Female Preponderance Research Articles

Conjunctival Melanoma in Aotearoa-New Zealand: A 21-Year Analysis of Incidence and Survival.

Conjunctival melanoma (CM) is a rare and aggressive malignancy. Global studies demonstrate increased burden of disease in countries with high rates of cutaneous melanoma. There are currently no reports on CM incidence, trends, or survival within Aotearoa-New Zealand (NZ), a country with the highest global rates of cutaneous melanoma, which this study aims to address. This was a retrospective review using the national cancer registry. Data on histologically confirmed CM diagnosed between January 1, 2000, and December 31, 2020, were obtained from the NZ Cancer Registry. Cases were identified using the International Classification of Disease, 10th edition (ICD-10) codes. Primary outcome measures were age-standardized incidence, trends, and survival. A total of 68 CM cases were identified. There was a preponderance for females (n=40, 58.8%) and CM predominantly affected European patients (n=63, 92.6%). Median follow-up was 5.0 years [interquartile range (IQR)=2.4-9.9y] and the median age at diagnosis was 68.5 years (IQR=57.0-79.0y), with non-Europeans presenting at a significantly younger age [-17.3y (95% CI: -31.3 to -3.2), P =0.019] than Europeans. The annual age-adjusted incidence(±SD) was 0.6±0.2 cases per million population per year with a stable incidence trend over 21 years. All-cause mortality was found in 28 cases (41.2%) and the median time to death was 3.76 years (IQR=2.1-5.7y). Five-year all-cause survival and disease-specific survival was 69% and 90%, respectively. This is the first report on CM incidence, trends, and mortality in NZ. The CM burden is in line with European and North American data, despite NZ having the highest rate of cutaneous melanoma. The incidence remained stable over 2 decades.

EVALUATION OF INCIDENCE OF MALIGNANCY IN SOLITARY THYROID NODULE AT A TERTIARY CARE HOSPITAL

Objective: This study aims to identify the incidence of malignancy in solitary nodule thyroid in a tertiary care hospital in Kalaburagi, Karnataka. Methods: This was a prospective non-randomized hospital-based interventional study carried out on 50 patients over a period of 1 y, who presented with clinically palpable solitary thyroid swellings and subsequently underwent surgery for the same at the Department of General surgery, Gulbarga Institute of Medical Sciences, Kalaburagi, Karnataka. Results: Over the total duration of the study period, there were 50 cases of clinically detected solitary thyroid nodule with a high female preponderance. The mean age of the incidence of solitary thyroid nodule was 40.6 y. The incidence of malignancy in solitary thyroid nodule was found to be 18%. Conclusion: It is concluded from the present study that 18% of solitary thyroid nodules are malignant, with female preponderance and a mean age of solitary thyroid nodule is 40.62 y.

Epidemiology and diagnostic trends of congenital adrenal hyperplasia in Denmark: a retrospective, population-based study.

The prevalence of newborns with congenital adrenal hyperplasia (CAH) detected by neonatal screening is well-described, but data including patients diagnosed later in life are extremely limited. This study aimed to describe diagnostic trends for all patients with CAH in Denmark. A nationwide population-based registry study including medical record review. We identified 462 patients (290 females) with any form of CAH. The prevalence of CAH combined was 15.1 (95% confidence interval [CI]: 12.3-16.1) and 9.0 (CI: 7.6-10.4) per 100,000 newborn females and males. There was a prevalence of salt-wasting (SW), simple-virilizing (SV), and non-classic (NC) CAH due to 21-hydroxylase deficiency of: SW-CAH: 6.4 (CI: 5.3-7.6) and 5.6 (CI: 4.6-6.8); SV-CAH: 2.0 (CI: 1.4-2.8) and 1.6 (CI: 1.0-2.7); and NC-CAH: 5.5 (CI: 4.4-6.9) and 2.5 (CI: 1.7-3.7) per 100,000 newborn females and males, respectively. Diagnosis of NC-CAH increased significantly during the course of the study. There was a female preponderance for SV-CAH (ratio: 1.8) and NC-CAH (ratio: 3.2). Median age at diagnosis, females and males respectively: SW-CAH: 4 (interquartile range [IQR]: 0-11) and 14 (IQR: 8-24) days, SV-CAH: 3.1 (IQR: 1.2-6.6) and 4.8 (IQR: 3.2-6.9) years, and NC-CAH: 15.5 (IQR: 7.9-22.5) and 9.4 (IQR: 7.2-23.2) years. The combined prevalence of CAH was 15.1 and 9.0 per 100,000 newborn females and males, respectively. The female preponderance was primarily due to diagnosis of more females than males with NC-CAH. International Fund of Congenital Adrenal Hyperplasia, Health Research Fund of Central Denmark Region, Aase and Einar Danielsen Fund, and "Fonden til Lægevidenskabens Fremme".

A CLINICAL STUDY OF INCIDENCE OF MALIGNANCY IN SOLITARY THYROID NODULE IN A TERTIARY CARE HOSPITAL

Introduction:Thyroid nodules are common entities presenting to the surgical outpatient department. They are defined as A discrete swelling in an otherwise impalpable gland. Incidence of malignancy has been observed to be quite high in solitary thyroid nodules. Thus, they have to be evaluated properly for optimum management. Aim of the study is to identify the incidence of malignancy in solitary nodule thyroid. Materials and Methods:This study was a prospective non-randomized hospital based interventional study carried out on 50 patients who presented clinically with solitary thyroid swellings who thereby underwent surgery for the disease from August 2020 to July 2022 at the Department of General surgery of our institute. Results:There were 50 cases of clinically detected solitary thyroid nodule with female preponderance more than males. The mean age of the incidence of solitary thyroid nodule was 40.6 years. The incidence of malignancy in solitary thyroid nodule was found to be 18%. Conclusions:It is concluded from the present study that 18% of solitary thyroid nodules are malignant, with female preponderance and a mean age of solitary thyroid nodule is 40.62 years.

P112 Patient Experience of Remote Healthcare during the Pandemic in Rheumatoid Arthritis and Adult Juvenile Idiopathic Arthritis

Abstract Background/Aims COVID-19 challenged traditional care models and necessitated introduction of remote consultations. We wanted to understand the experiences of people with rheumatoid arthritis (RA)/adult juvenile idiopathic arthritis (AJIA) on accessing healthcare remotely, and how well people understood their condition and treatment. Methods This collaborative work between the National Rheumatoid Arthritis Society (NRAS) and clinicians in Oxford led to the development of an electronic questionnaire that was disseminated in July 2021 for four weeks through e-newsletters and all NRAS social media platforms. Those living in the UK with RA and AJIA aged 18 and over were eligible. Analyses of data were performed in Microsoft Excel and IBM SPSSv28. Results We analysed 316 responses. There was a middle-aged (ages 46 to 54, 54.1%, n = 171), Caucasian (97.5%, n = 306), female (92.4%, n = 292) preponderance. Most had RA (93%, n = 294) followed by another inflammatory arthritis (4.1%, n = 13) and AJIA (2.8%, n = 9). The majority had their condition for >10 years (43.4%, n = 137) but some were diagnosed <12 months ago (3.2%, n = 10). Two thirds of participants (66.5%, n = 210) did not know their DAS28 score. Of the remaining third, the most commonly reported measure was moderate disease activity (12%, n = 38). Those with higher self-reported DAS28 scores were using analgesia more regularly (p < 0.01) but we found no difference in NSAID, DMARD or steroid use. Age did not influence steroid usage (p = 0.35), but those who had their condition for longer used more steroids and regular analgesia. Only 33.9% (n = 107) of responders felt their condition had been managed adequately in the pandemic, with more reporting poor status (40.8%, n = 129) rather than good (16.8%, n = 53). Those living in the South of England reported statistically better disease control than those from the North, despite having more virtual assessments (p = 0.02). Travelling and fear of Covid appeared more important than consultation skills. Just over a fifth (20.3%, n = 64) felt greater focus should be given to patient concerns. Of the 9.1% of patients (n = 29) with a new diagnosis made during the pandemic, 24.1% (n = 7) unable to book a GP appointment easily. Patients experienced a median symptom time of 4-10 weeks before consulting GPs. Once assessed, 31% (n = 9) were referred immediately while the median time was 4-8 weeks. We found 58.6% (n = 17) of patients received their diagnosis within their initial rheumatology consultation and 76.5% (n = 13) of these started a DMARD immediately. Conclusion Despite a greater emphasis on patient education and PROMs influencing clinical decision-making, it is staggering that two-thirds did not know their DAS28 score. Analgesia and steroid use were common in patients with well-established disease which remains a concern. Accessing appointments was a significant barrier to patients and delays in care were experienced at every step in the NHS management pathways. Remote consultations need greater emphasis on patient concerns. Disclosure R.S. Andev: Member of speakers’ bureau; RSA received speaker funds from Novartis. A. Bosworth: None. C. Jacklin: None. S. Dubey: None.

The role of NT-proBNP in the diagnosis of diastolic heart failure and its correlation with echocardiography

The primary aim of the current investigation was to evaluate the role of NT-proBNP in the diagnosis of diastolic heart failure and its correlation with echocardiography. Hospital based observational and analytical study undertaken on a total of 65 patients of diastolic heart failure fulfilling clinical inclusion criteria. The enrolled patients had a mean age of 54.5 years with a female preponderance (33 females vs. 32 males). Patients underwent clinical evaluation and echocardiography examination. NT-proBNP estimation was done using autoanalyzer working on principle of electrochemiluminisense. Patients were divided into various grades of diastolic dysfunction on the basis of echocardiography. Statistical analysis was done to find the significance of levels of NT-proBNP and its correlation with the grading of diastolic heart failure. There was a statistically significant higher level of serum NT-proBNP in patients with diastolic heart failure and the increasing levels were directly proportional to severity of diastolic dysfunction. The mean level of NTproBNP increased from 361.08 pg/ml to 3570 pg/ml in increasing severity of diastolic dysfunction. Results suggested positive correlation of rising NT-proBNP levels with increasing severity of diastolic dysfunction.

Sex-based electroclinical differences and prognostic factors in epilepsy with eyelid myoclonia.

Although a striking female preponderance has been consistently reported in epilepsy with eyelid myoclonia (EEM), no study has specifically explored the variability of clinical presentation according to sex in this syndrome. Here, we aimed to investigate sex-specific electroclinical differences and prognostic determinants in EEM. Data from 267 EEM patients were retrospectively analyzed by the EEM Study Group, and a dedicated multivariable logistic regression analysis was developed separately for each sex. We found that females with EEM showed a significantly higher rate of persistence of photosensitivity and eye closure sensitivity at the last visit, along with a higher prevalence of migraine with/without aura, whereas males with EEM presented a higher rate of borderline intellectual functioning/intellectual disability. In female patients, multivariable logistic regression analysis revealed age at epilepsy onset, eyelid myoclonia status epilepticus, psychiatric comorbidities, and catamenial seizures as significant predictors of drug resistance. In male patients, a history of febrile seizures was the only predictor of drug resistance. Hence, our study reveals sex-specific differences in terms of both electroclinical features and prognostic factors. Our findings support the importance of a sex-based personalized approach in epilepsy care and research, especially in genetic generalized epilepsies.

Lichen planus – A refractory autoimmune disorder

Lichen planus (LP) is a chronic inflammatory mucocutaneous disease of unknown aetiology with an estimated incidence of 0.5%–4.0% having a female preponderance at a ratio of 1.5:1. Oral lichen planus (OLP) is commoner than the cutaneous form and tends to be more persistent and more refractory to the treatment. The prevalence of oral lichen planus in Indian population is around 3% with more female predilection. Oral lesions occur in 50%–70% of the patients with lichen planus. LP is considered to be a T-cell-mediated autoimmune skin disease, in which CD8+ cytotoxic T lymphocytes are major mediators. TNF-α and IL-10, interferon-gamma (IFN-γ), IL-4, and IL-8, have been suggested to have an important role in the pathogenesis of OLP. The complications of Lichen Planus include post-inflammatory hyperpigmentation, scarring alopecia, dyspareunia, oesophageal stenosis & possible malignant transformation. Mucocutaneous site biopsy can confirm the diagnosis when taken from the edge of a plaque. There is no cure for Lichen Planus, the management is often performed with the use of antihistamines, corticosteroids, retinoids, immunomodulators, phototherapy and immunosuppressives. Inconsistent results are shown by griseofulvin and chloroquine derivatives. (further prospective studies are needed).

CLINICAL PROFILE OF NEUROLOGICAL INVOLVEMENT IN DENGUE IN CHILDREN ADMITTED TO A TERTIARY CARE CENTER

Background: Dengue is the second most common mosquito-borne disease affecting human beings after malaria. Transmitted by mosquitoes of the genus Aedes, clinical manifestations range from an asymptomatic state to a severe haemorrhagic fever. A change in the spectrum of clinical manifestations has been recently noted with neurological manifestations being recognized frequently 12.The incidence of encephalopathy and encephalitis, the most common neurological complications of dengue,has been estimated to be between 0.5 and 6.2%12 Aims And Objectives: 1.To study the clinical profile of Neurological involvement in children with dengue. 2.To study the Neurological complication in children with dengue infections. Study Design: prospective observational study Participants: The data was collected from 50 patients who had neurological manifestations and serologically proven dengue antibodies admitted in hospitals attached to M.R. Medical college Kalaburagi Results: Neurological manifestation and complications in dengue fever observed in 50 cases (13%).female preponderance is seen (ratio of 0.9:1).common symptoms were fever with seizures (60%), headache (56%), vomiting (70%), altered sensorium (40%) and blurring of vision (20%). clinical signs elicited were hepatomegaly (68%), splenomegaly (52%), oedema (52%), lymphadenopathy (20%). Mean GCS found to be 11.2. complications observed in study subjects were encephalitis (56%) followed by encephalopathy (36%), meningitis (4%), meningoencephalitis (4%), cranial nerve palsy (4%), intracranial bleed (2%). mortality observed in 4 cases (8%). Conclusion: Neurological manifestations in dengue fever is widespread and it may progress to life threatening complications like encephalopathy, encephalitis, Intracranial bleed etc through various diverse mechanisms. However, awareness is required for prevention, early recognition, and timely therapeutic intervention to prevent complications and mortality.

OUTCOME OF PARACETAMOL(ACETAMINOPHEN) POISONING CASES AT TERTIARY CARE HOSPITAL-A RECORD BASED RETROSPECTIVE STUDY

Paracetamol (PCM, Acetaminophen) is one of the most widely used drug in the world. It is an effective mild analgesic, antipyretic agent which is inexpensive and mostly sold as an over the counter drug. Paracetamol or acetaminophen overdose is a common means of self poisoning worldwide due to its wide availability and accessibility. A record based retrospective study was conducted at a tertiary care hospital to determine the demographic prole of paracetamol poisoning cases and to record the outcome of paracetamol poisoning cases .Primary outcome in terms of development of hepatotoxity and days of hospitalization and Secondary outcome in terms of recovery status as either survived or expired. Datas of 70 patients admitted with history of paracetamol poisoning in the past year was obtained and analysed for demodraphic and clinical features.It was observed that most predominance of paracetamol overdose in young age with median age of 26 with female preponderance and Hepatotoxicity was seen in only six cases of all paracetamol overdose with no mortalities.This study concluded that Paracetamol poisoning is frequently seen in young females attempting suicide. In India the rate of hepatic toxicity tends to be low. Mortality and Morbidity were not seen despite high doses of paracetamol ingestion.

A CROSS-SECTIONAL STUDY TO EVALUATE ACUTE KIDNEY INJURY IN SCRUB TYPHUS PATIENTS

Objective: This study was conducted with the objective to estimate the incidence and severity of acute kidney injury (AKI) scrub typhus patients. Methods: This was a cross-sectional study conducted 90 patients diagnosed with scrub typhus in a tertiary care center. Basic demographic and treatment details of the patients were recorded. Routine hematological investigations and biochemical profiles were performed upon admission and follow-up. AKI was defined and classified based on the RIFLE criteria. Results: Mean age of the patients was 49.0±19.5 years and female preponderance was observed. The hemoglobin level was significantly lower in AKI patients as compared to non-AKI patients. Meanwhile, there was a significant increase in mean TLC count, CRP, total bilirubin in AKI patients as compared to non-AKI patients. was significantly higher as compared to those without AKI. Increasing age, ICU admission, shock, urinary abnormalities, and mechanical ventilation were the factors significantly associated with AKI. Conclusion: AKI is a frequently reported complication in scrub typhus patients. In evaluating febrile illness associated with AKI, scrub typhus should be considered.

Goltz syndrome in male

Goltz syndrome or focal dermal hypoplasia is a rare meso-ectodermal, X-linked dominant genetic disorder with female preponderance. Though the involvement of multiple systems is present, the hallmark of this syndrome is typical cutaneous features. Here, we report a unique case of Goltz syndrome in a 21-year-old male who presented to us with multiple growths on the palpebral conjunctiva of the right eye along with abnormal ice pick–type lesions on the skin. No significant family history was present. The affected eye also had iris and choroidal coloboma. Mild mental retardation and gingival hyperplasia were noted on systemic examination. Being a multisystem disorder, an ophthalmologist should be aware of its extraocular manifestations that can be fatal.

Serum sodium and water imbalance after sellar, suprasellar, and parasellar surgeries: A prospective and observational study

Background: Sodium and water imbalance is common after sellar, suprasellar, and parasellar surgeries. A wide variation in the diagnostic criteria of diabetes insipidus (DI) has been noted in literature. A highly variable incidence of DI and hyponatraemia has been reported. There is paucity of Indian studies. Aims and Objectives: The study was designed to evaluate serum sodium level and water imbalance after sellar, suprasellar, and parasellar surgeries. This was evaluated in terms of occurrence of hyponatraemia and central DI on day 1 and day 7 in the post-operative period. Materials and Methods: Patients of either sex, aged from 18 to 65 years, ASA physical status I-II, GCS score ≥13, with baseline normal electrolyte level, posted for elective neurosurgical procedures for sellar, suprasellar, and parasellar tumours, were included for this study after satisfying the inclusion and exclusion criteria. A convenient sampling of 50 patients was considered for this study. The primary outcome measures were to determine the incidence of hyponatraemia and central DI. Other adverse event and any requirement of desmopressin in the post-operative period were also noted. Results: In the present study, the majority (74%) of patients were 31–50 years. Female preponderance was noted with male: female ratio as 1:1.4. Out of 50 cases 41 (82%) had transcranial surgery and 9 (18%) had transphenoidal surgery. The incidence of sodium and water disturbances (SWD) was observed in 22% (11/50) patients. Out of these 11 patients, nine developed DI and two had hyponatremia on day 1 in the post-operative period. Both the abnormalities were found to recover on day 7. Only 1 patient (2%) required desmopressin. Conclusion: The incidence of SWD after sellar, suprasellar, and parasellar surgeries was found to be common (22%). The hyponatraemia and DI responded to the therapy and were transient in nature.

Sturge–Weber Syndrome in Childhood Lupus Complicated by Macrophage Activation Syndrome

Sturge–Weber syndrome (SWS) is an uncommon, nonhereditary developmental condition characterized by nevus flammeus and ocular and neurological manifestations. Childhood-onset systemic lupus erythematosus (cSLE) is a rare disease with a female preponderance and is associated with multiple complications and a poor prognosis. The coexistence of cSLE and SWS is uncommon and can be associated with an increased risk of thromboembolic and neuropsychiatric complications. Macrophage activation syndrome (MAS) is one of the fatal complications of cSLE and an early diagnosis based on clinical findings and laboratory parameters is vital. We report a rare and unique case of SWS with cSLE in an 11-year-old boy, which was complicated by MAS.

HISTOPATHOLOGICAL SPECTRUM AND DESCRIPTIVE EPIDEMIOLOGY OF CENTRAL NERVOUS SYSTEM TUMORS DIAGNOSED AT A TERTIARY CARE CENTER

Central Nervous System (CNS) tumours are rare and account for 1-2% of all malignancies.[1,2] It can present as a primary tumour or a metastatic neoplasm. Primary tumours show a bimodal peak. Objective: To provide an overview of the descriptive epidemiology and histological spectrum of CNS tumours in a tertiary care centre. Methods: This is a retrospective study, which includes all histologically diagnosed cases of CNS tumours from 2017-2020, retrieved from archives of department of Pathology in Saveetha medical college. The frequency and distribution of CNS tumours based on age, gender, histology and grades according to WHO Classication of CNS Tumours 2016 were analysed. Results: In our study, the incidence of CNS tumours was more common in the age group of 41-50 years and had a female preponderance. The most common tumour observed was meningioma followed by astrocytoma. WHO Grade I tumour was found to be most common among the primary CNS tumours. Histological examination remains the gold standard for diagnosis of CNS tumours. This study shows the incidence and distribution of CNS tumours. It helps identifying the burden of the disease in the community and can be further used for comparative studies in the future.

A CLINICAL STUDY OF SOLITARY THYROID NODULE

Solitary thyroid nodule is dened as a discrete swelling in an otherwise impalpable gland with prevalence of 4-7% in adult population with female preponderance. Importance of solitary thyroid nodule lies in its risk of malignancy compared with other thyroid swellings (10-20% are malignant). Conditions that present with solitary thyroid nodule are dominant nodule of multinodular goiter, follicular adenoma, thyroid cyst, thyroid carcinoma, localized form of thyroiditis and colloid goiter. FNAC is the single most useful investigation which can detect most of these conditions. Surgery is the mainstay of treatment after optimizing the patients to euthyroid state. Patients were taken to surgery of which hemi-thyroidectomy,total thyroidectomy and completion thyroidectomy were done depending upon pre-operative FNAC and post-operative HPE.

Analysis of factors influencing outcome following primary total knee arthroplasty

Introduction: Osteoarthritis is a chronic and painful disease which causes pain and loss of movement in the knee that lead to difficulty in performing daily activities. In this study, we analyze various factors like age, sex, BMI, waist/hip ratio, tourniquet time, KL grade of OA knee, use of preoperative tranexamic acid, affecting the outcome post total knee arthroplasty surgery in osteoarthritic patients. Outcome till 6 month was evaluated by mean knee range of motion, Knee society score, SF12 score.Results: In our study, 12 patients (40%) had osteoarthritis knees according to K-L grade III, and 18 patients (60%) had osteoarthritis knees according to K-L grade IV. There were 18 (60.0%) females and 12 (40.0%) males in our study, showing a slight preponderance of females. Leftsided affection was slightly more than right.In our study 16 patients (around 53%) were with BMI ranging from 29 to 32 with mean BMI of 31+_2.3 and Mean Waist Hip ratio was 80.7+-6.Average duration of surgery was around 125.2+-16.26 minutes.The postoperative Knee Society Score at the end of our follow up study at 6 Month is 79.30 Conclusion: We have provided an overview of factor-related progress to the scientific community, but also present time-specific effects to be able to better understand the importance of these factors for Total Knee replacements in the clinic. We conclude tourniquet time, total time of surgery, total blood loss had insignificant effect on functional outcome of patient over a follow up period of 6 months. Excellent results can be expected in patient of younger age and with low BMI & Waist: Hip Ratio, with no comorbidity. Preoperative functional outcome was significant following early KL grade 3 OA knee patients undergoing Total Knee Replacement compared to KL grade 4 knee initially, but over the period of 6 month follow up outcome was found comparable.

A HISTOMORPHOLOGICAL STUDY OF SEBACEOUS CARCINOMA OF EYELIDS: A 3-YEAR RETROSPECTIVE STUDY

Background: Sebaceous Carcinoma (SC) is a rare and aggressive malignancy that develops from the sebaceous glands. SC is most common in the periocular region, head and neck, but can occur anywhere in the body. To study and analyse de Purpose: mographic characteristics and outcomes of cases of Sebaceous carcinoma. Retrospective Study of 24 patients with Sebac Materials and Method: eous Carcinoma conducted at Department of pathology, Sarojini Devi Eye Hospital, Hyderabad, Telangana, India, for a period of 3 years. The data collected was subjected to statistical tabulations and analysis was done. A total of 24 biopsies of histopathologically Results: diagnosed Sebaceous Carcinoma (SC) cases were reviewed during the 3year retrospective study period. All the patients were above 25 years old being in the age group of 25-90 years of age. Mean age of presentation of SC is 56 years. Most common age group of presentation is 50-60 years (n=7, 29.16%). The distribution of SC in males=6 (25%) and females=18 (75%) with a ratio of male to female 0.33:1. The incidence of SC is found to be more in periocular region (n=24, 100%). The earliest age of presentation of SC is 25 years while 90 years being the late age of presentation. The current results support that the Conclusions: Sebaceous carcinoma is most commonly located in periocular region compared to extraocular region with right eye and upper lid more frequently involved. Incidence of SC is more in females compared to males with high female preponderance

Clinical, Hematological, and Cytogenetic Profile of Myelodysplastic Syndromes in Adults: A Three-year Cross-sectional Study.

Myelodysplastic syndromes (MDS) are a group of clonal hematological disorders with a diverse clinico-hematological profile. Studies in India have shown a different biology from the West. This study aimed to assess the clinicopathologic profile of MDS patients, classify them according to the World Health Organization classification system, categorize them into International Prognostic Scoring System (IPSS) and the revised IPSS prognostic subgroups, and evaluate the treatment outcome. A cross-sectional study was conducted on 48 patients diagnosed with MDS from January 2017 to December 2019 from Rajagiri Hospital, India. Clinical, hematological, and cytogenetic features were analyzed. The patients were stratified according to the IPSS and revised IPSS and were followed-up for a minimum of six months. The patients most affected were those in the seventh decade of life. We found a slight female preponderance and a mean age of 57.5 years in females and 67.7 years in males. Anemia was the most common manifestation of MDS. On the other hand, thrombocytopenia was found to be the least common cytopenia. MDS with multilineage dysplasia was the most common subtype. Cytogenetic abnormalities were seen in 29.5% of cases. Most of the patients were in the low-risk prognostic categories. Our patients were older when compared to those of other Indian studies, with most in the low-risk categories which were like Western data.

The organizational role of ovarian hormones during puberty on risk for binge-like eating in rats

Puberty is a high-risk period for the development of dysregulated eating, including binge eating. While risk for binge eating in animals and humans increases in both males and females during puberty, the increased prevalence is significantly greater in females. Emerging data suggest that the organizational effects of gonadal hormones may contribute to the female preponderance of binge eating. In this narrative review, we discuss studies conducted in animals that have examined these organizational effects as well as the neural systems that may serve as intermediary mechanisms. Relatively few studies have been conducted, but data thus far suggest that pubertal estrogens may organize risk for binge eating, potentially by altering key circuits in brain reward pathways. These promising results highlight the need for future studies to directly test organizational effects of pubertal hormones using hormone replacement techniques and circuit-level manipulations that can identify pathways contributing to binge eating across development.