Prevalence Of Various Conditions Research Articles

Prevalence and factors influencing behavioral problems among adolescents in selected high schools of Bhubaneswar: A survey in Odisha

Background: Adolescent health and well-being are important for the health of future generation. Adolescence is a period of complex amalgamation of emotional, physical and social development leading to functional independence of the individual. It is also a period when behavioral problems could adversely impact the mental health. Timely identification and utilization of support system could lead better adjustment and less emotional and behavioral problems in adolescents. The objective of the present study was to identify the prevalence and the factors influencing behavioral problems among adolescents.
 Materials and methods: Behavioral problems such as depression, substance abuse, suicidal tendency and conduct disorder were surveyed in schools. A total of 300 adolescents (150 boys and 150 girls) responded to the survey questions. Beck’s depression inventory, adolescent alcohol and drug involvement scale, suicidal behavioral questionnaire revised were used to examine depression, substance abuse and suicidal tendency respectively. Self structured questionnaire were used to evaluate conduct disorder and the factors influencing behavioral problems. The self designed tools were validated by seven multi disciplinary experts from pediatric, nursing, psychology and psychiatrics.
 Results: Prevalence of various conditions is reported, depression was reported by 36%, drug abuse is 16%, conduct disorder was observed in 45% and 27% risk of suicide. Age, class and gender have a strong association with behavioral problems. In this study it has shown that females are more affected by behavioral problems than males and more problems are reported in higher class’s students. Attitude of mother has a strong impact on behavior of an adolescent. Overall, the current study highlights the prevalence and the factors that impact behavioral conditions in adolescents.
 Conclusion: It concludes that behavioral problems among adolescents are common. They are often under recognized. Identification and recognition through proper assessment is needed to give them right referral.

An Ordinal Measure of Population Health

We propose a population-level health index that addresses two of the main concerns of existing health measures: (1) the biases in self-assessed health measures, and (2) the difficulties associated with making comparisons across populations afflicted by a variety of conditions in a context in which multi-morbidity is high. Starting from a set of general axioms, we derive a partial order index that ranks health across populations based on the relative prevalence of various conditions within these populations, and that can be readily applied to many existing health surveys. We illustrate the use of our health measure by applying it to data from the National Health Interview Survey in order to examine health differences across racial groups in the U.S.

The epidemiology of outpatient pain treatment in pediatrics.

BackgroundThere is limited real-world, population-level data on the prevalence and treatment of pain in children. An understanding of pediatric pain conditions and its management can help inform provider education, treatment guidelines, and design of pediatric pain studies. Therefore, in this study, we aimed to describe the prevalence of conditions associated with acute and chronic pain in pediatric patients and to characterize pediatric pain treatment with nonsteroidal anti-inflammatory drugs, cyclooxygenase-2 (COX-2) inhibitors, opioids (immediate release or extended release), antidepressants, topical analgesics, anticonvulsants, and other therapies based on a large, real-world sample.Materials and methodsIn this cohort study, we used administrative claims data from the Truven Health MarketScan® Research Databases, which contain data regarding demography, prescription, diagnosis, and procedure performed. Descriptive statistics were used to assess the prevalence of various conditions associated with pediatric pain and to estimate the proportion of patients who received various analgesic and nonanalgesic treatments. All analyses were stratified according to demographics.ResultsThis study included data on more than 30 million pediatric patients from throughout the US. Overall, among patients with commercial insurance, surgery was the most common pain-related diagnosis, followed by orthopedic conditions, malignancies, trauma, and genetic conditions. For patients with Medicaid, surgery was also the most common diagnosis, followed by traumatic injury, orthopedic conditions, malignancies, and genetic conditions. These diagnoses varied by age, with most showing higher prevalence in older children. Treatment varied substantially by condition, and many children (more than 50% for most of the conditions evaluated) did not receive any prescription pain treatments. For patients with either commercial insurance or Medicaid who were using prescription opioids, immediate-release opioids were the most commonly used analgesic treatment for pain. Overall, prescription pain treatments were more common in the Medicaid population. Extended-release opioids were rarely used.ConclusionThe types of pain treatments varied substantially by condition and age of the patient, with the highest prevalence of use in older children.

The differential diagnosis of low back pain: a primer on the evolving paradigm.

The issue of low back pain (LBP) is as common as it is perplexing. LBP is thought to be a chronic issue in approximately 10% of the U.S. population. This condition has wide-reaching social and economical reverberations. Despite the availability of modern diagnostic tools, the cause of the pain generator is often unidentifiable. The authors were asked to create an overview of the etiology of LBP for physicians who implant neurostimulation devices for the treatment of chronic pain patients. Some prevalence data, based on the current available literature, have been provided for the more common structural conditions causing LBP. However, a comprehensive review of prevalence of various conditions and their respective manifestations as LBP is beyond the scope of this article. A review was performed of frequently cited articles with search terms for "low back pain" using PubMed, Medline, and Google Scholar. The authors also reviewed other literature from commonly utilized sources in the field of interventional pain medicine such as the journals of Neuromodulation, Pain Medicine, Spine, and Neurosurgery in the publication date range of 1975 to the present. Moreover, recent edition textbooks of other specialties such as obstetrics and gynecology, neurology, internal medicine, and surgery were referenced to develop a comprehensive list of the differential diagnoses. In order to capture the broad scope of information presented in this article, the criteria used to choose the references included published peer-reviewed articles that provided information on LBP as a symptom of a case report to common presentations of various conditions as described in a number of current, and commonly used, textbooks in their specialty. The article serves as a reference for commonly cited causes of LBP as well as less common conditions presenting with LBP as a possible symptom, which may occur as a solitary pain generator or in combination with other etiologies. The information is structured in such a fashion to allow a comprehensive overview for every reader, including the most experienced implanting physicians. The article is designed to kindle critical thinking regarding the massive scope involved in the assessment of a patient with a complaint of LBP. The results of the comprehensive research to produce this article clearly indicate the broad scope of this list of differential diagnoses. The reader should be aware that the lists are by no means all-inclusive. Perhaps additional efforts will be necessary to build on the available information in this article in the future. Furthermore, although some prevalence data for LBP, as it is related to structural spine, is readily available based on the excellent work of our colleagues and presented throughout this paper, for other disease processes, the prevalence data are scarce to nonexistent. This underscores the need for further research to better understand this elusive condition. The size and breadth of the topic at hand in this article would arguably deserve its own comprehensive textbook. The complexity and discussion points of each identified pain generator could be given a chapter or section to reflect complex learning deserved by each topic. With these limitations, the authors recommend the reader to evaluate this article in the context of a broader topic of LBP and neurostimulation. LBP is an extremely common condition associated, as a symptom, with various disease processes, regardless of their relationship with the lumbar spine or its innervation. This article underscores the broad nature of LBP as a symptom of many diagnoses. The primary conclusion reached by the authors is the most important recommendation by all mentors in medicine, which is to obtain a comprehensive history and perform a complete physical examination on each patient. Despite the fact that there is an emerging school of thought questioning the validity of the physical examination, this tool continues to be the current standard of care and used by a majority of clinicians around the world. The physician must analyze the information obtained from his/her history, physical examination, and diagnostic tools with the recognition of the broad nature of the differential diagnoses of LBP in order to be able to best treat the patient.

Changes in Megakaryocytes in Cases of Thrombocytopenia: Bone Marrow Aspiration and Biopsy Analysis

Thrombocytopenia (platelet counts less than 150,000/μl) is commonly encountered in various hematological disorders including myelodysplastic syndromes as well as various non-myelodysplastic hematological conditions. The present study was undertaken to calculate the prevalence of various conditions associated with thrombocytopenia and to record the megakaryocytic alterations in various cases of thrombocytopenia. Apart from this by means of statistical analysis it was tried to analyze whether a significant difference existed in megakaryocytic alteration noted in myelodysplastic versus non- myelodysplastic conditions. A prospective series of 60 bone marrow aspirations along with concomitant bone marrow biopsies was conducted in a tertiary care centre catering to both urban as well as rural population in north India. The distribution of morphological changes in cases of non myelodysplastic conditions and myelodysplastic were compared using Chi-Square test. A p-value less than 0.05 was considered significant. The commonest cause of thrombocytopenia for which bone marrow examination was sought was dimorphic anaemia (18 cases, 30%), followed by myelodysplastic syndrome (06 cases, 10%) which was followed equally by acute lymphocytic leukemia and blast crisis of chronic myeloid leukemia (CML). Of all the non-MDS conditions apart from dimorphic anaemia, idiopathic thrombocytopenic purpura and chronic myeloid leukemia (blast crisis); megakaryocytic dysplastic forms were not noted in any other condition. In cases of myelodysplasia; dysplastic forms, bare megakaryocytic nuclei, hypogranular forms and micromegakaryocytes were seen. Comparison between frequencies of normal, high and low number of nuclear lobes among MDS (n=9) and non MDS (n=68) conditions were found to be statistically significant. Further studies on the evaluation of megakaryocytic alteration and their contribution to thrombocytopenia can provide growing knowledge to the pathogenesis of numerous hematopoietic disorders that may identify broader clinical applications of the newer strategies to regulate platelet count and functioning.

Associated Morbidity of Chalazia

Chalazion may be associated with some local and systemic conditions. We studied the prevalence of various conditions among patients with chalazion. A retrospective observational case-control study of all the members who were diagnosed with chalazion in the Central District of Clalit Health Services in Israel (years 2000-2008; n = 9119) and 9119 age- and gender-matched controls randomly selected from the district members. We calculated the prevalence of various ocular, systemic, and demographic conditions as risk factors for chalazion. Demographically, a significant (P < 0.0001) tendency to develop chalazion was found in the population of lower socioeconomic class, in the population living in urban areas, in young females (10-29 years), in older men (older than 60 years), and in non-Ashkenazi Jews. The following risk factors of chalazion were statistically significant: blepharitis [odds ratio (OR), 6.2], rosacea (OR, 2.9), gastritis (OR, 1.4), anxiety (OR, 1.5), irritable bowel syndrome (OR, 1.7), and smoking (OR, 1.2). Diabetes (OR, 0.8) and hypothyroidism (OR, 0.8) were significantly less prevalent among chalazion patients. Some systemic conditions are significantly more prevalent and some are significantly less prevalent among patients with chalazion. Better understanding of the pathophysiological association between those diseases and chalazion may help in its treatment and prevention.

Consequences of Smoking during Pregnancy on Maternal Health

To estimate the incidence of maternal cardiovascular and pulmonary events and the prevalence of other comorbid conditions among pregnant smokers. We queried the Nationwide Inpatient Sample (NIS) from the Healthcare Cost and Utilization Project (HCUP) of the Agency for Healthcare Research and Quality (AHRQ) for pregnancy-related discharge codes for the years 2000-2004. The prevalence of various conditions and the incidence of various complications were compared between smokers and nonsmokers. The majority of smokers were young and white and had public insurance. Smokers were more likely to have experienced deep vein thrombosis (odds ratio [OR] 1.3, 95% confidence interval [CI] 1.1, 1.6), stroke (OR 1.7, 95% CI 1.2, 2.5), pulmonary embolus (OR 2.5, 95% CI 2.1, 3.0), and myocardial infarction (OR 4.6, 95% CI 3.3, 6.4). They were 3 times more likely to have experienced influenza or pneumonia (OR 2.9, 95% CI 2.7, 3.2) and 15 times more likely to have bronchitis (OR 15.2, 95% CI 12.8, 18.2). They were more likely to suffer from a number of comorbidities, including asthma (OR 4.0, 95% CI 3.7, 4.2) and gastrointestinal ulcers (OR 3.7, 95% CI 2.6, 5.5). Although they were less likely to have experienced gestational diabetes (OR 0.9, 95% CI 0.9, 1.0), preeclampsia (OR 0.8, 95% CI 0.8, 0.9), or eclampsia (OR 0.7, 95% CI 0.6, 0.9), they were more than 5 times as likely to have experienced an ectopic pregnancy (OR 5.4, 95% CI 4.6, 6.3). Smoking has a negative impact on maternal health. Counseling about the risks of smoking in pregnancy should include not only fetal risks but maternal risks as well.

The Nature of Neck Pain in a Private Pain Clinic in the United States

To determine the prevalence of different causes of neck pain in a private practice clinic. A retrospective audit of records. A private spine pain clinic in the state of Washington, USA. All consecutive patients, seen between January 2003 and January 2005, in whom a diagnosis of neck pain was made. Interventions. The records of all patients were examined to determine the prevalence of various diagnostic entities determined by history, examination, and invasive test such as controlled diagnostic blocks and provocation discography. Using different denominators, the prevalence of various conditions was determined in all patients who presented with neck pain, in patients in whom investigations were undertaken, and in patients who completed investigations. A large proportion of patients (36%) did not pursue investigations, which diluted the crude prevalence of various conditions. A further 17% deferred completing investigations. Among the 46% of patients who completed investigations, the prevalence of zygapophysial joint pain was 55%, discogenic pain was 16%, and lateral atlanto-axial joint pain was 9%. A diagnosis remained elusive in only 32% of those patients who completed investigations. In a private practice setting, a patho-anatomic diagnosis for chronic neck pain can be established in over 80% of patients, provided that appropriate investigations are undertaken. The prevalence of cervical zygapophysial joint pain encountered in the present study corroborates the prevalence rates established in academic studies. Cervical discogenic pain does not appear to be common among patients with chronic neck pain.

Current situation of screening for cancer

The large majority of human cancer diagnosed each year may be avoidable, but avoidable causes of many common cancers have not yet been clearly identified. A prerequisite of cancer prevention lies in identifying the determinants of cancer risk. Cancer control embraces a number of important elements with the aim of reducing the incidence of cancer and, failing primary prevention, reducing mortality either by finding disease at an earlier and more ‘curable’ stage or by improving the survival stage-for-stage through improvements in therapy. There are a number of disciplines involved within this embrace including epidemiology, clinical science, behavioural science and health education. It is a complex, and at times, uncoordinated package. Screening for cancer involves the examination of, but more frequently the performance of a test on, asymptomatic individuals in order to classify them as likely or unlikely to have the disease in question. Those who appear likely to have the disease are investigated further to arrive at a final diagnosis and those who are found to have the disease are treated. The organized application of early diagnosis and treatment activities in large groups is often described as population screening. The goal of screening generally is to reduce mortality from the disease among the people screened by early treatment of the cases discovered. Screening calls attention to the likelihood of disease before symptoms appear. Screening in connection with early diagnosis and treatment should be clearly distinguished from other uses of the term in epidemiology and clinical practice. In particular, ‘screening’ is commonly used to describe a series of tests done on a symptomatic patient for whom a diagnosis is not yet established. This type of screening is part of the practice of clinical medicine rather than public health or preventive medicine. Screening procedures may also be used to estimate the prevalence of various conditions without immediate disease-control objectives. Screening could be used both to refer to the identification of people at high risk of a disease but who do not yet have it and to the application of tests to this group for the early detection of disease. It is also important to distinguish between diagnostic tests and screening tests. Morrison [1] illustrates this using the example of diabetes. The use of a glucose tolerance test is considered to be a diagnostic test while use of the (random) blood sugar method may be considered a screening test. Thus a liver biopsy would be considered a diagnostic test for liver cancer and a biopsy of the prostate a diagnostic test for prostate cancer. It is also essential to distinguish between what is meant by ‘screening’ and ‘case-finding’. Screening is aimed at the general population and not merely those who have sought some medical attention. The criteria which should be fulfilled before screening for a particular form of cancer were outlined by Wilson and Jungner [2] (Table 1). These criteria cover a variety of issues including the utility and acceptability of the screening test, knowledge of the natural history and treatment outcome of cancer and the cost, economical and due to treatment and false positive tests. These criteria have stood the test of time.

Medicaid managed care and public health data.

In summary, there are a number of ways in which state public health data can be of value in the design of Medicaid managed care plans. At the level of the purchaser, such as a state Medicaid agency, public health data can assist in decision-making around pricing policy and can be useful in prioritizing interventions for those conditions that most severely affect the covered population. Quality assurance standards such as the HEDIS clinical performance measures can be used to define a baseline of prevention-oriented services or, by adding additional customized data points, to emphasize a particular service. From the standpoint of the managed care plan, public health data can be useful in understanding the needs of a community it serves or would like to serve and in estimating the prevalence of various conditions in that community that will influence the premium it will charge. Thus, there are multiple routes through which public health goals and priorities can be incorporated into managed care and can leverage the power of managed care to improve the public's health.