstruation must be ruled out for a thyroid profile in the first instance. Conclusion: It was concluded that thyroid disorders directly affected the BMI, fertility and menstrual cycle of gynecology patients and increased the incidence of AUB along with the medical and gynecological complications. Keywords: Amenorrhea; Hyperthyroidism; Hypothyroidism; Polymenorrhea; Thyrotoxicosis.

Verbal fluency in Lebanese children: Preliminary normative data, sociodemographic determinants, and patterns of clustering and switching

This study assessed the quantitative and qualitative performance of Lebanese-speaking children on verbal fluency (VF) tasks and investigated the effects of sociodemographic characteristics. This study included 219 Lebanese children aged between 5 and 12 years and 11 months, whose native language is Lebanese-Arabic. Semantic and letter VF tasks were assessed using a range of categories and letters. Switching and clustering strategies were analyzed for 177 Lebanese children. The number of words produced presented a significant increase with age (p < .004) in semantic (SVF), while in letter (LVF), the differences were significant between extreme age groups. Females generated more words in the clothes (p = .003) and household items (p = .002) categories. The total number of switches and clusters showed a significantly increasing pattern with age (p < .05). The number of switches was higher for participants with high maternal (p < .001) and paternal (p < .013) educational levels. Regression analyses showed that the total number of switches and clusters, and the mean cluster size had a significant effect on SVF performance (p < .001). The current study generated preliminary norms for VF tasks for Lebanese-speaking children. The results of the current study have an important contribution to neuropsychology research and clinical practice.