History Habits Research Articles

Preserving collectivity through continuity

The concept of “continuity” in prehistory has been studied by many scholars mostly through its expression in mortuary practices or symbolism. The study of the ‘continuity in buildings’ emerged primarily through the study of the Southwestern Asian Neolithic. Renewed excavations at Çatalhöyük, and then at Aşıklı Höyük, both in Central Anatolia contributed to the studies and enriched the data. From the mid-9th millennium BCE until its abandonment in the last quarter of the 8th millennium BCE, the long-durée occupation at Aşıklı Höyük testifies to technological developments in architecture and spatial continuity in the use of space. The well preserved architectural remains allow the study of the different rythms and motivations of rebuilding through the continous occupation of the site over a long period of one thousand years. The many strands of evidence suggest that continuity at Aşıklı differs conceptually and practically through the habitation history. Strenghtened by oral communication and story-telling, all activities were collective and collaborative from the beginning, but more actively maintained later in the occupation. Collaboration among the members of the community in the early stages of settlement was based mostly on practicality but as time progressed this extended into many other aspects of the social fabric. Rebuilding took on a meaning far beyond functionality, ultimately serving to preserve social memory and structure, social actions and ideology. Continuity manifested itself clearly throughout the 8th millennium BCE and provided stability that lasted for hundreds of years until the abandonment of the settlement.

A decade-long study on pathological distinctions of resectable early versus late onset colorectal cancer and optimal screening age determination

The incidence of Early-Onset Colorectal Cancer (EOCRC) is increasing. However, the prognosis of EOCRC compared to Late-Onset Colorectal Cancer (LOCRC), and the ideal age for initial colorectal cancer (CRC) screening are not clear. In this study, we identified the pathological differences between the groups and determined the optimal screening age for CRC patients. We included 10,172 patients diagnosed with CRC from January 2011 to December 2021 in this study. Survival differences were compared by plotting Kaplan–Meier survival curves and conducting landmark analysis. Additionally, the diagnostic age of CRC patients was analyzed using age cumulative curves. Compared to LOCRC patients, EOCRC patients had a higher proportion of deficient mismatch repair (dMMR) and more advanced TNM staging (P < 0.05). The five-year survival of EOCRC patients was significantly better than that of LOCRC patients (P < 0.05). Laparoscopic surgery improved the long-term survival of EOCRC patients. Proficient mismatch repair (pMMR) favored the long-term survival of EOCRC patients. The survival rate of EOCRC patients at TNM stages I and II was higher than that of LOCRC patients at the same stages (P < 0.05). The age cumulative curve showed a substantial increase in the number of CRC patients at 40 years. The long-term prognosis of EOCRC patients is better than that of LOCRC patients, especially among those with pMMR, stages I–II, and who undergo laparoscopic surgery. For people with a high risk of cancer, such as a family history of cancer and poor lifestyle habits, the starting age for CRC screening should be 40 years.

Association Between Quality of Life and Drug Adherence Among Patients With Diabetes in India.

Diabetes represents a significant global health concern. Effective diabetes management necessitates substantial behavioral and psychological modifications, including regular glucose monitoring, dietary adjustments, and medication adherence. However, treatment adherence remains suboptimal, particularly in developing countries, leading to poor glycaemic control, increased healthcare costs, and diminished quality of life (QoL). Common factors influencing medication nonadherence include lack of medication knowledge, age, education of patients, polypharmacy, duration of disease, cost of therapy, complexity of dosing regime, and the presence of comorbidities. So, the study aims to assess the adherence status to antidiabetic medication and its association with QoL among diabetes patients in the Anand district of Gujarat state. A study was carried out in Anand district, Gujarat, from 2023 to 2024, focusing on community-based cross-sectional research. In the eight blocks of Anand district, a two-stage cluster sampling method was utilized, with one village or town randomly chosen from each taluka, and 25 diabetes patients interviewed per area. Data collection involved visiting 200 participants' houses, starting with a randomly selected house and continuing until the target was met. The interviews, conducted in the local language, lasted around 45 minutes and utilized a pre-validated and pretested questionnaire. The questionnaire covered demographic details, disease characteristics, and medication adherence using the semi-structured scale from Adherence to Refills and Medications Scale (ARMS-D), as well as the assessment of QoL using the WHOQoL-BREF questionnaire. Descriptive and inferential statistics were used for data analysis. Sociodemographic attributes were presented in terms of percentages (%) and frequencies (N). The means and standard deviation (SD) of health-related QoL and adherence to anti-diabetic medication were reported. Multiple linear regression analysis was used to assess the impact of adherence to antidiabetic medication within each QoL area after adjusting for a few sociodemographic variables. P values below 0.05 were considered statistically significant. The study included predominantly older participants (58.1 years) with 53.5% being male. Most participants (65.5%) had diabetes for more than 5 years, 60.0% had comorbidities, and 29.0% experienced complications. Nonadherence to treatment was observed in 37.0% of patients. The study found that factors like age, education, occupation, family history of diabetes, smoking, alcohol consumption, exercise habits, and medication adherence significantly influenced the QoL in diabetic patients, with medication adherence showing the strongest positive association with all QoL domains. This study shows a high percentage of nonadherence to antidiabetic medications. Poor adherence had significantly lower mean scores across all domains of QoL. Community-based educational programs targeting older and less-educated individuals should promote regular physical activity. Developing strategies to improve medication adherence and ensuring affordable access to essential medications, along with prioritizing enhancements in the QoL through psychosocial support and lifestyle counseling are imperative for diabetic patients.

Construction and validation of a novel forecasting nomogram to the risk of colorectal adenomas: preventing colorectal cancer at its origin.

Colorectal adenomas are responsible for the origin of most colorectal cancers (CRC). Early detection together with active intervention of colorectal adenomas plays a crucial role in the prevention of colorectal cancer. This study aimed to construct and validate a new nomogram for the forecasting of the risk of colorectal adenomas based on lifestyle risk factors that could offer potential benefits for CRC prevention. Colonoscopy reports, pathology reports, physical factors, family history, personal history of disease, diet, and lifestyle habits were collected from 1133 subjects who underwent complete colonoscopy. All subjects were divided into the training cohort (n = 792) and the validation cohort (n = 341). A nomogram predicting the risk of colorectal adenoma development was constructed using the training cohort and the C-index was calculated. The predictive accuracy and clinical applicability of the nomogram were verified in the validation cohort. The nomogram was constructed by 6 statistically significant variables selected from 18 health factors, including advanced age, male, smoking, drinking, pickles, and irregular defecation. The C-index of the training cohort was 0.778 and the C-index of the validation cohort was 0.754. The calibration curve and decision curve analysis (DCA) also confirmed that the model has good predictive ability and high profit. The nomogram constructed in this study was validated and can be applied to predicting the occurrence risk of colorectal adenoma. The model can guide the identification of patients with non-symptomatic colorectal adenomas and the recognition of high-risk individuals for whom a colonoscopy is advisable.

Use of the Hospital Anxiety and Depression Scale in Patients with Oral Lichen Planus: An Institutional Experience.

Background Oral lichen planus (OLP) is a chronic inflammatory disorder affecting the oral mucosa. It commonly appears in reticular and erosive forms, among other variants that include bullous, papular, and plaque types. This condition can greatly diminish a patient's quality of life due to prevailing discomfort and anxiety. Materials and methodology A retrospective study was conducted involving patients with OLP in the Department of Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Chennai, India, measuring their anxiety and depression levels using the Hospital Anxiety and Depression Scale (HADS). Patient data were extracted from the private institution's electronic data recording system from June 1, 2023, to June 30, 2024. The retrieved data also included parameters such as age, gender, chief complaint, associated comorbidities, habit history, type of clinical variant, and previous medication history. SPSS Version 26.0 (IBM Corp., Armonk, NY) was employed for data analysis, utilizing Fisher's exact tests, chi-square tests, and Mann-Whitney U tests for comparisons, with a p-value of <0.05 considered as significant. To compare proportions between groups, the chi-square test was applied, and when the expected cell frequency was less than 5, Fisher's exact test was used. Results Out of 1,500 outpatients in the department, 367 were diagnosed with OLP and 212 met the diagnostic criteria for inclusion in a one-year study (June 1, 2023, to June 30, 2024). The most frequently reported age group was 51-60 years, representing 27.4% (n = 58) of the total population, with a female predominance of around 62.7% (n = 133). Patients' associated comorbidities revealed the prevalence of Grinspan syndrome in around 9.4% (n = 20). Additionally, the habit history indicated no significant history in 92% (n = 198) of cases. The majority of the study population was symptomatic, reporting a chief complaint of burning sensation (46.2%) (n = 98). The most common clinical variant reported was reticular (53.8%) (n = 114), followed by the erosive variant (36.8%) (n = 78). Medication history revealed that triamcinolone acetonide 0.1% (42.9%) (n = 91) was the most commonly prescribed medicine, followed by prednisolone 5 mg (32.5%) (n = 69). The HADS score indicated that 48.58% (n = 103) of patients had abnormal anxiety scores (mean of 15.8 ± 2.02), while 42.4% (n = 90) exhibited abnormal depression scores (mean of 16.3 ± 2.07). Notably, patients with the erosive variant showed higher anxiety scores compared to those with the reticular variant, with an average score of 9.3 ± 1.07, with a p-value of 0.041. Conclusion The findings underscore the substantial psychological burden associated with OLP, which affects patient's emotional well-being and treatment adherence. Addressing these psychological concerns through regular assessments and supportive interventions is crucial for improving the standard of living.

MANAGEMENT OF GESTATIONAL HYPERTENSION THROUGH FAMILY MEDICINE APPROACH: CASE REPORT

Several factors contribute to the incidence of hypertension during pregnancy, including a familial history of hypertension, obesity, and unhealthy dietary habits. Family habits can have a substantial impact on lifestyle, especially nutritional choices. This report presents a case of gestational hypertension in Mrs. DK, a 20-year-old pregnant woman with obesity, who was managed utilizing a family medicine approach. The identified root cause of her problem as an inherited genetic susceptibility to hypertension, exacerbated by poor dietary habit within the family. Mrs. DK and her family was given comprehensive intervention to ensure a healthy pregnancy. This strategy provided her with results in the form of controlled blood pressure and enhanced understanding of her condition and nutritional requirements, as well as strategies to fulfill them. Ongoing surveillance is necessary to guarantee that goals are being met.

Oral issues and childhood stress in eight-to-ten-year-old schoolchildren: a case-control study.

The aim of the present study was to investigate whether oral problems, harmful oral habits, and sociodemographic factors are associated with the occurrence of stress in schoolchildren. A case-control study nested within a cross-sectional study was conducted with a sample of 375 schoolchildren eight to ten years of age in the city of Diamantina, Brazil. The case group (with childhood stress) and control group (without childhood stress) were matched for age and sex at a 1:4 ratio (75 cases to 300 controls). Data collection involved the self-administration of a questionnaire by parents/caregivers addressing sociodemographic characteristics and the child's history of harmful oral habits. The children answered the Child Stress Scale (CSS) and underwent a clinical oral examination to determine the presence/absence of dental caries, malocclusion, and traumatic dental injuries. Data analysis involved the calculation of frequencies, the chi-square test, and conditional logistic regression (95% CI; p ≤ 0.05). The final adjusted conditional logistic regression model showed that dental caries (OR = 1.78, 95% CI: 1.01 - 3.14, p = 0.044) and biting objects (OR = 1.81, 95% CI: 1.02 - 3.22, p = 0.041) remained associated with stress in the schoolchildren analysed. The present results showed that children with dental caries and the habit of biting objects were more likely to have childhood stress. The study allows paediatric dentists to expand their knowledge with regards to the influence of oral problems and harmful habits on the occurrence of childhood stress and serves as a guide for decision-making related to oral problems in schoolchildren.

The effect of early childhood non-nutritive sucking behavior including pacifiers on malocclusion: a randomized controlled trial.

Systematic reviews on the effects of pacifiers on occlusion have highlighted the need for quality RCTs. Single region, three parallel-armed, prospective, randomized controlled trial. To investigate the correlations between early childhood non-nutritive sucking habits and malocclusion. Specifically to test whether the use of a study pacifier has differing effects compared to other pacifiers and control, and whether the duration of pacifier use or digit sucking influence the occlusion. The subjects were firstborn children, born in 2008 in Vantaa, Finland. One-third of participants were offered study pacifiers, free of charge, from birth up to 2 years of age. The history of the subjects' sucking habits, including pacifier use was screened in a questionnaire at the age of 2 years, and clinical examinations were performed at the age of 7 years. In addition, the subjects were divided into groups that were equally matched regarding their mother's level of education. Posterior crossbite, anterior crossbite, overjet, deep bite, open bite, and crowding. Three districts were randomly allocated to three study groups by drawing lots. It was not possible to blind the clinicians or parents from the intervention. Blinding during data analysis was performed. From the original cohort of 2715 children born in the town of Vantaa, 1911 were excluded and 353 were lost to follow-up. The remaining 451 children were divided into three groups according to the use of pacifiers. The prevalence of posterior crossbite at the age of 7 years was higher if a non-study pacifier had been used (P = .005) even when matched for the mother's level of education (P = .029). The prevalence of posterior crossbite was higher if the pacifier habit had continued for 12 months or more compared to 11 months or less, 7% and 1%, respectively, (P = .003). Digit sucking for 12 months or more was associated with crowding (P = .016). The prevalence of crossbite in the study pacifier group was less than in control pacifiers. No adverse harms were reported other than effects on the dentition. The use of pacifiers is associated with the posterior crossbite, especially if their use continues for a year or more. Parents/guardians should be advised to stop the use or reduce the use of pacifiers to a minimum after their child's first birthday. ClinicalTrials.gov NCT01854502.

Biogeography and Conservation in the Arabian Peninsula: A Present Perspective.

The Arabian Peninsula, with its rugged mountains, wadis, alluvial plains, sand dune deserts, and diverse coastlines, spans over 3 million km2. The Peninsula is situated at the crossroads of Africa and Asia and is a meeting point for diverse biogeographic realms, including the Palearctic, Afrotropical, and Indomalayan regions. This convergence of biogeographic zones has resulted in a remarkably diverse flora and fauna, which is adapted to the harsh and varied climates found throughout the Peninsula. Each of the countries of the Arabian Peninsula are biologically diverse and unique in their own right, but Yemen, Saudi Arabia, and Oman are the most diverse in terms of their landforms and biological diversity. The mountainous regions support a cooler and more moderate climate compared to the surrounding lowlands, thus forming unique ecosystems that function as refugia for plant and animal species, and have a high endemism of plant species. The desert ecosystems support a variety of lifeforms that are specially adapted to an extreme arid climate. Due to its long history of human habitation and subsistence agriculture, particularly in the mountainous areas, the Arabian Peninsula possesses unique crop varieties adapted to extreme arid climates, making them important genetic resources for the future in the face of climate change. The Arabian Peninsula, though rich and diverse in its biological diversity, has been greatly affected by human activities, especially in the last 50 years, including urbanization, habitat destruction, overgrazing, and climate change, which pose significant threats to the biodiversity of the region. This review presents the biogeography and background of conservation efforts made in the countries in the Arabian Peninsula and gives the progress made in botanical research and conservation practices throughout the Peninsula.

Evaluation history of dietary food groups and nutritional habits of individuals diagnosed with a memory disorder: a case–control study

PurposeCognitive decline and dementia are major causes of disability. Research has suggested a relationship between dietary intake and memory problems in individuals. This study aims to examine the dietary histories of participants with newly diagnosed memory problems.Design/methodology/approachA total of 285 subjects (129 cases and 156 controls) were included in this retrospective case−control study. This paper used a food frequency questionnaire to determine the intake of dietary food groups in the previous year and a general questionnaire to assess food habits. The strength of the association between dietary history and memory problems was assessed using logistic regression and Pearson’s tests.FindingsIn this study, 73% of participants had a lower middle income and consumed less than the recommended number of meats, fruits and vegetables (1.2, 1.8 and 0.99 units/day, respectively). Participants with memory problems were more likely to take supplements than those without (P = 0.01). There was no significant difference in energy intake between the case and control groups (1634 Kcal vs 1656 Kcal). The results of the logistic regression showed that consuming any of the food groups in the previous nine months was not associated with memory problems. However, the Pearson test showed that an increase in the consumption of high-quality protein and vegetables had a slightly nonsignificant relationship with a decrease in the severity of memory disorder.Originality/valueIt is safe to suggest consuming adequate amounts of high-quality protein and affordable protein from sources such as dairy products, meats and vegetables. Research is insufficient to recommend the use of dietary supplements as a means of preventing memory disorders.

Pilot of a Bowel Habit Assessment Tool to Enable Early Identification of C. diff Infection

Background: Gastrointestinal conditions are common in hospitalized patients. Decreased mobility, dietary changes, medications and their underlying illness may alter patients’ bowel movements. It’s important for health care providers to be aware of patient’s bowel habits, especially for early identification of Clostridiodies difficile infection (CDI). Prior research has shown that patient modesty may be a barrier to discussing bowel habits with nurses and providers. This can lead to delay in diagnosis of CDI, lack of timely isolation and possible misclassification of community onset CDI cases as hospital onset (HO-CDI). Methods: A Bowel Habits Assessment Tool (BHAT) was developed to assist health care providers in learning skills to assess and document patient bowel habits accurately. The tool provides a structured approach to help clinicians gather relevant information, identify abnormalities, and promote effective communication with patients. The tool was developed by an infectious disease physician and modeled on existing tools utilized to take a sexual history. A team of infectious disease physicians, nurses and a gastroenterologist reviewed the tool and provided feedback. See Table 1. The tool was introduced as a pilot program at a 180 bed academically affiliated Veterans Affairs Hospital. Micro educational sessions were held to provide education about the importance of a bowel habit history, introduce the tool and teach its use in clinical care. The teaching sessions were led by an Infectious Disease physician and a nurse infection preventionist. An anonymous pre and post survey employing a 5-point Likert scale was administered to participants. All participation was voluntary. This project was reviewed and approved as a Quality Improvement by the VA Research Office, Eastern Colorado Health Care System. Results: Twenty nine healthcare personnel participated in the pilot. Participants included nurses (13), resident physicians (13), medical students (2) and nursing assistants (1). 59% of participants stated that they strongly agree with the statement “I am comfortable discussing patient’s bowel habits” on the pre-survey. (Question 1). This increased to 73% after the BHAT educational session. The mean difference between pre and post survey responses for question one was 0.45 (CI 0.08761 to 0.8089, p= 0.0167). All participants found the BHAT related to their work and useful, with 41% strongly agreeing and 52% somewhat agreeing that the BHAT was useful. See figure 1: Survey Responses. Conclusions: The effectiveness of a bowel habit assessment tool was demonstrated using a pre and post survey. BHAT improved clinicians comfort level discussing patient’s bowel habits.

Impact of distress on the nutritional status of patients with type 2 diabetes mellitus at the National Hospital of Endocrinology in 2022

Diabetes Mellitus (DM), particularly Type 2 Diabetes Mellitus (T2DM), is one of the most prevalent non-communicable chronic diseases and poses significant challenges for the healthcare sector and the community. Distress in patients with T2DM leads to severe physical and mental consequences. This study aims to analyze the relationship between distress and the nutritional status of T2DM patients. A cross-sectional descriptive study was conducted on 203 T2DM patients at the National Hospital of Endocrinology from October to December 2022. Of the participants, 54.2 % were female with an average age of 62.1 (±12.4). The waist circumference (WC) and waist-to-hip ratio (WHR) were significantly different between genders (p < 0.05). The prevalence of overweight/obesity was high at 46.7 %, with females having a 2.3 times higher WC and a 1.5 times higher WHR compared to males. The study identified several factors related to the nutritional status and distress in T2DM patients, including age, gender, residence, family history of T2DM, lifestyle habits, and nutritional status (p < 0.05). Early and comprehensive evaluation of T2DM patients is essential to improve treatment outcomes and quality of life.

Helicobacter pylori positive oral squamous cell carcinoma demonstrate higher pathological tumor staging and poorer overall survival

BackgroundHelicobacter pylori (H pylori), a bacterium characterized by its spiral shape and gram-negative nature, impacts approximately half of the global population, showing a greater prevalence in developing nations. There are various factors that contribute to the pathogenicity of H pylori in the gastric mucosa, leading to gastric ulcer, gastritis and gastric cancers. The relationship between H pylori and gastric cancers has been well documented. The association between Oral Squamous Cell Carcinoma (OSCC) and H pylori still remains a grey field. The study aimed to evaluate the presence of H pylori in OSCC. Materials and MethodsThe study consisted of 46 case samples and 21 controls. The case samples comprised of histopathologically confirmed cases of OSCC obtained from patients undergoing wide local excision. Fresh tissue samples were collected during cryosection and stored in eppendorf tubes. The control samples were collected from the gingiva and buccal mucosa of apparently healthy patients with no history of habits, undergoing procedures such as gingivectomy and impaction. All the cases and controls were subjected to immunohistochemistry for Helicobacter pylori antibody. The cases demonstrating Helicobacter pylori in immunohistochemistry further underwent additional Real-Time- Polymerase Chain Reaction (RT-PCR) and culture methodology for subsequent confirmation. Results15/46 cases (32.6 %) showed positive immunohistochemical expression of H pylori in OSCC, while all the twenty-one controls were negative (p value 0.001). Out of the 15 cases tested using culture methodology, a total of 7 cases, representing 46.7 % of the sample, were positive for the presence of H pylori (p- value 0.003). Similar statistically significant results were also obtained for 16S rRNA gene with RT- PCR. Furthermore, H pylori positive cases were frequently found in higher pathological tumor staging. A significant increase in overall survival rate was evident among the H pylori negative cases. ConclusionHelicobacter pylori was significantly expressed in OSCC tissues when compared to healthy tissues. Immunohistochemical analysis of the presence of H pylori in FFPE OSCC samples yielded more positive results when compared to culture and PCR methodology. We opine that in OSCC, H pylori may have a role in the faster progression of the disease, rather than merely a ‘chance spectator’.

Early Postoperative Small Bowel Obstruction after Colorectal Surgery: Incidence and Exploratory Analysis of Potential Risk Factors.

Early postoperative small bowel obstruction (EPSBO) is a common complication following colorectal surgery, which can significantly impact patient outcomes. This study aimed to investigate the incidence of EPSBO and identify potential risk factors among patients who underwent colorectal surgery. A descriptive study was conducted on a cohort of 100 patients who underwent colorectal surgery at a tertiary center at SKIMS, Srinagar, Jammu & Kashmir, India. Descriptive, bivariate, and predictive screening analyses were performed to examine patient characteristics, assess association between different relevant variables and EPSBO, and identify significant predictors, respectively. Our study included a total of 100 patients, with a mean age of 50.39 years. Postsurgery, 11% of the individuals in the cohort developed EPSBO. Early postoperative small bowel obstruction developed around 4.30 days after surgery, and radiographic data revealed dilated gut loops in 72.70% of EPSBO cases. Bivariate analysis revealed significant association between EPSBO and variables such as previously operated, medical comorbidities, smoking status, anemia, neoadjuvant chemoradiotherapy (NACRT), bowel preparation, operative procedure, surgery duration, and type of anastomosis (p < 0.05). History of previous bowel habits, previously operated, perioperative bowel preparation, and blood transfusion were identified as the most influential predictors of EPSBO in the predictive screening study. This study provides insights into the incidence of EPSBO and its potential risk factors for postcolorectal surgery among patients. The findings emphasize the need to take the patient's history of past bowel habits and other factors into account when determining the risk of EPSBO. Future studies should go deeper into these correlations and consider treatments to reduce the occurrence of EPSBO in this patient population. Ahmad B, Ul Hag MF, Shah MA, et al. Early Postoperative Small Bowel Obstruction after Colorectal Surgery: Incidence and Exploratory Analysis of Potential Risk Factors. Euroasian J Hepato-Gastroenterol 2024;14(1):70-74.

Investigation of age and smoking in NSCLC patients with uncommon EGFR mutations.

In addition to the two common epidermal growth factor receptor (EGFR) mutations, there are many uncommon mutations. Due to the high number of uncommon types, as well as the rarity of patients, there is lack of information regarding patient demographics, especially age distribution and smoking status. Against this background, we conducted an analysis to clarify the background of patients with uncommon EGFR mutations, especially considering their age distribution and smoking status. We retrospectively reviewed the medical records of non-small cell lung cancer (NSCLC) patients diagnosed in a multicenter clinical practice from 2002 to 2023. Patients included all cases of non-advanced and advanced NSCLC with uncommon EGFR mutations. Information on 158 patients with uncommon EGFR mutation was collected. Median age was 72 years, with the age distribution showing that most patients were in their 70s. There was a significant difference between the proportion of patients aged up to 59 years and the proportion aged 75 years or older. In 88 patients with a smoking habit history, a significant correlation was found between smoking index and age. Among non-smokers, there was a peak between ages 70 and 74, which was older than the peak among smokers. Even in elderly patients and NSCLC patients with a history of smoking, although it is unclear whether EGFR mutation is common or uncommon, EGFR gene testing should be performed considering the possibility of these patients being EGFR-positive.

Survey of long term survivors of oral cancer: Looking beyond cancer biology.

6087 Background: While surgery is the main stay of treatment for early stage oral cancers, advanced stages require adjuvant treatments in the form of radiotherapy or concurrent radiotherapy. Yet, the effectiveness of these interventions is not solely determined by clinical measures but also by personal factors such as individual motivation, support from loved ones, and financial security. These aspects might explain the survival rate variations among patients who, despite having similar prognostic categories and stages of disease, show differing outcomes. The role of social determinants in influencing patient survival, apart from the acknowledged impact of disease biology, is not well understood. Methods: All treatment-naive oral cavity cancer patients who underwent definitive treatment during 2014 to 2018 at our institute and are alive for more than five years were selected for this study. A custom investigator-administered questionnaire was developed and it had 32 questions under six domains- personal, habit history, financial, social, functional, and emotional. The study was approved by the institutional ethics committee. Of the 1787 potential participants, we found that 219 had expired, only 442 patients agreed to answer the questionnaire, while 45 refused to participate. The rest of the patients were not reachable telephonically. Results: This survey had 442 patients, of which 90% were males, with a mean age of 52.1 years. The most common site of the presentation was buccal mucosa (60%), and 59% presented in the locally advanced stage. Post-operatively, 71% received adjuvant therapy. All patients were motivated to undergo the radical treatments and had their family support. However, post-treatment, about 10% of individuals experienced a change in marital status. Financial constraints did affect 20% of patients during and after treatment, and more than 70% had their out-of-pocket expenditure above 50% of the total cost. While 80% did not have trouble attending social functions, 46% reported trouble eating socially. However, this was more common for patients who received adjuvant treatment (p &lt; 0.001). About 21% reported shoulder dysfunction and body discomfort. However, no statistically significant associations could be drawn for any of the domains of the questionnaire when compared to patients between the early and late stages. Shoulder discomfort was experienced more by patients who were treated for tongue cancer (p-value 0.010). Conclusions: The results of this study shed light on the challenges faced by long-term survivors of oral cancer following radical treatment regimens. More than half of patients reported that out-of-pocket expenses constituted more than half of their total treatment costs. A notable minority of people suffer from shoulder dysfunction, suggesting there is a clear opportunity for advancements in reconstruction and rehabilitation.

Case report: A Boy with an inability to walk; do not forget about scurvy

Scurvy, a condition caused by vitamin C deficiency, is characterized by a syndrome of multisystem disorder due to defective collagen production and antioxidative function. This condition is infrequent in this modern era; thus, it is often not within the list of differential diagnoses. The broad clinical picture is generally overlooked as other systemic illnesses, resulting in an extensive investigation that delays the diagnosis. Herein, we report a case of an 8-year-old boy with underlying autism spectrum disorder who presented with lower limb pain and other constitutional symptoms. Examination revealed multiple hyperpigmented scars over the upper and lower limbs and gingival hyperpigmentation. With history of picky eating habits and clinical symptoms supported by radiographic findings, scurvy was suspected and subsequently confirmed based on a low level of ascorbic acid. With vitamin C supplementation and proper nutritional support, the patient recovered well.

Barriers to upper gastrointestinal screening among the general population in high-prevalence areas: a cross-sectional study.

In China, there are large differences between regions in the use of gastroscopies and public awareness of upper gastrointestinal (UGI) screening. This study investigated the current context and analyzed the barriers that influence UGI screening behavior among the general population in UGI cancer high-prevalence areas. A total of 320 participants anonymously answered an online questionnaire. The rank sum test was used to analyze the difference in the scores of the UGI screening awareness questionnaire among participants with different socio-demographic characteristics. Using the awareness level of UGI screening and gastroscopy as the dependent variable, and the socio-demographic characteristics as the independent variable, simple linear regression and binary logistic regression analysis were used to determine the factors influencing attitudes toward gastroscopy screening. We used Spearman's correlation analysis to examine the correlation between UGI screening awareness level and willingness to undergo a gastroscopy. There was a correlation between the willingness to undergo gastroscopy and the awareness level of UGI screening (r = 0.243, p < 0.001). Linear regression analysis found that age, type of residence, education level, employment status, monthly income, history of gastroscopy, dietary habits, physical exercise, and convenience in obtaining information were significantly correlated with the awareness level of UGI screening ( p < 0.05). Binary logistic regression analysis found that factors significantly associated with gastric cancer screening behavior include residence, monthly income, and self-perceived health status ( p < 0.05). It is necessary to improve education about UGI cancer and screening knowledge, with a focus on populations with lower education and income.

Breastfeeding and non-nutritive sucking habits as covariates of malocclusion in the primary dentition among Tanzanian children: A cross-sectional study

Introduction: Studies on the effect of feeding practices and sucking habits on malocclusion traits in the primary dentition of pre-schoolchildren from developing countries are scarce. Purpose: Assessing the association of feeding and sucking habits with malocclusion traits, and the association of malocclusion traits with observed oral functional problems. Methods: It was a cross-sectional survey of children aged 3-5 years residing in Kinondoni and Temeke Districts of Dar es Salaam region in Tanzania. Data was analyzed using Statistical Package for Social Scientists, SPSS version 21.0. Univariate analysis was applied to generate frequencies of different variables. Cross tabulations and Chi-square statistics were used to assess bivariate relationships and multivariate analyses were performed by multiple logistic regression. Results: Most pre-schoolchildren (82.5%) were breastfed for less than two years. A history of non-nutritive sucking habits was reported in 28.1% of the children, mostly in boys than girls (33.6% versus 21.8%, respectively. The current non-nutritive sucking habits were reported in 17.8% of the participants. Overall, malocclusion traits were most significantly seen in children who were breastfed for less than two years, compared with those who were breastfed for two years or more (48.5% versus 27.3%, respectively). The presence of various malocclusion traits was significantly found among most of the children who had a history of non-nutritive sucking habits, compared with those who had never performed the habits (65.9% versus 38.6 %, respectively). In the logistic regression analyses, children who were breastfed for a shorter duration (&lt;2 years), their probability of being found with different traits of malocclusion in the primary dentition was almost three times that for those who were breastfed for a longer duration (≥ two years). Also, children who were not actively performing non-nutritive sucking habits were less likely to have an open bite compared with those who were actively performing non-nutritive sucking habits. An open bite in children was significantly associated with speech problems (p&lt;0.01) and swallowing with tongue thrusting (p=0.000). Conclusion and recommendations: Most of the children who were breastfed for a shorter duration and children who had non-nutritive sucking habits were found with various malocclusion, compared with those who were breastfed for a longer duration and those who had no non-nutritive sucking habits. It is crucial to recommend exclusive breastfeeding for up to 6 months and continuation of breastfeeding practice, possibly for up to 2 years of age due to its nutritional, immunological, and stomato-gnathic system developmental benefits.

Correlation of xerostomia in methadone therapy program patient with oral health related quality of life using oral health impact profile-14: a cross-sectional study

ABSTRACTIntroduction: Methadone Therapy Program (MTP) patients receive treatment with antidepressants which work as salivary flow inhibitors that promote xerostomia. Decreased salivary secretion affects several essential aspects of life quality, such as speaking, chewing, and food swallowing. It also increases the risk of rampant caries. This study aimed to analyze correlation of xerostomia in MTP with Oral Health Related Quality of Life (OHRQoL) using the Oral Health Impact Profile (OHI-P 14). Methods: Type of research was a cross-sectional design, this study's main independent variable was xerostomia, the dependent variable was OHRQoL, and the confounders were age, gender, education, occupation, caries status, oral hygiene status, history of HIV infection, smoking habits, and alcohol consumption. Data analysis used logistic regression to see the risk factors that influence OHRQoL. Results: Xerostomia is a subjective dry mouth complaint asked through a questionnaire. Of the 26 respondents, 13 (50%) reported dry mouth. Salivary Flow Rate (SFR) measurement showed the result of 13 people was &lt;0.3 (hyposalivation). OHrQOL was measured using OHI-P 14 questionnaire, 12 respondents had good OHRQoL (score &gt; 6.5) and 13 respondents had bad (score ≤6.5). Risk factors associated with OHRQoL were age (p=0.08) and duration of methadone consumption (p=0.06). Conclusion: There is no correlation between xerostomia in MTP with Oral Health Related Quality of Life (OHRQoL) using the Oral Health Impact Profile (OHI-P 14). Future research should involve several hospitals that carry out MTP so that the research results are more valid.KEYWORDSmethadone, oral health related quality of life, OHrQOL, OHIP-14, xerostomia