ABSTRACT
Leakage of methyl isocyanate from the Union Carbide plant in Bhopal, India, killed thousands and left deleterious trans-generational effects. Gas-exposed populations experience higher rates of lung and metabolic diseases, and immune dysregulation, all associated with adverse outcomes in coronavirus disease 2019 (COVID-19). We used publicly available, official data from government sources to estimate COVID-19-associated crude mortality in populations with and without a history of gas exposure. Overall, there were 1240 deaths among patients hospitalized with known COVID-19 in Bhopal, of which 453 (36.53%) were in gas-exposed individuals, 726 (58.55%) were in gas-unexposed individuals and the exposure status of 61 (4.92%) individuals could not be determined. There were 351 and 375 deaths in gas-unexposed people in the first (April 2020-February 2021) and second (March 2021-July 2021) waves, respectively; in the gas-exposed population, there were 300 and 153 deaths in the two respective waves. The overall annualized crude mortality of COVID-19 was 3.84 (95% CI 3.41 to 4.33) times higher in the gas-exposed population at 83.6 (95% CI 76.1 to 91.7) per 100 000 compared with the gas-unexposed population, at 21.8 (95% CI 20.2 to 23.4) per 100,000. When stratified by age, compared with unexposed people, the gas-exposed individuals experienced 1.88 (95% CI 1.61 to 2.21) and 1.24 (95% CI 1.02 to 1.50) times the mortality rates in the age groups of 35-65 and >65 y, respectively. These findings indicate that gas-exposed individuals are likely to have a higher risk of severe COVID-19 and death and need to be specifically targeted and recognized for preventive and promotive efforts.
Subject(s)
COVID-19 , SARS-CoV-2 , Humans , COVID-19/mortality , COVID-19/epidemiology , India/epidemiology , Adult , Male , Female , Middle Aged , Isocyanates/adverse effects , Survivors/statistics & numerical data , Aged , Bhopal Accidental Release , Environmental Exposure/adverse effects , Adolescent , Young Adult , Child , Child, PreschoolABSTRACT
BACKGROUND: It is ascertained that the survival rate of patients infected with type 16 human papillomavirus (HPV16) positive is better as compared to those infected with HPV16 negative. The present study was conducted to determine rgw role of HPV16 and risk factors in assessing oropharyngeal cancer (OPC) death. METHODOLOGY: A total of 102 clinically and histologically proven cases of oral pharyngeal cancer were included. Seropositivity for HPV16 E6 as a marker of HPV16-positive cancer was estimated. RESULTS: Out of 102 patients, there were 70 males and 32 females. Significant risk factors associated with OPC survival overall in the univariate analysis was female sex (hazard ratio [HR] 0.54, 95% confidence level [CL]: 0.36-80), alcohol use >2 drinks/day (HR 1.54, 95% CL: 1.12-2.08), smoking >10 pack-years (HR 2.20, 95% CL: 1.42-3.58), moderate dental (HR 1.54, 95% CL: 1.02-2.32), underweight (HR 2.24, 95% CL: 1.34-3.60), and Stage IV cancer (HR 2.82, 95% CL: 1.76-4.40). There was significant low risk for death among HPV16 positive (HR 0.48, 95% CL: 0.32-0.70). CONCLUSION: HPV16 status is an independent prognostic factor for OPC deaths. The common risk factors were female gender, moderate oral care, underweight body mass index, excessive alcohol, and smoking tobacco.
ABSTRACT
Osteomas are osteogenic tumors that commonly affects frontal and ethmoidal sinuses. Temporal osteomas are extremely rare with less than 200 cases have been reported in the literature; within the temporal bone, osteoma rarely affects the mastoid but commonly involves external auditory meatus, middle ear, and styloid process. We present here a case of osteoma of mastoid region of temporal bone presenting as a single painless postauricular mass.
