Sociodemographic Distribution Research Articles

Association Between Disability and Suicide Mortality in the Spanish Community-Dwelling Adult Population. A Population-Based Follow-Up Study.

To assess the association of disability with suicide mortality, separately for women and men by age group. Information was obtained from a representative national sample of 161,809 community-dwelling adults (≥18years). Participants contributed to follow-up time from baseline interview (2008) until suicide, death by other causes, or 2017. We calculated, by sex, standardized suicide mortality differences (SSMD), comparing persons with and without disabilities standardized to sociodemographic distribution of disability population. 29 women died by suicide during 800,754 person-years follow-up and 97 men during 735,709 person-years. Among women with disabilities, SSMD (95% Confidence interval) per 100,000 person-years at 5years was 54.4 deaths (-17.2 to 126.1) [100.0 (-27.4 to 227.4) in women <65years and -4.8 (-27.3 to 17.7) in women ≥65 years (P homogeneity = 0.11)]. Among men, SSMD increased by 122.2 deaths (4.1 to 240.3) [37.2 (-40.2 to 114.6) in men <65years and 74.7 (-51.8 to 200.5) in men ≥65years (P homogeneity = 0.62)]. Suicide risk was higher in women and men with disability. In women higher risk was only notable for those <65. Men presented similar effects in both age groups. Nevertheless, due to imprecision of estimates, results should be viewed cautiously.

Dental caries lesions and impact on quality of life in adolescents living in urban and rural areas. A case study.

The concept of quality of life (QoL) developed from early studies on subjective wellbeing and satisfaction with life, interpreted as resulting from living conditions, and recognized by means of objective indicators. Indicators have been developed and validated to measure the relationship between quality of life and health Aim: To determine, during an Educational Social Practice, the association between presence of dental caries lesions and its impact on quality of life of adolescents living in rural and urban areas in Argentina. Materials and Method: This was an observational cross-sectional study in (a) a rural area (Tres Isletas; Chaco Province/Schools No. 601 and 477) and (b) an urban area (Villa Soldati; Buenos Aires City/Nuestra Sra. Fátima School). The sample included 40 students from the urban area (UG) and 30 from the rural area (RG). A calibrated researcher (Kappa 0.80) collected the survey data and performed the clinical examinations. The following were recorded: (a) sociodemographic distribution in terms of age and gender; (b) presence of dental biofilm according to Silness and Löe; caries lesions according to ICDAS II /INTCy criteria, and (d) DMFT, total and per component. Quality of life was assessed using the CPQ 11-14r. Statistical processing included calculation of frequency distribution of the variables (X± DS), and chi-square and Mann-Whitney tests to calculate association and comparisons between groups. Results: The sample included 47 girls (67.1%) and 23 boys (32.9%). Distribution according to sex and age did not differ significantly between sites (UG:12.9 years ± 0.5 and RG:11.8 years ±1.1). No significant difference was found between sites for a) plaque biofilm (p=0.759); b) DMFT, total value and per component, or c) individual and grouped ICDAS scores. Percentage analysis of the CPQr 1-14 scores showed significant differences between groups for questionnaire total scores (26.9% ± 2.2 in UG and 4.1% ± 0.8 in RG) and for the different domains. Conclusion: Perceived impact on quality of life caused by dental caries lesions was significantly higher in urban than the rural group, although neither the dental caries process nor the amount of biofilm differed significantly between groups.

Prevalence and Sociodemographic Correlates of Smoking among Schoolchildren in Albania.

Smoking among children remains a critical public health issue, with millions of minors engaging in tobacco use, leading to addiction and long-term health consequences. Our objective was to assess the prevalence and sociodemographic distribution of smoking habits among Albanian children. A cross-sectional study was conducted in Albania in 2022, including a nationwide representative sample of 5454 schoolchildren aged 11, 13, and 15 years (N = 5454; ≈52% girls; response rate: 96%). Data on smoking habits were gathered, along with sociodemographic factors of schoolchildren. Binary logistic regression was used to assess the associations of smoking variables with sociodemographic factors. The prevalence of smoking variables was 12% for lifetime cigarette smoking, 7% for current cigarette smoking, 20% for lifetime smoking of e-cigarettes, and 13% for current smoking of e-cigarettes. Independent positive correlates of both cigarette and e-cigarette smoking included male gender, age 15, and pertinence to more affluent families (all p < 0.01). The prevalence of smoking among Albanian children is seemingly high, which should be a cause of serious concern to decisionmakers and policymakers in this transitional country. Albania should immediately consider the implementation of expanded comprehensive tobacco control measures, which will save lives, reduce illness, and help reduce the economic burden associated with tobacco-related illness.

Skin mycosis distribution, and burden of visits over a decade in Colombia: ecological study

ObjectivesTo describe the sociodemographic distribution of dermatomycosis and the visits burden over a 10-year period of care. MethodsAn ecological study was conducted using data on visits and people treated in the Colombian Health System during 2010-2019 using the International Classification of Diseases, Tenth Revision codes (ICD-10). Departments and geopolitical regions were the units of analysis, and visit burden was reported as frequency, intensity (visits per person), and rate of dermatomycosis visits (per 10,000 visits; 95% confidence interval). ResultsA total of 4,570,593 visits were analyzed. The most used ICD-10 codes were B369 (superficial mycosis, unspecified), B360 (pityriasis versicolor), B354 (Tinea corporis), B359 (dermatophytosis), and B351 (Tinea unguium) (56.5%), with visits primarily involving the adult population (27-59 years; 32.2%), women (43.4%), and urban populations (57.3%). Amazonas department had the highest rate of visits (2.36 per 10,000), while Nariño had the highest intensity of visits (1.94 visits per person). Caribbean region had the highest rate of visits (17.0 per 10,000 visits; 17.0-17.0), followed by the Amazon region (16.3 per 10,000 visits; 16.2-16.4). ConclusionsThe annual visits burden of dermatomycosis in Colombia is high and concentrated in susceptible geographic areas, possibly due to socio-environmental factors. This health problem is overshadowed by chronic diseases and trauma but is often recurrent, and chronic, and induces out-of-pocket costs for treatment.

An Overview of Nurses' Teamwork Perceptions at RS in 2024

Background: Ineffective teamwork and communication in healthcare has been identified as a major cause of medical errors that harm both patients and providers. Teamwork is the focus of attention in healthcare as the success and failure of the system largely depends on team performance. Objectives: This study aims to determine the picture of nurses' teamwork perceptions at RS in 2024. Methods: This study is a quantitative study with a cross-sectional design conducted in May-June 2024 at one of the hospitals in Padang, Indonesia. The population in this study were all nurses working in the inpatient room of RS with a sample size of 48 nurses selected through purposive sampling technique. Data were collected using a questionnaire consisting of socio-demographic instruments and teamwork perception instruments adopted from AHRQ 2020. Data were analyzed using computerized software. Results: The socio-demographic frequency distribution of respondents showed that most nurses were aged 17-35 years (62.5%), female (91.7%), had a Diploma of Nursing education (54.1%), and a working period between 1-14 years (79.1%). The perception of teamwork of nurses at RS is generally in the good enough category with a mean perception of teamwork of 128.00 (SD 35.39). The communication dimension obtained the highest score with a mean of 26.17 (SD 19.93) followed by the dimensions of team structure, leadership, situation monitoring, and mutual support. Conclusion: The perception of nurses' teamwork at RS in 2024 was in the good enough category with the communication dimension getting the highest score. Socio-demographic factors such as age, gender, education, and tenure influence perceptions of teamwork where nurses who are more experienced and have higher education tend to have more positive perceptions of teamwork.

CLINICAL PROFILE OF PATIENTS WITH MUSCULOSKELETAL TUBERCULOSIS VISITING A TERTIARY CARE CENTRE IN INDIA

Background: Musculoskeletal tuberculosis a major cause of mortality and morbidity in India and other developing countries. Musculoskeletal TB comprises around 10 to 30% of all EPTB cases. Even though skeletal tuberculosis is an important debilitating disease, the literature in statistical data regarding the socio-demographic distribution and clinical presentation of disease is very scarce. Objective: To study the socio- demographic and clinical profile of musculoskeletal tuberculosis patients reaching the Orthopaedics Department in a tertiary care hospital in India. Methodology: 186 patients with musculoskeletal tuberculosis who have completed treatment were called for a follow up and data regarding demographic, person and illness related factors affecting disease were collected and were tabulated and represented in various charts and diagrams, and analysed. Results: Almost equal sex distribution was seen. Maximum proportion (26%) of the patients were belonging to 40-49 age group, with a mean age of 49.6 years. Patients with age &lt;40 had less incidence compared to middle aged and elderly patients. Maximum number of patients were belonging to upper lower class (102 out of 186). Spine was the commonest site involved among the 138 cases. Spinal involvement was predominant in dorso- lumbar junction followed by thoracic spine and lumbar spine. 100% patients had pain as the presenting complaint and other complaints were not consistent. Only 16% of the patients had history of pulmonary tuberculosis and history of contact with tuberculosis case was present in 25% cases. 28% cases were diabetic and other comorbidities were less frequent. 19% of the cases had multi drug resistance. Conclusion: It was seen that Musculoskeletal tuberculosis is most frequently seen in middle age with majority of spine affected cases. The study reinforces the acquaintance of tuberculosis with low socioeconomic status and to some extend the debilitating diseases. It often has an atypical presentation leading to delay in diagnosis.

IJCM_407A: Mortality pattern among adults at a tertiary care centre, Tamil Nadu -a retrospective observational study

Background: Records of vital events like death constitute an important component of the Health Information System. Therefore, these hospital-based death records maintained by Medical Records Department (MRD) can provide information regarding the causes and distribution of deaths, pattern of major illness which are of immense importance in planning health care services. But obtaining meaningful statistics from these records is considerably lacking. Hence, the need of present study. Objective: 1. To identify the mortality pattern among 18-45 years in tertiary care hospital, Madurai, Tamil Nadu from January to December 2022 2. To evaluate socio-demographic distribution and causes of deaths during that period. Methodology: It was an Institution based retrospective observational study. From MRD, Complete enumeration of hospital records of all medically certified deaths of in-patients of 18-45 years who died during January 1st to December 31st 2022 was carried out from May 2023 to August 2023 (n=2038). Data was checked for completeness, entered into Excel sheet and analyzed using SPSS software. Necessary permission was sought from hospital administrative authority to access the hospital records. Results: Among 2038 deaths, 72.52% were males, 26.60% belonged to 41 to 45 years of age. After categorization of all deaths, Road Traffic Accident (RTA) constituted the leading cause of death (28.26%; n=576) followed by Respiratory System (RS)(11.68%), CVS(9.22%) and others. Coronary Artery Disease constituted 39.36% deaths among CVS, 63.12% by Cerebrovascular Accidents among CNS and 23.95% by pneumonia among RS and 77.70% by CKD among renal. In all age groups, RTA constitute the major cause of death with maximum mortality among 18 to 25 years. RS and RTA constituted the major cause of mortality among females and males respectively. Significant association observed between age, gender and causes of mortality(P&lt;0.05) Conclusion: More stringent measures needed to combat RTA deaths

Peptic Ulcer Disease among Patients Undergoing Upper Gastrointestinal Endoscopy in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Peptic ulcer is a common disease of gastrointestinal tract usually present with epigastric pain and discomfort. Upper gastrointestinal endoscopy is its gold standard investigation. There has been limited study on the prevalence of peptic ulcer disease among patients undergoing upper GI endoscopy especially in Nepal. Our study aimed to find the prevalence of peptic ulcer disease among patients undergoing upper GI endoscopy at our centre. A descriptive cross-sectional study was conducted among patients undergoing upper gastrointestinal endoscopy at a tertiary care centre from October 1, 2022 to March 31, 2023. Data was retrieved from hospital records using a preformed proforma and sample size of 219 was calculated and data of 273 cases was collected using the convenience method of sampling. Among 273 patients, peptic ulcer disease was found in 29 (10.62%) of patients among which 28 (10.25%) had antral ulcer and only 1 (0.36%) had duodenal ulcer. The prevalence of peptic ulcer disease is lower in our study centre compared to other studies and further studies can be conducted on the associated risk factors and socio-demographic distribution of peptic ulcer disease.

Racial and sociodemographic distribution of colorectal cancer screening in Canada: A cross-sectional study.

To assess the racial and sociodemographic distribution of colorectal cancer (CRC) screening uptake in Canada, identify disparities, and evaluate the potential predictors and barriers to CRC screening. Data from the 2017 cycle of the Canadian Community Health Survey (CCHS) were analyzed, focusing on individuals aged 50-74years. CRC screening participation rates were evaluated at both national and provincial levels and across various sociodemographic characteristics. Multivariable logistic regression models were employed to identify predictors and barriers to CRC screening. Of the 56,950 respondents to the 2017 CCHS, 41.7% (n = 23,727) were between 50 and 74years of age. The overall CRC screening participation rate was 59.8%, with provinces like Alberta and Manitoba achieving rates of 65.7% and 66.5%, respectively. Significant disparities were observed across socioeconomic, geographical, and racial or ethnic groups. Notably, older adults [AOR 2.41, 95% CI 2.06‒2.83], higher income earners [AOR 1.99, 95% CI 1.77‒2.24], and non-smokers [AOR 1.76, 95% CI 1.55‒2.0] had higher odds of screening, while immigrants and minority ethnic groups, especially South-East Asians [AOR 0.48, 95% CI 0.29‒0.78] and South Asians [AOR 0.65, 95% CI 0.44‒0.95], had lower odds of being up to date with CRC screening. A significant portion of unscreened individuals cited their healthcare provider's perception of the test as unnecessary. While there is promising progress in CRC screening participation rates across Canada, significant disparities persist. Addressing these disparities is crucial for public health. Efforts should focus on enhancing public awareness, facilitating accessibility, and ensuring cultural appropriateness of CRC screening initiatives.

Traditionally removed mandibular central incisors and oral health-related quality of life: a cross-sectional study among adolescents in Maasai populated areas, Northern Tanzania

BackgroundThe traditional removal of mandibular anterior teeth has been existing for many years in the Sub-Saharan African countries. This study aimed to assess the prevalence and sociodemographic distribution of traditionally removed mandibular central incisors (TRMCI) and its association with oral impact on daily performance (OIDP) among adolescents in Maasai populated areas in the Northern part of Tanzania.MethodsUsing a two-stage cluster sample design, with schools as the primary sampling unit, 23 out of 66 eligible rural schools were randomly selected. From each selected school, one class, expected to contain adolescents aged 12–14 years, was identified. The students from these selected classes were invited to participate in the study. A total of 989 adolescents were invited and 906 (91.6%) accepted to participate and completed both an interview and a clinical oral examination.ResultsMean age was 13.4 years (12–17 years, SD 1.2) and 43.9% were males (n = 398). The participants from Longido district amounted to 47.1%. The Maasai group constituted 79.6% of the study participants. The frequency of the participants missing at least one mandibular central incisor were 18.5%. Multivariable logistic regression revealed that adolescents from Longido district were more likely to report at least one TRMCI (OR = 2.5, 95% CI 1.4–3.3). Adolescents from non-Maasai group were less likely to have atleast one TRMCI compared to adolescents from Maasai ethnic group (OR = 0.02, 95% CI 0.002–0.15). Adolescents with at least one TRMCI were more likely to report impacts on OIDP (OR = 3.3, 95% CI 1.9–5.7) than those without TRMCI. Independent of the TRMCI status, adolescents from Longido district were less likely than their counterparts to report oral impacts (OR = 0.4, 95% CI 0.2–0.6). Similarly, adolescents from non-Masaai group were more likely than their counterparts to report oral impacts (OR = 2.2, 95% CI 1.4–3.5).ConclusionTRMCI is common among adolescents in the Maasai populated areas in the Northern part of Tanzania and strongly associated with the district of residence and Maasai ethnicity and has a negative impact on oral health related quality of life. There is a need for oral health education in the rural Maasai communities in Tanzania to increase awareness of the negative consequences of this practice.

Community-based symptom reporting among agro-pastoralists and their livestock in Chad in a One Health approach

One Health Syndromic Surveillance has a high potential for detecting early epidemiological events in remote and hard-to-reach populations. Chadian pastoralists living close to their animals and being socio-economically unprivileged have an increased risk for zoonosis exposure. Engaging communities in disease surveillance could also strengthen preparedness capacities for outbreaks in rural Chad. This study describes a retrospective cross-sectional survey that collected data on clinical symptoms reported in people and livestock in Chadian agro-pastoral communities. In January-February 2018, interviews were conducted in rural households living in nomadic camps or settled villages in the Yao and Danamadji health districts. The questionnaire covered demographic data and symptoms reported in humans and animals for the hot, wet, and cold seasons over the last 12 months. Incidence rates of human and animal symptoms were comparatively analyzed at the household level. Ninety-two households with a homogeneous socio-demographic distribution were included. We observed cough and diarrhea as the most frequent symptoms reported simultaneously in humans and animals. In all species, the incidence rate of cough was significantly higher during the cold season, and diarrhea tended to occur more frequently during the wet season. However, the incidence rate of cough and diarrhea in animals did not predict the incidence rate of these symptoms in humans. Overall, the variations in reported symptoms were consistent with known seasonal, regional, and sociological influences on endemic diseases. Our retrospective study demonstrated the feasibility of collecting relevant health data in humans and animals in remote regions with low access to health services by actively involving community members. This encourages establishing real-time community-based syndromic surveillance in areas such as rural Chad.

The attitudes and practices of United Arab Emirates consumers towards food waste: A nationwide cross-sectional study.

Reducing global food waste is an international environmental, health, and sus-tainability priority. Although significant reductions have been achieved across the food chain, progress by UAE households and consumers remain inadequate. This study seeks to understand the association between consumer attitudes, knowledge, and awareness relating to food waste practice of residents living in the UAE. to help inform policy and action for addressing this national priority. A cross-sectional study was conducted using a validated semi-structured online questionnaire through stratified sampling (n =1052). The Spearman correlation coefficient was performed to determine the correlations. Two independent regression analysis were used to determine the association between food waste practice with: 1) knowledge and awareness and attitude subdomains, and 2) sociodemographic characteristics. Respondents (n=1072) largely reflect the socio-demographic characteristics and population distribution across the seven Emirates. As expected, a significant and negative correlation was found between food waste practice knowledge and awareness and overall attitude. The regression models showed reduced food waste practice was associated with better knowledge, personal attitude, financial attitude (first model), older age and fewer adults in the household (second model). We found a significant and negative association of personal attitude (a commitment, intention), financial attitude (cost-saving motivation), and (existing) knowledge of Food waste (FW) with practice of food waste, indicating that better knowledge about FW, personal attitude or financial attitude was associated with reduction in undesirable food waste practice. While awareness and emotional attitude (moral concerns) were positively and significantly associated with food waste practice (undesirable behaviour). Food waste poses significant challenges in the UAE, and addressing it requires a comprehensive understanding of the multifaceted factors influencing consumer behavior. By promoting knowledge, fostering positive attitudes, and considering socio-cultural factors, policymakers can develop effective strategies to reduce food waste in households and contribute to sustainable development goals.

Prevalence and socio-demographic distribution of uncorrected refractive errors in school-going adolescents in Kakamega County, Kenya

Prevalence and socio-demographic distribution of uncorrected refractive errors in school-going adolescents in Kakamega County, Kenya

Association of self-reported periodontal disease and inequities with long haul COVID-19.

In 2000, the Surgeon General's report highlighted that the mouth is a mirror for overall health of an individual and that disparities in oral health are directly proportionate to general health inequities. Among patients hospitalized due to COVID-19, diabetes and cardiovascular disease are the most common comorbidities; several studies support the association of these conditions with periodontal disease. This study's main aim is to assess the disproportionate impact of the COVID-19 pandemic on populations from lower socioeconomic statuses. The study also aims to assess the association of self-reported periodontal disease with COVID-19 disease course and severity. A sample population of Indiana residents with positive diagnosis of SARS-CoV-2 were recruited. A validated survey tool was sent to this cohort inquiring about sociodemographic distribution; co-morbid conditions, current symptoms of "long haul COVID," course of their COVID-19 infection; history of periodontal disease, existing periodontal disease symptoms, and oral hygiene habits. 209 individuals with a history of positive COVID test were returned to the survey, and association of participant characteristics and periodontal disease-related survey items with COVID-related survey items were evaluated using chi-square tests. Lower sense of smell ratings was associated with less education (p = 0.021), being unemployed/disabled (p = 0.008), worse health status (p<0.001), more frequent bleeding gums (p = 0.031), more frequent toothache (p<0.001), lower oral health rating (p = 0.002), and vaccine status (p = 0.011). Lower sense of taste ratings were associated with older age (p = 0.018), worse health (p<0.001), more frequent bleeding gums (p<0.001), more frequent mobile or loose tooth (p = 0.010), presence of gum disease (p<0.001), more frequent loss of teeth (p = 0.013), more frequent toothache (p<0.001), worse oral health (p = 0.001), teeth lost due to gum disease (p = 0.006), and vaccine status (p = 0.001). History of hospitalization due to COVID-19 was found to be associated with a history of gum disease within the past 12 months.

“The Commercial, Socio-Demographic and Legal Aspects Distribution of the Informal Business in The Urban Areas of Tanzania”

Urban areas worldwide are primarily home to the informal sector due to enormous potential for job and income generation. Despite of its massive contribution to the country’s economy, it has very little information about the socio demographic characteristics that are found and discovered in the literature. The sociodemographic, economic, and legal characteristics of the Informal sector and people associated are examined in this paper’s empirical profile of the sector in an urban setting in Mwanza. 80 respondents provided information as the data collected from the questionnaire. The study used the Cross-tabulation and descriptive statistics in data analysis. The findings display that men dominate in the industry, the education levels of people are low, that the majority of people are young (19–26 years old), married, and that family labor is used. Businesses are also willing to operate at times and places that are convenient for their clients. The report also exposes that 82.5% of running activities lacked a license, and that 55% of the activities received funding from the owners’ own sources. Also, the findings showed almost 70 to 80% of Tanzania depend on IS and approximately 75% Of Mwanza region has Informal sectors which contributed to more employment of people than formal sectors. Generally, the study concludes that the IS significantly develops urban people’ quality of life. Therefore, in order to improve performance and improve the standard of living for those involved, as well as to enable Local Government Authorities to receive revenue in the form of taxes, the study suggests that Local Government Authorities should address training needs and intervene in the Informal Sector’s operations in the region, country at large. The results will also be used for the monitoring the implementation of local authority, regional and national, commitments such as implementing the Tanzania Development Vision for 2035.

Characterizing the Burden of Occupational Chemical Exposures by Sociodemographic Groups in the United States, 2021.

Objectives. To estimate the number and prevalence of workers in the United States exposed to chemical hazards available in the Canadian job-exposure matrix (CANJEM) database and examine exposure disparities across sociodemographic groups. Methods. We merged US worker demographic data from the Current Population Survey with CANJEM to characterize the burden and sociodemographic distribution of 244 chemical exposures in the United States in 2021. An interactive version of the full data set is available online (https://deohs.washington.edu/us-exposure-burden). Results. Of the chemical exposures examined, the most prevalent were cleaning and antimicrobial agents (14.7% of workforce estimated exposed), engine emissions (12.8%), organic solvents (12.1%), polycyclic aromatic hydrocarbons (10.1%), and diesel engine emissions (8.3%). Racial and ethnic minoritized groups, persons with lower educational attainment, foreign-born noncitizens, and males were generally overrepresented in exposure to work-related chemical hazards. Conclusions. In the United States, marginalized sociodemographic groups are estimated to experience an inequitable burden to many chemical exposures because of occupational segregation. Data from this analysis can inform occupational and public health research, policy, and interventions aimed at reducing the burden of disease and health inequities in the United States. (Am J Public Health. 2024;114(1):57-67. https://doi.org/10.2105/AJPH.2023.307461).

Audit of all cases of total abdominal hysterectomy (TAH) at a private hospital in Enugu, Nigeria: Indications and post-operative outcomes

Background: Hysterectomy is a major and one of the commonest gynaecological procedures performed by gynaecologists, world over. It is the surgical removal of the uterus either through the vagina or an abdominal incision. Being such a major procedure in gynaecological practice with consequences on reproduction and sexual performance, we undertook this audit in the private hospital to review its prevalence, indication and outcomes. Aim: The aim of this study was to review the indications and outcomes of all cases of TAH in a private hospital Methodology: This was a 3-year retrospective study in a private hospital in Enugu, south-east, Nigeria. Result: From the theatre register and case files of patients, it was found that a total of 58 patients had major gynaecological surgeries in the centre. Out of this total, 20 were TAH giving a prevalence of 34.5% of major gynaecological surgeries. The socio-demographic distribution of the patients shows that 12(60%) were aged between 46 and 55, 10(50%) were civil servants and 10(50%) had tertiary education. Majority of them 8(40%) were para 4, followed by para3 (20%). The major indications were symptomatic uterine fibroid, 9(45%) and abnormal uterine bleeding 8(40%). Conclusion: Total abdominal hysterectomy was a common gynaecological procedure and the major indications were symptomatic uterine fibroids and abnormal uterine bleeding. Majority of the cases were done with spinal anaesthesia and the only identifiable post-operative morbidity was anaemia.

Chronic Lymphocytic Leukemia (CLL) in Adolescents and Young Adults (AYA): Clinical Characteristics, Prognostic Factors and Survival for 498 Patients

Background Chronic lymphocytic leukemia (CLL) is primarily a disease of the elderly; however, it can also present in Adolescents and Young Adults (AYA) aged 15 to 39 years. Recent information of case series no larger than 227 patients each described clinical outcomes such as a 5-year Overall Survival (OS) of 90% and a 10-year OS of 78% for AYA 1-4. Data on the effect of age on OS in CLL is conflictive among studies 2,3. A higher proportion of males with CLL have been reported in the younger ages compared with olders in some series 2,4 but not in others 3. Sociodemographic characteristics and distribution between younger and older CLL patients have not been extensively reported 2-4. The objective of our study is to describe the clinical and sociodemographic characteristics, prognostic factors and survival in AYA diagnosed with CLL. Materials and Methods Cases of CLL were obtained from the Surveillance, Epidemiology, and End Results (SEER) Database from 2000 to 2020. Statistical analyses were conducted with SPSS® version 25. Patient characteristics were reported in frequencies and compared with the Chi-squared test. The Kaplan-Meier method was used to estimate the median Overall Survival (OS). Cox Regression was done to identify independent prognostic factors of survival. Results A total of 51,992 cases of CLL were identified. The median age of diagnosis was 69 years (interquartile range: 18 years). 498 AYA cases (1% of total population) were found (Table 1). For them, 66.1% were males, 70.3% were non-Hispanic whites and 90.2% lived in metropolitan areas. A median income of ≥$75,000 was noted in 45.6% of the patients. Chemotherapy was received by 32.7% and radiation therapy was given to 1.6%. The median OS for AYA population was not reached (Figure 1), with a 5-year and 10-year OS of 91% and 84%, respectively. OS was different between AYA vs older population, and age was found to be an independent prognostic factor for survival in the entire population of CLL (p&amp;lt;0.001, Figure 1). The age group comparison also found more proportion of males in AYA vs olders (66.1% vs 58.5%, p&amp;lt;0.001), more proportion of non-white patients in AYA group (29.6% vs 15.3%, p&amp;lt;0.001) and that AYA patients were more prone to receive chemotherapy (32.7% vs 14.8%, p&amp;lt;0.001). The multivariate analysis specific for AYA population found that American Indian/Alaska Native Non-Hispanic patients had poor prognosis compared with other races (HR=19.1, CI 95%: 2.2-166.5, p=0.008). Also, receiving radiotherapy (Beam radiation) was associated with poor prognosis (HR=5.5, CI 95%: 1.6-19.6, p=0.008). Compared to people with income &amp;lt;$35,000, all patients with higher income had better prognosis (for patients with ≥$75,000 median income the HR was 0.01, 95% IC: 0.001-0.11, p&amp;lt;0.001). Chemotherapy was not found to be an independent prognostic factor in this population (p=0.8). Conclusions To the best of our knowledge, this is the largest epidemiological study available for CLL in AYA to this date. Sociodemographic differences and epidemiologic prognostic factors described in this research contribute to understand this disease. Interventional studies are required to identify possible targeted therapies that could improve survival outcomes in this population. We believe that the differences in distribution and prognosis for the described variables in our study can contribute towards optimizing the randomization in interventional trials in the future.

PROFILING OF MEDICOLEGAL CASES OF MECHANICAL INJURIES TO HEAD AT TERTIARY CARE CENTER - A PROSPECTIVE STUDY

Aims and Objectives: The study aims to profile the medicolegal cases of head injury in relation to its sociodemographic distribution, the type and nature of the injury, and the type of skull fractures reported. Methods: The present prospective study of 318 medicolegal assault cases for mechanical injuries exclusively to the head, including the face, which reported a total of 404 wounds on the head and face, who reported to the emergency, Guru Nanak Dev Hospital attached to Government Medical College, Amritsar was conducted November 1, 2018, to April 2020. The study was conducted after seeking permission from the Institutional Ethics Committee, Government Medical College, Amritsar. Results: Among the total of 318 cases, the majority of them, 289 (90.9%) were male and 29 (9.1%) were female. Two hundred and forty-four (76.7%) of the reported cases belonged to a rural background, whereas 74 (23.3%) were from an urban background. The most common was the cortical cut reported in 29 (37.2%) cases, followed by depressed fractures in 22 (28.2%) cases. The comminuted fractures were present in 18 (23.1%) cases, whereas there was a fissure fracture in 09 (11.5%) cases. Conclusion: It is observed that assault-related cases of medicolegal injuries on the head are much more common in the younger generation and rural population. Thus prevention of assault-related activities, the primary focus should be encouraging the young generation about rationalism and tolerance.

Pattern of fibroid presentation and management in ESUT Teaching Hospital, Enugu: A 5-year review

Background: Fibroids are usually under-reported. It is the most common benign pelvic tumors in women. Most women may have uterine fibroids before the age of 45 to 50 years yet, its actual prevalence is unknown. It is much commoner among women of black race and has become a major presenting pathology in many gynaecological clinics. Aim: The aim of this study was to audit the pattern of presentation and the management of uterine fibroids in ESUTH Methodology: This was a 5-year retrospective study conducted in ESUT Teaching Hospital, Enugu. A total of 9,588 folders were retrieved but only 596 had adequate information needed for the study and were used for the study. Data was collected from gynaecology clinics, theatre registers and patient’s case notes using a structured proforma. The data was analyzed using Statistical Products and Service Solutions version 25.0 Results: At the end of the data collection, 9,588 women were seen at the gynaecology clinic over the 5-year period. Out of these, 596 patients diagnosed with uterine fibroids and whose case files contained the requisite information needed for the study were recruited. From the figures above, the prevalence of uterine fibroid in ESUT Teaching Hospital, Enugu, over the period was 6.2%. According to socio-demographic distribution of the patients; majority of them were aged 31-35 years (37.8%), followed by those 36-40 years (34.2%). Very few of them were aged 25-30 years (9.2%). Most of the population studied were of the Igbo ethnic group (81.7%) and majority of them (81%) were nulliparous. The major presenting symptoms among the studied population were heavy menstrual bleeding, (55.4%), abdominal swelling, (54.5%), inability to conceive, (36.4%), abdominal pain, (18.6%), incidental findings (17.8%), and polyps, (9.4%). However, some had more than one presenting complaints. Regarding treatment options, majority (64.4%) had myomectomy, 27.3% had procoagulants like tranexamic acid, 18.8% had progestogens, 18% had NSAIDs for pain and bleeding, 9.4% had polypectomy, 8.6% had GNRH-analogue, while only 1% had hysterectomy. However, 19% did not receive any treatment, while many receive more than one treatment. There were varying degrees of influence by age and parity on the clinical presentations and treatment options accepted by the patients. Conclusion: The prevalence of uterine fibroid was found to be more among nulliparous women aged 24 to 30 years. A significant number presented with menorrhagia and inability to conceive. Majority of them chose myomectomy as an option of treatment.