Morbidity Pattern Research Articles

Patterns and Life Course Determinants of Black–White Disparities in Biological Age Acceleration: A Decomposition Analysis

Despite the prominence of the weathering hypothesis as a mechanism underlying racialized inequities in morbidity and mortality, the life course social and economic determinants of Black–White disparities in biological aging remain inadequately understood. This study uses data from the Health and Retirement Study (n = 6,782), multivariable regression, and Kitagawa–Blinder–Oaxaca decomposition to assess Black–White disparities across three measures of biological aging: PhenoAge, Klemera–Doubal biological age, and homeostatic dysregulation. It also examines the contributions of racial differences in life course socioeconomic and stress exposures and vulnerability to those exposures to Black–White disparities in biological aging. Across the outcomes, Black individuals exhibited accelerated biological aging relative to White individuals. Decomposition analyses showed that racial differences in life course socioeconomic exposures accounted for roughly 27% to 55% of the racial disparities across the biological aging measures, and racial disparities in psychosocial stress exposure explained 7% to 11%. We found less evidence that heterogeneity in the associations between social exposures and biological aging by race contributed substantially to Black–White disparities in biological aging. Our findings offer new evidence of the role of life course social exposures in generating disparities in biological aging, with implications for understanding age patterns of morbidity and mortality risks.

A cross sectional study on morbidity pattern in two primary health centers of Bishnupur District, Manipur

Background: PHCs and PHSCs are the grass-root level of the health care system of India which deals directly with the majority of the population as they live in rural areas and have no access to proper health care systems. This study was conducted due to the scarcity of studies and limited health care services amongst people in rural populations of Manipur to determine the morbidity pattern of patients attending OPD in 2 PHCs of Bishnupur District under RHTC, RIMS, Imphal, Manipur for the year 2021. Methods: A cross-sectional study based on previous records was conducted from 1 January to 31 December 2021 among the newly registered outpatients attending the OPD of Oinam and Leimapokpam PHCs in Bishnupur District. Secondary data from the two PHCs were collected. Data analysis was done by using SPSS software version 21. Results: The study found that almost half (46.4%) of patients attending OPD are 15-49 years followed by <15 years (38.7%). Out of total morbidity, respiratory diseases (24.8%) followed by GIT (15.9%), OBG, skin diseases and NCD constitute major morbidity among the study population. Conclusions: The study gives an outline of the morbidity pattern of patients attending OPD in two PHCs of the Bishnupur district in one year which could help healthcare providers and administrators to plan, practice and deliver quality services as per community needs.

Clinical implications of ADHD, ASD, and their co-occurrence in early adulthood—the prospective ABIS-study

BackgroundAttention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are childhood-onset disorders associated with functional and psychosocial impairments that may persist into adulthood, leading to serious personal and societal costs.ObjectiveThis study aimed to examine the socio-economic difficulties, physical and mental comorbidities, and psycho-social vulnerabilities associated with ADHD, ASD, and their co-occurrence among young adults.Methods16 365 families with children born 1997–1999, were involved in the prospective population-based ABIS study (All Babies in Southeast Sweden). A total of 6 233 ABIS young adults answered the questionnaire at the 17–19-year follow-up and were included in this case–control study. Diagnoses of ADHD and ASD from birth up to 17 years of age were obtained from the Swedish National Diagnosis Register. N=182 individuals received a single diagnosis of ADHD, n=78 of ASD, and n=51 received both diagnoses and were considered the co-occurrence group. Multiple multinomial logistic regression analyses were performed.ResultsIn the univariate analyses all three conditions were significantly associated with concentration difficulties, worse health quality, lower socio-economic status, lower faith in the future, less control over life, and lower social support. In the adjusted analyses, individuals with ADHD were almost three-times more likely to have less money compared with their friends (aOR 2.86; p < .001), experienced worse sleep quality (aOR 1.50; p = .043) and concentration difficulties (aOR 1.96; p < .001). ASD group were two-fold more likely to experience concentration difficulties (aOR 2.35; p = .002) and tended not to have faith in the future (aOR .63; p = .055), however, showed lesser risk-taking bahaviours (aOR .40; p < .001). Finally, the co-occurrence was significantly associated with unemployment (aOR 2.64; p = .007) and tended to have a higher risk of autoimmune disorders (aOR 2.41; p = .051), however, showed a 51% lower risk of stomach pain (aOR .49; p = .030).ConclusionsAll these conditions significantly deteriorated several areas of life. ADHD/ASD co-occurrence is a heavy burden for health associated with several psychosocial vulnerabilities, that shared a similar morbidity pattern with ADHD although showed less risk cognitive and behavioral profile, similar to the ASD group. Long-term follow-up and support for individuals with these conditions over the life course are crucial.

EPID-22. AN INTEGRATED, MULTI-DATABASE ANALYSIS OF THE SAFETY OF BENIGN MENINGIOMA RESECTION IN OCTOGENARIANS

Abstract OBJECT Given that multiple co-morbidities are present in up to 80% of octogenarians, resection of benign tumors, such as meningiomas, is a challenging proposition, especially in the context of frailty naturally associated with aging. Here, we characterized the patterns of clinical practice, morbidity, and mortality associated with benign meningioma resection for octogenarian using the Surveillance, Epidemiology and End RESULTS (SEER), SEER-Medicare (SEER-M), National Cancer Database (NCDB), and National Readmission Database (NRD). METHODS Logistic regression, propensity-score matching (PSM)-method (covariates balanced using PSM: socio-demographics, facility features, and comorbidities), and accelerated failure time (AFT) models. RESULTS In SEER, the adjusted odds ratios of recommendation for surgery were 0.59 (95%CI=0.53-0.66, p&amp;lt; 0.001) and 0.17 (95%CI=0.15-0.21, p&amp;lt; 0.001) for benign meningioma patients age 60-79 and &amp;gt; 80, relative to patients age 40-59. Expectedly, the hazard of death increased with advancing aging strata in patients who underwent meningioma resection. However, in independent analyses of NCDB and SEER-M, likelihood of death after benign meningioma resection was not significantly elevated in patients age &amp;gt; 80 relative to age- and PSM-matched patient cohorts. In the NRD, age &amp;gt; 80 was associated with increased odds of 90-day medical readmission after meningioma resection (OR: 1.63, 95%CI=1.33-1.99) but not 90-day neurologic readmission (OR: 1.02, 95%CI:0.76-1.37) relative to age 40-59. CONCLUSION We found no increased risk for patients age &amp;gt; 80 who were selected for and underwent resection in terms of mortality and 90-day neurologic readmission risk. However, the octogenarians have a higher risk of 90-day medical readmission. These findings suggest that neurosurgeons, in general, exert sound judgment in the selection of elderly patients for benign meningioma resections.

The effect of a mobile health technology integrated care across multimorbidity patterns in atrial fibrillation patients: a latent-class ancillary analysis from the mAFA-II randomised clinical trial

Abstract Background Multimorbidity confers an increasing health problem, especially with the progressive aging of the population. Hypertension, diabetes mellitus (DM), chronic heart failure (CHF) are highly prevalent and ultimately entails multimorbidity in patients with atrial fibrillation (AF), with detrimental effects on prognosis. The Mobile Health Technology for Improved Screening and Optimized Integrated Care in AF (mAFA-II) cluster randomised trial showed the efficacy of a mobile health implemented ‘Atrial fibrillation Better Care’ (ABC) pathway (mAFA intervention) for an integrated care management of patients with AF. Purpose Evaluate the effect of mAFA intervention according to the patterns of multimorbidity as identified through a latent-class analysis (LCA) approach. Methods The mAFA-II trial is a cluster randomised trial that enrolled adults AF patients between June 2018 and August 2019 in 40 centres in China. Clusters were randomised to mAFA intervention or usual care. We performed a LCA according to several variables (including age over 75, coronary artery disease (CAD), CHF, chronic kidney disease (CKD), DM, hypertension, peripheral artery disease and prior ischemic stroke), and modal posterior probability was used to define class membership of patients. The interaction between the effect of mAFA intervention and class allocation on the risk of the primary composite outcome of stroke, thromboembolism, all-cause death, and rehospitalizations was assessed through multivariable Cox-regression models, and results were expressed as adjusted Hazard Ratio (aHR) and 95% Confidence Intervals (95%CI). Results 3324 AF patients (mean age 68.5±13.9; 38.0% females) were enrolled in the trial and included in the analysis. We identified 3 comorbidity patterns, which differed according to prevalence of conditions and risk factors: (i) low morbidity pattern (n=1234, 37.1%), (ii) hypertensive/CAD pattern (n=1534, 46.2%), and (iii) mixed morbidity pattern (n=556, 16.7%). Overall, subjects in the mixed morbidity patterns were older, had a higher burden of diseases, and showed the highest prevalence of CKD, diabetes and history of stroke (Figure 1). Multivariable Cox-regression analysis showed a significant interaction between the effect of mAFA intervention and comorbidity patterns on the risk of the primary composite outcome (pint= 0.004), with the effect of mAFA intervention being greatest in the low morbidity pattern (aHR:0.08, 95%CI:0.02-0.32) and somewhat diluted in the mixed morbidity pattern group with a trend towards lower risk (aHR:0.69, 95%CI:0.37-1.28, Figure 2). Conclusions Multimorbidity is common and heterogeneous in AF patients. The effect of a mHealth-technology implemented ABC pathway appeared lower in magnitude in those patients with mixed morbidity patterns, suggesting that these patients require further interventions, aiming at addressing non-cardiovascular comorbidities and overall clinical complexity, to improve their outcomes.Clusters distributionCox-regression models for interaction

Patterns of comorbidities and influence on the natural history of patients with atrial fibrillation: a latent class analysis from a prospective observational european AF registry

Abstract Background Patients with Atrial Fibrillation (AF) usually present with multiple comorbidities at diagnosis, and their combinations heterogeneously influence management and outcomes. While the effect of multimorbidity on the natural history of AF is well-known, the influence of patterns of multimorbidity is far less understood. Purpose To identify and analyse subgroups of AF patients according to their comorbidities, through a latent class analysis of a contemporary cohort of AF patients. Methods We used data from a European-wide prospective observational AF registry, and performed a latent class analysis, according to the presence of chronic diseases (including cardiovascular, respiratory, metabolic and other conditions); class membership was assigned according to the modal posterior probability. Multivariable logistic regression models were used to analyse odds of receiving oral anticoagulant (OAC) prescription and type of OAC received; the risk of the primary outcome of all-cause death and MACE was assessed using multivariable Cox-regression model. Results 9,613 AF patients were included in this analysis (mean age 68.9 ± 11.4 years, 40.2% females), and were grouped in 5 classes, which were different according to the burden of comorbidities: low morbidity pattern (46.1%), cardiovascular pattern (25.0%), metabolic pattern (11.3%), heart failure pattern (9.7%) and multisystemic pattern (8.0%) (Figure 1). Patients in the multisystemic pattern were older and more frequently frail and with polypharmacy compared to other classes. Compared to the low morbidity pattern, odds of receiving OAC was lower in those with cardiovascular pattern (OR [95%CI]: 0.73 [0.62-0.86]), heart failure pattern (OR [95%CI]: 0.60 [0.48-0.75] and multisystemic pattern (OR [95%CI]: 0.28 [0.22-0.36]), while those with metabolic pattern were more likely prescribed OAC (OR [95%CI]: 1.55 [1.20-2.00]). All patterns were less likely treated with NOAC compared to VKA (Figure 2). When analysing the risk of the primary composite outcome, all patterns except for the metabolic pattern were associated with higher hazard of events, with highest magnitude observed for the heart failure pattern (HR 2.68 [95%CI: 2.22-3.25]) and the multisystemic pattern (HR 2.67 [2.13-3.35]) (Figure 2). Conclusions Comorbidities are heterogeneously distributed in the AF population, and different phenotypes of AF patients may be identified according to the combination of other chronic diseases, with different OAC use for stroke prevention and an unequal impact on long-term prognosis. These findings reinforce the need for tailored preventive strategies to improve outcomes in AF patients, especially those with multimorbidity.Figure 1Figure 2

Patterns of Morbidity Across the Lifespan: A Population Segmentation Framework for Classifying Health Care Needs for All Ages.

Classification systems to segment such patients into subgroups for purposes of care management and population analytics should balance administrative simplicity with clinical meaning and measurement precision. To describe and empirically apply a new clinically relevant population segmentation framework applicable to all payers and all ages across the lifespan. Cross-sectional analyses using insurance claims database for 3.31 Million commercially insured and 1.05 Million Medicaid enrollees under 65 years old; and 5.27 Million Medicare fee-for-service beneficiaries aged 65 and older. The "Patient Need Groups" (PNGs) framework, we developed, classifies each person within the entire 0-100+ aged population into one of 11 mutually exclusive need-based categories. For each PNG segment, we documented a range of clinical and resource endpoints, including health care resource use, avoidable emergency department visits, hospitalizations, behavioral health conditions, and social need factors. The PNG categories included: (1) nonuser, (2) low-need child, (3) low-need adult, (4) low-complexity multimorbidity, (5) medium-complexity multimorbidity, (6) low-complexity pregnancy, (7) high-complexity pregnancy, (8) dominant psychiatric/behavioral condition, (9) dominant major chronic condition, (10) high-complexity multimorbidity, and (11) frailty. Each PNG evidenced a characteristic age-related trajectory across the full lifespan. In addition to offering clinically cogent groupings, large percentages (29%-62%) of patients in two pregnancy and high-complexity multimorbidity and frailty PNGs were in a high-risk subgroup (upper 10%) of potential future health care utilization. The PNG population segmentation approach represents a comprehensive measurement framework that captures and categorizes available electronic health care data to characterize individuals of all ages based on their needs.

Abstract 17321: Cardiometabolic Risk Increased in All Socioeconomic Status During the Venezuelan Humanitarian Crisis: The EVESCAM Cohort Study

Background: Social determinants of health (SDOH) significantly impact cardiovascular disease (CVD). Poverty is the most important underlying cause of preventable death, disease, and disability, and interacts with other SDOH. Venezuela was declared as suffering a humanitarian crisis, and besides the increase in poverty, other SDOHs such as traumatic stressors, violence, food insecurity, and treatment interruptions increased. This study aimed to estimate the changes in cardiometabolic risk factors (CMRF) in different socioeconomic statuses (SES) during the humanitarian crisis in Venezuela. Methods: Data from the EVESCAM Study was analyzed. The nationally-representative baseline assessment was conducted in 2014-2017 (N=3414) using a multi-stage stratified sampling and further follow-up on a subset of 35% of participants was undertaken in 2018-2020 (N=1257). Changes in CMRF and their prevalence among three SES (Low-SES N=657[52.3%], Middle-SES N=384[30.5%], and High-SES N=216[17.2%]) were compared. Results: There was a decrease in the prevalence of obesity (p=0.001), but an increase in the prevalence of dyslipidemia (total cholesterol ≥200mg/dL, and Low-Density Lipoprotein cholesterol ≥130mg/dL, P=0.001), low Mediterranean diet adherence (p=0.001), and depression (p=0.001) in all SES. Diabetes prevalence decreased only in middle-SES (p=0.01) and low-SES (p=0.03). Anxiety and hypertension did not change significantly. The prevalence of participants with high CVD risk (Globorisk score &gt;20%) increased in all SES (P=0.001). Conclusion: There was an increase in multiple CMRF in all SES during the Venezuelan humanitarian crisis. This scenario could determine a particular pattern of morbidity determined by the interaction of several factors, including a shortage of basic goods, severe hyperinflation, and a breakdown of the healthcare infrastructure. Efforts are needed to improve the health and CVD risk of populations facing humanitarian crises.

Nutritional status and morbidity pattern among school children in an urban slum of Kolkata, India

Background: Sickness and morbidity rates in Indian school going children are among the highest in the world. Poor health and sickness absenteeism results in school dropouts and it is more among the female children as compared to male children. Present study was conducted to study the nutritional status and morbidity pattern among children attending the school health clinics in an urban area of West Bengal India. Methods: A cross-sectional study was conducted in the field practice area of urban health centres (UHC) of AIIH and PH Kolkata, West Bengal. Children enrolled in class 1-10 were included in the study by using systematic random sampling technique. Data was collected by using semi-structured questionnaire, clinical history and physical examination was done. Results: Out of total 254 students, 129 (50.8%) were boys and 125 (49.2%) were girls. Dental caries and skin diseases like ringworm infection, cuts and fungal infection were most common types of morbidity found in school children. Dental caries and skin diseases both were more common in girls as compared to the boys. Underweight was found in more than 70% of the children and their BMI was significantly low as compare to the ICMR standard. Conclusions: The proportion of malnutrition is very high in the school children of the field practice area of UHC Chetla and there is need to create opportunities to increase the family income and awareness programme to increase the nutritive values of foods prepared at household level.

Assessment of common health problems and characteristics of health behaviour among elderly population in rural area of eastern India

Naturally, aging is an inevitable process, and as people grow older, various physiological and pathological effects manifest in the human body. Old age should be viewed as a completely normal and natural biological phenomenon. It is crucial to extensively study the patterns of morbidity, encompassing common health issues and health behaviors in the elderly population, in order to formulate effective preventive strategies that can enhance their quality of life. The objective of this study was to assess the sociodemographic profile and the prevalence of multiple health issues and health-related behaviors among the elderly population. Among the 124 participants in this study, 59.7% were female, and 40.3% were male. The average age of the elderly participants was 70.3 years, with a significant portion (45.2%) falling within the 60-69 age group. Our study revealed that arthritis was the most common health condition among the elderly, affecting 64.5% of the participants, followed by gastrointestinal diseases (48.3%) and cataracts (45%). Given the diverse physical health challenges faced by the elderly, it is imperative to strengthen geriatric healthcare services at all levels of the healthcare system. This will ensure the provision of comprehensive and tailored services to the vulnerable elderly population, ultimately improving their overall well-being and quality of life.

The Pattern of Morbidity and Access to Healthcare Service in the Riverine Flood-prone Villages of Assam, India

Background: Floods are considered one of the common phenomena causing substantial death, morbidity, and damage to infrastructure as well as economic conditions across the world. India receives 75% of its total rainfall in the monsoon season, as a result, annually on average 8 million people are affected by the floods. The Brahmaputra valley of Assam is one of the worst flood-affected regions in the country. This study focuses on understanding the pattern of morbidity, health service utilization, and challenges faced to access healthcare services in the riverine flood-prone villages of Assam. Methods: A mixed method study was followed to conduct the study. Primary data have been collected through interview schedules from 83 households. Descriptive statistics of both frequency and percentage were shown for categorical as well as continuous variables. Qualitative data were analyzed using a thematic framework. Results: The research findings indicate that in the flood-prone villages people face difficulty in accessing healthcare. However, the challenges intensify during flood times. It was identified that illnesses like fever, skin infection, diarrhea, and dysentery are linked to floods. Three themes were identified from the qualitative analysis i.e., lack of transportation facilities, non-functional sub-centres, and lack of money. The transportation facilities and the non-functional sub-centers were some of the causes along with the financial constraint to avail the health care facilities. Conclusion: It can be concluded that to improve the health service condition in the flood-prone areas, there is an urgent need to improve both the quality and quantity of the sub-centres infrastructures and the manpower. Other public health interventions such as providing food, water, and shelter, especially during floods need to be developed. Encouraging early flood preparedness and public health awareness programs through community participation would also help to reduce the damage to these people.

MORBIDITY AND MORTALITY PATTERNS OF INDIAN RIVER LAGOON COMMON BOTTLENOSE DOLPHINS (TURSIOPS TRUNCATUS TRUNCATUS) 2002-2020.

Mortality patterns in cetaceans are critical to understanding population health. Common bottlenose dolphins (Tursiops truncatus truncatus) inhabiting the Indian River Lagoon (IRL), Florida have been subjected to four unusual mortality events (UMEs), highlighting the need to evaluate morbidity and mortality patterns. Complete gross examinations were conducted on 392 stranded dolphins and histopathological analyses were conducted for 178 animals (2002-2020). The probable causes of mortality were grouped by etiologic category: degenerative, metabolic, nutritional, inflammatory (infectious and noninfectious disease), and trauma. Probable cause of mortality was determined in 57% (223/392) of cases. Inflammatory disease (infectious/noninfectious) and trauma were the most common. Inflammatory disease accounted for 41% of cases (91/223), with the lungs (pneumonia) most commonly affected. Trauma accounted for 36% of strandings (80/223). The majority of trauma cases were due to anthropogenic activities (entanglement, fishing gear or other debris ingestion, and propeller strikes), accounting for 58% of trauma cases (46/80). Natural trauma (prey-associated esophageal obstruction or asphyxiation, shark bites, and stingray interactions) accounted for 12% of all cases (26/223), and trauma of undetermined origin was identified in 4% of cases (8/223). Starvation or inanition (nutritional) were the probable cause of mortality in 17% of cases and peaked during the 2013 UME (61% of cases). Degenerative and metabolic etiologies accounted for 5% of cases. This study represents the most comprehensive evaluation of morbidity and mortality patterns in IRL dolphins. Because IRL dolphins are routinely exposed to anthropogenic threats and have endured multiple UMEs, these baseline data are critical to the conservation and management of this population.

Exploring the Lives of Women Rag Pickers in an Indian Metropolitan City: A Mixed-Methods Cross-Sectional Study on Social and Occupational Determinants Shaping Their Existence.

Globally, occupational hazards are a concern, especially in waste management. With 31.2% of its population in urban areas, India is confronted withescalating waste management challenges. People worldwide generate about two-thirds of a kilogram of waste daily. Effective solid waste management is crucial due to population growth, changing waste patterns, and rapid urbanisation. It profoundly impacts environmental, resident, and worker health. Rag picking is an informal profession undertaken by a marginalised population of the society, which involves collecting waste from trash cans, streets, and household waste. To assess the burden and the pattern of morbidity, and the occupational factors associated with it, as well as their health-seeking behaviour, the present study was carried out among women rag pickers in Mumbai, India. A cross-sectional descriptive study was conducted through a mixed-method approach in Mumbai's Chembur and Govandi areas, focusing on women rag pickers aged 15 to 49 years. The research was conducted over a period of three months, during which a total of 150 female rag pickers from individual familieswere identified and included in the study through purposive sampling.The structured questionnaires gathered quantitative data on socio-demographics, health-seeking behaviour, morbidity, and monthly expenses. The qualitative data were collected through focus group discussions with rag pickers, analysing themes related to rag picking as occupational preference and substance usage factors. Ethical approval from the institute and informed consentfrom each participant were obtained prior to data collection. Among the cohort of 150 women ragpickers, 67.3% were aged between 15 and 30 years, with 82% belonging to the lower socio-economic class. A notable 43.4% of these women engaged in significant tobacco use, primarily through oral consumption, while about 56.7% of their family members exhibited high substance use, including pan, tobacco, and alcohol. In terms of health-seeking behaviour, 51% refrained from seeking treatment for minor ailments, 29% resorted to home remedies or self-medication, and 20% sought care at hospitals. A morbidity analysis over the past three months revealed prevalent health issues, informing potential interventions. Examination of monthly expenditure patterns unveiled an average income of 9000 INR (130 USD), with a significant 61% allocation towards food and grocery expenses. Qualitative insights indicated that the preference for rag picking was driven by limited alternativesand substance use was influenced by peers and served as a means to cope with stress. These findings underscoredistinct health-seeking behaviours, and the unique needs of women rag pickers, providing valuable guidance for targeted policies to enhance their well-being. These findings underscore the need for targeted interventions to improve the well-being and socio-economic conditions of women rag pickers in India. Universal healthcare coverage, community-based initiatives,and social inclusion are vital for addressing their unique challenges and enhancing their quality of life.

Assessment of Pattern, Distribution, and Determinants of Ocular Morbidity among Residents Seeking Care at Medical Camps in Mathare Slums, Nairobi County, Kenya

Ocular morbidities are considered a major contributor of disabling conditions in both low and high resourced countries. The overall global burden of eye diseases is estimated at 61.4 million Disability Adjusted Life Years (DALYs) which accounts for 4% of total Disability Adjusted Life Years. There have been strong institutional collaborations on attaining Vision 2020-right to sight, which is a global initiative aimed at reducing preventable level of blindness has enhanced institutional collaboration in fight against blindness. Some eye problems that affects people quality of life but do not result in blindness have been ignored in favor of those causing visual impairment. The residents of Mathare slums in Nairobi County, Kenya, seeking care at medical camps, were subjected to an objective eye examination aimed at ascertaining ocular morbidity patterns, causes, and distribution. A descriptive community-based cross-sectional study design was employed. The study persons were patients over ten years who presented with eye-related constraints at the medical camps. The period of study range was between October and November 2022. Results were displayed using descriptions and visualization techniques after data was imported into Excel 2010 for analysis. Results on the pattern indicated a majority of respondents (34.44%) were diagnosed with conjunctiva diseases. This was followed by 30.29% being diagnosed with refractive errors, 11.62% with the cornea, and 8.30% with lens diseases. On distribution, Conjunctiva disease (34.44%) affected most of the respondents, and the majority of these respondents (19.5%) aged between 10 and 20 years affirmed to have atopic Conjunctivitis. A refractive error also commonly affected 30.29% of the participants, with Presbyopia (7.46%) comprising the highest form of refractive error. Cataracts (7.05%) and dry eye syndrome (6.22%) were more evident among patients aged above 40 years. Most of the respondents (43.5%) were found to have pathologies resulting from developmental causes, followed by allergies (24.1%) and refraction errors (10.4%). Hypertension was the most common comorbidity in Mathare slum affecting 12.4% of the respondents; this was followed by peptic ulcer disease (5.4%), diabetes (4.6%), arthritis (2.5%), and lastly, HIV (0.41%). Results showed that ocular Morbidity in the Mathare slum was not associated with determinants like house structure material, number of house rooms, household population, and cooking energy source. It is recommended that health institutions within the Mathare slum and similar contexts be fully equipped with essential eye medications and integrate eye health education in the health facilities. Physical exercise, healthy eating, and medical approved supplements are also recommended to help prevent metabolic disorders and improve age-related eye disorders. Clinical control of existing comorbidities will aid in reducing some eye diseases like cataracts and diabetic retinopathy.

Health Condition of Traffic Police Personnel in Nagpur Division of Maharashtra, India

Overweight and obesity is a medical condition in which abnormal or excess body fat has accumulated to an extreme that may harm health and reduce life expectancy. It may increase the risk of hypertension, diabetes mellitus, cardiovascular disease and musculoskeletal disorder.The investigation has been conducted to assess overweight and obesity and understand its relation with the morbidity pattern in traffic police personnel.The present investigation has been conducted in the Nagpur division among 277 traffic police personnel, including both male and female police personnel. Information has been collected through an interview schedule.The study shows that more than 50 percent of traffic police personnel are overweight, and 17 percent are obese. Between male and female traffic police personnel, there is a significant difference in BMI (ᵪ2 =14.069, df=3, p=0.003). Forty percent of traffic police personnel suffer from musculoskeletal disorders, cardiovascular disease, and diabetes in 11 percent of traffic police personnel.

Polymerase chain reaction-positivity and predictors for SARS-CoV-2 infection among diagnosed cases' in North West Ethiopia.

The lack of sophisticated diagnosing equipment for polymerase chain reaction (PCR) during the incidence of variant types of COVID-19 underestimates the morbidity and mortality patterns of this pandemic. Thus, this study aimed to estimate seropositive and confirmatory predictors for COVID-19 suspected and tested cases through polymerase chain reaction (RT-PCR) in two diagnosing. A facility-based descriptive cross-sectional study was employed among COVID-19 suspected cases from January 2, 2022, to June 9, 2022. The data were collected both using a structured interviewees and nasopharyngeal (NP) swabs. The nasal swab (NS) was analyzed in the laboratory for RNA detection of the virus using PCR. The collected data were entered into Epi Data version 4.2 and then exported to STATA (SE) version R-14 software for further analysis. multivariable logistic regression was used to assess the associated risk. A total of 285 suspected cases have participated in this study. The overall mean (±SD) age of the participants was 37.5 (±18.5) years. The majority, 174 (61.1%) of the tested groups were symptomatic when diagnosed. The positivity of RT-PCR for suspected and COVID-19 diagnosed cases were confirmed in 62/285 (21.75%). In multivariable analysis, they were aged 26-50 years (adjusted odds ratio [AOR] = 4.2, 95% confidence interval [CI] = 1.5-10.75), had comorbidity (AOR = 5.8; 95% CI = 2.1-12.2), and cigarette smokers (AOR = 13.5; 95% CI = 5.3-36.6) were significantly associated with developing COVID-19 infection. More than two in every nine suspected cases were positive RT-PCR tests, and the infectivity of COVID-19 was significantly associated with age 25-50 years, comorbidities, and cigarette smoking. The deployment of high-quality diagnostic kits like RT-PCR is crucial for the early detection and risk stratification of suspected cases.

Статистический анализ данных по неотложной челюстно-лицевой хирургии

There are no actual statistical data on maxillofacial trauma, nor is there a published analysis addressing morbidity patterns, including cases requiring admission to maxillofacial surgery departments. Such data and the respective analysis could help to assess effectiveness of the maxillofacial trauma and diseases prevention and treatment measures, improve the emergency care approaches, identify problems in the medical aid system's maxillofacial surgery domain. This study aimed to analyze the aspects of emergency admission to hospitals for reasons requiring maxillofacial surgery. We processed hospital records of 15,227 patients admitted from 2018 through 2022. The analysis revealed the number of emergency maxillofacial cases to be at a fairly high level and show no downward trend. The majority of the patients are young, able-bodied men. Of all the admitted persons, 28.6% came to the hospital on their own; 22.9% were nonresidents and foreigners. The average hospital stay was 3.85 days, it did not change significantly during the studied period. The prevailing types of trauma were maxillofacial injuries and mandibular fractures. For 29.9% of patients with the latter type, the treatment method of choice was osteosynthesis. Up to 70% of all the patients needed to be followed-up by a maxillofacial surgeon after discharge. The mortality rate in maxillofacial surgery departments is extremely low; all such cases involved concomitant pathologies.

Prevalence and Pattern of Ocular morbidity amongst school going children in rural and urban areas of Aligarh

Introduction: Many ocular diseases have their origin in early childhood and if the morbidity goes unnoticed it may adversely affect the child’s school performance and may also cause severe ocular disability in the later part of life. An early recognition and intervention leads to lifelong impact. Objective: To study the prevalence and pattern of various ocular morbidities in school going children of urban and rural areas of Aligarh. Methods: This was a cross-sectional study carried out from October 2017 to July 2019 in 10 schools in Aligarh, a district in North Western UP. Schools from urban and rural areas were listed and 5 urban and 5 rural schools were selected by lottery method. Results: Of the total 9982 students enrolled in study, 5742 children were from urban schools, and 4240 children were from rural schools. A total 2189 students were found to be suffering from various ocular morbidities, yielding an overall prevalence of ocular morbidity of 21.93%. The prevalence in urban and rural schools was 22.41% and 21.27% respectively (P=.286). Refractive error was found to be the most common ocular morbidity followed by Vitamin A Deficiency. Conclusion: Refractive errors and Vitamin A deficiency were the most common ocular disorders identified which are preventable and treatable causes of childhood blindness. These conditions can be easily identified by regular eye screening programs and promptly corrected. Awareness among school teachers should also be improved and they should play an active role in identifying the ocular problems and referring them for timely management.

Discharge against medical advice in the neonatal unit of Rivers State University Teaching Hospital, Nigeria: a two-year prospective study

Background: Discharge against medical advice (DAMA) is a silent contributor to neonatal morbidity and mortality in Nigeria. Parents' autonomous decision to discontinue medical care of their babies admitted remains an ethical contention that is frustrating for pediatricians and portends poor neonatal outcomes. DAMA remains a challenge arising from an interplay of parental and hospital-related factors. Hence, epidemiologic data are needed, where none previously exists. Aim of the study was to determine the prevalence, neonate and family sociodemographic characteristics, morbidity pattern and reasons for DAMA among neonates admitted to the Rivers State University Teaching Hospital. Methods: A prospective observational study was conducted among neonates admitted from April 2021 to March 2023. Results: Of 1830 neonatal admissions, 87 were discharged against medical advice giving a DAMA prevalence of 4.8%, of which 48 (55.8%) were females. Most, 66 (75.9%) were born at term, 51 (58.6%) had normal birth weight, 38 (43.7%) admitted at &lt;2 hours of life and (41.4%) were above 2nd birth order. Forty-seven (54%) of mothers, 41 (47.1%) of fathers had tertiary education and 61 (70.1%) were of low/middle socioeconomic class. Neonatal sepsis (61.2%) and neonatal jaundice (31.8%) were the commonest morbidities. Most, 65 (74.7%) of DAMA cases occurred in the 1st week of life and the father 63 (73.3%) was the main requestor of DAMA. The commonest reason for DAMA was financial constraints 50 (57.5%). Conclusions: The prevalence of DAMA was 4.8%. Neonatal sepsis and neonatal jaundice were the commonest morbidity with financial constraints being the main reason for DAMA. The father was the requestor for DAMA in the majority of the cases.

A cross-sectional study to assess the morbidity pattern among female agricultural workers in the rural area of Central India: a study protocol

Agriculture serves as the primary source of income for a substantial number of agricultural workers, with a significant portion of the Indian population, especially in rural areas, engaged in this occupation. However, the health status of female agricultural workers is often adversely affected by various factors, including working conditions, environmental exposure, and other morbidities. As a result, they are at risk of developing several diseases, such as tuberculosis, diabetes, hypertension, lung disease, muscle pain, joint pain, and pesticide poisoning, which constitute the main occupational health concerns in this sector. Unfortunately, despite the prevalence of these health risks, many female agricultural workers do not prioritize their own health and wellbeing. According to the latest survey data by the National sample survey office (NSSO), around 54% of the Indian workforce is engaged in agriculture, mainly in rural areas. There are no unions for female agricultural workers, and they cannot receive occupational health facilities and social security schemes provided to them. This study aims to understand female agricultural workers and health-seeking behaviours and morbidities. Objectives- This study assesses the morbidity pattern among female agricultural workers and the health-seeking behaviour of female agricultural workers. It also identifies the utilization of social security schemes among female agricultural workers in villages. The study focuses on assessing the morbidities among female agricultural workers aged 18 and above residing in the villages of Wardha district of Maharashtra. For this purpose, A pretested questionnaire covering sociodemographic data, morbidity profile, socioeconomic variables, family, education, and social security measures will be utilized. The study aims to conduct a community-based cross-sectional survey among 131 female agricultural workers from the specified region.