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Abstract Objectives Breast cancer is a leading cause of morbidity and mortality among women worldwide. This study aims to analyze the trends in breast cancer incidence, mortality, and disability‐adjusted life years (DALYs) across different age groups from 1990 to 2021, and to project the mortality rate for the next decade. Methods Global breast cancer data were analyzed, focusing on three distinct age groups: 15–49 years, 50–69 years, and 70+ years. Joinpoint regression analysis was used to identify periods of significant changes in cancer rate trends (joinpoints). Age‐specific annual percent changes (APC) and average annual percent changes (AAPC) were calculated to identify trends over time. Additionally, an autoregressive integrated moving average (ARIMA) model was employed to forecast future mortality rates. Results The overall incidence of breast cancer increased significantly with an AAPC of 1.6% from 1990 to 2021. The highest increase was observed in the 15–49 years age group (AAPC: 1.3%), while the 70+ years age group showed the lowest increase (AAPC: 0.2%). Mortality rates exhibited a complex pattern, with a modest overall increase (AAPC: 0.8%), a slight increase in the 15–49 years age group (AAPC: 0.4%), and decreases in both 50 and 69 years (AAPC: −0.4%) and 70+ years age groups (AAPC: –0.3%). DALY rates increased slightly overall (AAPC: 0.7%), primarily driven by the 15–49 years age group (AAPC: 0.4%), while the older age groups showed a declining trend (AAPC: −0.4%). Conclusion Incidence rates are rising across all age groups, with the highest increase observed among younger women (15–49 years). In contrast, older age groups (50 + years) are experiencing improvements in mortality and DALYs. These findings underscore the need for targeted public health interventions, enhanced screening practices, and ongoing advancements in breast cancer treatment to address the evolving burden of this disease across different age groups.

Background: Breast cancer is the most prevalent cancer in women worldwide. The progressive rise in breast cancer incidence in young and reproductive-aged women is a cause for concern. Objectives: The primary objective of this study was to investigate the survival of patients with breast cancer in women from the reproductive age group (15-49 years). The secondary objective was to identify significant factors associated with their survival. Materials and Methods: This retrospective study was performed in the Department of Statistics, Utkal University, Odisha, India. We utilized data from the Surveillance, Epidemiology, and End Results (SEER) database, specifically from November 2020, covering 2000 - 2018, maintained by the National Cancer Institute. The Kaplan-Meier non-parametric estimation technique was used for survival estimation, and standard Cox proportional hazard (PH) and Cox PH with a gamma frailty term were employed to determine significant potential determinants. Results: Among women with breast cancer in the reproductive age group, the average survival time was 97.4 months (8.1 years), and the overall survival probability was 0.836. Young women (< 40 years) with breast cancer had poorer survival and a higher risk of death. An increasing incidence of HR+/HER2-subtype of breast cancer was present in 65% of women in this age group. Women with distant metastasis faced a significantly elevated risk (hazard ratio [HR], 66.66, 95% confidence interval [CI], 61.11–72.71), approximately 67 times higher, compared to those with localized staged breast cancer. Furthermore, the ER−/PR+/HER2- group (HR, 6.50; 95% CI, 5.25-8.03) had a similar increased risk of mortality as those in the triple-negative group (HR, 6.25; 95% CI, 5.83-6.71). Conclusion: Young women (15–49 years) consistently have a higher risk of breast cancer recurrence or death as compared to older women (> 49 years). This study provides evidence that the ER/PR/HER2 status is an important prognostic factor and should be considered in the management and treatment decisions for patients with breast cancer in this population.

Abstract Objectives This paper aims to comprehensively analyze trends in gynecological cancers among elderly women in the United States from 1975 to 2020. Methods Surveillance, Epidemiology, and End Results (SEER) population data were utilized for the analysis. Annual Percentage Change (APC) and Average APC were estimated using join‐point regression to assess trends in mortality rates. Results The study reveals an increasing pattern of incidence and mortality in all gynaecological cancer sites except cervical cancer among elderly. The incidence of cervical cancer decreased from 1975 to 2007 and then increased, whereas cancer‐specific mortality decreased from 1977 to 2020, indicating positive advancements in detection and treatment. Conclusions Despite progress in managing certain gynecological cancers, challenges persist, particularly evidenced by increasing mortality rates for cancers in other female genital organs. This underscores the necessity for sustained research efforts and targeted interventions to address these ongoing challenges effectively.

Introduction: The pain after Laparoscopic Cholecystectomy (LC) which has both somatic and visceral component. Interfascial plane blocks play a major role in Multimodal Analgesia (MMA). Previous studies have found good analgesic benefits with Erector Spinae Plane (ESP) and Oblique Subcostal Transversus Abdominis Plane (OSTAP) blocks. However, till date no study exists which compares the above blocks with addition of dexamethasone. Aim: To compare ESP with OSTAP block using low concentration of Local Anaesthetic (LA) and dexamethasone as part of MMA in elective LC. Materials and Methods: A total of 66 patients were included in this study and finally, 60 patients were analysed. They were randomised to receive either bilateral ESP at T7 level or bilateral OSTAP with 20 mL 0.2% ropivacaine and 4 mg dexamethasone before starting anaesthesia. Primary outcome measures were total opioid consumption and mean Visual Analog Scale (VAS) in the first 24 hours postoperatively. Secondary outcome measures were intraoperative opioid consumption, opioids or block related complication, and patients’ feedback for procedural satisfaction and postoperative pain control. The results were analysed using the Statistical Package for the Social Sciences (SPSS) software version 23.0. Continuous and categorical data were analysed using appropriate statistical analysis. A p-value

Background: Place of delivery has major implication on decreasing maternal morbidity and mortality. India has adopted various policies to encourage institutional births, still there are large numbers of deliveries which occur at home. Thus, it is imperative to understand the risk factors associated with home deliveries among women in India. Methods: The national representative district level household data-4 (2012-13) have been used for this analysis. A multiple logistic regression model has been used to determine the significant factors associated with home deliveries. Results: A total of 22,363 live births were selected for analysis for the year 2012. Out of which 3,602 (15.4%) are found to be home delivery births, remaining are either private or government institutional births. North-east states are found to be high prevalence of home deliveries. The potential factors viz., age of women, educational level of both husband and wife, age at first birth, higher order parity and not registered for ANC check-up, etc., are significantly associated with home delivery birth preferences among women in India. Conclusion: Our analysis demonstrates that targeting the significant predictors particularly education of family members and compulsory registration for ANC check-up will significantly reduce the preference for home delivery.

IntroductionSuicide is a major social and health issue in India. Yearly statistics show a concerning increasing pattern of suicidal deaths in India which is higher in comparison to the global trend. There is limited evidence regarding historical analysis of suicide or any forecasting for suicide in India towards predicting the possible risks of death due to suicide.MethodsThis paper examines the trend of suicide rate and characteristics of suicide victims in India, based on the longitudinal time series data over the last 50 years-collected from the National Crime Record Bureau Reports (1969 to 2018) of the Government of India. In our analysis, we have used the time series model to forecast the suicide rates in India for the next decade. ARIMA (4,1,0) model is found to be the best fit model for forecasting the data.FindingsThere has been an observable and rising trend of suicide rates in India over the last five decades. The forecast indicates a continuance of rising suicide cases for an upcoming couple of years in India with a limited decline in the following years. The prediction model indicates a future relatively consistent pattern of suicide in India which does not seem to be a very encouraging trend. As we have not included the period staring the year 2020 onwards affected by Covid-19 and which has several disruptions in personal and family spaces, the projected suicide trend during the period of next two to three years (2020-22) may rise far high and then it may show a declining path. Along with this, there is a shift in means of suicide in the last couple of decades. Constituting the second-highest number of cases, Illness associated suicide was visibly a serious concern.ConclusionThe present analysis finds that there is no visible substantial relief for suicide deaths during the coming years in India. On the other hand, more extensive exploration of sample cases may provide important information for suicide prevention. Availability of detailed and more inclusive data will be highly useful for analysis and suicide preventive policies. Investment in public health care and other welfare activities like education and employment generation will yield visible positive results in suicide control.

Context: Partograph is a simple, effective and low-cost intrapartum monitoring tool that helps in early identification of complications if any and helps in prompt intervention to save the life of the mother and the newborn. There is limited study about its usage and challenges in plotting from India particularly Odisha. Aim: To determine the usage of partograph and explore the issues/challenges in its plotting at various levels of health facilities Settings and Design: A cross-sectional study was carried out from April to June 2018 in ten different public health facilities from two tribal districts of Odisha, India. Materials and Methods: Quantitative information from 1552 mothers using pre-tested epi-info questionnaire tool and qualitative information through 22 in-depth interviews among health care providers. Statistical Analysis Used: Quantitative data using Ms Excel 10 and IBM SPSS ver. 22 and qualitative data using the inductive content analysis method. Results: Partograph plotting was found in 48.7% (adherence) while its completeness was only 1.03%. Partograph plotting was significantly better at CHCs compared to DHH and SDH (P = 0.000). No significant association of partograph adherence was observed with the birth outcome, complications, referral status and type of delivery. Though majority health care providers knew the importance of the partograph, hardly they use it. The main reasons were increased workload, shortage of staff, cases arriving at a later stage and lack of monitoring from a higher level. Conclusions: On job training on partograph, regular monitoring and strict policy will improve the adherence and completeness in partograph plotting.

Context: Overweight and obesity has become a major contributor to global burden of chronic diseases and disability. Obesity among rural India is emerging as a major health problem because of change in lifestyle and food habits, thereby increases the risk of multiple morbid conditions among rural population. Aims: This study aims to find out the association of overweight/obesity with different socio-demographic factors and explore the co-morbidities among overweight and obese in a rural setting. Settings and Design: A cross-sectional study was done in a randomly selected primary health centre of Khurda district, Odisha for 4 months. Materials and Methods: This study was done among 183 patients aged >20 years with BMI >25 kg/m2 after taking their consent. Anthropometric measurements were done and data were collected using a semi-structured questionnaire. Statistical Analysis Used: Descriptive statistics such as proportion, mean and standard deviation were calculated and inferential statistics such as Chi-square test, univariate and multivariate regression was done using the SPSS version 20.0. Results: Mean age of participants was 45.7 (±13.8) years. About 93.4% were Grade II obese while 51.9% were at risk according to their waist–hip ratio. Around 53.6% of participants had multi-morbidity. Age, occupation and number of children were significantly associated with obesity. Morbidity was significantly associated with age, occupation, marital status and number of children. Increased grade in obesity the more is the probability of having morbidity. Conclusions: There is an urgent need to screen for obesity at rural health facility and early management for prevention from co-morbidities.