Yr Age Research Articles

Evaluation of Mortality Statistics in Turkey from 2017 to 2022: An Analysis of the Impact of COVID-19

Background: Examining death statistics at regular intervals is highly useful for assessing public health. This study aimed to analyze cause-specific mortality statistics, to ascertain their distribution over the years, and to offer remedial solutions to enhance public health outcomes. Methods: In this retrospective descriptive study, an analysis was conducted on data sourced from the "Death and Cause of Death Statistics" provided by the Turkish Statistical Institute between 2017 and 2022. Results: While the crude mortality rate remained stable from 2017 to 2019, a discernible increase in mortality rates has been observed since 2020, attributed to the impact of the pandemic. The crude death rate was the highest in the <5 yr and ≥65 yr age groups. Approximately 70% of the total mortality cases in Turkey were attributed to cardiovascular diseases, cancers, respiratory diseases, and diabetes. Conclusion: Given the world's rapidly aging population, an increase in deaths related to the four major noncommunicable diseases is foreseen. Therefore, there is an imperative need to enhance efforts aimed at preventing and controlling these diseases.

Testing Paleomagnetic Dating on Pre‐Historic Flank Eruptions From SE Slope of Etna Volcano

AbstractDuring the last 20 kyr, the Etna volcano has been characterized by almost continuous summit eruptions and by less frequent—yet definitely more destructive—flank eruptions issuing at <1,000 m asl altitudes and reaching the Ionian Sea. The chronological framework of pre‐historic (pre‐2,750 yr BP) flank eruptions is supported only by few radiometric and paleomagnetic ages. Here we paleomagnetically investigated 15 Holocene lava flows from SE Etna lower slopes and dated 12 of them. Paleomagnetic dating at Etna relies on best method pre‐requisites: European location where reference geomagnetic models are well defined, and detailed stratigraphic evidence is available. We sampled 45 sites (450 oriented cores) from lavas loosely constrained in the 19,000–2,000 yr BP age window. Ten eruptions yielded a minimum 40% refinement with respect to initial age constraints, with four lava flows achieving refinement up to 90%. We obtained 620–1,398 yr (998 yr on average) dating accuracy for three flows bracketed in relatively short (1,398–1,644 yr) independent age constraints. By contrast, five flows characterized by longer 6,567–7,439 yr initial age windows yielded multiple age solutions. Finally, four lava flows with 1,644–6,567 yr‐long initial age windows were tightly dated with 120–680 yr age ranges. We conclude that at volcanoes where best paleomagnetic dating pre‐requisite are fulfilled, singular solutions are expected for 30% of the analyzed flows and, significant refinements for the others. Seven kyr seems to represent an independent age window threshold length to get or not significant dating refinements.

Typhoid and Non-Typhoid Salmonellosis Related Mortality in Iran, National Data from the Ministry of Health.

Despite the declining trend, salmonellosis is still an important preventable cause of death in Iran and the world, especially in certain age and occupational subgroups, and the need for preventive measures, especially raising awareness of at-risk groups, is necessary. Data were obtained from the Ministry of Health covering the years 2013 to 2019. The data were then stratified by year, season, month, and province of death as well as sex, age group, belonging to rural vs. urban communities and cause of death and were then analyzed using SPSS to report differences in age, sex, seasonal patterns, and spatial distribution. Non-typhoid salmonellosis (NTS) and typhoid were recorded as the cause of 800 and 32 deaths, respectively, with the highest number in 2015 and 2013. Septicemia was the cause of 87.3% of deaths due to NTS, whereas typhoid was the cause of 62.5% of its respective cases. The highest percentage of death related to both occurred in spring (P<0.001). NTS mortality rates were higher in the 70-80 and 80-90 age groups, while typhoid mortality was greatest in the under 10 yr age group. NTS mortality was higher in urban while typhoid mortality was higher in rural areas (P<0.001). Most deaths occurred in Ardabil, Sistan and Baluchistan and Khorasan Razavi provinces and Sistan and Baluchistan, West Azerbaijan and Khorasan Razavi related to NTS and typhoid, respectively. Salmonella remains a preventable cause of death, especially among the elderly and children, the data gathered in this study provides important information for priority setting in specific subpopulations and food safety policy.

Abstract P3106: Sex-specific Limitation Of Cardiac Capacity: Return To Fundamental Structure And Function.

Objective: The physiology underlying the sex-specific limitation of cardiac pumping capacity remains unresolved. This study experimentally manipulated the pressure gradient (PG) driving venous return to evidence whether cardiac structure and/or function explain sex differences in cardiac capacity in young and older individuals. Methods: Healthy women and men matched by age and physical activity were included within young ( n =40, age=25±4 yr) and older ( n =55, age=60±8 yr) age groups. Cardiac volumes and output (Q) were assessed via transthoracic echocardiography from moderate to peak exercise under two hemodynamic conditions (‘low’ and ‘high’ PG between lower and upper body) generated via opposite PG identically delivered in a lower body pressure chamber. Main outcomes included sex differences in delta (‘high’ ‘low’ PG) left ventricular (LV) end-diastolic volume (ΔLVEDV), stroke volume (ΔSV) and Q (ΔQ). Results: In young individuals, ‘high’ PG increased exercise LVEDV and SV in men ( P ≤0.002), but not in women ( P ≥0.562), relative to ‘low’ PG. Accordingly, ΔLVEDV, ΔSV and ΔQ were enhanced in young men compared with young women, specifically at the highest exercise intensities ( P ≤0.019). In contrast, right and left atrial volumes were similarly increased by ‘high’ PG in both sexes ( P ≤0.007). ‘High’ PG exclusively prolonged LV filling time during exercise in young men ( P ≤ 0.036). In older women and men, ‘high’ PG did not modify exercise cardiac volumes ( P ≥0.124) and impaired established markers of LV diastolic function ( P ≤0.049). Conclusions: The female young heart is not constrained by venous return or structural factors external to the myocardium. An impaired ability to lengthen LV filling time with augmented venous return may limit female-specific cardiac capacity. With older age, cardiac chambers are not distended and LV diastolic function is impaired with increased PG in both sexes.

Fetomaternal outcome in pregnant patients with fibroids at a tertiary care hospital.

Objective: To determine frequency of adverse pregnancy outcomes in patients presenting with uterine fibroids at a tertiary care hospital. Study Design: Descriptive Cross Sectional. Setting: Department of Obstetrics and Gynecology, Independent Medical Collage, Faisalabad. Period: January 2021 to December 2022. Material &amp; Methods: A descriptive cross sectional study was performed over a period of two year from January 2021 to December 2022 at Obstetrics and Gynecology department of Independent University Hospital, Faisalabad. Results: Among total 48 patients of our study 7 patients were aged &lt;20 while 18 were between 20 to 30 years of age and 23 were in 30 to 40 yr age group. Out of 48 patients, 27 were primigraidas, 18 patients were in G2 to G4 group and 10 were &gt;G4. Among 48 patients, 8 had body mass index&lt;25 kg/m2.12 patients had BMI between 26-30kg/m2 and 28 patients had BMI&gt;30kg/m2. 7 patients had symptoms &lt;6 months.14 patients had symptoms for more than 6 months but less than 1 yr while 27 patients had symptoms &gt;1 yr. In our study, 6 patients has spontaneous miscarriages. In our study 9 patients had preterm birth and 22 patients needed caesarean section and 10 patients had PPH. Conclusion: Pregnancy in patients with fibroids, should be considered as high risk, as it is associated with adverse pregnancy outcome. So pregnancy has to be cautiously reserved in the antenatal period, through regular follow up, to detect any obstetric complications and so improve the outcome.

1340-P: Complications 30 Years from Diagnosis amongst Participants in the Cognition and Longitudinal Assessment of Risk Factors over 30 Years (CLARiFY) Study

There are few longitudinal cohort studies in type 1 diabetes that originate in the immediate post-DCCT era. We recruited participants who had initially presented with childhood onset type 1 diabetes (&amp;lt;15 yr age) to a tertiary hospital in Australia between 1990-1992 into the Cognition and Longitudinal Assessment of Risk Factors over 30 Years (CLARiFY) Study. Microvascular co-morbidity outcomes were measured using a clinical neuropathy screening tool and spot urinary albumin to creatinine ratios (ACR). In this interim study, 56 participants had complete neuropathy screening. 7/56 (12.5%) met the criteria for neuropathy with the mean (SD) HbA1c of 8.57 (1.49) compared to 8.04 (1.46) in the non-neuropathy participants (p-value=0.41). Pearson's correlation coefficients were calculated to assess pairwise associations between HbA1c and continuous neuropathy outcomes and observed non-significant negative correlations between HbA1c and vibration (r=-0.12, P=0.38). Of the 56 participants with neuropathy measurements, 40 also had urine albumin-creatinine ratios (ACR). 27/40 (67.5%) had normal ACR (ACR&amp;lt;3 mg/mmol) with HbA1c of 7.8 (1.3); 10/40 (25.0%) had microalbuminuria (3 mg/mmol&amp;lt;ACR&amp;lt;30 mg/mmol) with HbA1c of 10.3 (2.3); and 3/40 (7.5%) had macroalbuminuria (ACR&amp;gt;30 mg/mmol) with HbA1c of 10.3 (2.3). Using a one-way ANOVA test, HbA1c was significantly different between the three groups (p-value = 0.01.). Using the ACR as a continuous variable, the Pearson's correlation coefficient with A1c was 0.49 (p-value= 0.001). Collectively, these data show that in a cohort of type 1 adults diagnosed in childhood, elevations of ACR are more common and associate with glycemic control when compared to measures of neuropathy. Disclosure A.Brown: None. E.L.Feldman: None. E.L.Reynolds: None. O.Gbadeyan: None. C.Moran: None. S.A.Sakowski: None. V.Srikanth: None. E.A.Northam: None. F.Cameron: None. R.Beare: None. Funding National Institutes of Health (R01DK129320)

MVPA and Motor Proficiency between Children with ADHD and Typical Development: Associations with Sleep Quality.

This study examined the associations of motor proficiency with moderate-to-vigorous physical activity (MVPA) and sleep quality in children with attention-deficit/hyperactivity disorder (ADHD) and children with typical development (TD). This cross-sectional study included 88 medical-naive children with ADHD age 6-12 yr (mean (SD) age, 8.43 (1.38) yr; 81.8% boys) and 40 age-matched children with TD (mean (SD) age, 8.46 (1.44) yr; 60% boys). MVPA was recorded by a wGT3X-BT accelerometer for 7 consecutive days. Motor proficiency was assessed using the Test of Gross Motor Development-Third Edition. Sleep quality was assessed using a self-report questionnaire. Children with ADHD spent significantly less time in MVPA daily, displayed less proficiency in locomotor and ball skills, and reported poorer sleep quality (e.g., longer sleep latency, less sleep duration, and lower sleep efficiency) than children with TD. MVPA guideline attainment and sleep duration significantly predicted locomotor skills development; in turn, locomotor skills predicted MVPA guideline attainment. MVPA and ball skills increased by age in children with ADHD. Our results highlight the importance of promoting MVPA, motor proficiency, and sleep duration in children with ADHD and TD since childhood.

Measles Seroprevalence and Related Factors in Women Aged 15-49 Years Old, in Mersin, Turkey.

If the mother is immune to measles, the infant is protected against measles infection after birth with maternal immunity. Therefore, the mother's immunity to measles is the most important factor in protecting the baby from measles in the first year. This study aimed to investigate measles seroprevalence and related factors in women between Oct 2019 and Jun 2021. The cross-sectional study was conducted on women aged 15-49 yr in Mersin city. Overall, 400 people were included in the study. NovaLisa Measles IgG ELISA (NovaTec Immunodiagnostica GmbH®) kit was used to measure measles IgG antibodies in serological analyses. The research was conducted between Oct 2019 and Jun 2021. In the analysis of the data; descriptive statistics, chi-square analysis, and binary logistic regression analysis were used. The statistical significance level was accepted as P≤0.05. Measles seropositivity was detected in 103 (25.7%) of the women. This rate was found 5.5% in the 15-19 yr age group, 20.0% in the 20-24 yr age group, 14.5% in the 25-29 yr age group, 23.0% in the 30-34 yr age group, 42.3% in the 35-39 yr age group, 42.3% in the 40-44 yr age group and 37.5% in the 45-49 yr age group. In the logistic regression analysis, the rate of seropositivity was compared to those in the 15-19 yr age group; it was found to be 4.33 times (P=0.03) at the age of 20-24 yr, 12.71 times (P<0.001) at the age of 40-44 yr, and 10.40 times (P<0.001) at the age of 45-49. Three out of every four babies born in our region are not adequately protected against measles.

RISK ASSESSMENT OF DIABETES USING INDIAN DIABETES RISK SCORE IN NON DIABETIC INDIVIDUALS

Background and Objectives: Diabetes has emerged as a major health challenge in India due to a rapid rise in the number of diabetes cases. Early identification of high risk individuals through screening and early interventions in the form of lifestyle modifications and treatment would help in the prevention of diabetes and its complications. This study was done to assess the risk of type 2 diabetes mellitus (T2DM) in an urban slum population using the Indian Diabetes Risk Score (IDRS) and to determine the factors associated with high risk score. Methods: A cross-sectional study was conducted among Department of Gen. Medicine Sri Aurobindo Medical College and Post Graduate Institute, Indore (18 Months). With the institutional ethical committees permission. A total of 100 study participants were selected randomly. A pre-designed and pre-tested structured questionnaire was used for data collection. Assessment of risk of T2DM was done using the IDRS. Results: Of the 100 study participants, 74% were at high risk (IDRS ≥60) followed by 24% at moderate risk (IDRS 30-50) and 2% at low risk (IDRS &lt;30). 45 individuals in the age group ≥50 yr were at high risk compared to 25 in 35-49 yr age group. Most (n=25, 87.5%) of sedentary workers were at high risk compared to those employed in moderate (n=38, 75.4%) and strenuous work (n=10, 51.9%). Interpretation &amp; Conclusions: 74.3 percent of study participants were high-risk for T2DM. High-risk IDRS scores were associated with age, occupation, abdominal obesity, general obesity, and high blood pressure.

Determinants of post discharge mortality among hospitalized COVID-19 patients.

The post-acute effects of COVID-19 are continually being updated. This investigation was conducted to evaluate the determinants of post discharge mortality in hospitalized COVID-19 patients, especially 18-45 yr of age. A series of three nested case-control analyses was conducted on follow up data collected in the National Clinical Registry for COVID-19 between September 2020 and February 2023 from 31 hospitals. Matching (1:4) was done by the date of hospital admission ±14 days for the following comparisons: (i) case-patients reported as dead vs. controls alive at any contact within one year follow up; (ii) the same in the 18-45 yr age group and (iii) case-patients reported as dead between the first and one year of follow up vs. controls alive at one year post discharge. The one year post discharge mortality was 6.5 per cent (n=942). Age [≤18 yr: adjusted odds ratio (aOR) (95% confidence interval [CI]): 1.7 (1.04, 2.9); 40-59 yr: aOR (95% CI): 2.6 (1.9, 3.6); ≥60 yr: aOR (95% CI): 4.2 (3.1, 5.7)], male gender [aOR (95% CI): 1.3 (1.1, 1.5)], moderate-to-severe COVID-19 [aOR (95% CI): 1.4 (1.2, 1.8)] and comorbidities [aOR (95%CI): 1.8 (1.4, 2.2)] were associated with higher odds of post-discharge one-year mortality, whereas 60 per cent protection was conferred by vaccination before the COVID-19 infection. The history of moderate-to-severe COVID-19 disease [aOR (95% CI): 2.3 (1.4, 3.8)] and any comorbidities [aOR (95% CI): 3 (1.9, 4.8)] were associated with post-discharge mortality in the 18-45-yr age bracket as well. Post COVID condition (PCC) was reported in 17.1 per cent of the participants. Death beyond the first follow up was associated with comorbidities [aOR (95%CI): 9.4 (3.4, 26.1)] and reported PCC [aOR (95% CI): 2.7 (1.2, 6)]. Prior vaccination protects against post discharge mortality till one year in hospitalized COVID-19 patients. PCC may have long term deleterious effects, including mortality, for which further research is warranted.

Verbal autopsy to assess causes of mortality among the economically productive age group in the tribal region of Melghat, central India.

Verbal autopsy (VA) is the systematic and retrospective inquiry (from relatives) about the symptoms of an illness prior to death. In tribal India, 67-75 per cent of deaths occur at home with an unknown cause of death (CoD). Hence, the aim of this study was to determine the CoD in the 16-60 yr age group utilizing VA. A prospective, community based longitudinal study was conducted in 32 tribal villages in the Melghat region of Maharashtra, between 2004 and 2020. Number of deaths and VAs in 16-60 yr age group were collected by village health workers (VHWs) and supervisors, verified by five different persons (internal-external) and cross-checked by three VA interpretation trained physicians. A modified version of WHO VA was used. Cause-specific mortality fractions were calculated. Of the 1011 deaths recorded, mortality in males was significantly higher than females (P<0.001). A total of 763 VAs were conducted which revealed that tuberculosis was the leading CoD, followed by jaundice, heart diseases, diarrhoea, central nervous system infections and suicide. Suicides were significantly more common among males than in females (P=0.046). Significantly, more deaths occurred during the monsoon (P=0.002), especially diarrhoeal deaths (P=0.024). The findings of this study suggest that, in Indian tribal areas, infectious diseases are the leading causes of morbidity and one of the major causes of deaths in economically productive age group. Intensified VHW-mediated interventions are required to reduce the premature deaths.

Incidence of needlestick injury among healthcare workers in western India.

Injuries occurring from contaminated sharps are a major occupational health hazard. It carries a risk of transmitting blood-borne diseases such as human immunodeficiency virus (HIV), hepatitis B and hepatitis C. Healthcare workers (HCWs), including personnel handling biomedical waste, are at risk. The objective of this study was to determine the incidence and details of needlestick injury (NSI) among HCWs. We analyzed data of all HCWs who reported NSI over the past three years. Demographic details, type and source of injury, use of personal protective equipment (PPE), immediate post-exposure measures, hepatitis B vaccination status and HCWs and source's HIV, hepatitis B and hepatitis C serological status were studied. Fifty-six cases of NSI were recorded over three years, accounting for an incidence of 10.4/100 occupied beds per year. Maximum cases (73.2%) occurred between the 20 and 40 yr age group. The distribution among the work category was doctors (37.5%), nursing staff (26.8%), phlebotomy technicians (12.5%), housekeeping/subordinate staff (12.5%) and others (10.7%). Appropriate PPE was donned by 66 per cent of the HCWs. The majority of cases (46.4%) occurred in wards and operating rooms (23.2%). Phlebotomy (35.7%), followed by procedures, such as hemoglucotest (HGT) measurement, intravenous cannula insertion and operative procedures (33.9%), were the most common situation during which HCWs suffered NSI. While 64.2 per cent HCWs were vaccinated for hepatitis B, only 5.4 per cent of the HCWs completed post-exposure anti-retroviral regimen. We conclude that a relative lack of awareness towards preventive measures and inexperience among HCWs may be contributory to high occurrence of NSI events. This study emphasizes upon ensuring active hospital-wide hepatitis B vaccination of all HCWs and supportive therapy to improve compliance towards post-exposure prophylaxis.

Sex Differences in the Speed-Duration Relationship of Elite Runners across the Lifespan.

To determine if the speed-duration relationship is altered with age and sex of elite Master's runners. The world's top 10 performances for men and women in three events (800, 1500, and 5000 m) across six age groups (18-34 yr, 40-49 yr, 50-59 yr, 60-69 yr, 70-79 yr, and 80-89 yr) were analyzed from public data to establish theoretical models of the speed-duration relationship. Critical speed (CS) and the curvature constant ( D ') were estimated by fitting the average speeds and performance times with a two-parameter hyperbolic model. Critical speed expressed relative to the 18- to 34-yr-olds, declined with age (92.2% [40-49] to 55.2% [80-89]; P < 0.001), and absolute CS was higher in men than women within each age group ( P < 0.001). The percent difference in CS between the men and women progressively increased across age groups (10.8% [18-34] to 15.5% [80-89]). D ' was lower in women than men in the 60-69 yr, 70-79 yr, and 80-89 yr age groups ( P < 0.001), but did not differ in the 18-34 yr, 40-49 yr, or 50-59 yr age groups. Critical speed progressively decreased with age, likely due to age-related decrements in several physiological systems that cause reduced aerobic capacity. The mechanism for the larger sex difference in CS in the older age groups is unknown but may indicate physiological differences that occur with aging and/or historical sociological factors that have reduced participation opportunities of older female runners resulting in a more limited talent pool.

Physiological Effects of Centrifuge-Simulated Suborbital Spaceflight

BACKGROUND: High-G acceleration experienced during launch and re-entry of suborbital spaceflights may present challenges for older or medically susceptible participants. A detailed understanding of the associated physiological responses would support the development of an evidence-based medical approach to commercial suborbital spaceflight.METHODS: There were 24 healthy subjects recruited into 'younger' (18-44 yr), 'intermediate' (45-64 yr) and 'older' (65-80 yr) age groups. Cardiovascular and respiratory variables were measured continuously during dynamic combinations of +Gx (chest-to-back) and +Gz (head-to-foot) acceleration that simulated suborbital G profiles for spaceplane and rocket/capsule platforms. Measurements were conducted breathing air and breathing 15% oxygen to simulate a cabin pressure altitude of 8000 ft.RESULTS: Suborbital G profiles generated highly dynamic changes in heart rate, blood pressure, and cardiac output. G-induced hypoxemia was observed, with minimum arterial oxygen saturation < 80% in a quarter of subjects. Increased age was associated with greater hypoxemia and reduced cardiac output responses but did not have detrimental cardiovascular effects. ECG changes included recurrent G-induced trigeminy in one individual. Respiratory and visual symptoms were common, with 88% of subjects reporting greyout and 29% reporting blackout. There was one episode of G-induced loss of consciousness (G-LOC).DISCUSSION: Suborbital acceleration profiles are generally well tolerated but are not physiologically inconsequential. Marked hemodynamic effects and transient respiratory compromise could interact with predisposing factors to precipitate adverse cardiopulmonary effects in a minority of participants. Medically susceptible individuals may benefit from expanded preflight centrifuge familiarization that includes targeted physiological evaluation in the form of a 'G challenge test'.Smith TG, Pollock RD, Britton JK, Green NDC, Hodkinson PD, Mitchell SJ, Stevenson AT. Physiological effects of centrifuge-simulated suborbital spaceflight. Aerosp Med Hum Perform. 2022; 93(12):830-839.

High-risk human papillomavirus in Turkish patients with clinically suspicious cervical lesions analyzed by multiplex-PCR.

Human papillomavirus (HPV) infection is known to be the main cause of cervical cancer. This study aimed to determine the prevalence of high-risk HPV genotypes in smear specimens taken from women who had normal or abnormal cytology using a multiplex PCR method. The study included 270 women aged between 19 and 69 yr with or without suspicious cervical abnormalities. A Pap smear sample from each patient was cytologically examined, and HPV typing was performed using a multiplex fluorescent PCR method. Those who were high-risk HPV positive and had a normal or abnormal cytology were further evaluated by colposcopy and biopsy. The total HPV positivity was 43 per cent (116/270). HPV positivity in the patients with an abnormal cytology was 77 per cent (33/43), whereas it was only 37 per cent (83/227) in women with normal cytology, which showed a significant difference (P<0.05). HPV positivity was also related to the age group when all the subjects were considered (P<0.05), and the highest prevalence of HPV infection was in the 30-39 yr age group. High-risk HPV types 16, 18, 31, 35, 51 and 56 were more common in the normal cytology patients, whereas high-risk HPV types 16, 31, 35, 45, 58 and 68 were commonly found in the abnormal cytology patients. The determination of high-risk HPV genotypes in women with clinically suspicious cervical lesions should be conducted during an annual follow-up, irrespective of a normal or abnormal cytology by the age of 30 years or above.

Maternal complications in women presenting with first trimester threatened miscarriage.

Objective: To determine the frequency of miscarriage, hypertensive disorder of pregnancy, placental abruption and preterm birth in women with first trimester threatened miscarriage. Study Design: Cross-sectional study. Setting: Department of Obstetric &amp; Gynaecology, Sir Syed Hospital and Pakistan Naval Ship Shifa Hospital (Karachi). Period: April, 2021 to March, 2022. Material &amp; Methods: Ninety two women 18-40 year old, diagnosed as threatened miscarriage at ≤ 13 weeks based on history, examination and ultrasound were included in the study after informed consent and followed till delivery. Women with genital infection, other form of miscarriage and multiple pregnancy were excluded. Data recorded from hospital documents. Maternal age, parity and Gestational age assessed. Miscarriage, hypertensive disorder of pregnancy, placental abruption, preterm birth and PPROM expressed as frequency and percentages. Logistic regression analysis performed. Chi square test (x2) used and P-value ≤ 0.05 taken as significant. Results: Mean age of women was 29.21±3.49 years. Mean parity was 2.65±1.15. Mean Gestational age at presentation was 7.96±1.78 weeks. 11.11%. (10/90) cases had miscarriage. 88.88% (80/90) women continued their pregnancy. 42.5% (34/80) had hypertensive disorder of pregnancy. 20% had pregnancy induced hypertension and 22.5% had pre-eclampsia. Preterm birth was seen in 26.3% (21/80). Frequency of PPROM and placental abruption was 6.3% (5/80) each. Women of 21-25 yr age were more at risk of hypertensive disorder of pregnancy than other age groups. There was no significant affect of maternal age and parity on preterm birth and placental abruption. Frequency of Preterm birth was 38.4% in women with hypertensive disorder, more than 2 times higher than non-hypertensives (17.4%) and found significant (P-value=0.043). Conclusion: Hypertensive disorder of pregnancy was the most common maternal complication observed in women who had threatened miscarriage in first trimester. Preterm birth had significant association with hypertensive disorder of pregnancy.

Identify etiology of morbidity events of earlier children among multigravida women

Morbidity condition are more prevalent in the children who are exposed to various risk factors like overcrowding, poor nutrition etc. morbidity in the children residing in the rural area is more as compared to the urban area.Because socio-economical strata and standard of living, inadequate knowledge.Children are the future of any healthy nation they are asset of nation, unfortunately this assets falls children, because of poor maintenance of health, Malaria and acute respiratory infection are higher among children in rural setting and children whose mothers are 16–17 and 28–33 years of age. Objective: To identify the etiology of morbidity events of earlier children among multigravida women. Research Methodology: The quantitative approach and community based cross-sectional study design was used. Were enrolled 492 multigravida women with her 992 earlier children from 0-18 yr age group with used simple random sampling technique, Analyses was done using SPSS version 26.00 and identify etiology events of earlier children among multigravida women. Result: major finding identify etiology of morbidity events of earlier children among multigravida women’s group was G2P2 in that; 1(0.2%) illness having before pregnancy in multigravida women and having illness during pregnancy, 23(3.8%) were taken treatment during pregnancy, 50(8.2%) women were having consanguinity marriage.

Deforestation, plantation-related land cover dynamics and oil palm age-structure change during 1990–2020 in Riau Province, Indonesia

The expansion of plantations, such as oil palm, in Indonesia has caused large-scale deforestation. Loss of tropical forest, in particular peatland forest, is a major ecological and environmental threat as well as a source of atmospheric carbon emissions. Understanding the spatio-temporal dynamics of plantation expansion may illuminate pathways to reduce deforestation while maintaining high yields in existing plantations. Beyond mapping forest conversion to plantations, it is also important to understand post-conversion plantation success and crop age. In the case of oil palm, the typical productive lifespan is 25–30 years before replanting or conversion to other land use becomes necessary. Knowledge about the extent of oil palm in different productive growth stages is important for yield estimation and improving management strategies. This study characterizes the land-cover and land-use changes inherent to oil palm plantation expansion and age-structured oil palm dynamics across Riau, the province with the greatest production of oil palm in Indonesia, using a 30 year time-series of Landsat satellite imagery. From 1990 to 2020, Riau lost 4.63 M ha of forest, while oil palm extent grew six-fold, reaching an estimated 3.52 M ha in 2020. Rapid expansion of oil palm plantations in Riau resulted in the predominance of younger age classes (<10 yr-old) and rapidly increasing yields during 2010–2020. Conversion dynamics changed over time such that, after 2014, the <10 yr age class declined by 14%, whereas the 10–20 yr-old (peak yield stage) and ⩾20 yr-old (decline stage) age classes increased by 11% and 3%, respectively. In 28 years of observation (1992–2020), 41% of oil palm planted between 1990 and 1992 underwent at least one cycle of replanting in Riau.

1016-P: Equitable Glycemic Improvement in Youth with T1D during COVID-19

Aim: Despite disruptions caused by the COVID-pandemic, prior studies suggest some improvements in glycemic control. We investigated whether this improvement was equitable and seen across socioeconomic status (SES) groups in youth with T1D. Method: Using EHR-extracted visit and CGM data, we geocoded patient addresses linked with census-tract derived education from the 20American Community Survey and a composite measure of SES, the Neighborhood Deprivation Index (NDI) . Analyses included youth ≤18 years old using CGM with T1D duration ≥6 months (age &amp;lt;6 yrs) or ≥1 yr (age ≥6 yrs) . We performed t-tests and regressions comparing SES and CGM metrics during the pandemic (4/1/20-3/15/21) with pre-pandemic (4/1/19-3/15/20) . Results: The pre-pandemic sample had 641 youth (52% female, age 12.5±3.5, T1D 6.2±3.5 yrs) and the pandemic sample had 650 youth (52% female, age 13.5±3.6, T1D 6.8±3.8 yrs) ; 86% were common to both samples. Addresses allowed for geocoding of 98%; 44% of youth lived in low education census tracts where ≥30% of adults in the census tract had no more than a high school education. Mean CGM-derived glucose management indicator (GMI) improved during the pandemic for both those living in lower (8.07±0.05% pre vs. 7.91±0.% during, p&amp;lt;0.05) and higher SES education tracts (7.82±0.% pre vs. 7.69±0.% during) . There was similar improvement in GMI in lower vs. higher SES education tracts (0.16±.vs. 0.13±.06) . Other CGM metrics similarly improved during the pandemic, mean CGM glucose decreased by 6.7 mg/dL and 5.4 mg/dL in low and high SES education tract patients respectively (both p&amp;lt;.05) . Those living in the most deprived NDI areas had the highest GMI both pre and during the pandemic (p&amp;lt;0.05) and demonstrated similar or greater improvements than those from Iess deprived areas. Conclusion: Equitable improvements in CGM metrics during the pandemic was evident in youth with T1D. Future studies can assess how changes in healthcare delivery during the pandemic can reduce disparities and sustain benefits to all patients. Disclosure S.Ojukwu: None. A.Adam: None. T.Kaushal: None. L.J.Tinsley: None. L.K.Volkening: None. C.Chen: None. L.M.Laffel: Advisory Panel; Medtronic, Roche Diabetes Care, Consultant; Boehringer Ingelheim International GmbH, Dexcom, Inc., Dompé, Insulet Corporation, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Novo Nordisk, Provention Bio, Inc. Funding National Institutes of Health (K12DK094721, P30DK036836)

Frequency of Rectal Cancer among Young and Older patients

Aim: To determine the frequency of rectal cancer among young and older patients. Methods: All patients determined to have rectal carcinoma at tertiary consideration from January 2018 to December 2019 were recruited for this cross sectional study. Segment just as clinicopathological information of the rectal cancer patients were gathered reflectively and recently analyzed histologically affirmed instances of either sexual orientation remembered for this investigation while the patient critical ill and unstable patients, pregnant and lactating ladies and patient with hemorrhoids were rejected from the study. Patient information included age, sex, nationality, tumor morphology, tumor stage and separation, carcinoembryonic antigen (CEA) levels at show, and so forth. Results: Among all the fifty (50) patients under study, 30(60%) were below 40 years and 20(40%) were ≥40 yr of age. The mean age (yrs) at presentation was 46.64±8.74 the youngest patient was 18 years old. More than 70% of the patients were belonged to rural area of province including tribal and non-tribal population. Of the 50 patients, 45 were diagnosed with rectal adenocarcinoma, while five patients in the ≥40 yr age group had squamous cell carcinoma. The ulcerative morphology was identified as 20(40%) and 5(10%) in young and older patients whereas the polypoid morphology was seen in 10(20%) and 15(30%) young and older patients respectively. Among young and older population the level of tumour was also studied and observed as low 10(20%) and 12(24%) and high 8(16%) and 20(40%). In younger population the well, moderate and poorly differentiated cells was seen in 3(6%), 7(14%) and 6(12%) while in older patients the well, moderate and poorly differentiation was seen in 9(18%), 12(24%) and 13(26%). Conclusion: The young patients had transcendence of low rectal tumors, progressed T-stage and poorly differentiation tumor and advance level stage of illness stage when contrasted to older patients. Keywords: Liver abscess, C-reactive protein, and Inflammatory marker