Yrs Age Research Articles

Comparative evaluation of facial divine proportions in males and females with average growth pattern

Facial beauty of an individual depends on proportion and its relationship to various facial parts which varies in each individual. The values of measured proportion in beautiful faces are likely to approximate divine proportion and may show variation with ethinicity, sex, growth pattern. Hence, aim of the study was to evaluate and compare vertical and horizontal parameters of facial divine proportions in male and female subjects with average growth pattern. 30 subjects (18-30 yrs age) with average growth pattern (based on cephalometric measurements FMA, Yaxis, GoGn-SN and facial axis angle) were divided into two groups as Group I (Male subjects, n=15) ; Group II (female subjects, n=15). Standardized frontal facial photographs of all the subjects were obtained. Nine vertical and four horizontal parameters were measured on all the facial photographs using IC Measure software and were used to evaluate horizontal and vertical facial proportions and then compared to divine proportions considering 1.618 as 100%. Horizontal and Vertical facial proportion in males were higher than females. Group I showed that three of seven vertical facial proportions were close to divine proportion (1.618) whereas only one vertical facial proportion in Group II were close to divine proportions. Horizontal facial proportions in both the groups deviated more from divine proportion (1.618).There was difference between males and females for the vertical and horizontal facial proportions with values being larger in males. This should be considered as an accessory guideline in planning orthodontic or orthognathic treatment.

Occlusal splint therapy- myth or fact? -A case report

The term Temporomandibular Joint Disorders (TMD) refers to a group of intricate disorders with a variety of etiologies that frequently call for multimodal therapy strategies. Treatment of TMDs requires careful diagnosis and treatment planning to resolve occlusal and functional problems. In contemporary dental practice, splint therapy can be used as an effective and conservative means of treatment of TMDs. In this case report occlusal splint therapy was used to treat a male patient of 27yrs age who had symptoms of TMD, including pain in the head, neck, and shoulder. After 8 months of splint therapy, a clinical examination and radiographic interpretation showed considerable changes, including decreased pain frequency, better jaw function, and radiographic evidence of altered joint spaces. This case report shows the effectiveness of occlusal splint therapy in treating temporomandibular joint disorders.

Region, Location, and Age-Specific Comparison of Nutritional Status of In-School Adolescent Girls (10-19 years) in Nigeria

Objective: This study was conducted to assess the nutritional status of adolescent girls using anthropometric indices. Methods: Descriptive cross-sectional study of 2261 in-school adolescent girls aged 10 -19 was conducted. A multistage stratified random sampling procedure was used to select participants from three geopolitical zones in Nigeria. Two states selected from each zone; North Central (Kogi and Niger States), South East (Abia and Imo States) and South West (Osun and Ondo States). Body Mass Index-for-age, Waist-Hip-Ratio (WHR), and Waist-Height-Ratio were calculated by anthropometry of weight, height, hip, waist and Mid-Upper Arm Circumferences. Data were analysed on SPSS Version 24. Frequency, percentages, mean and standard deviations were used for descriptive while logistic regression and chi-square analyses were used for inferential statistics. Significance was taken at p<0.05. Results: Mean age was 14.86 years (± 1.78 years) and actual body weight was 47.81 kg (± 9.02 kg), which is lower than the ideal weight of 54.52 kg (± 9.05 kg). The negative variance of -6.71 kg shows that the girls weighed 6.71 (±9.73) kg less than their ideal weight. Overweight/Obesity/Risk of Abdominal Obesity was highest in South East region (p = .005) while underweight/undernourishment was highest in South West (p = .005). However, no significant difference was recorded between the urban and peri-urban populations (p = .005). Older girls; 14 -16yrs (OR = 2.311, 95%CI = 1.263 – 4.229) and 17 -19yrs (OR = 2.182, 95%CI = 1.253 – 3.799) were twice more likely to be Overweight/Obesity compared to 10 -13yrs. Those who were within the 14 -16yrs age range were thrice more likely to have higher WHR (OR = 3.043 95%CI = 2.334 -3.978) than those younger. Conclusion: There was a significant difference in the nutritional status of adolescent girls across regions and age ranges hence a need for regional nutrition-sensitive intervention programmes among adolescent girls. Keywords: High School Girls; Health Status; Body Stature; Body Measurement; Nigeria Region

Sociodemographic, nutritional and anthropometric factors determining overweight and obesity in an adult moroccan population

BACKGROUND: Knowledge of the determinants of the weight status of a population is important to be considered in actions aimed at improving public health. OBJECTIVE: The aim was to study the sociodemographic, nutritional and anthropometric factors associated with overweight and obesity in an adult Moroccan population. METHODS: This study focused on 507 adult subjects from the Rabat-Salé-Kénitra region in Morocco, according to a validated conceptual and methodological framework. Sociodemographic data were collected using a questionnaire, physical activity (PA) was assessed by the Marshal questionnaire, dietary intakes were estimated by a “dietary history” type survey. Anthropometric parameters were also measured using impedancemetry and a tape measure. RESULTS: The majority of the study population was 20 to 29 years old, females, urban and had an medium socio-economic level (SEL). The population’s dietary intake was high in calories, proteins, carbohydrates, fats, sugars, and sodium; and low in vitamin C, vitamin A, vitamin E, folic acid, iron, calcium and zinc. Univariate analysis revealed that overweight and obesity are associated with the 30–39 yrs age group, average SEL, insufficient PA, high intakes of calories, proteins, carbohydrates and lipids, as well as with high waist circumference and excessive body fat percentage. CONCLUSION: Factors associated with overweight and obesity were identified in the study population, revealing a coexistence of high intakes of energy and macronutrient and low intake of several micronutrients. The prevalence of deficiencies and excesses of these intakes testifys of a double burden of malnutrition in this population. The results are very relevant for guiding nutritional education actions among this population.

An Analysis on Link of Maternal Lipid Profile and Gestational Diabetes Mellitus: A Case Control Study of 120 Women

BACKGROUND: Gestational diabetes mellitus GDM is a clinical condition, or disease, wherein, a marked reduction in the sensitivity of insulin, during pregnancy, is attributed to the metabolic disturbance that occurs widespread. Although, information on the association among dyslipidaemia and GDM remains uncertain till date. The main objective of the present investigation is to detect any correlation between lipid profile of GDM subjects and healthy control women,using biochemical indicators. METHODS: A careful clinical case study was performed, involving a total of 120 subjects, comprising two distinct groups. Group I includes 60 pregnant women, those were recently detected as GDM cases. Group ll covers healthy control subjects collected from Open Patients unit and Registry of Diabetic Unit of Dhanalakshmi Srinivasan Institute Medical science and Hospital, Perambalur, Tamil Nadu. Both groups' subjects were bifurcated, based on their age groups, and found to be 25 to 45 years. Estimation of glycemic condition, in prior and post fasting was performed, using an analyzer appropriately. Similarly, maternal lipid profile for both groups was also determined. Moreover, HbAl c, an important biochemical indicator was also detected for both groups of subjects with respect to their age, using HPLC technique. Received data were pooled and a statistical analysis was performed, using Student t test to identify the significance difference or association between GDM group and healthy subjects, in specific, on the maternal lipid profile. FINDING: Analysis showed that there is a significant difference observed in the maternal lipid profile of GDM group, when compared with healthy subjects. The P value of Very Low Lipid protein VLDL, low density lipoprotein LDL, High density lipoprotein HDL was found to be 0.01, 0.028, and 0.038 respectively. Whereas, p value for HbAl c was recorded as 0.02, and found significant difference at 0.01 percent level. Interestingly, no difference was observed in the limit of FG, and Triglycerides limit, and were reported as p _0.28, and p- 0.316 respectively. A marked difference was also detected among the 30 to 35 yrs age group. INTERPRETATION: Present investigation elucidated that there is a strong correlation between GDM subjects and dyslipidemia. Further, this study strengthened and promised that elevated maternal lipid profile is highly linked with GDM condition.

Preoperative peripheral inflammatory markers are predictors of postoperative central diabetes insipidus in craniopharyngioma patients: a retrospective study

BackgroundPostoperative central diabetes insipidus (CDI) is commonly observed in craniopharyngioma (CP) patients, and the inflammatory response plays an important role in CPs. We aimed to evaluate the predictive value of preoperative peripheral inflammatory markers and their combinations regarding CDI occurrence in CPs.MethodsThe clinical data including preoperative peripheral inflammatory markers of 208 CP patients who underwent surgical treatment were retrospectively collected and analyzed. The preoperative peripheral white blood cells (WBC), neutrophils, lymphocytes, monocytes, platelet (PLT), neutrophil-to-lymphocyte ratio (NLR), derived-NLR (dNLR), monocyte-to-lymphocyte ratio (MLR) and PLT-to-lymphocyte ratio (PLR) were assessed in total 208 CP patients and different age and surgical approach CP patient subgroups. Their predictive values were evaluated by the receiver operator characteristic curve analysis.ResultsPreoperative peripheral WBC, neutrophils, NLR, dNLR, MLR, and PLR were positively correlated and lymphocyte was negatively associated with postoperative CDI occurrence in CP patients, especially when WBC ≥ 6.66 × 109/L or lymphocyte ≤ 1.86 × 109/L. Meanwhile, multiple logistic regression analysis showed that WBC > 6.39 × 109/L in the > 18 yrs age patients, WBC > 6.88 × 109/L or lymphocytes ≤ 1.85 × 109/L in the transcranial approach patients were closely associated with the elevated incidence of postoperative CDI. Furthermore, the area under the curve obtained from the receiver operator characteristic curve analysis showed that the best predictors of inflammatory markers were the NLR in total CP patients, the MLR in the ≤ 18 yrs age group and the transsphenoidal group, the NLR in the > 18 yrs age group and the dNLR in the transcranial group. Notably, the combination index NLR + dNLR demonstrated the most valuable predictor in all groups.ConclusionsPreoperative peripheral inflammatory markers, especially WBC, lymphocytes and NLR + dNLR, are promising predictors of postoperative CDI in CPs.

362 The Influence of Supplemental Protein Level on the Intake, Digestion, and Metabolism of Beef Cattle Consuming Low-Quality, High-Fiber Roughages

Abstract Two studies were conducted to evaluate the influence of graded levels of supplemental protein on the intake, digestion, ruminal fermentation, and metabolism of beef cows consuming low-quality forage base diets (6% CP and 74% NDF). For both studies, 15 ruminally cannulated cows (4/5 yrs age, 803 and 757 kg = avg BW for study 1 and 2, respectively) were stratified by BW and, within stratum, randomly assigned to three supplemental treatment groups (n = 5). In study 1, cows were assigned to the following treatments: 1) control, no supplement; 2) 0.25 % BW of a 20% CP supplement; and 3) 0.25 % BW of a 40% supplement. Both supplements were composed of soybean meal and ground corn with the composition adjusted to hit the target CP level. In study 2, cows were assigned to the following alfalfa pellet supplement treatments: 1) control, no supplement; 2) 0.20 % BW of alfalfa pellets, and 3) 0.40 % BW of alfalfa pellets. In study 1, forage intake, DM fill, liquid fill and total tract digestibility were not influenced by supplemental treatment (P ≥ 0.49). However, total DM intake increased linearly (P = 0.02) with increasing supplemental protein, with the 40% CP supplemented cows consuming 39% more DM than control cows. No treatment differences (P ≥ 0.97) were observed for heart rate or surface temperature just before feeding (hour 0) nor 5 hours post-feeding averaging 46.0 bpm, 15.3°C, and 35.2°C, respectively. In study 2, both forage intake and total intake increased linearly (P ≤ 0.02) with increasing amounts of supplemental alfalfa. Cattle supplemented alfalfa pellets at 0.4% of BW had 33 and 71% greater forage and total DM intake compared with non-supplemented control cows, respectively. In contrast, there were no treatment effects (P ≥ 0.11) on DM fill and total tract digestibility averaging 15.73 kg and 44.99%, respectively. In contrast, liquid fill tended to increase (P = 0.08) linearly with increasing levels of supplemental alfalfa. Heart rate nor surface temperature prior to feeding and 5-hours post feeding were influenced (P ≥ 0.83) by the addition of supplemental alfalfa averaging 51.91 bpm, 15.05°C and 31.75°C, respectively. In summary, overall total DM intake was enhanced with the addition of supplemental protein, however, only modest effects were observed in ruminal fill and total tract digestion. Additionally, heart rate and surface body temperatures were not influenced by supplemental treatments under the conditions of these studies.

Years of life lost associated with COVID-19 deaths in Portugal: two years of pandemic

Abstract Background The impact of the COVID-19 pandemic on the Portuguese population is still underexplored. Therefore, the characterization of years of life lost (YLL) due to this epidemic may provide relevant data for establishing effective strategies in future epidemics. The aim of this study was to calculate YLL associated with COVID-19 deaths in Portugal between 2020 and 2022. Methods This was an observational, cross-sectional study. Data on the average resident population and life expectancy at birth by age group and sex were obtained from Statistics Portugal (INE) and GBD 2019 standard life-table, respectively. Data on COVID-19 deaths were extracted from the Directorate-General of Health's (DGS) reports. YLL was calculated as the number of COVID-19 deaths multiplied by standard life expectancy at the age of death, globally, by sex and age group. YLL was calculated by 100,000 population and age-standardized. Results Between 2020 and 2022, 3413013 cases of COVID-19 were reported in Portugal, of which 21342 (0.6%) eventually died of the disease. The number of deaths by sex was similar globally or by age group. Globally, the YLLs estimated for COVID-19 in Portugal were 309383,8. YLLs were higher for males than for females for most age groups except of age groups 10-19 yrs (76.56 vs 153.11) and > 80 yrs (58710.88 vs 68491.44). YLLs age-standardized also showed a steady increase as we progressed in the age group [from 3.25 (0-9 yrs) to 885.54 (>80 yrs)], in which from the 50-59 yrs age group onwards we observed a steeper slope of increase in YLLs. Conclusions COVID-19 has had a major impact on mortality rates in Portugal, with this impact being greater in the older population, especially in people aged over 70 years. Also, males presented higher YLLs than females, with this difference increasing substantially as age increases. These insights can be useful in terms of public health as the disease progresses to an endemic phase. Key messages • COVID-19 has had a major impact on mortality rates in Portugal. • Calculating YLLs associated with COVID-19 in Portugal provides relevant data for establishing effective strategies in future epidemics.

Clinico-Epidemiological Profile and Outcome of Poisoning in Children Presenting at a Tertiary Care Hospital of Eastern Nepal

Background: Pediatric poisoning is common emergency worldwide and represents major and preventable cause of morbidity and mortality in children. The study describes epidemiology and outcome of acute poisonings in children presenting to Nobel Medical College through Emergency and Outpatient department and determines causative agents and characteristics of acute poisoning in several pediatric age groups.
 Material and Methods: This was hospital based prospective cross-sectional study which included all acutely poisoned patients under 18yrs age of either sex who presented to Nobel Medical College Teaching Hospital during 1year period (January 2021 to December 2021). Various socio-demographic variables, poisoning details, clinical manifestations, treatment given, outcome and complications were entered in predesigned proforma. Data was entered in excel sheet and descriptive analysis was done using SPSS software (version 20).
 Results: During the study period total 56 children with poisoning were admitted and enrolled. The mean age (±SD) of children with poisoning was 8.18 ± 5.50 Years. Poisoning cases werepredominant in male children (n=56, 53.6%). The most common poison wasorganophosphates(OP) compounds (41.1%). More than three-fourth of cases (92.9%) were symptomatic where nausea/vomiting (78.6%) was most common clinical symptoms, About 83.9% children survived, 10.7% expired and 5.4% left against medical advice (LAMA). Complications were seen in about 37.5% where shock was most common complications
 Conclusion: Poisoning was common in adolescent age group.Overall nature of poisoning was accidental however, in adolescent age group majority of them were suicidal in nature.Organophosphates (OP) compounds was most common type of poisoning

1143-P: Elevated Serum IgA and the Gut Microbiome in Pediatric Type 1 Diabetes (T1D)

Elevated serum IgA occurs in ~20% of children with new onset T1D, although its potential role in T1D pathogenesis is not understood. Gut dysbiosis is present at onset of T1D and is strongly associated with its pathogenesis. Mucosal IgA is well known to influence the microbiome and vice versa. In animal models, serum IgA responds to microbiome changes, thereby inducing a protective response to gut invasion by pathogens. However, the relationship between gut microbiome and serum IgA in humans with T1D is unknown. Thus, we aimed to assess if elevated serum IgA is associated with gut dysbiosis at T1D onset. We enrolled 47 children between 7/2021 and 9/2022: New onset T1D with elevated serum IgA (T1D-Hi-IgA, n=14), new onset T1D with normal serum IgA (T1D-Nl-IgA, n=18) and controls (siblings of new onset T1D, n=15). Exclusions: <2 yrs age; antibiotics; probiotics; inflammatory bowel disease; celiac disease; or acute illness <10 days of stool collection. Demographic and clinical variables, diet questionnaires and stool were collected. Stool microbiome was determined via 16Sv4 rDNA sequencing. Differences in alpha and beta diversity along with taxa abundance were assessed. We found that the relative abundance of members of families Oscillospiraceae and Lachnospiraceae, both of which contain butyrate producers, were significantly associated with elevated IgA irrespective of T1D status (p<0.05); higher in T1D-Hi-IgA vs T1D-Nl-IgA (p<0.05); yet similar in T1D-Hi-IgA vs controls. Measures of alpha diversity, including richness and evenness, were also increased in T1D-Hi-IgA vs T1D-Nl-IgA, though these differences did not reach significance (richness: p=0.074; evenness: p=0.135). Similar results were observed for beta diversity. In sum, in children with new onset T1D, elevated serum IgA is associated with beneficial microbial taxa such as butyrate producers, with a trend towards increased diversity, similar to healthy siblings. Further studies are needed to understand its involvement in T1D pathogenesis. Disclosure A.Thakkar: None. M.J.Redondo: None. J.Hajjar: None. J.Petrosino: None. K.L.Hoffman: Consultant; Cooper Surgical. J.Cormier: None. M.Ahmed: None. X.C.Huang: None.

59-OR: Glycemic Control with Extended Use of Automated Insulin Delivery (AID) in Children Age 2–6 Years with Type 1 Diabetes (T1D)

T1D management in children < age 6 yrs is challenging due to unpredictable food intake and activity. Efficacy of AID with the Tandem t:slim X2 insulin pump with Control-IQ technology (CIQ) in this age group has not been well studied. Data included 95 children with T1D age 2 to < 6 yrs (age 3.9±1.2 yrs, 46% male, 75 % non-Hispanic white, 34% on multiple daily injections) enrolled in a 13-week extended use phase of a randomized trial of closed loop control (CLC) with CIQ. In this phase, the group assigned to CLC for the initial 13 weeks continued on CLC (CLC-CLC) and those initially using standard care (SC) were placed on CLC (SC-CLC). CGM time in range 70-180 mg/dL (TIR) was the primary outcome. The SC-CLC group (n=33) increased TIR using CLC in the extension compared to the SC period (68±9% vs. 56±13%, p<0.001) with no significant change in hypoglycemia (%CGM < 54 mg/dL 0.4±0.3% vs. 0.5±0.6%, p=0.03). TIR increased within the first week of CLC use similar to the first 13 weeks of AID use for the CLC-CLC group (Figure). CLC training was completed virtually for 82% of the SC-CLC group. The CLC-CLC group (n=62) maintained TIR (71±11% vs. 70±10%, p=0.80) with slightly lower rates of hypoglycemia (%CGM < 54 mg/dL 0.5±0.4% vs. 0.6±0.5%, p=0.08). In conclusion, these data show that in young children age 2 to < 6, CLC with Control-IQ technology leads to increased TIR without an increase in time in hypoglycemia. Disclosure R.Wadwa: Consultant; Eli Lilly and Company, Other Relationship; Dexcom, Inc., Eli Lilly and Company, Research Support; Dexcom, Inc., Eli Lilly and Company, Beta Bionics, Inc., Tandem Diabetes Care, Inc. C.Kollman: Research Support; Insulet Corporation, Dexcom, Inc., Tandem Diabetes Care, Inc. R.Beck: Consultant; Eli Lilly and Company, Novo Nordisk, Diasome, Insulet Corporation, Research Support; Tandem Diabetes Care, Inc., Beta Bionics, Inc., Dexcom, Inc., Bigfoot Biomedical, Inc., Medtronic, Ascensia Diabetes Care, Roche Diabetes Care, Eli Lilly and Company, Novo Nordisk. M.D.Breton: Consultant; Dexcom, Inc., Tandem Diabetes Care, Inc., Roche Diabetes Care, Sanofi, Arecor, Research Support; Dexcom, Inc., Tandem Diabetes Care, Inc., Novo Nordisk. Pedap trial study group: n/a. Z.Reed: None. B.A.Buckingham: Advisory Panel; Medtronic, Novo Nordisk, Consultant; Lilly, Research Support; Medtronic, Insulet Corporation, Tandem Diabetes Care, Inc. M.D.Deboer: Research Support; Dexcom, Inc., Tandem Diabetes Care, Inc. L.Ekhlaspour: Consultant; Ypsomed AG, Tandem Diabetes Care, Inc., Other Relationship; NIH - National Institutes of Health, Research Support; MannKind Corporation, Tandem Diabetes Care, Inc., JDRF, Speaker's Bureau; Insulet Corporation. E.C.Cobry: None. M.Schoelwer: Research Support; Tandem Diabetes Care, Inc., Insulet Corporation. C.Berget: Consultant; Insulet Corporation, Dexcom, Inc., Other Relationship; Tandem Diabetes Care, Inc. J.W.Lum: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (U01DK127551); Tandem Diabetes Care, Inc.; Dexcom, Inc.

Abstract #1405044: Prevalence and Pattern of Dyslipidemia within 6 months of Diagnosis of Type 1 Diabetes

Type 1 diabetes (T1D) is often synonymous with glycemic control with emphasis on maintaining and following up with glucose control. Most international guidelines recommended that screening for dyslipidemia as a cardiovascular risk factor should begin at around puberty. Over the last decade, there have been various studies in different regions of the world regarding the prevalence and pattern of dyslipidemia in T1D. Recent guidelines have recommended screening for dyslipidemia as early as 2 years’ age. However, data regarding dyslipidemia in Indians with T1D is scarce. We studied the prevalence and pattern of dyslipidemia soon after diagnosis of T1D in Indian population. This retrospective observational study using medical records (2008-2022) included patients (age >2 years) with T1D, who attended endocrine clinic at a tertiary care hospital. Patients with uncontrolled hypothyroidism, preexisting cardiovascular disease, familial hypercholesterolemia, or those already on statins were excluded. The information retrieved from the medical records included age at diagnosis of diabetes, family history of CAD or dyslipidemia, height, weight, BMI, blood pressure. The biochemical parameters were noted: fasting lipid profile in mg/dl (total cholesterol, triglycerides, LDL-cholesterol, non-HDL-cholesterol, HDL-cholesterol) done within six months of diagnosis of T1D, and Hba1c at that time. The cut offs for dyslipidemia were taken as per ISPAD and ADA guidelines. Lipid profile, soon after diagnosis of T1D, was available in 161 patients (93 males, 68 females). The mean age of the study population was 15.73 (±9.9) yrs, and mean BMI was 16.8 (±7.01) kg/m2. At least one abnormal lipid parameter was found in 67.7%, with elevated T.Chol in 11.8%, TG in 24.2%, LDLc in 36.6%, non-HDLc in 33.5% and low HDL in 14.9%. On stratifying according to age, 56.2% subjects <10yrs age (n=32) had at least one abnormal lipid with low HDLc being most common (28.1%), followed by raised TG (25%). In patients 10-19 yrs age group and those >19 yrs age, raised LDLc was most common (40.2% and 42.1% respectively), followed by low HDLc (31.9% and 38.6% respectively). Most patients with T1D (67.7%) had dyslipidemia within six months of diagnosis of T1D. Majority of children <10 yrs age also had abnormal lipids initially; most common being low HDLc and elevated TG. In patients >10yrs age, raised LDLc is most common. Dyslipidemia being an independent CV risk factor needs to be assessed for and addressed to, along with glycemic control, early in the course of T1D.

Design, development and pilot testing of 'Quest', a smartphone-based relapse prevention app for patients with alcohol dependence

To design, develop and pilot the 'Quest' app for smartphone-based relapse prevention for patients diagnosed with alcohol dependence syndrome (ADS). Principles of relapse prevention and motivation enhancement were used to develop the Quest App. Four addiction psychiatrists reviewed the app using the "app evaluation framework". Thirty patients (>18yrs age) diagnosed with ADS, who had an Android smartphone, were fluent in writing and reading English and agreed to use the app regularly for the next three months were enrolled in this study. After initial treatment for intoxication/withdrawal and with written consent, patients in the study group (TAUQ) were requested to download the Quest application from a downloadable installation file. The usability and acceptability of Quest App amongst TAUQ patients was evaluated using the usability section of the mHealth App Usability Questionnaire (MAUQ). The short-term effectiveness at the end of three months was compared between TAUQ and comparison group who received Treatment as Usual (TAU). Both acceptability (65%) and usability (5.8 out of 7) of the app were high. The patient groups (with or without Quest app) showed a significant reduction in drinking at 30, 60, and 90 days follow-up compared with their baseline number of drinking days. There was no significant difference between the two groups (with or without Quest App) in the median number of lapses and the median number of days of heavy drinking. This is the first attempt to develop a smartphone app and test its feasibility in preventing relapse among patients with ADS in the Indian population. Further validation of the app after incorporating feedback and testing on a larger sample size and multiple languages is required.

Evaluation of Knowledge, Awareness, and Attitude of Dental Professionals of Delhi-NCR Region Towards Child Abuse and Neglect (CAN)

INTRODUCTION: Child abuse is engaging in an action or not engaging in an action by the parents or child’s guardian(s) that violates the child’s rights and puts his/her favorable life, development and dignity at risk. Children who have been abused or who experience dental neglect may/may not present to a dental professional for evaluation. It is an ethical and legal responsibility of dental practioners to have knowledge, awareness, and to participate actively in diagnosis, and report the cases of child abuse. AIM: To evaluate the knowledge, awareness and attitude regarding child abuse and neglect (CAN) amongst dental practioners of Delhi- NCR region. MATERIALS AND METHOD: Present study was designed as a cross sectional observational study using a pretested, prevalidated close-ended questionnaire. Questionnaire was distributed among the 500 dental professionals in Delhi-NCR region. Filled questionnaires were collected on the same day. The response formats were tabulated and subjected to descriptive and analytical statistics in SPSS 19.0. R RESULTS: Majority of the respondents were aware about child abuse and neglect, gender predominance and associated role of socioeconomic status. Knowledge regarding presenting symptoms, referral and treatment options was found to be inadequate and the respondents wanted to enhance their knowledge regarding the same. About 92.7% - Age group of 20-30 yrs. feel CAN is matter of concern. Females had more awareness and positive attitude towards attending programs regarding CAN. Age group above 50yrs age – 54.5% professionals referred the cases of CAN for care. 89.9% of dental Professionals of Age group 20-30 yrs. willing to attend programs for increasing their awareness CONCLUSION: Knowledge and Awareness of dentists about the indicators of child abuse was found to be inadequate. However, the respondents showed positive attitude towards improving their professional knowledge. Keywords: [Child abuse, Physical abuse, Neglect, oro-dental Injuries, Child protection training

CLINICOPATHOLOGICAL PROFILE OF RESPIRATORY DISEASES IN GERIATRIC POPULATION OF SMART CITY DAHOD GUJARAT

We have taken 1234 patients for study in which males were773 females were 461. 394 patients required inpatient respiratory critical care with community acquired pneumonia, bronchogenic carcinoma, acute respiratory tract infections,acute exacerbation of COPD, bronchial asthma exacerbations and other pleural diseases. 890 patients belong to the age group 65-74yrs and 344 in 75+ yrs age group. studied demographic patient age, sex distribution above the age of 65yrs with more prevalence in males. Respiratory diagnosis in geriatric population upper respiratory tract infections percentage diagnosis is higher. Respiratory diagnosis of inpatient respiratory diseases highest is the acted exacerbation of the COPD. In pneumonia community acquired pneumonia high prevalence in age and sex distribution and highest isolated micro organisms is staphylococcus. For pulmonary TB males are higher with isolated new sputum positive cases

Study on Clinical Manifestations Of Biliary Ascariasis Patients in Sadar Hospital, Cox’s Bazar

Aims: Aim of the study was to know the clinical presentations of biliary ascariasis. Materials and Methods: It was a cross-sectional observational study had been carried out on 50 patients over a period from January 2017 to December 2018 at the Department of Medicine, Sadar Hospital, Cox’s bazar. The clinical presentation, ultrasonographic findings, management and follow up of patients diagnosed to have biliary ascariasis were recorded in a pre-designed case record form and finally all the relevant data were processed and analyzed. Results: This study revealed that maximum patients of biliary ascariasis belonged to 31-40 yrs age group. Number of female patients was more (86%) in comparison to male patients (14%). Among female patients, 20.93% patients were pregnant. Most of the patients 92%came from rural areas. All patients in this study presented with upper abdominal pain. Other complaints were nausea, vomiting, fever and jaundice. Most of the patients (38%) had history of passage of worm with vomitus. Ultrasonographic profile of this study revealed that ascaris was most commonly entrapped in the common bile duct (80%). The percentage of complications was 38%. Acute acalculous cholecystitis was the commonest. The percentage of Cholangitis and acute pancreatitis was also significant. Conclusion: Bangladesh is an endemic zone for ascaris lumbricoides infestations. Ultrasonography is the investigation of choice for diagnosis and follow up of the patient of biliary ascariasis. Majority of the patient can be managed with conservative treatment and mechanical removal of worms by endoscopy. This study recommends that proper hygiene and regular deworming can prevent biliary ascariasis. J Dhaka Med Coll. 2021; 29(1): 87-93

An Autopsy Based Comparative Study Between Males and Females Age of Sagittal Suture fusion at Tertiary Health Care Center at Jaipur (Rajasthan)

Background: A reasonably correct estimation of age in elderly people is essential in legal, medical, social andadministrative matters. Skulls are usually well preserved in decomposed, mutilated state or in fragmentary bodies.Sagittal suture has a very wide range of fusion. The aim of this study is to collect data of sagittal suture fusion ofmale and female and comparing with each other, so the more appropriate estimation of age can occur by includingsexual dimorphism of sagittal sutural fusion.Material and Methods: This study was conducted in 100 autopsy cases of Department of Forensic Medicine, S.M.S.Medical College &amp; Attached Hospital, Jaipur of aged between 20 to 70 yrs, With making group of male and femalefor each year of age. The obliteration of the sutures was ascertained endocranially as well as ectocranially. TheSagittal suture was studied in four parts and Scale for closure is studied by Acsadi-Nemeskeri complex methodResults: Ectocranially the start of fusion of sagittal suture was observed at the age of 51-60 yrs age group in femalesand in 46-50 yrs in males and endocranially at 31-40 yrs in males and 41-50 yrs in females.Conclusion: When comparison between males and female subjects for ectocranially closure were made, closure wasearlier in males. Completion is perfected at the age of 61-70 years. The study showed that fusion of endocraniumbegan first on S4 &amp; last on S1 in both sexes.Though consensus of opinion in our country is that the obliteration of the skull sutures in females is somewhatearlier than that of males, in the present study no such pattern in difference was noticed in endocrinal suturalfusion.

Food sources of zinc and nutritional status with usual dietary zinc intake in Korean toddlers and preschool children.

This study aimed to evaluate the food sources of zinc and the usual intake of dietary zinc among Korean toddlers and preschool children. A total of 2,679 children aged 1-5 years was selected from the 2009-2013 Korea National Health and Nutrition Examination Survey (KNHANES) data. Dietary data collected from a single 24-h recall were used to evaluate the food sources of zinc. To estimate usual zinc intake, the distribution obtained from single 24-h recall data in the total sample was adjusted using the ratio of within-to-between-person variance in zinc intake obtained from 2-day 24-h recall sub-sample data of the 2009 KNHANES. The proportion of children with usual zinc intake below the estimated average requirement (EAR) and above the tolerable upper intake level (UL) was assessed. The main sources of zinc in Korean children were grains, dairy products, and meat. The mean usual intakes of zinc among all individuals, those aged 1-2 yrs, and those aged 3-5 yrs were 5.50, 5.01, and 5.83 mg/d, respectively. In all participants, 1.1% of the children consumed zinc below the EAR, whereas 10.7% exceeded the UL. The proportion of children with excessive zinc intake was 25.6% in the 1-2 yrs age group and 0.6% in the 3-5 yrs age group. According to the current UL, the risk of excessive zinc intake appears to be high among Korean toddlers. Future studies that monitor the health effects of excessive zinc intake are needed to appropriately guide zinc intake in children.

Proximal Interruption of Pulmonary Artery: Spectrum of Radiological Findings With Emphasis on Chest Radiograph and Contrast-Enhanced Computed Tomography (CECT).

Introduction Proximal interruption of pulmonary artery (PIPA) is a congenital anomaly presenting withaberrant termination of the pulmonary artery at the hilum. It results in a variety of radiological andclinical manifestations. Clinically, isolated PIPA can be asymptomatic till late adulthood or can present with dyspnoea, chest discomfort, hemoptysis and recurrent infections. PIPA can be associated with multiple cardiovascular anomalies such as tetralogy of Fallot (TOF), ventricular septal defects (VSD), and scimitar syndrome. We present a spectrum of cases with both isolated proximal interruption of the pulmonary arteryand cases associated with other cardiovascular abnormalities.Typical chest radiographs and chest contrast-enhanced computed tomography (CECT) findings are discussed and demonstrated in detail.Proper and early diagnosis is a crucial step as it can significantly modify the treatment choice, thereby reducing morbidity. Objective To document the different presentations of the proximal arrest of pulmonary arteries, to document associations with cardiovascular and pulmonary manifestations, and to elaborate on and demonstrate the various radiological imaging findings. Material and methods All the cases that were reported with proximal interruption of pulmonary artery on the CECT studies conducted between 2019 and 2022 at a tertiary care hospital in Telangana, India. The demographic data, clinical presentation, chest radiographs, and chest CECT were collected retrospectively. Data analysis was done using Microsoft Excel 2019 to calculate descriptive statistics.A total of 22 cases were identified of which three cases were excluded of as they were previously operated and 19 cases were taken as the study population. Results Nineteen patients were included in the study. Demographic details, clinical history, CECT, and chest radiographs were collected wherever available. The majority of the cases belonged to the ≤ 10 yrs age group with the most common clinical presentation being a previous diagnosis of tuberculosis or recurrent upper respiratory tract infections. The predominant findings on chest radiographs were deviation of the trachea to the affected side, volume loss in the ipsilateral lung field, and compensatory hyperinflation of the contralateral lung field. On the CECT chest, the main findings were interrupted pulmonary artery, hypoplastic lung fields with bronchiectasis, or ground glassing. Associated cardiovascular and pulmonary malformations were identified with notable cases: TOF, right-sided aortic archand scimitar syndrome. Their typical imaging findings have been elucidated and discussed in detail. Conclusions Patients with recurrent respiratory infections or hemoptysis having hypoplastic lung field with hyperinflation of the contralateral lung on chest radiographs should be evaluated for pulmonary artery interruptions. Chest CECT allows evaluation of the bronchial tree and lung parenchyma at the same time which helps distinguish pulmonary interruption from conditions such as Swyer-James-Macleod syndrome, pulmonary hypoplasia, thromboembolismand arteritis. Cases with PIPA can also be associated with cardiovascular and pulmonary anomalies such as TOF, partial anomalous pulmonary venous connection (PAPVC), and VSD. The knowledge of these associations is essential as they can influence the mode of treatment and can help reduce the long-term morbidity and mortality associated with the condition.

Prophylactic and Early Thyroidectomy in RET Germline Mutation Carriers in Pediatric and Adult Population: Long-Term Outcomes of a Series of 63 Patients

Prophylactic and early thyroidectomy in RET germline mutation carriers allows the removal of the thyroid before medullary thyroid carcinoma (MTC) develops, or while it is still confined to the gland. This study was aimed to assess the clinicopathological features in RET carriers according to the age at surgery and the long-term outcomes after prophylactic and early thyroidectomy. A retrospective analysis of 63 operated asymptomatic RET carriers diagnosed after familial genetic screening was performed. Twenty-one RET carriers were operated at pediatric (<18 yrs) and 42 at adult (≥18 yrs) age. Serum preoperative calcitonin levels were significantly lower in pediatric compared to adult patients (p = 0.04); moreover, adult RET carriers had a greater frequency of microMTC at pathology (p = 0.009). Permanent postoperative morbidity occurred in 9.5% of patients, without differences between the two groups. Biochemical postoperative cure was achieved in all patients. At a median follow-up of 14 years, all C-cell hyperplasia patients are disease-free; conversely, biochemical, and structural recurrence of disease occurred in three adults and one pediatric patient with microMTC. The independent predictive factors of MTC were the age at surgery, the preoperative calcitonin level and the RET mutational risk profile (p < 0.02). In conclusion, prophylactic and early thyroidectomy are safe and effective procedures in achieving definitive cure in most RET carriers. However, since recurrences may occur at long-term in case of microMTC, thyroidectomy should be possibly performed earlier to prevent microMTC development.