The epidemiology and disease pattern of pediatric ocular morbidities in Western India: The National Institute of OphthalMology AmBlyopia StUdy in Indian Paediatric EyeS (NIMBUS) study report 1

Purpose: To determine the pattern of pediatric ocular morbidities in western India. Methods: This was a retrospective longitudinal study that included all consecutive children aged ?15 years who presented to the outpatient department of a tertiary eye center for the first time. Patient demographics, best?corrected visual acuity (BCVA), and ocular examination data were compiled. Subgroup analysis was also performed based on age group (years): ?5, 5–10, and >10–15. Results: A total of 11,126 eyes of 5563 children were included in the study. The mean age of the study population was 5.15 (±3.32) years with males (57.07%) being predominant. Approximately half of the patients (50.19%) were under the age of 5 years, followed by those aged 5–10 years (45.1%) and >10–15 years (4.71%). Among the study eyes, the BCVA was ?20/60 in 58.57%, indeterminable in 35.16%, and <20/60 in 6.71%. The commonest ocular morbidity noted was refractive error (28.97%) followed by allergic conjunctivitis (7.64%) and strabismus (4.95%) in the total study cohort and also after age stratification. Conclusion: Refractive error, allergic conjunctivitis, and strabismus are the major causes of ocular morbidity in pediatric eyes at a tertiary care center. Planning screening programs at the regional and national levels is crucial to decreasing the burden of eye disorders. These programs also need to have a suitable referral mechanism established and be smoothly connected to primary and secondary health?care centers. This will help to assure quality eye care delivery, while also reducing the strain of overworked tertiary centers.

Características clínicas y resultados de pacientes con fibrosis quística con enfermedad pulmonar avanzada: experiencia en 10 años del Instituto Nacional del Tórax / Clinical features and outcomes of cystic fibrosis patients with advanced lung disease: experience of 10 years at the Instituto Nacional del Tórax

La enfermedad pulmonar avanzada (EPAV) es la principal causa de morbimortalidad en pacientes con Fibrosis Quística (FQ). Objetivo: describir características clínicas de pacientes con FQ con EPAV y mortalidad en el seguimiento. Método: Estudio descriptivo, retrospectivo de pacientes con FQ y EPAV: VEF1 4 años de vida. Un 75% era portador de infección crónica por Pseudomonas. Un 68% era dependiente de oxígeno y un 18% de ventilación mecánica no invasiva. El 70 % tuvo 2 o más hospitalizaciones el último año de seguimiento. De 27 pacientes derivados a trasplante, 7 se trasplantaron, 3 fallecieron en lista para trasplante, 9 presentaron alguna contraindicación: 4 de ellos por desnutrición y 5 por mala adherencia y escasa red de apoyo. En el seguimiento un 32% (n = 14) falleció, 93% de causa respiratoria. Conclusión: Un 39% de los pacientes tenían EPAV cuyo diagnóstico de FQ en promedio fue a los 11,2 años (SD ± 13 a). Las barreras de ingreso a lista para trasplante fueron: desnutrición, mala adherencia y falta de red de apoyo. Esta es una población con una elevada mortalidad.

Advanced cystic fibrosis lung disease (ACFLD) is the leading cause of morbidity and mortality in patients with Cystic Fibrosis (CF). Objective: to describe clinical characteristics of patients with CF with ACFLD and mortality during follow-up. Method: Descriptive, retrospective study of patients with CF and ACFLD: FEVi < 40%, oxygen dependent, and/or referred to a lung transplantprogram. Clinical, microbiological, functional, genetic and mortality characteristics were collected. Results: Of 111 controlled patients, 39% met criteria for ACFLD. 52% were men and the mean age was 29,8 years- old. The average BMI was 19.9 kg/m2, 72% had pancreatic insufficiency and 87% had a genetic study, being the DF508 mutation the most frequent (67%). The average age of diagnosis was 11.2 years (SD ± 13 years), being in 54,5% over the age of 4 years. 75% had chronic Pseudomonas infection. 68% were oxygen dependent and 18% on noninvasive mechanical ventilation. In the last year of follow-up 70% had 2 or more hospitalizations. Of 27 patients who have been referred for transplantation, 7 underwent lung transplantation, 3 died waiting on the transplant list, 9 had contraindications: 4 due to malnutrition and 5 to poor adherence and poor support network. 32% (n = 14) of the ACFLD patients died, 93% due to respiratory causes. Conclusion: 39% of the patients had ACFLD. The average age for CF diagnosis was 11.2 years (SD ± 13 years) Barriers to entering the transplant list are: malnutrition, poor adherence, and lack of a support network. This is a population with a high mortality.

Angiotensin II and human obesity. A narrative review of the pathogenesis / Angiotensina II y obesidad humana. Revisión narrativa de la patogénesis

Abstract Angiotensin II (Ang II) is a hormone and the main effector of the renin-angiotensin system (RAS). This peptide has crucial pathophysiological effects on hypertension, cardiac hypertrophy, endothelial proliferation, inflammation and tissue remodelling through G protein-coupled receptors. The pro-inflammatory role of Ang II has been reported in various inflammatory processes. Obesity is linked to a chronic inflammatory process which in turn is the cause of some of its morbidities. Ang II is related to the comorbidities related to the comorbidities of obesity, which include alterations in the heart, kidney, hypertension and coagulation. In this regard, activation of AT1 receptors by Ang II can induce an inflammatory process mediated by the transcription factor NF-kB, triggering inflammation in various systems that are related to the comorbidities observed in obesity. The aim of this review was to highlight the pro-inflammatory effects of Ang II and the alterations induced by this hormone in various organs and systems in obesity. The search was done since 1990 through Medline, EMBASE and PubMed, using the keywords: angiotensin II; angiotensin II, obesity; angiotensin II, kidney, obesity; angiotensin II, coagulation, obesity; angiotensin II, inflammation, obesity; angiotensin II, adipose tissue, obesity; angiotensin II, hypertension, obesity; angiotensin II, insulin resistance, obesity; angiotensin II, adiponectin, leptin, obesity; angiotensin II, COVID-19, obesity. Angiotensin II through its interaction with its AT1 receptor, can induce alterations in diverse systems that are related to the comorbidities observed in obesity. Therapeutic strategies to decrease the production and action of Ang II could improve the clinical conditions in individuals with obesity.

Resumen La angiotensina II (Ang II) es una hormona y el principal efector del sistema renina-angiotensina (SRA). Este péptido tiene importantes efectos fisiopatológicos en la hipertensión, la hipertrofia cardíaca, la proliferación endotelial, la inflamación y la remodelación tisular a través de receptores acoplados a la proteína G. El papel pro-inflamatorio de la Ang II se ha reportado en diversos procesos inflamatorios. La obesidad está ligada a un proceso inflamatorio crónico que a su vez es causa de algunas de sus morbilidades. Se ha demostrado que la Ang II está relacionada con las comorbilidades de la obesidad, que incluyen alteraciones en el corazón, el riñón, la hipertensión y la coagulación. En este sentido, la activación de los receptores AT1 por la Ang II puede inducir un proceso inflamatorio mediado por el factor de transcripción NFkB desencadenado inflamación en diversos sistemas que se relacionan con las co-morbilidades observadas en la obesidad. El propósito de esta revisión fue destacar el efecto pro-inflamatorio de la Ang II y las alteraciones inducidas por esta hormona en diversos órganos y sistemas en la obesidad. La búsqueda se hizo desde 1990 a través de Medline, EMBASE and PubMed, utilizando las palabras clave: angiotensina II; angiotensina II, obesidad; angiotensina II, riñón, obesidad; angiotensina II, coagulación, obesidad; angiotensina II, inflamación, obesidad; angiotensin II, adipose tissue, obesidad; angiotensin II, hipertensión, obesidad; angiotensin II, resistencia a la insulina, obesidad; angiotensin II, adiponectina, leptina, obesidad; angiotensina II, COVID-19, obesidad. La angiotensina II a través de su interacción con su receptor AT1 puede inducir alteraciones en diversos sistemas que están relacionados con las comorbilidades observadas en la obesidad. Estrategias terapeúticas para disminuir su producción y la acción de la AngII pudieran mejorar las condiciones clínicas en individuos con obesidad.

Perfil de morbidade no primeiro ano de vida entre recém-nascidos de alto risco / Morbidity profile in the first year of life among high-risk newborns

Os cuidados destinados aos recém-nascidos prematuros extremos têm propiciado importantes resultados na sobrevida dessas crianças. Objetivo: Caracterizar o perfil de morbidade no primeiro ano de vida entre recémnascidos de alto risco. Materiais e Métodos: Trata-se de uma pesquisa exploratória realizada no ambulatório de seguimento de recém-nascidos de alto risco do norte de Minas Gerais. A coleta de dados foi referente às admissões no período de março de 2014 a abril de 2015. O instrumento contemplava características: demográficas, sociais, condições de gestação e parto, intercorrências no pós-parto e condições de saúde das crianças acompanhadas ao longo do primeiro ano de vida. Realizou-se a análise estatística descritiva e o teste Qui-Quadrado, assumindo-se um nível de significância de 5% para comparação da distribuição das morbidades por faixas de peso. Resultados: Participaram deste estudo 282 recém-nascidos, sendo 53,9% do sexo masculino. Entre as mães, 58,2% era multípara e 35,8% hipertensas. Em relação ao peso de nascimento, 59,6% dos recém-nascidos acompanhados pesaram menos de 1500 gramas. As principais morbidades identificadas no primeiro ano de vida foram atraso do desenvolvimento neuro-psicomotor, infecções de vias aéreas superiores, as alterações neurológicas e as afecções respiratórias crônicas. Foram registradas diferenças estatisticamente significantes para o atraso do desenvolvimento neuro-psico-motor (p<0,001), intercorrências neurológicas (p=0,008) e episódios de diarreia (p=0,047), entre as faixas de peso de nascimento. Conclusão: A assistência ambulatorial para o recém-nascido prematuro de alto risco contribui para a identificação e a prevenção de doenças recorrentes nessa população(AU)

Introduction: Care for extremely premature newborns has provided important results in the survival of these children. Objective: To characterize the morbidity profile in the first year of life among high-risk newborns. Materials and Method: This is an exploratory research carried out at the follow-up clinic for high-risk newborns in the north of Minas Gerais. Data collection referred to admissions in the period from March 2014 to April 2015. The instrument included characteristics: demographic, social, pregnancy and delivery conditions, postpartum complications and health conditions of children monitored during the first year of life. Descriptive statistical analysis and the chisquare test were performed, assuming a significance level of 5% to compare the distribution of morbidities by weight range. Results: A total of 282 newborns participated in this study, 53.9% of whom were male. Among the mothers, 58.2% were multiparous and 35.8% were hypertensive. Regarding birth weight, 59.6% of newborns monitored weighed less than 1500 grams. The main morbidities identified in the first year of life were delayed neuro-psycho-motor development, upper airway infections, neurological disorders and chronic respiratory conditions. Statistically significant differences were recorded for delayed neuro-psycho-motor development (p<0.001), neurological complications (p=0.008) and episodes of diarrhea (p=0.047), between birth weight ranges. Conclusion: Outpatient care for high-risk premature newborns contributes to the identification and prevention of recurrent diseases in this population(AU)

Impact of comprehensive eye examination in identifying the ocular co-morbidities in patients screened for cataract surgery through the out-reach activities

Purpose: To evaluate the impact of comprehensive eye examination in identifying the ocular co?morbidities in patients presenting for cataract surgery through the community screening program. Methods: This was a hospital?based retrospective cross?sectional descriptive study in a tertiary eye care institute. Comprehensive eye examination was performed for all patients screened for cataract surgery through the out?reach activities. Patients suspected to have any ocular co?morbidity were revaluated by sub?specialty trained ophthalmologists, and further management was planned. The demographic details of patients, sub?specialty consultation, final diagnosis, and type of the treatment received by these patients were recorded. Results: During the study period, 4022 patients were referred to the base hospital for cataract surgery, of whom 922 (22.9%) needed a specialist opinion. Glaucoma (238) and retinal disorders (232) constituted half (51%) of these referrals. There were 313 (33.9%) patients having co?morbidities because of corneal, oculoplastic, and neuro?ophthalmic conditions. After specialist review, 397 (43.1%) patients underwent only cataract surgery, 55 patients (5.9%) underwent combined surgeries, and 168 (18.2%) patients underwent other procedures. Cataract surgery was not performed in 470 (50.9%) patients, of which 302 were prescribed glasses or managed medically. Conclusion: All patients screened for cataract surgery through out?reach programs require a comprehensive eye examination to identify ocular diseases other than cataract. Provisions must be made for providing alternative or additional treatment in those with various ocular co?morbidities.

Epidemiological and Clinical Profile of COVID-19 cases attending Rural HealthTraining Centre of one of the Medical Colleges of Ahmedabad, Gujarat, India

Introduction : disease is very much required for future preparedness. To assess the epidemiological andObjective : clinical profile of cases of COVID 19 Cross sectional descriptive study was carried out at a RuralMethod : Health Training Centre (RHTC). All cases reported in the month of January 2022 were included in the study. The information about the epidemiological and clinical profile was collected from RHTC records by conducting telephonic interview. Total 83 cases were reported. Among them, 43 (54.4%) casesResults : were in age group 20-39 years. Male: Female ratio was 1.37:1. There was one death and patient had ovarian cancer as co-morbidity. Total 71 patients could be contacted for telephonic interview. Fever was most common symptom and was presenting symptom on first day followed by cough/cold and sore throat. None had shortness of breath or chest pain. Hospitalization rate was 5.63% and none required oxygen supplementation or intensive care. Recovery period was 3-5 days. Out of total, 90% cases were fully vaccinated and 95.8% had knowledge of CAB. Diabetes and hypertension were most common co- morbidities and were statistically significantly more in age > 40 years. The COVID-19 cases inConclusions : the beginning of year 2022 had clinical presentation different than the earlier waves. Periodic situational analysis can guide in policy making for handling this pandemic in future.

Health status of Koraga community: A pilot study among a particularly vulnerable tribal group of Udupi District, Karnataka, India

Background & objectives: Undertaking tribe-specific assessment of health status provides the required data for planning appropriate interventions. Hence, a study was conducted to assess the health profile of the Koraga tribe. Methods: This community-based cross-sectional study was conducted among a particularly vulnerable tribal group, the Koragas residing in the Udupi district. Data were collected using a pro forma and were analyzed using the SPSS software version 16.0. Results: A total of 273 participants aged ?18 yr and 94 children aged ?17 yr were recruited through screening and referral services organized in Koraga hamlets of the Udupi district. Among the adults, 59.7 per cent were females and their median age was 35 yr. About 13.9 per cent had elevated blood pressure and 18.4 per cent had impaired/elevated random blood sugar levels. About 47.6 per cent were underweight and 35.2 per cent were anaemic. Multivariate logistic regression analysis showed that individuals with morbidities were more likely to be aged ?45 yr [45-60 yr: adjusted odds ratio (AOR)=4.3; 95 per cent confidence interval (CI)=1.3-13.8 and >60 yr: AOR=6.4; 95 per cent CI=1.7-23.7] and overweight or obese [23-24.9 kg/m2: AOR=8.1; 95% CI=1.3-48.2 and >25 kg/m2: AOR=7.9; 95% CI=1.6-38.4]. Of the 26 Koraga children aged ?5 yr, 30.7 and 42.3 per cent had their height for age and weight for age below the third percentile, respectively. Further, 15.3 per cent of under-five children and 27.9 per cent of 6-17 yr old children were severely wasted. About 21.2 per cent of the children aged ?17 yr were found to be anaemic and 56.3 per cent had symptoms of respiratory tract infection in the past 15 days. Interpretation & conclusions: Malnutrition was prevalent among Koraga adults and children, which warrants designing and implementing appropriate social and health interventions in this population.

Hospitalization & health expenditure in Odisha: Evidence from National Sample Survey (1995-2014)

Background & objectives: Financing healthcare services through out-of-pocket payments is common in India. Household impoverishments due to health expenditure can be daunting, especially among the economically vulnerable households. This study investigated hospitalization and patient’s health expenditure in Odisha State in India. Methods: The national sample survey data were used to assess hospitalization and patient’s health expenditure over two time periods (1995 and 2014). Disease classification was made following International Classification of Diseases 10th revision (ICD-10). The hospitalization rate and health expenditure were estimated for infectious, cardiovascular, non-communicable, disability and other diseases. Andersen model was used to examine the determinants of healthcare expenditure. Results: Findings of the study revealed that hospitalization in Odisha increased nearly three folds and health expenditure by more than two times between 1995 to 2014. While the hospitalization for other diseases remained consistently higher, health expenditure for disability was the highest and it increased three times within the last two decades. The socio-economic and demographic divides in the hospitalization rate and health expenditure were evident. Interpretation & conclusions: Our analysis indicated that predisposing factors such as age and marital status played an important role in hospitalization whereas, enabling factors likely determined the health expenditure. There is a need to recognize the unique vulnerabilities of older population, widowed and health financial mechanism for disability-related illness.

Psychological Morbidities and Coping Styles: A Rural Institution-Based Cross-Sectional Comparative Study between Undergraduate Medical Students Undergoing Different Phases of Training

Background?Psychological morbidities are high among undergraduate medical students. They experience the transition between pre-/para-clinical and clinical training as a stressful period, and cope differently. Research studies from India in this regard are lacking. Aims?The aim of this study is to assess and compare the prevalence of psychological morbidities and their respective associated factors and coping styles between pre-/para-clinical and clinical undergraduate medical students. Materials and Methods?This institution-based cross-sectional observational design study was conducted among undergraduate medical students (a total of 382) in pre-/para-clinical and clinical years by using a questionnaire in the period between April and June 2019. A stratified random sampling technique was used to select the study participants. The survey included standard self-administered questionnaires like General Health Questionnaire-28 (GHQ-28) and Lin–Chen's coping inventory to assess psychological morbidities and coping styles, respectively. Associated factors for psychological morbidities and coping styles between two groups were compared using the Chi-square test, independent t-test, and binary logistic regression analysis. Results?Out of the 382 responders, psychological morbidities (GHQ-28 score?>?23) were found in 61% participants. Both groups reported high levels of psychological morbidities; a slightly higher preponderance in clinical (61.5%) than in pre-/para-clinical students (60.6%) with a nonsignificant difference. Compared with the pre-/para-clinical group, the clinical group was found to have more substance consumption behavior (p?<?0.001), dissatisfaction with academic performance (p?<?0.001), sought psychiatric consultation (p?<?0.004), and at that time on psychiatric treatment (p?<?0.04). Active problem coping behavior was more significantly used by the pre-/para-clinical group, while passive problem coping and passive emotional coping behaviors were positively significantly correlated with psychological morbidities in the clinical group. Conclusion?This study suggests a significant correlation between psychological morbidities and passive coping styles in the clinical group. These students need interventions to encourage the use of more active coping styles during training to provide advances in future career. A strong correlation between psychological morbidities and dissatisfied academic performance may be a call for an efficient and more student-friendly curriculum.

Study Of 215 Patients Who Required High Flow Nasal Cannula During Corona Virus Epidemic

Background:High flow nasal cannula is a newer modality of treatment for hypoxemic respiratory failure. Present study is conducted to evaluate demographic characteristics, co-morbidities and outcome parameters of patients on High flow nasal cannula. Material And Methods:In retrospective observational study all patients on High flow nasal canula with covid-19 were evaluated for demographic characteristics and outcome with comorbidities during study period.Result:Maximum number of patients belongs to age group 51-60 years. Highest mortality was in the age group of 61-70 years.Conclusion:The High flow nasal cannula therapy may provide important newer modality and helpful in patients with respiratory failure.

Covid Vaccine Side Effects and Covid Infection after Vaccination- A Cross Sectional Study in Hubballi, Karnataka

Introduction: Vaccination against Covid-19 has become the promising strategy in controlling rise in Covid cases. Covishield and Covaxin were the two vaccines initially available in India which have been administered to all those >18years of age. These vaccines exhibit a spectrum of side effects, which may affect vaccination rates. The study was conducted to estimate the frequency of side effects of Covid vaccines in India and their relationship with co-morbidities and prior Covid-19 infection. Methodology: A cross sectional questionnaire-based online survey was conducted for duration of one month among 1800 participants who had received at least one dose of Covid vaccine at KIMS Hospital, Hubballi, Karnataka, selected using systematic random sampling and information about vaccination, comorbidities and covid infection after vaccination was collected. Results: The most common side effects were fever, headache and generalised body ache. The prevalence of infection after complete vaccination with Covishield (4.45%) was higher than Covaxin (1.08%) and difference was statistically significant. The prevalence of side effects and Covid-19 infection after vaccination did not vary with co-morbidities. Conclusion: The side effects reported were not serious and the prevalence was similar in both the vaccines. The prevalence of infection still remains high after vaccination; hence Covid Appropriate Behaviour should be continued.

Adição por comida: prevalência e fatores associados em um estudo de base populacional no Rio de Janeiro / Food addiction: prevalence and factors associated in a population-based study in Rio de Janeiro

Adição por comida caracteriza-se por uma perda de controle sobre o consumo de certos tipos de alimentos, na maioria das vezes hiperpalatáveis, e por tentativas fracassadas de ultrapassar o problema alimentar apesar das consequências adversas. A tese atual descreve a prevalência de adição por comida e fatores associados (socioeconómicos, demográficos, estilos de vida, estado nutricional, comorbilidades psiquiátricas e clínicas) em uma amostra representativa da cidade do Rio de Janeiro, Brasil. Este é um estudo transversal que utiliza dados do Compulsão alimentar no Rio -Binge Eating in Rio Survey, um inquérito domiciliar que incluiu 2.297 indivíduos dos 18 aos 60 anos. Os participantes forneceram informações sociodemográficas, antropométricas, sobre o estilo de vida, comorbidades clínicas e psiquiátricas. O instrumento utilizado para avaliar a adição por comida foi a escala modificada de adição por comida de Yale 2.0. A entrevista foi aplicada face-a-face. E os dados foram coletados entre setembro de 2019 e fevereiro de 2020. Prevalência e respectivos intervalos de confiança de 95% (95%CI) foram estimados considerando o peso da amostral e o desenho complexo do inquérito. Foram utilizados modelos de regressão logística para estimar a razão de chance entre as comorbidades psiquiátricas, clínicas e adição por comida. Os modelos foram ajustados para potenciais variáveis de confusão, sexo, idade e IMC. A prevalência de Adição por comida foi de 2,78% (95%CI 1,40 a 4,17) e, foi classificada como leve em 17% dos casos, moderada em 36% e como severa em 46%. A prevalência de adição por comida nas mulheres foi superior à dos homens, 4,08% vs 1,39 (p=0.001), com tendência decrescente com a idade (p=0,017). Quanto ao IMC, adição por comida foi mais prevalente entre aqueles com IMC mais elevado 6,76 % (IC95%CI 4,19 a 10,70) em comparação com aqueles com IMC normal 0,69% (IC95%CI 0,31 a 1,53). Entre aqueles que tinham adição por comida, a prevalência de sintomas psiquiátricos foi de: 75,41% com sintomas de depressão, 77,05% com sintomas de ansiedade, 19,7% de transtorno de compulsão alimentar, 32,79% de transtorno de déficit de atenção e hiperatividade, e 19,7% de consumo de álcool. Adição por comida foi associada a todas as comorbidades psiquiátricas, tanto nos modelos brutos como nos modelos ajustados. Entre as morbidades clínicas, os modelos brutos e ajustados mostraram uma associação entre adição por comida e uma maior chance de diabetes, AVC, asma, asma crônica, dores de cabeça, problemas musculares, e refluxo gastroesofágico. Quanto à força da associação, aumentou quando ajustado para problemas crônicos da coluna vertebral e IMC. Como observado em outros países, a adição por comida foi mais frequente nas mulheres e nos indivíduos mais jovens; associou-se à obesidade, também a IMC mais elevado, a comorbidades psiquiátricas e a várias comorbidades clínicas.

Food addiction (FA) is characterized by a loss of control, causing overeating of certain kinds of foods, most often hyperpalatable foods, and failed attempts to overcome the eating problem despite adverse consequences. The current thesis describes the prevalence of FA and associated factors (socioeconomic, demographic, lifestyle, nutritional status, psychiatric and clinical comorbidities) in a representative sample of the city of Rio de Janeiro, Brazil. This is a cross sectional study using data from the Binge Eating in Rio Survey, a household survey that included 2.297 individuals from 18 to 60 years. The participants will provide sociodemographic information, lifestyle, clinical comorbidities, and psychiatrics. The instrument used to evaluate the FA will be the Modified Yale Food Addiction Scale 2.0. The interview was applied face-to face. Data were collected from September 2019 to February 2020. Prevalence and respective 95% confidence intervals (95%CI) were estimated considering the sample weight. In analyses were performed logistic regression models to estimate odd ratios between psychiatric and clinical comorbidities. Models were an adjustment for potential confounder variables, gender, age, and Body Mass Index (BMI). The prevalence of FA according to YFAS 2.0 was 2.78% and, 17.42% was classified as mild, 36.49% as moderate, 46.09% as severe. The prevalence of FA in women was higher than men, 4.08% vs 1.39% (p=0.001), and with a decreasing trend with age (p=0.017). Regarding the BMI, FA was more prevalent among those with a higher BMI 6.76 % (95%CI 4.19 to 10.70) compared those in the normal BMI range 0.69% (9is 5%CI 0.31 to 1.53). Among those who had a FA, the prevalence of psychiatric symptoms was as follows: 75.41% with symptoms of Depression, 77.05% symptoms of Anxiety, 19.7% Binge Eating Disorder, 32.79% Attention Deficit Hyperactivity Disorder symptoms, and 19.7% alcohol use. Food addiction was associated with all psychiatric morbidities in both the crude and adjusted models. Among the clinical morbidities the unadjusted and crude models showed an association between food addiction and an increased chance of diabetes, stroke, asthma, chronic asthma, headaches, muscle problems, and gastroesophageal reflux. Regarding the increase of association, when adjusted for chronic spinal problems and BMI increases the OR values: FA was a prevalent condition in Brazil, more frequent in women and younger individuals, and associated also with higher BMI as observed in studies from high income countries. Furthermore, it shows that they constitute a group with specific characteristics and deserve special attention in this regard. FA was associated with psychiatric comorbidity and several clinical comorbidities in our sample.

Drug - Drug Interactions among Chronic Kidney Disease patients in a tertiary hospital.

Background: Drug interaction (more precisely ‘drug-drug interaction’) refers to modifying the action of one drug by another when administered simultaneously or in quick succession. Chronic Kidney Disease (CKD) patients often require polypharmacy, which puts them at the risk of the developing Drug - Drug Interactions (DDIs) and various adverse reactions. Not all patients taking interacting drugs experience adverse consequences, but it is advisable to take due precautions to avoid mishaps in all cases where interactions are possible. Hence, this study was undertaken to identify the DDIs among the drugs prescribed to CKD patients. Materials and methods: A Cross-sectional study was conducted in the Department of Nephrology. A total of 80 patients with CKD were included. Patients with CKD with other comorbid conditions, CKD patients of either sex above the age group of 18 years were included. LEXICOMP drug interaction software was used for potential DDI (pDDI) identification. Results: Patients mean age was 47.24±14.37 years with male predominance of 72.5 %. A total of 604 drugs were prescribed with a mean of 7.55 ± 2.73. The most common medications prescribed was Amlodipine (6.3%). DDIs were identified in 74 patients. 46 showed 1 to 5 pDDIs, 22 patients showed 6 to 10 p DDIs, 4 patients showed 11 - 15 DDIs, and 2 patients showed 16 to 20 pDDIs. According to the Lexicomp severity classification, 270 were Type C, 57 were Type D & 55 were Type B. Conclusion: The recognition of potential DDI and key combinations of drugs avoids treatment failure situations or minimizes drug toxicity .

Prevalence of Autism Spectrum Disorders (ASD) and its association with medical issues and behaviour problems among Children with Intellectual Disability (ID)

Background: The presence or absence of Intellectual Disability(ID) has been recognized as one of the strongest determinant of outcomes for individuals with Autism Spectrum Disorder(ASD). Behavioural problems which are commonly reported in autism may be related to core features of autism, comorbid diagnoses or symptoms . There is paucity of Indian studies on prevalence of ASD among children diagnosed with ID and also the prevalence of behaviour problems in this population. This study was conducted with the objectives to assess the prevalence of ASD in the intellectually disabled, as well as the associated comorbidity patterns. Methodology: It was a cross sectional study including 122 children with mild/moderate Intellectual Disability between 6 to 18 years. Indian Scale for Assessment of Autism(ISAA), Behaviour Problems Inventory(BPI) was administered and questions were asked to know medical symptoms. Results: Prevalence of co-morbid ASD in children with ID was with 16.39%. Children with ASD had higher behavioural problems (p=0.001), higher medical complaints like GI symptoms (constipation p=0.001, bloating p=0.03, abdominal pain p=0.03) and seizure (p=0.002). Behaviour problems were higher in children with more severe autism scores. Conclusion: There is a notable prevalence of ASD in children with ID. These children tend to have higher behavioural problems and co-morbid medical issues which needs clinical attention for better overall management of these children.

Características clínico-epidemiológicas de los pacientes ingresados en el Hospital "Amalia Simoni" durante la pandemia Covid-19 / Clinical-epidemiologic characteristics of the patients admitted in the Hospital "Amalia Simoni" during the Covid-19 pandemics

RESUMEN Introducción: desde los finales del año pasado en Wuhan, se informó de una neumonía de etiología desconocida, que llevó a la Organización Mundial de la Salud a declarar la infección por SARS-CoV-2, como una emergencia sanitaria denominándola como enfermedad por coronavirus 2019 (COVID-19). En Cuba se confeccionó un programa de enfrentamiento, en el cual la atención hospitalaria, siguió un riguroso protocolo de atención a pacientes positivos de la COVID-19, en áreas de cuidados mínimos, intensivos o progresivos. Objetivo: caracterizar clínica/epidemiológica pacientes positivos de la COVID-19, ingresados en el Hospital "Amalia Simoni". Materiales y métodos: se realizó un estudio descriptivo, transversal de 1 066 ingresos en el Hospital "Amalia Simoni", de marzo-mayo del 2020. Se revisaron historias clínicas y se obtuvo: edad, sexo, procedencia, sintomatología, comorbilidades y evolución epidemiológica. Datos que se evaluaron mediante estadísticas descriptivas. Resultados: se halló un predominio de edad media, sin diferencias de sexo, predominaron los casos de la ciudad de Camagüey y de los municipios con mayor urbanización. Prevalecieron la tos y la fiebre, además de la mitad de los casos sin comorbilidades, con solo un pequeño porcentaje de casos confirmados. Conclusiones: con un enfoque basado en la medicina preventiva en los casos estudiados, predominó la edad media, de procedencia de áreas urbanizadas con mayor población y aglomeraciones sociales. Se destacó que el ingreso precoz, basada en la pesquisa de la Atención Primaria logró disminuir los casos confirmados a un pequeño porcentaje, al igual que los graves y un solo fallecido (AU).

ABSTRACT Introduction: from the end of the last year in Wuhan, China, it was informed an unknown etiology pneumonia leading the World Health Organization to declare the infection with SARS-CoV-2 a sanitary emergency naming it coronavirus disease 2019 (Covid-19). A confrontation program was elaborated in Cuba, in which hospital care followed a rigorous protocol to take care to Covid-19-positive patients in areas of minimal, intensive and progressive care. Objective: to clinically/epidemiologically characterize Covid-19-positive patients admitted in the Hospital "Amalia Simoni". Materials and methods: a cross-sectional, descriptive study was carried out in 1 066 patients admitted in the Hospital "Amalia Simoni" in the period March-May 2020. Clinical records were reviewed and data gathered were age, sex, origin, symptomatology, co-morbidities and epidemiological evolution, data obtained through descriptive statistics. Results: it was found the predominance of medium age, without sex differences; the cases of patients from the city of Camaguey and from the municipalities with biggest urbanization predominated. Cough and fever prevailed; half of cases did not have comorbidities, and only a little percent of cases was confirmed. Conclusions: with an approach based in preventive medicine, medium age, and provenance from urban areas with bigger population and social concentrations predominated in the studied cases. It was showed that precocious admission, based on the Primary Health Care screening, succeeded in diminish confirmed cases to a little percent, as diminished the seriously ill ones; only one patient died (AU).

Surgical diseases and surgical outcomes in geriatric patients

Background: To study the demography, disease distribution and co morbid conditions, complications and mortality among elderly patients undergoing operation in general surgical wards.Methods: A prospective observational study was conducted among elderly patients of age ≥60 years admitted in General Surgery wards at our institute for a period of a year. Results: A total of 137 patients were recruited in this study. Out of them 62.04% were men and 37.96% were women. Most common system involved was hepatobiliary with a total of 38 cases (27.7%), most common surgical disease in our study was hernias (27%) and gallstone disease (25%). About 55.5% of our study population had co morbid medical conditions. Hypertension was the most common co morbidity (38%) in our study. Out of 137 cases, 115 cases were elective cases and 22 were emergency cases, operated in emergency settings. About 16.7% of the study population had surgical complications. Post-operative seroma formation at the surgical site was the most common complication. About 7 cases were succumbed to death and mortality rate was about 5.1% in our study population.Conclusion: Prevalence of medical co morbidities is higher in elderly population. Out of them, hypertension and diabetes mellitus are the most common co morbid conditions. Most common indications for elective surgery in our study are hernias and gallstone disease. Early elective surgical intervention is preferred in elderly population when presented, as age, co morbidities and emergency settings increase risk of perioperative mortality.

Health and nutritional status of school children from a rural area of Andhra Pradesh

Background: Healthy children build a wealthy nation. Good health of children is of paramount importance to the nation’s growth. Health and nutritional status of school children is highly variable from one region to another due to different environmental, socioeconomic and cultural factors. Hence health status of school children from each area should be assessed periodically so that relevant health programmes can be applied to prevent common morbidities such as malnutrition, infections and infestations. Methods: A cross sectional study of 500 rural school children from 5 to 15 years was conducted to assess the nutritional status by anthropometry and health status by clinical examination.Results: Out of the 500 school children 46.8% girls, 71.4% were 5 to 10 years old, 70.2% studying in 1st to 5th class.  33.4% were stunted. 25.6% and 27% were underweight according to weight and Body mass index criteria respectively. Common health problems among school children in this study were anemia (31%), dental caries (27.2%), upper respiratory infections (13.4%), skin infections and scabies (12.6%), head lice infestation (6.8%), refractive errors (6%) and ear discharge (5.2%).Conclusions: Though the pattern of nutritional and health problems were same in different studies, the severity of them varied from region to region. Hence periodic screening of school children to identify them and to apply relevant health programmes goes a long way in reducing such morbidities.

Caesarean section in a tertiary care centre

Background: Caesarean section constitutes a major surgical procedure characterized with morbidity even if it is performed a planned procedure. Postoperative infection in obstetrics continues to affect the practice of every surgeon. Infection can cause an increase in patient’s stay in the hospital, create discomfort, cause disfigurement and lead to morbidities to the patient. Thus, preventive measures need to be constantly evaluated and updated and hence authors have to study and analyse prevalence of postoperative infectious morbidities.Methods: The study was conducted in an Urban Based Medical College Hospital in Ahmedabad. It was a retrospective cross-sectional study of 50 cases of patients who suffered infectious complications post caesarean from 1st March 2019 to 31st March 2020.Results: The prevalence rate of surgical site infection in my study is 5.9% whereas of post-operative puerperal sepsis is 0.6%, of post-operative urinary tract infection is 1.09%, of post-operative breast abnormalities is 0.16%. The most common infectious morbidity amongst all was surgical site infection (surgical site) infection and its prevalence was 5.9%.Conclusions: The development of post-operative infection is an important event that can be prevented by taking proper precautions and following prescribed guidelines. There should be specific use of antibiotics in the post-operative period. In the event of early signs of sepsis antibiotics should be administered properly as per culture sensitivity report. The decrease in infection rate also indirectly reduce the health costs involved in treating them post operatively.

Perceived Morbidity Patterns among Workers in the Oil Industry of Nigeria

Background: Globally, the oil industry is replete with several high-risk activities as seen in seismic exploration, construction, drilling, production, and maintenance. Generated hazards could impact exposed workers. Exposure to associated hazards and rigour of activities usually puts workers in oil and gas installations at risk of developing several occupational illnesses. Environmental problems have also been reportedly associated with these activities as well. This study was thus aimed at determining the perceived environmental effects and morbidity patterns among staff of an oil and gas installation in the Niger Delta Region of Nigeria. Methods: A descriptive, cross-sectional study design was used in conducting this study in an onshore oil and gas hub in Nigeria. Study group comprised engineers and technicians of various oil and gas specialties. A random sampling method was used to select 256 personnel from the study population. A self-administered questionnaire was administered to the personnel of the facility. Data was analysed using the Statistical Package for Scientific Solutions (SPSS) version 17.0 (statistical software package) for analyses. Ethical considerations were adhered to during this study. Results: Common complaints include transient tinnitus (97.3%), joint pain of varying degrees (83.6%), occasional prickling sensation in the skin (78.1%) and the lowest frequency of health effects was claims of stressful feeling (56.6%). Environmental problems including the destruction of aquatic biodiversity as well as water contamination were reported in this study. Conclusion: This study found experience of several morbidities by the respondents. They also reported observation of certain environmental problems related with oil exploratory activities at the oil and gas installation. It is recommended that a regular review of measures be put in place to prevent these health and environmental problems from occurring in or around oil and gas installation located in Nigeria

Epidemiological Intersection: The Revelation Of Covid – 19 Pandemic

Human existence and their health rely on their intellectual interactions with ecosystem which eventually accompanies brilliant technological innovations. At par with the technological progress, humans also have been facing several intimidating communicable and non-communicable diseases. Amidst such disease threats, humans have discovered multiple ways to uplift the average life span all over the globe but still not up to the fitness benchmarks of healthy ageing trajectory. COVID-19 has specifically revealed the fragility of humans as they continue succumbing exponentially to the interactions of this communicable disease with their existing non-communicable diseases like hypertension, cardiac pathology and diabetes. In human evolution, the COVID-19 pandemic could be the most perfect synapse or intersection of non-communicable diseases with this transmissible disease leading to a situation that can be even named as “Global Medical Stampede” characterized by sudden increase in the number of patients requiring life-saving procedures for which there is lack of adequate manpower and technological support in health care system. This whole chaotic scenario could easily trigger acute psychological and physiological stress primarily caused by fear among the public favoring the frightening consequences of the pandemic. This article aims to suggest refinement in public health paradigms to enable preparations to face such disease threats from the immediate future without further procrastination.