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This article provides original insight into women's experiences of adulthood diagnoses of attention deficit hyperactivity disorder (ADHD) and autism. Research exploring experiences of adulthood diagnoses of these conditions is emerging. Yet, there is no research about the gendered experiences of an adulthood combined ADHD and autism (AuDHD) diagnosis. This article addresses this gap through interpretative phenomenological analysis of email interviews with six late-diagnosed AuDHD women revealing the complex interplay between late diagnosis, being a woman, and combined diagnoses of ADHD and autism. It underscores how gender norms and stereotypes contribute to the oversight and dismissal of women's neurodivergence. Interpretative phenomenological analysis reveals the inextricability of femininity and neurotypicality, the gendered burden, discomfort, and adverse consequences of masking, along with the adverse outcomes of insufficient masking. Being an undiagnosed AuDHD woman is a confusing and traumatising experience with profound and enduring repercussions. The impact of female hormones exacerbated participants' struggles with (peri)menopause often being a catalyst for seeking diagnosis after decades of trauma. The epistemic injustice of not knowing they were neurodivergent compounded this trauma. Diagnosis enabled participants to overcome epistemic injustice and moved them into a feminist standpoint from which they challenge gendered inequalities relating to neurodiversity. This article aims to increase understanding and representation of late-diagnosed AuDHD women's lived experiences. The findings advocate for trauma-informed pre- and post-diagnosis support which addresses the gendered dimension of women's experiences of being missed and dismissed as neurodivergent. There needs to be better clinical and public understanding of how AuDHD presents in women to prevent epistemic injustice. [ABSTRACT FROM AUTHOR]

Background: Transition readiness, or skills and preparation for navigating adult health care, is an important factor in the successful transition from child and adolescent mental health services (CAMHS) to adult care; however, predictors of transition readiness are not fully understood. One factor which may impact transition readiness among youth accessing CAMHS is the presence of a co‐occurring physical health condition; however, this has not been previously examined. Within a cohort of youth receiving CAMHS, the objective of this study was to understand if there is an association between co‐occurring physical health conditions and transition readiness and if this relationship is impacted by severity of mental health symptoms. Methods: This study was a secondary analysis of baseline data from the Longitudinal Youth in Transition Study, including 237 16‐ to 18‐year‐old youth accessing outpatient CAMHS from four different clinical sites. Participants completed self‐report measures on mental health symptoms, functioning, service use, transition readiness, and physical health conditions. Multiple linear regression models were used to measure the association between the presence of health conditions and transition readiness scores as well as determine if there was an interaction between mental health symptoms and physical health conditions to predict transition readiness. Results: Co‐occurring physical conditions were reported by 41% of youth and were associated with greater overall transition readiness. There was no interaction between mental health symptom severity and co‐occurring physical conditions, though attention problems were independently associated with lower transition readiness scores. Conclusions: Youth accessing CAMHS who have a co‐occurring physical condition have overall greater transition readiness than youth without a co‐occurring condition. Further research should explore the role of frequency and types of healthcare encounters in transition readiness for transition age youth needing ongoing mental health care to better understand how to support self‐management and care navigation skill development. [ABSTRACT FROM AUTHOR]

Background: Tobacco smoke exposure (TSE) is a major public health concern, impacting not only smokers but also those around them, particularly children and adolescents. TSE is linked to various neuropsychiatric conditions and significantly impacts quality of life. This study examines the prevalence, socio-demographic factors, and the impact of TSE on the severity of neurological and psychiatric co-morbidities. Methods: Data from the National Survey of Children's Health (NSCH) in the US from 2020 to 2021 were used in this study. We included 91,404 children and adolescents aged between 0 to 17 years for the TSE prevalence and socio-demographic analysis, and 79,182 children and adolescents aged between 3 and 17 years for the neuropsychiatric co-morbidities analysis. The mean age of these individuals was 8.7 (standard deviation: 5.3), and 11,751 (12.9%) had confirmed TSE. Results: Our analysis showed that TSE is more common in males (53%) than females (47%). Additionally, the odds of TSE were higher in families with a lower income level and with American Indian/Native Alaska racial descent. We found that 36.4% of youths with TSE developed at least one co-morbid condition. The most common neuropsychiatric co-morbidities were anxiety problems (15.7%), Attention-Deficit Hyperactivity Disorder (ADHD) (15.5%), behavioral and conduct problems (13.7%), and learning disability (12%). Females had lower odds of co-morbid anxiety (OR: 0.3, p = 0.02) and Autism Spectrum Disorder (ASD) (OR: 0.9, p = 0.04) than males. Asians showed lower odds of co-morbid ADHD (OR: 0.3, p-value: 0.001), anxiety problems (OR: 0.4, p-value: 0.003), speech/other language disorder (OR: 0.4, p-value: 0.001), developmental delay (OR: 0.4, p-value: 0.001), behavioral and conduct problems (OR: 0.4, p-value: 0.003), and learning disability (OR: 0.5, p-value: 0.004). Conversely, American Indian children and adolescents had higher odds of co-morbid headaches (OR: 3, p-value: 0.005). TSE co-occurring with Tourette's Syndrome (TS) (OR: 4.4, p < 0.001), ADHD (OR: 1.3, p < 0.001), developmental delay (OR: 1.3, p < 0.001), behavioral problems (OR: 1.3, p < 0.001), headaches (OR: 1.3, p = 0.005), depression (OR: 1.2, p = 0.02), anxiety (OR: 1.2, p < 0.01), ASD (OR: 1.2, p < 0.001), and learning disability (OR: 1.2, p = 0.03) may contribute to a more severe manifestation. Conclusions: ADHD, behavioral/conduct problems, and learning disabilities were the most prevalent co-occurring conditions with TSE. Our findings show that 36.4% of youths with TSE had at least one neuropsychiatric comorbidity. Screening for these conditions in youths exposed to TSE is crucial for early detection and interventions to increase their mental health and well-being. [ABSTRACT FROM AUTHOR]

Objective To analyze the co-morbidity of spinal curvature abnormality and myopia and the relevant factors in primary and middle school students in Guangzhou from 2019 to 2023, so as to provide references for the establishment of the mechanism of Co-morbidity, Shared Etiology, and Shared Prevention of common diseases in students. Methods From September 2019 to 2023, used stratified random cluster sampling, 4 248, 4 230, 4 266, 25 476, 25 587 primary and middle school students were selected as subjects for spinal curvature abnormality and myopia screening and questionnaire survey. The SymbolcA@2test was used for comparing the group differences and univariate analysis. The multivariable logistic regression model was used to explore the influencing factors of their co-morbidity. Results the co-morbidity rates of spinal curvature abnormality and myopia were 2.96%-6.00% from 2019 to 2023 in primary and middle school students in Guangzhou. The differences in the co-morbidity rates among students of each phases of studying and the difference of the co-morbidity rate in primary and middle school students over the past 5 years were statistically significant (P＜0.05). Multivariate logistic regression analysis showed that low BMI junior and senior high school students (OR=1.72, 1.89, 95%CI: 1.11-2.67, 1.47-2.41) were more likely to suffer these two diseases. Primary school students in grades 4 to 6 who had menarche or spermatorrhea (OR=1.77, 95%CI: 1.04-3.02), screening time 2-＜3h or≥3h per day (OR=3.06, 2.28, 95%CI: 1.41-6.68, 1.02-5.19), outdoor activities time＜2h per day (OR=2.28, 95%CI: 1.22-4.26), junior high school students with low BMI (OR=1.72, 95%CI: 1.11-2.67), whose teacher "never or occasionally" reminded reading and writing posture (OR=1.50, 95%CI: 1.06-2.12), who were not strict with requiring standing and sitting posture themselves (OR=2.51, 1.99, 95%CI: 1.29-4.86, 1.06-3.74), senior high school students with low BMI (OR=1.89, 95%CI: 1.47-2.41) who had activities in the teaching building during recess (OR=1.33, 95%CI: 1.02-1.75), distance from chest to the edge of table "never or occasionally" more than 1 fist away during reading and writing (OR=1.27, 95%CI: 1.05-1.53) had a higher risk of spinal curvature abnormality and myopiaco-morbidity (P＜0.05). Conclusion The co-morbidity of spinal curvature abnormality and myopia was associated with daytime outdoor exercise and sedentary behavior with bad posture. Early screening and early treatment of spinal curvature abnormality and myopia should be strengthened among adolescent students, especially in urban, female and emaciated students. [ABSTRACT FROM AUTHOR]

Limited research exists regarding the impact of the Ukrainian War on mental distress among refugees or the presentation of post-traumatic stress disorder (PTSD) as a co-morbidity. This study analyzes the mental distress experienced by displaced Ukrainian refugees, including exposure to war-related trauma, PTSD, psychological distress based on socio-demographic factors, prevalence of concurrent mental illnesses, and associated risk factors. Ukrainian refugees in Israel were included in the study shortly after their arrival. Participants completed questionnaires on socio-demographic information, exposure to war-related events, presence of PTSD, depression, anxiety, and current life satisfaction. The 128 participants reported an average of 6.4 traumatic events (SD = 2.97). Among them, 69.5% (n = 89) met the criteria for probable PTSD, 36.7% (N = 47) for depression, and 53.1% (N = 68) for anxiety. The "comorbidity" cohort, consisting of refugees with PTSD and depression/anxiety or both, included 65 participants (53.3%), the "only PTSD" group was 24 participants (19.7%), and 33 (27%) had "no probability". Women and those who had left family members behind were 2.9 and 3.2 times more likely to experience comorbidity, respectively. Refugees with comorbidity reported higher distress and functional impairments compared to the "only PTSD" group, and lower life satisfaction than those with "no probability". This study highlights the significant traumatology experienced by Ukrainian refugees, with attention to the unique impact of comorbidity on functional and subjective well-being among refugees. Therefore, a comprehensive approach is necessary to appropriately diagnose and support refugees, considering the interconnected impact of PTSD, anxiety, and depression. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to study Risk factors, Demographic profile of patients of Influenza A, H1N1 attending the tertiary care centre of Kashmir, North India. Materials and Methods: The present study was carried out at Government Medical College and associated Hospitals Srinagar, Department of Microbiology. Patients with symptoms of Influenza like illness (ILI) attending outpatient department of SMHS and chest diseases hospital as well as hospitalized cases in the month of February 2019, were recruited. 128 Patients of all age groups were included in the study. Clinical specimens of nasopharyngeal and throat swabs (nasal swab/TS) were collected. Results: Out of total 46 influenza positive cases, majority 39% patients belonged to 41-60 years age group followed by 21-40 years (26%), 61-80years (19.5%), 0-20years (10%) and least fraction of patients 4.3% belonged to 81-100 years. 58.6% patients were males while 31.3% patients were females. Hypertension was the chief predisposing factor 10.1% for influenza followed by diabetes mellitus 7.8%. From the 46 influenza patients, 23.9% patients were vaccinated and 76% were non vaccinated. 78.2% patients were reported in IPD and 21.7% cases were reported in OPD. 17 cases of CAP were reported in IPD and 3 cases reported in OPD. 56.5% patients had severe acute respiratory infections and 43.4% patients had influenza like illness. Conclusion: Despite the fact that the H1N1 pandemic has concluded, epidemics serve as a perpetual reminder of the underlying threat. The sole method of minimizing the disease progression and associated mortality appears to be vaccination, early recognition of the disease, and prompt initiation of treatment. [ABSTRACT FROM AUTHOR]

As the COVID‐19 pandemic persists, SARS‐CoV‐2 infection is increasingly associated with long‐term neurological side effects including cognitive impairment, fatigue, depression, and anxiety, colloquially known as "long‐COVID." While the full extent of long‐COVID neuropathology across years or even decades is not yet known, we can perhaps take direction from long‐standing research into other respiratory diseases, such as influenza, that can present with similar long‐term neurological consequences. In this review, we highlight commonalities in the neurological impacts of influenza and COVID‐19. We first focus on the common potential mechanisms underlying neurological sequelae of long‐COVID and influenza, namely (1) viral neurotropism and (2) dysregulated peripheral inflammation. The latter, namely heightened peripheral inflammation leading to central nervous system dysfunction, is emerging as a shared mechanism in various peripheral inflammatory or inflammation‐associated diseases and conditions. We then discuss historical and modern examples of influenza‐ and COVID‐19‐associated cognitive impairment, depression, anxiety, and fatigue, revealing key similarities in their neurological sequelae. Although we are learning that the effects of influenza and COVID differ somewhat in terms of their influence on the brain, as the impacts of long‐COVID grow, such comparisons will likely prove valuable in guiding ongoing research into long‐COVID, and perhaps foreshadow what could be in store for individuals with COVID‐19 and their brain health. [ABSTRACT FROM AUTHOR]

Background and aims: Hyperglycemia, also known as diabetes, is a metabolic disorder characterized by elevated levels of glucose in the bloodstream. It can lead to the prolonged dysfunction, injury, and deterioration of several organs. In addition, dengue is a viral illness transmitted by mosquitoes that has reached epidemic proportions worldwide. In this article, we focused on the severity of comorbidities, difficulties in managing them, and preventive measures meant to lessen the risks associated with comorbidities in diabetic patients with dengue infection. Methods: We explored a number of databases, including PubMed, Scopus, Embase, Web of Science, Google Scholar, and the Cochrane Library, for this review article using various related keywords. Results: The findings of this review article indicate that elderly dengue patients with diabetes should be admitted to the hospital for close observation and early management using fluid therapy. An observed association exists between dengue hemorrhagic fever (DHF) and diabetes, indicating a possible consequence in this specific group. Additionally, patients with diabetes who contract dengue show elevated levels of inflammatory markers. Diabetes mellitus deteriorates the immune system, which exacerbates the progression of dengue fever. Cutting‐edge technology and scientific research may assist in addressing the challenges that diabetes and dengue viruses pose in low‐ and middle‐income countries. Implementing innovative diabetic care management is essential to ensuring consistency of care, improving a healthy lifestyle, and lowering patient risk factors and comorbidities. Conclusion: Dengue fever has spread to epidemic levels throughout the world. Inflammatory markers increase and the prevalence of DHF is greater in diabetes individuals with dengue infection. Given the continued growth of dengue in Asian nations, it is imperative that we concentrate our efforts and resources on providing more precise and effective treatment for this emerging issue. [ABSTRACT FROM AUTHOR]

A drug design strategy called a codrug or mutual prodrug binds two or more pharmacophore with similar or different pharmacological activities elicit synergistic action or help to target the parent drug to specific site/organ/cells respectively and to improve physicochemical, biopharmaceutical and drug delivery properties of therapeutic agents. This review presents various codrug design approach, objectives, properties and therapeutic approach in a methodical manner. Codrugs offer a promising approach in pharmaceutical research, combining multiple active compounds into one molecule to improve drug efficacy and minimize side effects. They can be tailored for specific tissues or organs, making them effective in treating CNS, cardiovascular, cancerous, inflammatory, infectious and comorbid disorders. By enhancing drug delivery through increased lipophilicity, codrugs provide targeted therapy and better outcomes across various medical conditions. Since the 2000s, mutual prodrugs and codrugs have been recognized as potential treatments for a range of illnesses. This approach is commonly used to improve physicochemical, biopharmaceutical and drug delivery properties of therapeutic agents. Additional clinical trial profiles will help expand the scope of codrug therapy. Care must be taken to maximise the positive effects of codrugs while minimising their negative side effects and toxicity. [ABSTRACT FROM AUTHOR]

Introduction: Childhood obesity is associated with chronic low-grade systemic inflammation, which results in obesity-related comorbidities. This study compared the inflammatory markers between obese and normal children and assessed obesity-related comorbidities. Methods: In this cross-sectional analytical study, 40 obese children between 5-18 years of age were recruited as cases, and an equal number of age and gender-matched normal children as the control. The inflammatory markers-high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), and adiponectin were compared between the groups. Hypothyroidism, dyslipidemia, insulin resistance, hypertension, and nonalcoholic fatty liver disease (NAFLD) were screened among obese children. Results: We observed a male-female ratio of 1.5:1 in each group. The median hs-CRP between obese and normal children were 2.53 mg/L (0.94,6.85) and 0.77 mg/L (0.19,7.19), and the median IL-6 levels were 3.56 pg/ml (2.17,5.48) and 3.76 pg/ml (1.08,7.91) respectively. The median IL-10 levels between obese and control groups were 2.06 pg/ml (0.35,6.3) and 1.82 pg/ml (0.41,6.5), and the median adiponectin levels between the groups were 8.6 mcg/ml (6.65,16.04) and 9.79 mcg/ml (8.45,11.91) respectively. We didn’t observe significant differences in the markers between the groups. Dyslipidemia, insulin resistance, and metabolic syndrome were seen in 80%, 52.5%, and 45% of obese children, respectively. Other comorbidities-NAFLD, hypertension, and hypothyroidism, were observed in 27.5%, 25%, and 7.5% of obese children, respectively. IL-6 had a significant positive correlation with total cholesterol (r = 0.40), LDL levels (r = 0.50), and HDL (r = 0.32). Conclusion: There was no difference in inflammatory markers between obese and normal children. Dyslipidemia and insulin resistance were the most common comorbidities.

Abstract Introduction Haemodialysis patients self-report increased levels of anxiety and depression. We wished to determine the prevalence of distress in a multi-ethnic dialysis population and patient factors associated with distress. Methods We reviewed self-reported distress thermometer (DT) scores from 971 haemodialysis patients with corresponding laboratory investigations, bioimpedance body composition and hand grip strength (HGS). Results The median age was 66.0 (55–75) years, 62.9% were male, 46.5% were of white ethnicity and 45.4% were diabetic. The results showed that 57.4% were classified as having no/minimal, 34% moderate, and 8.7% severe distress. Frailty increased from 31.5% to 47.9% and 56%, in the none/minimal, mild to moderate and severe distress groups (χ 2 17.6, p = 0.001), as did smoking (12.9% versus 16.7% versus 25%, χ 2 12.5, p = 0.001), and more patients reporting severe distress had suffered a previous myocardial infarction (MI) (17.4% versus 16.7% versus 27.4%, χ 2 7.1, p = 0.029). Haemoglobin decreased (109.6 ± 14.6 versus 107.6 ± 14.2 versus 103.5 ± 14.4 g/L, p

Background: Recovery processes during residential treatment for eating disorders, especially in patients with a history of maltreatment, are insufficiently understood. This study aimed to explore the temporal relationships among comorbid factors, including depression, anxiety, and self‐compassion, with the influence of childhood maltreatment. Method: Using Dynamic Time Warp (DTW), weekly scores from the Symptom Checklist‐5, Eating Disorder Examination, and Self‐Compassion Scale were analysed over 12 weeks. The study generated undirected and directed networks to identify influential symptoms in a transdiagnostic sample, comparing patients with and without childhood maltreatment. Results: The study included 124 patients with eating disorders (ED) (97% women), mean age of 30.9 years (SD = 9.7, range 18–61 years). Diagnoses included anorexia nervosa (26%), bulimia nervosa (38%), and other specified feeding and eating disorders (36%). The directed DTW network showed that hopelessness, worrying, and restlessness had the highest out‐strength, predicting changes in self‐compassion and ED behaviour. In maltreatment cases, hopelessness and low acceptance predicted changes, while worry, restlessness, and nervousness were predictive in non‐maltreatment cases. Conclusion: Temporal network analyses suggest that a change in hopelessness, worrying, and restlessness drives symptom improvement in ED behaviour and the development of self‐compassion during residential treatment. These processes vary between patients with and without a history of childhood maltreatment separately, indicating the need for further analyses. Key points: Temporal network analysis can contribute to further advances in personalised medicine.Our study indicates that patients with eating disorders (ED) and a history of childhood maltreatment differ from patients without a history of childhood maltreatment in network dynamics, indicating different therapy processes.We find that a change in hopelessness and acceptance of disliked personality traits preceded and predicted change in ED behaviour and the ability to feel self‐compassionate in patients with ED and a history of childhood maltreatment.These findings point to a need to study patients with a history of maltreatment separately to further advance the field of personalised medicine in ED treatment. [ABSTRACT FROM AUTHOR]

Background: Mental illness (MI) remains stigmatized globally, including in India, where suicide and suicidality have been rising. Internalization of society’s negative stereotypes by people with MI is known as internalized MI stigma. Aims: The present paper examined the prevalence of internalized MI stigma in a large sample of rural Indian participants with comorbid chronic medical conditions and previously undiagnosed, mostly mild-to-moderate depression/anxiety. It further examined correlates of internalized MI stigma and its association with suicidality. Subjects and Methods: Face-to-face interviews were conducted at four-time points with adults with depression/anxiety and chronic physical illness in primary health centers in Ramanagaram, Karnataka. Topics included demographics, social support, depression (9-item Patient Health Questionnaire scale), anxiety (7-item General Anxiety Disorder scale), suicidality (Mini-International Neuropsychiatric Interview), and internalized MI stigma (Internalized Stigma of Mental Illness [ISMI] scale). Data analysis included linear and hierarchical logistic regression. Results: At baseline, 29.1% of participants showed a high level of internalized stigma, and 10.4% exhibited at least moderate suicidality. Hierarchical logistic regression showed that every 1-point increase on the ISMI scale more than tripled the odds of moderate to high suicidality (adjusted odds ratio [AOR] 3.24). Those being at least moderately depressed/anxious were 2.4 times more likely to be at least moderately suicidal than participants with no-mild depression/anxiety. Social support lowered the odds of suicidality (AOR 0.44). Conclusions: Internalized MI stigma and suicidality were substantial among these rural adults with mostly mild-to-moderate anxiety/depression. Higher stigma was associated with increased suicidality, independently of depression/anxiety. Therefore, efforts to reduce internalized MI stigma should be included in mental health treatment.

INTRODUCTION. Generalised anxiety disorder (GAD) is the least studied anxiety disorder, as patients present with comorbid mood disorders. Finding effective treatment methods for GAD is of the utmost importance; therefore, it is essential to develop novel medicinal products for GAD. Proper clinical programme design is key to obtaining reliable data on the effectiveness and safety of a medicinal product. Currently, the Russian Federation lacks methodological guidelines for clinical studies of these medcinal products, and there is a need for developing such guidelines.AIM. This review aimed to assess the possibility of applying the methodological approaches described in international guidelines to Russian clinical trials to develop medicinal products for GAD.DISCUSSION. Having analysed the main provisions of the Guideline on the clinical investigation of medicinal products indicated for generalised anxiety disorder by the European Medicines Agency (EMA), the authors of this review outlined the main stages of clinical development and the methodology for using clinical data to evaluate the safety and efficacy of medicinal products for GAD. Clinical development programmes for these medicinal products should take into account research staging and mandatory long-term safety and additive effect assessments. This review highlights aspects of selecting the design, population, and primary and secondary endpoints for a clinical trial. Particular attention is paid to the consideration of comorbidities in patients.CONCLUSION. The provisions set forth in the EMA guideline can inform the development of national guidelines for studying medicinal products for GAD.

Background: HIV/AIDS is a major cause of infant and childhood morbidity and mortality in Africa. It is also an escalating problem of frightening proportions in Nigeria. Objectives: To determine the mode of transmission, clinical presentation, co-morbidity and the outcome among children with HIV/AIDS at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt. Methods: From January 2003 to December 2007, all children with HIV infection who registered in our clinic were followed up prospectively. Clinical and laboratoryevaluation were performed at presentation, the children were managed according to standard treatment guidelines and the outcome noted. Results: Of the 384 children with HIV infection, 190 (49.5 percent) were males and 194 (50.5 percent) females; a M: F ratio of 0.98:1. Their ages ranged from five months to 180 months. Two hundred and sixty three (68.5 percent) of the children were less than 18 months of age at presentation. Three hundred and forty six (90.1 percent) of the children acquired the infection vertically. The common symptoms at presentation in the 336 (87.5 percent) of the children who were symptomatic included fever in 75.3 percent, cough in 64.9 percent, weight loss in 41.1 percent and diarrhoea in 40.8 percent. The common signs were generalized lymphadenopathy in 44.1 percent, pallor in 39.3 percent and hepatomegaly in 38.1 percent. Common co-morbidities included tuberculosis in 23.7 percent and pneumonia in 15.4 percent. Majority (66.9 percent) presented in WHO stage 3 and 4. Twenty seven (7.0 percent) have died while 67 (17.4 percent) have been lost to follow up. Age specific mortality was highest among those aged below 18 months. The greatest contributors to case fatality were pneumonia (44.4 percent) and malnutrition (33.3 percent). Conclusion: Paediatric HIV/AIDS is predominantly transmitted from mother to child and constitutes a significant cause of childhood morbidity and mortality at the UPTH. In view of a high rate of those lost to follow up, it is advocated that strategies such as support groups and expert patient training should be put in place to track down defaulters.

Introduction: Since the outbreak of Coronavirus Disease 2019 (COVID-19) in China, the epidemic has rapidly spread all over the world in just a few months. Different steroids have been proven effective in treating COVID-19 pneumonia. However, comparative efficacy data between different steroids have been evaluated in a few studies from various parts of the world. To date, no study with a large number of patients has been conducted in the eastern part of India. Aim: To compare the efficacy of dexamethasone and methylprednisolone in terms of outcomes and disease progression in COVID-19 pneumonia patients. Materials and Methods: This retrospective cohort study included 377 patients with moderate and severe COVID-19 pneumonia admitted to Medical College and Hospital from May 2020 to December 2020, Kolkata, West Bengal, India. Patient records were divided into two groups based on the type of steroids administered (dexamethasone and methylprednisolone). Clinical, laboratory, treatment, and outcome data were tabulated for analysis. Demographic patterns in the two groups were compared, and efficacy was analysed in terms of hospital course (hospital stay length, type of respiratory support received) and final outcome (cured or death) in both groups. The data collected were analysed using Statistical Package for Social Sciences (SPSS) software version 29.0. Qualitative variables were expressed as counts and percentages, while quantitative variables were presented as mean±Standard Deviation (SD). Results: There were no significant differences between the two treatment groups based on demographic features (age, sex), co-morbidities (diabetes, hypertension, etc.), disease severity (hypoxia, hypotension) on admission day, and smoking status. The study showed that methylprednisolone significantly reduced the requirement for high-flow oxygen (p-value=0.002), Non Invasive Ventilation (NIV) (p-value=0.001), and invasive ventilation (p-value=0.001) compared to dexamethasone. However, there was no significant difference (p-value=0.800) in the duration of hospital stay between the methylprednisolone and dexamethasone treatment groups. Kaplan-Meier survival analysis also showed a significant survival benefit among patients who received methylprednisolone compared to dexamethasone (log-rank p-value=0.039). Conclusion: The present study concludes that in COVID-19 pneumonia, the administration of methylprednisolone leads to a significant reduction in mortality and the need for high-flow oxygen, NIV, and invasive ventilation compared to dexamethasone.

Disordered eating (DE) is associated with elevated cardiometabolic risk (CMR) factors, yet little is known about this association in non-Western countries. We examined the association between DE characteristics and CMR and tested the potential mediating role of BMI. This cross-sectional study included 2005 Chinese women (aged 18–50 years) from the 2015 China Health and Nutrition Survey. Loss of control, restraint, shape concern and weight concern were assessed using selected questions from the SCOFF questionnaire and the Eating Disorder Examination-Questionnaire. Eight CMR were measured by trained staff. Generalised linear models examined associations between DE characteristics with CMR accounting for dependencies between individuals in the same household. We tested whether BMI potentially mediated significant associations using structural equation modelling. Shape concern was associated with systolic blood pressure (β (95 % CI) 0·06 (0·01, 0·10)), diastolic blood pressure (DBP) (0·07 (95 % CI 0·03, 0·11)) and high-density lipoprotein (HDL)-cholesterol (–0·08 (95 % CI –0·12, −0·04)). Weight concern was associated with DBP (0·06 (95 % CI 0·02, 0·10)), triglyceride (0·06 (95 % CI 0·02, 0·10)) and HDL-cholesterol (–0·10 (95 % CI –0·14, −0·07)). Higher scores on DE characteristics were associated with higher BMI, and higher BMI was further associated with lower HDL-cholesterol and higher other CMR. In summary, we observed significant associations between shape and weight concerns with some CMR in Chinese women, and these associations were potentially partially mediated by BMI. Our findings suggest that prevention and intervention strategies focusing on addressing DE could potentially help reduce the burden of CMR in China, possibly through controlling BMI. [ABSTRACT FROM AUTHOR]

Purpose: This study explores the association of the American Society of Anesthesiologists (ASA) score with 90-day mortality in complicated mild traumatic brain injury (mTBI) patients, and in trauma patients without a TBI. Methods: This retrospective study was conducted using a cohort of trauma patients treated at a level III trauma center in Stockholm, Sweden from January to December 2019. The primary endpoint was 90-day mortality. The population was identified using the Swedish Trauma registry. The Trauma and Injury Severity Score (TRISS) was used to estimate the likelihood of survival. Trauma patients without TBI (NTBI) were used for comparison. Data analysis was conducted using R software, and statistical analysis included univariate and multivariate logistic regression. Results: A total of 244 TBI patients and 579 NTBI patients were included, with a 90-day mortality of 8.2% (n = 20) and 5.4% (n = 21), respectively. Deceased patients in both cohorts were generally older, with greater comorbidities and higher injury severity. Complicated mTBI constituted 97.5% of the TBI group. Age and an ASA score of 3 or higher were independently associated with increased mortality risk in the TBI group, with odds ratios of 1.04 (95% 1.00–1.09) and 3.44 (95% CI 1.10–13.41), respectively. Among NTBI patients, only age remained a significant mortality predictor. TRISS demonstrated limited predictive utility across both cohorts, yet a significant discrepancy was observed between the outcome groups within the NTBI cohort. Conclusion: This retrospective cohort study highlights a significant association between ASA score and 90-day mortality in elderly patients with complicated mTBI, something that could not be observed in comparative NTBI cohort. These findings suggest the benefit of incorporating ASA score into prognostic models to enhance the accuracy of outcome prediction models in these populations, though further research is warranted. [ABSTRACT FROM AUTHOR]

Introduction: Childhood obesity is associated with chronic low-grade systemic inflammation, which results in obesity-related comorbidities. This study compared the inflammatory markers between obese and normal children and assessed obesity-related comorbidities. Methods: In this cross-sectional analytical study, 40 obese children between 5-18 years of age were recruited as cases, and an equal number of age and gender-matched normal children as the control. The inflammatory markers-high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), and adiponectin were compared between the groups. Hypothyroidism, dyslipidemia, insulin resistance, hypertension, and nonalcoholic fatty liver disease (NAFLD) were screened among obese children. Results: We observed a male-female ratio of 1.5:1 in each group. The median hs-CRP between obese and normal children were 2.53 mg/L (0.94,6.85) and 0.77 mg/L (0.19,7.19), and the median IL-6 levels were 3.56 pg/ml (2.17,5.48) and 3.76 pg/ml (1.08,7.91) respectively. The median IL-10 levels between obese and control groups were 2.06 pg/ml (0.35,6.3) and 1.82 pg/ml (0.41,6.5), and the median adiponectin levels between the groups were 8.6 mcg/ml (6.65,16.04) and 9.79 mcg/ml (8.45,11.91) respectively. We didn't observe significant differences in the markers between the groups. Dyslipidemia, insulin resistance, and metabolic syndrome were seen in 80%, 52.5%, and 45% of obese children, respectively. Other comorbidities-NAFLD, hypertension, and hypothyroidism, were observed in 27.5%, 25%, and 7.5% of obese children, respectively. IL-6 had a significant positive correlation with total cholesterol (r = 0.40), LDL levels (r = 0.50), and HDL (r = 0.32). Conclusion: There was no difference in inflammatory markers between obese and normal children. Dyslipidemia and insulin resistance were the most common comorbidities. [ABSTRACT FROM AUTHOR]

Eating disorders (EDs) are often accompanied by gastrointestinal (GI) distress. Anxiety sensitivity is the tendency to interpret sensations of anxiety as threatening or dangerous, and includes both broad physical symptoms (e.g., elevated heartrate) and GI‐specific symptoms. Physical and GI‐specific anxiety sensitivity may be important risk and maintaining factors in EDs. This study tested the hypothesis that greater reductions in both types of anxiety sensitivity during the first month of treatment would predict lower ED symptoms and trait anxiety at discharge and 6‐month follow‐up. Patients (n = 424) in ED treatment reported physical and GI‐specific anxiety sensitivity, ED symptoms, and trait anxiety at treatment admission, 1‐month into treatment, discharge, and 6‐month follow‐up. Analyses were conducted with hierarchical linear regression with imputation, controlling for relevant covariates. Results indicated that early reduction in GI‐specific but not general physical anxiety sensitivity predicted both lower ED symptoms and lower trait anxiety at discharge and 6‐month follow‐up. These findings demonstrate the importance of GI‐specific anxiety sensitivity as a potential maintaining factor in EDs. Developing and refining treatments to target GI‐specific anxiety sensitivity may have promise in improving the treatment not only of EDs, but also of commonly co‐morbid anxiety disorders. Highlights: Anxiety sensitivity, the fear of symptoms of anxiety, is common in eating disorders (EDs), and may predict treatment outcomes.In this study, greater reduction in anxiety sensitivity for gastrointestinal symptoms within the first month of ED treatment predicted lower ED symptoms and anxiety at discharge from treatment but not 6‐month follow‐up. By contrast, reduction in more general physical anxiety sensitivity did not predict ED symptoms or anxiety at discharge or follow‐up.Findings highlight the importance of targeting anxiety about body sensations in treatment for EDs. [ABSTRACT FROM AUTHOR]

Purpose: Chronic obstructive pulmonary disease and obstructive sleep apnea are two common respiratory diseases. Chronic obstructive pulmonary disease patients co-morbid with obstructive sleep apnea are associated with increased cardiovascular adverse events, frequent acute exacerbations, and higher mortality. Only a few studies on obstructive sleep apnea among patients with chronic obstructive pulmonary disease are available in Vietnam. The study aims to determine the prevalence of obstructive sleep apnea in patients with chronic obstructive pulmonary disease in Vietnam. Methods: This is a cross-sectional study in patients with chronic obstructive pulmonary disease at multi-sites in Vietnam: the People's Hospital of Gia Dinh, Bach Mai Hospital, Phoi Viet Clinics, and Lam Dong Medical College using type 3 sleep monitoring device at sleep labs to diagnose obstructive sleep apnea in all study participants. Results: Two hundred seventy-eight patients with chronic obstructive pulmonary disease were enrolled. Among the patients, 93.2% were male, with an average age of 66.9 ± 9.3 and a BMI of 21.9 ± 3.8 kg/m2; 82.0% were symptomatic including 44.6% in group B and 37.4% in group D with average post-FEV1 of 49.8 ± 18.3% predicted values. One hundred seventeen patients (42.1%) with chronic obstructive pulmonary disease presented obstructive sleep apnea defined by AHI ≥ 15 events/h. Conclusions: The prevalence of obstructive sleep apnea in patients with chronic obstructive pulmonary disease in Vietnam was 42.1% for an AHI of ≥ 15 events/h. [ABSTRACT FROM AUTHOR]

Introduction: Since the outbreak of Coronavirus Disease 2019 (COVID-19) in China, the epidemic has rapidly spread all over the world in just a few months. Different steroids have been proven effective in treating COVID-19 pneumonia. However, comparative efficacy data between different steroids have been evaluated in a few studies from various parts of the world. To date, no study with a large number of patients has been conducted in the eastern part of India. Aim: To compare the efficacy of dexamethasone and methylprednisolone in terms of outcomes and disease progression in COVID-19 pneumonia patients. Materials and Methods: This retrospective cohort study included 377 patients with moderate and severe COVID-19 pneumonia admitted to Medical College and Hospital from May 2020 to December 2020, Kolkata, West Bengal, India. Patient records were divided into two groups based on the type of steroids administered (dexamethasone and methylprednisolone). Clinical, laboratory, treatment, and outcome data were tabulated for analysis. Demographic patterns in the two groups were compared, and efficacy was analysed in terms of hospital course (hospital stay length, type of respiratory support received) and final outcome (cured or death) in both groups. The data collected were analysed using Statistical Package for Social Sciences (SPSS) software version 29.0. Qualitative variables were expressed as counts and percentages, while quantitative variables were presented as mean±Standard Deviation (SD). Results: There were no significant differences between the two treatment groups based on demographic features (age, sex), co-morbidities (diabetes, hypertension, etc.), disease severity (hypoxia, hypotension) on admission day, and smoking status. The study showed that methylprednisolone significantly reduced the requirement for high-flow oxygen (p-value=0.002), Non Invasive Ventilation (NIV) (p-value=0.001), and invasive ventilation (p-value=0.001) compared to dexamethasone. However, there was no significant difference (p-value=0.800) in the duration of hospital stay between the methylprednisolone and dexamethasone treatment groups. Kaplan-Meier survival analysis also showed a significant survival benefit among patients who received methylprednisolone compared to dexamethasone (log-rank p-value=0.039). Conclusion: The present study concludes that in COVID-19 pneumonia, the administration of methylprednisolone leads to a significant reduction in mortality and the need for high-flow oxygen, NIV, and invasive ventilation compared to dexamethasone. [ABSTRACT FROM AUTHOR]

Background: The transitional state between normal aging and dementia is known as Cognitive impairment (CI) where a person has memory complaints and objective evidence of CI but no evidence of dementia. With the globe undergoing a "demographic transition," the magnitude of neurodegenerative disorders is rising. In India, 27.3% of older persons with comorbidities had CI. Early identification of CI will likely help initiate proper remedial intervention, leading to better overall outcomes. In order to determine the prevalence of CI in older persons and whether it is associated with co-morbid conditions, this study was designed. Methods: A descriptive cross-sectional study was conducted among 350 older adults aged ≥60 residing in rural areas of Lucknow, selected using multistage cluster sampling. The Hindi Mental State Examination (HMSE) scale was used to assess cognitive function. A pretested semi-structured questionnaire was used to collect information on sociodemographic characteristics and comorbidity status. Results: Among 350 participants, with mean ± SD age 70.66 ± 9.53 years, the prevalence of CI as per HMSE (<23) was 24.9%. Overall, the mean HMSE score was less in individuals with (25.2) than without (27.19) comorbidities. Those with comorbidities had significantly lower mean scores in all individual domains of HMSE. Conclusion: CI affects one-fourth of the older adult population. Risk increases with the presence of comorbidities. Hence, screening, and early treatment are recommended. [ABSTRACT FROM AUTHOR]

Obesity is known to increase overall disease burden but does obesity management actually help reduce disease burden? To investigate the effects of weight loss on disease burden in people with obesity using the National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) in Korea. Pure longitudinal observational study using Nationwide cohort database. Out of 514,866 NHIS-HEALS cohort, participants with class II obesity in Asia-Pacific region (30 ≤ body mass index [BMI] < 35) who underwent health check-up provided by NHIS during 2003–2004 (index date) were included. All final participants continued to receive a total of 5 biennial health check-ups over the next 10 years without missing. A group-based trajectory model (GBTM) was used to categorize subjects based on 10-year BMI change patterns. The changes of co-morbidities, healthcare resource utilization, and medical cost were analyzed. The final study subjects (9857) were categorized into 3 trajectory clusters based on the pattern of BMI (kg/m2) change: maintenance (57.35%) with an average change of −.02 ±.06, loss (38.65%) with −.04 ±.08, and substantial loss (4.0%) with −.10 ±.18. The annual increases in the number of co-morbidities per subject in each cluster were.18,.18, and.16 (all P <.001), respectively. The increase of healthcare resource utilization over time was lowest for the substantial loss compared to maintenance and loss. With each passing year, the average annual total healthcare cost increased by ₩21,200 ($16.48, P =.034) and ₩10,500 ($8.16, P =.498) in the maintenance and loss, respectively, but decreased by ₩62,500 ($48.59, P =.032) in the substantial loss. Weight loss in people with obesity was associated with a reduced burden of disease, as evidenced by lower co-morbidity, healthcare resource utilization rate, and decreased medical costs. This study highlights the potential positive long-term impact on Korean society when actively managing weight in individuals with obesity. • People with obesity was categorized according to 10-year body mass index (BMI) change patterns. • Increase of co-morbidities was the slowest in substantial weight loss group. • Use of healthcare resource was the lowest in substantial weight loss group. • Overall healthcare cost was decreased in substantial weight loss group. [ABSTRACT FROM AUTHOR]

Background: Mental illness (MI) remains stigmatized globally, including in India, where suicide and suicidality have been rising. Internalization of society's negative stereotypes by people with MI is known as internalized MI stigma. Aims: The present paper examined the prevalence of internalized MI stigma in a large sample of rural Indian participants with comorbid chronic medical conditions and previously undiagnosed, mostly mild-to-moderate depression/anxiety. It further examined correlates of internalized MI stigma and its association with suicidality. Subjects and Methods: Face-to-face interviews were conducted at four-time points with adults with depression/anxiety and chronic physical illness in primary health centers in Ramanagaram, Karnataka. Topics included demographics, social support, depression (9-item Patient Health Questionnaire scale), anxiety (7-item General Anxiety Disorder scale), suicidality (Mini-International Neuropsychiatric Interview), and internalized MI stigma (Internalized Stigma of Mental Illness [ISMI] scale). Data analysis included linear and hierarchical logistic regression. Results: At baseline, 29.1% of participants showed a high level of internalized stigma, and 10.4% exhibited at least moderate suicidality. Hierarchical logistic regression showed that every 1-point increase on the ISMI scale more than tripled the odds of moderate to high suicidality (adjusted odds ratio [AOR] 3.24). Those being at least moderately depressed/anxious were 2.4 times more likely to be at least moderately suicidal than participants with no-mild depression/anxiety. Social support lowered the odds of suicidality (AOR 0.44). Conclusions: Internalized MI stigma and suicidality were substantial among these rural adults with mostly mild-to-moderate anxiety/depression. Higher stigma was associated with increased suicidality, independently of depression/anxiety. Therefore, efforts to reduce internalized MI stigma should be included in mental health treatment. [ABSTRACT FROM AUTHOR]

Gambling disorder can be treated with cognitive behavioral therapy (CBT), but treatment is under-dimensioned in many settings. For example, in Sweden, a setting with mixed responsibility for addiction treatment between health care and social services, treatment for gambling disorder has only recently been introduced in the responsibilities of public institutions. After the introduction of gambling in treatment legislation in 2018, few studies have assessed the real-world feasibility of such treatment. In addition, treatment in social services specifically has not been documented or evaluated, and therefore, in a pioneer gambling treatment facility in such a setting, this study aimed to investigate treatment outcome in patients with gambling disorder six months after completed CBT treatment within a social service setting. Twenty patients receiving CBT treatment during 2018–2020 were followed with respect to gambling habits at end of treatment and at follow-up six months after treatment. The National Opinion Research Center DSM Screen for Gambling Problems (NODS) was used as screening tool. Rates of gambling abstinence, as well as subjective experience of the treatment, are reported. Ninety percent of the patients were abstinent from gambling at six-month follow-up, and 95 percent of the patients no longer fulfilled criteria of a gambling disorder. In conclusion, these pilot results suggest that CBT treatment is a feasible method for treatment of gambling disorder also in a social service setting. However, due to the limited sample size of this pilot study, and the limited background information of clients who could not be reached, future studies with larger sample sizes are needed.

Abstract Background and aims Hyperglycemia, also known as diabetes, is a metabolic disorder characterized by elevated levels of glucose in the bloodstream. It can lead to the prolonged dysfunction, injury, and deterioration of several organs. In addition, dengue is a viral illness transmitted by mosquitoes that has reached epidemic proportions worldwide. In this article, we focused on the severity of comorbidities, difficulties in managing them, and preventive measures meant to lessen the risks associated with comorbidities in diabetic patients with dengue infection. Methods We explored a number of databases, including PubMed, Scopus, Embase, Web of Science, Google Scholar, and the Cochrane Library, for this review article using various related keywords. Results The findings of this review article indicate that elderly dengue patients with diabetes should be admitted to the hospital for close observation and early management using fluid therapy. An observed association exists between dengue hemorrhagic fever (DHF) and diabetes, indicating a possible consequence in this specific group. Additionally, patients with diabetes who contract dengue show elevated levels of inflammatory markers. Diabetes mellitus deteriorates the immune system, which exacerbates the progression of dengue fever. Cutting‐edge technology and scientific research may assist in addressing the challenges that diabetes and dengue viruses pose in low‐ and middle‐income countries. Implementing innovative diabetic care management is essential to ensuring consistency of care, improving a healthy lifestyle, and lowering patient risk factors and comorbidities. Conclusion Dengue fever has spread to epidemic levels throughout the world. Inflammatory markers increase and the prevalence of DHF is greater in diabetes individuals with dengue infection. Given the continued growth of dengue in Asian nations, it is imperative that we concentrate our efforts and resources on providing more precise and effective treatment for this emerging issue.

This article discusses the co-morbidity of COVID-19 and fungal infections. It highlights the significant role that fungal infections play in the prognosis of COVID-19 patients, with candidemia and mucormycosis being particularly prevalent. The article emphasizes the need for improved antifungal therapies, early detection strategies, and preventive measures to reduce fungal transmission. It also calls for multidisciplinary collaboration and research to better understand the pathogenesis of fungal co-infections in COVID-19 patients. [Extracted from the article]

Introduction: Depression is a significant co-morbid condition for diabetics. Co-morbid depression results in worsened diabetes complications, deleterious effects on self-care activities, non adherence, and poor treatment outcomes. Aim: To assess the prevalence of depression among type 2 diabetic patients attending a tertiary hospital and to find its association with socio-demographic and lifestyle factors. Materials and Methods: A hospital-based cross-sectional study was done in the diabetic clinic of Government Stanley Medical College and Hospital, Chennai, Tamil Nadu, India between June 2016 and August 2016, involving 500 patients with Type II Diabetes Mellitus (T2DM) of less than five years’ duration. The prevalence of depression was calculated using Beck’s Depression Inventory Scale for a period of three months. The results were expressed in proportions, and the association of factors was tested using the Chi-square test and multivariable logistic regression analysis. A p-value

Context: As per the national policy, two doses of COVID-19 vaccine at least four weeks apart were available for administration to all HCW’s since January 2021. A small proportion of individuals will contract COVID-19 despite complete vaccination. Healthcare workers (Health Care Providers) represent a very high-risk group for contracting COVID-19 infection. Aim: To determine the breakthrough infection rate of COVID-19 among vaccinated healthcare providers and students. Methodology: The present cross-sectional study was conducted at All India Institute of Medical Sciences, Nagpur from August to December 2022. The sample size of 308 was achieved through proportionate stratified sampling among different cadres of employees working at the institute. Statistical Analysis: Chi-square test was used for significance. Fischer’s Exact test was used wherever necessary. A P value < 0.05 was considered statistically significant. Strength of the association was estimated using odds ratio. Results: The mean (SD) age of participants in our study was 29.26 (±8.64) years. Prevalence of COVID breakthrough infection was found to be 28.25% [95% CI: 23–33]. It was found that those participants having one or more co-morbidities and are directly involved in COVID patient care were likely to suffer more from COVID-19 breakthrough infection. Conclusion: Predictors of COVID-19 breakthrough infection found to be a presence of one or more co-morbidities, direct involvement with COVID-19 patients and not observing respiratory hygiene. There is increased risk among participants with comorbidities and involving directly in patient care. Therefore, it is recommended that vaccine policy needs to focus on high-risk group.

Introduction: The outbreak of Coronavirus Disease 2019 (COVID-19) affected a large number of people worldwide within a short period of time. The mortality rate was high, and there was no specific medicine available to cure it. Therefore, the situation demanded the rapid development of a vaccine. When the vaccines were introduced, there was limited knowledge about their efficacy, side-effects, and duration of protection. Hence, a detailed study was conducted in these areas. Aim: To study the immunological responses following Covishield vaccination and determine the duration of protection offered by the vaccine. Materials and Methods: The present study is a prospective observational study conducted at Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India from March 2021 to May 2023, involving the staff members of the hospital and college who were above 18-year-old. Individuals with immunodeficiency, those on immunosuppressive medication, or anyone with proof of COVID-19 were excluded. The total sample size was 56. Blood samples were collected before administering the vaccine, at 0, 3, and 12 months, and tested for Complete Blood Count (CBC), COVID-19-specific Immunoglobulin G (IgG), Cluster of Differentiation (CD) 45, CD3, CD4, CD8, etc. The findings were statistically analysed using Statistical Packages of Social Sciences (SPSS) software version 22.0 and STATA software version 10. Results: A total of 154 volunteers initially provided the first blood samples. However, only 129 of them provided blood samples 2nd time and received two doses of the vaccine. Out of these, only 56 participants completed the fourth time blood test. The results consistently demonstrated a rise in IgG levels over time, with consistently higher levels observed in females. Participants above 45 years exhibited higher IgG levels. Individuals with co-morbidities also showed an increase in IgG levels. The research revealed that individuals who were initially IgG negative experienced a greater fold increase in IgG levels after the first dose of vaccination. The incidence and duration of side-effects post-vaccination reduced with each successive vaccine dose. Conclusion: All the volunteers developed adequate IgG antibodies. Two doses of Covishield effectively resulted in lasting immunity in 94.64% of cases, and three doses achieved 100% immunity. Females and participants above 45 years consistently exhibited higher antibody levels. Individuals with co-morbidities also developed antibodies, albeit at slightly lower levels. The side-effects were mild and short-lived. No long-term after effects were detected even after two years and two months following vaccination.

BackgroundDecedents with late-life dementia are often found at autopsy to have vascular pathology, cortical Lewy bodies, hippocampal sclerosis, and/or TDP-43 encephalopathy alone or with concurrent Alzheimer's disease (AD) lesions. Nonetheless, it is commonly believed that AD neuropathologic changes (NC) are the dominant or exclusive drivers of late-life dementia.ObjectiveAssess associations of end-of-life cognitive impairment with any one or any combination of five distinct NC. Assess impairment prevalence among subjects having natural resistance to each type of NC.MethodsBrains from 1,040 autopsied participants of the Honolulu-Asia Study, the Nun Study, and the 90 + Study were examined for NC of AD, Lewy body dementia, microvascular brain injury, hippocampal sclerosis, and limbic predominate TDP-43 encephalopathy. Associations with impairment were assessed for each NC and for NC polymorbidity (variable combinations of 2-5 concurrent NC).ResultsAmong 387 autopsied decedents with severe cognitive impairment, 20.4% had only AD lesions (ADNC), 25.3% had ADNC plus 1 other NC, 11.1% had ADNC plus 2 or more other NC, 28.7% had no ADNC but 1-4 other NC, and 14.5% had no/negligible NC. Combinations of any two, three, or four NC were highly frequent among the impaired. Natural resistance to ADNC or any other single NC had a modest impact on overall cohort impairment levels.ConclusionPolymorbidity involving 1-5 types of concurrent NC is a dominant neuropathologic feature of AD and related dementias. This represents a daunting challenge to future prevention and could explain failures of prior preventive intervention trials and of efforts to identify risk factors.

Turner syndrome (TS) affects 50 per 100 000 females. TS affects multiple organs through all stages of life, necessitating multidisciplinary care. This guideline extends previous ones and includes important new advances, within diagnostics and genetics, estrogen treatment, fertility, co-morbidities, and neurocognition and neuropsychology. Exploratory meetings were held in 2021 in Europe and United States culminating with a consensus meeting in Aarhus, Denmark in June 2023. Prior to this, eight groups addressed important areas in TS care: (1) diagnosis and genetics, (2) growth, (3) puberty and estrogen treatment, (4) cardiovascular health, (5) transition, (6) fertility assessment, monitoring, and counselling, (7) health surveillance for comorbidities throughout the lifespan, and (8) neurocognition and its implications for mental health and well-being. Each group produced proposals for the present guidelines, which were meticulously discussed by the entire group. Four pertinent questions were submitted for formal GRADE (Grading of Recommendations, Assessment, Development and Evaluation) evaluation with systematic review of the literature. The guidelines project was initiated by the European Society for Endocrinology and the Pediatric Endocrine Society, in collaboration with members from the European Society for Pediatric Endocrinology, the European Society of Human Reproduction and Embryology, the European Reference Network on Rare Endocrine Conditions, the Society for Endocrinology, and the European Society of Cardiology, Japanese Society for Pediatric Endocrinology, Australia and New Zealand Society for Pediatric Endocrinology and Diabetes, Latin American Society for Pediatric Endocrinology, Arab Society for Pediatric Endocrinology and Diabetes, and the Asia Pacific Pediatric Endocrine Society. Advocacy groups appointed representatives for pre-meeting discussions and the consensus meeting. [ABSTRACT FROM AUTHOR]

While motor and psychiatric phenotypes in idiopathic dystonia are increasingly well understood, a few studies have examined the rate, type, and temporal pattern of other clinical co-morbidities in dystonia. Here, we determine the rates of clinical diagnoses across 13 broad systems-based diagnostic groups, comparing an overall idiopathic dystonia cohort, and sub-cohorts of cervical dystonia, blepharospasm, and dystonic tremor, to a matched-control cohort. Using the SAIL databank, we undertook a longitudinal population-based cohort study (January 1st 1994–December 31st 2017) using anonymised electronic healthcare records for individuals living in Wales (UK), identifying those diagnosed with dystonia through use of a previously validated algorithm. Clinical co-morbid diagnoses were identified from primary health care records, with a 10% prevalence threshold required for onward analysis. Using this approach, 54,166 dystonia cases were identified together with 216,574 matched controls. Within this cohort, ten of the main ICD-10 diagnostic codes exceeded the 10% prevalence threshold over the 20-year period (infection, neurological, respiratory, gastrointestinal, genitourinary, dermatological, musculoskeletal, circulatory, neoplastic, and endocrinological). In the overall dystonia cohort, musculoskeletal (aOR: 1.89, aHR: 1.74), respiratory (aOR: 1.84; aHR: 1.65), and gastrointestinal (aOR: 1.72; aHR: 1.6) disorders had the strongest associations both pre- and post-dystonia diagnosis. However, variation in the rate of association of individual clinical co-morbidities was observed across the cervical, blepharospasm, and tremor dystonia groups. This study suggests an increased rate of specific co-morbid clinical disorders both pre- and post-dystonia diagnosis which should be considered during clinical assessment of those with dystonia to enable optimum symptomatic management. [ABSTRACT FROM AUTHOR]

Copyright of Cyprus Turkish Journal of Psychiatry & Psychology (CTJPP) / Kıbrıs Türk Psikiyatri ve Psikoloji Dergisi is the property of Cyprus Turkish Journal of Psychiatry & Psychology (CTJPP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Depression is a significant co-morbid condition for diabetics. Co-morbid depression results in worsened diabetes complications, deleterious effects on self-care activities, non adherence, and poor treatment outcomes. Aim: To assess the prevalence of depression among type 2 diabetic patients attending a tertiary hospital and to find its association with socio-demographic and lifestyle factors. Materials and Methods: A hospital-based cross-sectional study was done in the diabetic clinic of Government Stanley Medical College and Hospital, Chennai, Tamil Nadu, India between June 2016 and August 2016, involving 500 patients with Type II Diabetes Mellitus (T2DM) of less than five years' duration. The prevalence of depression was calculated using Beck's Depression Inventory Scale for a period of three months. The results were expressed in proportions, and the association of factors was tested using the Chi-square test and multivariable logistic regression analysis. A p-value <0.05 was considered statistically significant. Results: The study included 500 participants, of whom the majority (276, 55%) were female, with a mean age of 46.2 years. The prevalence of depression was 55 (11%). It was found that being female, illiterate, and unemployed were significantly associated with depression. Among disease-related factors, diabetes duration of 3-5 years, insulin injection usage, and the presence of diabetic complications were significantly associated with depression. Regarding lifestyle factors, the prevalence of depression was significantly higher among those who were non adherent to dietary modification practices and those with family worries and work-related tension. Multivariable logistic regression analysis revealed that the independent predictors of depression among diabetics were the presence of diabetic complications {Odds Ratio (OR)-2.48 (1.27-4.84)}, family worries {OR-2.54 (1.34-4.80)}, non adherence to follow-up {OR-2.61 (1.37-4.99)}, and non compliance with dietary modifications {OR-2.93 (1.43-5.99)}. Conclusion: The present study revealed that about one in 10 (11%) diabetics with less than five years' duration have associated depression, with significant independent predictors being non compliant behaviours, the presence of complications, and family issues. Hence, diabetics should be screened simultaneously for depression, giving due attention to those with complications, family issues, and non compliant behaviours. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Uludag University Medical Faculty / Uludağ Üniversitesi Tıp Fakültesi Dergisi is the property of Journal of Uludag University Medical Faculty and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)