Background: Skin biopsy is the method to assist clinicians to make definite dermatological diagnosis which further helps in holistic management. Skin cancers are relatively rare clinical diagnosis in developing countries like Nepal, but the prevalence is on rise. Objectives: To investigate the profile of skin biopsies and frequencies and pattern of skin cancers in a tertiary care centre of Western Nepal. Materials and Methods: The materials consisted of 434 biopsies (1.37%) out of 31,450 OPD visits performed in the Department of Dermatology, Manipal Teaching Hospital, Pokhara, Nepal, during the period of Dec 2011-Nov 2014. Data were collected and analyzed using SPSS-16 with reference to incidence, age, sex, race and clinical and histopathological features. Results: The commonest disorders observed in biopsies were papulosquamous lesions, skin tuberculosis of different types, benign skin tumors, leprosy, collagen and fungal diseases. Viral diseases were rarely seen, probably due to straight forward clinical diagnosis. Dermatological malignancies accounted for 55/434 (12.67%) of biopsies. Skin disorders in general were commoner in females 280/434 (64%), including malignancies 32/55(58.2%). Mean age of patients with skin cancer was 54.5 years. Facilities for proper laboratory investigation of dermatological disorders will improve the quality of life. Conclusions: The most prevalent lesion in skin biopsies was papulosquamous disorders followed by skin tuberculosis of different types. Dermatological malignancy constituted 55/434 (12.67%) cases. The prevalence of skin malignancy is on rise in Nepalese society probably due to increase in life expectancy and better diagnostic services.
Purpose: This study was performed to investigate the prevalence, morphology, and calcification pattern of the elongated styloid process in the Mathura population and its relation to gender, age, and mandibular movements. Materials and Methods: The study analyzed digital panoramic radiographs of 2,706 adults. The elongated styloid process was classified with the radiographic appearance based on the morphology and calcification pattern. The limits of mandibular protrusion were evaluated for each subject. The data were analyzed by using a Student's t-test and chi-squared test with significance set at p=0.05. Results: Bilateral elongation having an "elongated" type styloid process with a "partially mineralized" pattern was the most frequent type of styloid process. No correlation was found between styloid process type and calcification pattern on the one hand and gender on the other, although elongated styloid was more prevalent in older and male populations (p<0.05). Further styloid process elongation showed no effect on mandibular protrusive movement (p>0.05). Conclusion: Dentists should recognize the existence of morphological variation in elongated styloid process or Eagle syndrome apparent on panoramic radiographs. We found higher prevalence of elongated styloid process in the population of the Mathura region when compared with other Indian populations. The calcification of the styloid process was more common in the older age group with no correlation to gender, mandibular movement and site. "Type I" with a "partially calcified" styloid process was observed more frequently in the population studied.
Background: The aim of this study was to assess correlation between pain and degenerative bony changes on cone-beam computed tomography (CBCT) images of temporomandibular joints (TMJs). Methods: Two hundred eighty-three temporomandibular joints with degenerative bony changes were evaluated. Pain intensity (numeric rating scale, NRS) and pain duration in patients with degenerative joint disease (DJD) were also analyzed. We classified condylar bony changes on CBCT into five types: osteophyte (Osp), erosion (Ero), flattening (Fla), subchondral sclerosis (Scl), and pseudocyst (Pse). Results: Degenerative bony changes were the most frequent in the age groups of 10~19, 20-29, and 50~59 years. The most frequent pain intensity was "none" (NRS 0, 34.6%) followed by "annoying" (NRS 3-5, 29.7%). The most frequent condylar bony change was Fla (219 joints, 77.4%) followed by Ero (169 joints, 59.7%). "Ero + Fla" was the most common combination of the bony changes (12.7%). The frequency of erosion was directly proportional to NRS, but the frequency of osteophyte was inversely proportional. The prevalence of Ero increased from onset until 2 years and gradually decreased thereafter. The prevalence of Osp, Ero, and Pse increased with age. Conclusions: Osp and Ero can be pain-related variables in degenerative joint disease (DJD) patients. "Six months to 2 years" may be a meaningful time point from the active, unstable phase to the stabilized late phase of DJD.
Purpose: The purpose of this study was to compare the differences in clinical signs and symptoms, and psychological profiles of temporomandibular joint osteoarthritis (TMJ OA) between juvenile and adult patients. Methods: Two-hundred eighty-three TMJ OA patients who visited the Orofacial Pain Clinic of Seoul National University Dental Hospital were classified by juvenile (153 patients; mean age $14.2{\pm}1.7$ years, range 9-16 years) and adult (130 patients; mean age $34.0{\pm}2.8$ years, range 30-40 years) groups, and compared the clinical symptoms based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis I guidelines including Graded Chronic Pain (GCP) scale, mandibular range of motion, and the associated symptoms. Psychological profiles were also evaluated using the Symptom Checklist 90-Revision (SCL-90-R). Results: Juvenile patients reported lower pain intensity and a lower prevalence of headache and clenching than adult patients. Their mandibular range of motion was also higher than adult patients. Juvenile patients showed a lower percentage of patients with T-score above 50 in somatization (SOM), obsessive-compulsive (O-C), interpersonal sensitivity (I-S), and paranoid ideation (PAR) than adults. Based on the GCP scale, the percentage of the high disability group was lower in juveniles. Conclusions: Juvenile TMJ OA patients generally showed milder clinical symptoms than adults. Adult patients showed higher prevalence of psychological problems and higher disability than juvenile patients. Age should be considered in evaluation and treatment of TMJ OA patients to achieve better treatment results and understanding its pathophysiology.
Background: Lung cancer is the most lethal type of cancer in the world. Several benign lung diseases may mimic lung carcinoma in its clinical and radiological presentation, which makes the differential diagnosis for granulomatous diseases more relevant in endemic regions like Brazil. This study was designed to describe the prevalence and the diagnostic work-up of benign diseases that mimic primary lung cancer in patients hospitalized at a university hospital from south of Brazil. Methods: This was a transversal study, which evaluated the medical records of 1,056 patients hospitalized for lung cancer treatment from September 2003 to September 2013 at University Hospital of Santa Maria. Results: Eight hundred and four patients underwent invasive procedures for suspected primary lung carcinoma. Primary lung cancer was confirmed in 77.4% of the patients. Benign disease was confirmed in 8% of all patients. Tuberculosis (n=14) and paracoccidioidomycosis (n=9) were the most frequent infectious diseases. The diagnosis of benign diseases was obtained by flexible bronchoscopy in 55.6% of the cases and by thoracotomy in 33.4%. Conclusion: Infectious diseases are the most frequent benign diseases mimicking lung cancer at their initial presentation. Many of these cases could be diagnosed by minimally invasive procedures such as flexible bronchoscopy. Benign diseases should be included in the differential diagnosis during the investigation for primary lung cancer in order to avoid higher cost procedures and mortality.
Detailed description of malaria in low transmission areas is crucial for elimination. The current study aimed to provide a comprehensive description for malaria transmission in Jazan, a low transmission district, southwestern Saudi Arabia. Patients at a tertiary care hospital were recruited in our study between August 2016 and September 2018. Malaria diagnosis was performed through a species-specific nested polymerase chain reaction (nested PCR), microscopy and Paramax-$3^{TM}$ rapid detection test (RDT). Malaria was detected in 30 patients by the PCR, with point prevalence of 10.9%. Of these malaria infections, 80% was imported, 26.6% was asymptomatic and 23.3% was sub-microscopic. Malaria was reported throughout the year, with February/March and September/October peaks. Infection was significantly more in males than in females (P=0.01). Likewise, infections were detected more in febrile than in non-febrile patients (P=0.01). Adult aged 15-24 years, fever and travel were identified as high-risk factors. Malaria was primarily attributed to Plasmodium falciparum mono-infections, followed by P. vivax mono-infections and lastly to falciparum/vivax mixed infections accounting 76.6%, 16.6%, and 6.6% of PCR-confirmed malaria cases, respectively. The nested PCR was superior to the smear microscopy (sensitivity 76.6%; specificity 100%) and the RDT (sensitivity 83.3%, specificity 94.2%). The overall percent agreement between microscopy and the RDT was 92.7% (kappa=0.63). High proportion of imported malaria including sub-microscopic and sub-patent cases were described. We suggest that incorporation of molecular tool into the conventional malaria diagnosis is beneficial in Jazan district.
Kwon, Yong-Suk;Kim, Yangsuk;Ahn, Eun-Mi;Kang, Hyun Ju;Park, Young-Hee;Kim, Young
The Korean Journal of Community Living Science
/
v.27
no.4
/
pp.875-889
/
2016
The aim of this study was to assess a dietary status and to examine the factors related to the prevalence of metabolic syndrome in Korean children and adolescents. For this study, 5,576 subjects aged 10~18 years, who participated in the health and dietary intake survey (24h recall method) of the 2007~2013 Korea National Health and Nutrition Examination Survey (KNHANES), were sampled. The five components for the diagnosis of metabolic syndrome in the subjects were taken from the modified NCEP-ATP III. The total prevalence of metabolic syndrome among the subjects was 4.6%. The total prevalences of the metabolic syndrome components among the subjects were central obesity 8.4%, hypertriglyceridemia 18.8%, low HDL-cholesterol 13.4%, hypertension 22.4%, and hyperglycemia 5.2%. The gender, age, weight status, frequency of daily meals and eating-out frequency of subjects affected the prevalence of metabolic syndrome. Based on these results, There should be to improve the dietary guidelines and nutrition education to decrease the prevalence of metabolic syndrome for Korean children and adolescents.
The aim of this study was to estimate the benefit from repeated examinations in the diagnosis of enterobiasis in nursery school groups, and to test the effectiveness of individual-based risk predictions using different methods. A total of 604 children were examined using double, and 96 using triple, anal swab examinations. The questionnaires for parents, structured observations, and interviews with supervisors were used to identify factors of possible infection risk. In order to model the risk of enterobiasis at individual level, a similarity-based machine learning and prediction software Constud was compared with data mining methods in the Statistica 8 Data Miner software package. Prevalence according to a single examination was 22.5%; the increase as a result of double examinations was 8.2%. Single swabs resulted in an estimated prevalence of 20.1% among children examined 3 times; double swabs increased this by 10.1%, and triple swabs by 7.3%. Random forest classification, boosting classification trees, and Constud correctly predicted about 2/3 of the results of the second examination. Constud estimated a mean prevalence of 31.5% in groups. Constud was able to yield the highest overall fit of individual-based predictions while boosting classification tree and random forest models were more effective in recognizing Enterobius positive persons. As a rule, the actual prevalence of enterobiasis is higher than indicated by a single examination. We suggest using either the values of the mean increase in prevalence after double examinations compared to single examinations or group estimations deduced from individual-level modelled risk predictions.
Jung, Jaehun;Seo, Hye-Young;Kim, Young Ae;Oh, In-Hwan;Lee, Yo Han;Yoon, Seok-Jun
Journal of Preventive Medicine and Public Health
/
v.46
no.6
/
pp.293-299
/
2013
Objectives: The purposes of this study were to evaluate the prevalence of epilepsy and to estimate the cost of epilepsy in Korea, 2010. Methods: This study used a prevalence based approach to calculate the cost of epilepsy. Claims data from the Korean national health insurance and data from the Korea health panel, the Korea National Statistical Office's records of causes of death, and labor statistics were used to estimate the cost of epilepsy. Patients were defined as those who were hospitalized or visited an outpatient clinic during 2010 with a diagnosis of epilepsy (International Classification of Diseases 10th revision codes G40-G41). Total costs of epilepsy included direct medical costs, direct non-medical cost and indirect costs. Results: The annual prevalence of treated epilepsy was 228 per 100 000 population, and higher in men. The age-specific prevalence was highest for teenagers. The total economic burden of epilepsy was 536 billion Korean won (KW). Indirect cost (304 billion KW) was 1.3 times greater than direct cost (232 billion KW). By gender, the male (347 billion KW) were more burdened than the female (189 billion KW). The estimated cost in young age younger than 20 years old was 24.5% of the total burden of epilepsy. Conclusions: A significant portion of the economic burden of epilepsy is borne by people in young age. To reduce the economic burden of epilepsy, effective prevention and treatment strategies are needed.
This study describes recent trends in incidence, survival and prevalence of subgroups of esophageal and gastric cancer in Linzhou city between 2003 and 2009. Data of esophageal and gastric cancer for the period of interest were extracted from the Linzhou Cancer Registry. Using information on tumor morphology or anatomical site, data were divided into six groups; esophageal squamous cell carcinoma, esophageal adenocarcinoma, other and unspecified types of esophageal cancer, and cardia, non-cardia, and unspecified anatomical site of stomach cancer. Incidence, survival and prevalence rates for each of the six cancer groups were calculated. The majority of esophageal cancers were squamous cell carcinomas (82%). Cardiac cancer was the major gastric cancer group (64%). The incidence of esophageal squamous cell carcinoma and gastric cardiac cancer increased between 2003 and 2009. Both esophageal and gastric cancer had a higher incidence in males compared with females. Overall survival was poor in all sub-groups with 1 year survival ranging from 45.9 to 65.6% and 5 year survival ranging from 14.7 to 30.5%. Prevalence of esophageal squamous cell carcinoma and gastric cardiac cancer was high (accounting for 80% overall). An increased focus on prevention and early diagnosis, especially in esophageal squamous cell carcinoma and gastric cardiac cancer, is required.
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