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1. Elevated Homocysteine Level and Brain Atrophy Changes as Markers to Screen the Alzheimer Disease: Case Series

Author: Ram Prakash Sah, C. S. Vidya, Pratibha Pereira, Shubha Jayaram, Anshu Kumar Yadav, and P. Sujatha
Subjects: alzheimer's disease, brain atrophy, homocysteine, vitamin b12, Medicine, Geriatrics, RC952-954.6
Abstract: Alzheimer disease (AD) is the most common cause of dementia worldwide. Its clinical manifestations include a progressive loss of memory and other cognitive domains, as well as brain atrophy. An elevated homocysteine level (>15 µmol/L), known as hyperhomocysteinemia, is also an attributing risk factor for AD, vascular pathologies, and brain atrophy. Neuroimaging studies including T2-weighted magnetic resonance imaging scans revealed white matter hyperintensities in the periventricular and deep white matter, enlarged ventricles, widened sulci, and decreased white matter mass, which are features of aging, as well as cerebrovascular changes. This case series investigated changes in biochemical marker levels including serum homocysteine, folate, and vitamin B12, and the degree of atrophic variations in cortical-subcortical white matter in AD. The present study hypothesized that serum homocysteine levels might be used as a surrogate marker to screen for AD at an earlier stage.
Published: 2024
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2. Estimation of Serum Adenosine Deaminase Levels as a Marker for Risk Assessment and Immunomodulation in Patients with Diabetic Foot

Author: K Deepa, MS Shwetha, Sudhir, Divya Shree, P Manoj, Shubha jayaram, and Manjunatha Goud
Subjects: blood glucose, cell-mediated immunity, diabetic complication, t-lymphocyte function, Medicine
Abstract: Introduction: Diabetic foot ulcers are critical complications of uncontrolled diabetes, with peripheral neuropathy, peripheral arterial disease, and immune suppression as primary contributing factors. Adenosine Deaminase (ADA), an enzyme, has been identified as a promising marker for cell-mediated immunity. Its estimation may serve as a predictive marker for immunomodulation, which, in turn, leads to complications among individuals with diabetes. Aim: To estimate serum ADA levels in diabetic patients without diabetic foot and diabetic patients with diabetic foot. Additionally, the study aimed to investigate the association of ADA serum levels with glucose, Glycated Haemoglobin (HbA1c), and the severity of wounds. Materials and Methods: This cross-sectional study was conducted in the central laboratory Department of Biochemistry at Krishna Rajendra Hospital (KR Hospital), Mysuru Medical College and Research Institute, Mysuru, India, from August to September 2021. The study included diabetic foot cases (n=45) and Type 2 diabetes patients on regular follow-up in the Department of Medicine without diabetic foot and any other complications (n=45). Venous blood samples were analysed for ADA, glucose, HbA1c, and complete blood count. The data were statistically analysed using the Mann-Whitney U test, Kruskal-Wallis test, and Spearman rank correlation test. Results: The present study observed a higher incidence of diabetic foot among males. It showed a statistically significant increase in serum ADA, HbA1C, and neutrophil count in patients with diabetic foot compared to patients with diabetes without diabetic foot ulcers, with mean Standard Deviation (SD) of 71.79±25.11, 11.53±3.11%, and 75.91±9.77%, respectively. Serum ADA exhibited a positive correlation with HbA1C and different grades of ulcers. Conclusion: The present study demonstrated a significantly increased serum ADA in diabetic ulcers and a positive correlation with different grades of ulcers. This finding contributes to a better understanding of the disease's pathogenesis at different stages. Furthermore, the positive correlation between ADA and HbA1C levels may play an important role in predicting the glycaemic and immunological status of these patients.
Published: 2024
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3. Global, regional, and national incidence of six major immune-mediated inflammatory diseases: findings from the global burden of disease study 2019Research in context

Author: Dongze Wu, Yingzhao Jin, Yuhan Xing, Melsew Dagne Abate, Mohammadreza Abbasian, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Foad Abd-Allah, Michael Abdelmasseh, Mohammad-Amin Abdollahifar, Deldar Morad Abdulah, Aidin Abedi, Vida Abedi, Hassan Abidi, Richard Gyan Aboagye, Hassan Abolhassani, Katrina Abuabara, Morteza Abyadeh, Isaac Yeboah Addo, Kayode Nelson Adeniji, Abiola Victor Adepoju, Miracle Ayomikun Adesina, Qorinah Estiningtyas Sakilah Adnani, Mohsen Afarideh, Shahin Aghamiri, Antonella Agodi, Anurag Agrawal, Constanza Elizabeth Aguilera Arriagada, Aqeel Ahmad, Danish Ahmad, Sajjad Ahmad, Sohail Ahmad, Ali Ahmadi, Ali Ahmed, Ayman Ahmed, Janardhana P. Aithala, Abdullateef Abiodun Ajadi, Marjan Ajami, Mostafa Akbarzadeh-Khiavi, Fares Alahdab, Mohammad T. AlBataineh, Sharifullah Alemi, Adel Ali Saeed Al-Gheethi, Liaqat Ali, Sheikh Mohammad Alif, Joseph Uy Almazan, Sami Almustanyir, Jaber S. Alqahtani, Ibrahim Alqasmi, Ihsan Ullah Khan Altaf, Nelson Alvis-Guzman, Nelson J. Alvis-Zakzuk, Yaser Mohammed Al-Worafi, Hany Aly, Reza Amani, Hubert Amu, Ganiyu Adeniyi Amusa, Catalina Liliana Andrei, Adnan Ansar, Hossein Ansariniya, Anayochukwu Edward Anyasodor, Jalal Arabloo, Reza Arefnezhad, Judie Arulappan, Mohammad Asghari-Jafarabadi, Tahira Ashraf, Jamila Abdulhamid Atata, Seyyed Shamsadin Athari, Daniel Atlaw, Maha Moh'd Wahbi Atout, Avinash Aujayeb, Asma Tahir Awan, Haleh Ayatollahi, Sina Azadnajafabad, Ahmed Y. Azzam, Alaa Badawi, Ashish D. Badiye, Sara Bagherieh, Atif Amin Baig, Berihun Bantie Bantie, Martina Barchitta, Mainak Bardhan, Suzanne Lyn Barker-Collo, Francesco Barone-Adesi, Kavita Batra, Nebiyou Simegnew Bayileyegn, Amir Hossein Behnoush, Uzma Iqbal Belgaumi, Maryam Bemanalizadeh, Isabela M. Bensenor, Kebede A. Beyene, Akshaya Srikanth Bhagavathula, Pankaj Bhardwaj, Sonu Bhaskar, Ajay Nagesh Bhat, Saeid Bitaraf, Veera R. Bitra, Archith Boloor, Kaustubh Bora, João Silva Botelho, Rachelle Buchbinder, Daniela Calina, Luis Alberto Cámera, Andre F. Carvalho, Jeffrey Shi Kai Chan, Vijay Kumar Chattu, Endeshaw Chekol Abebe, Fatemeh Chichagi, Sungchul Choi, Tzu-Chieh Chou, Dinh-Toi Chu, Kaleb Coberly, Vera Marisa Costa, Rosa A.S. Couto, Natália Cruz-Martins, Omid Dadras, Xiaochen Dai, Giovanni Damiani, Ana Maria Dascalu, Mohsen Dashti, Sisay Abebe Debela, Robert Paul Dellavalle, Andreas K. Demetriades, Alemayehu Anley Demlash, Xinlei Deng, Hardik Dineshbhai Desai, Rupak Desai, Syed Masudur Rahman Dewan, Sourav Dey, Samath Dhamminda Dharmaratne, Daniel Diaz, Mahmoud Dibas, Ricardo Jorge Dinis-Oliveira, Mengistie Diress, Thanh Chi Do, Duy Khanh Doan, Masoud Dodangeh, Milad Dodangeh, Deepa Dongarwar, John Dube, Arkadiusz Marian Dziedzic, Abdelaziz Ed-Dra, Hisham Atan Edinur, Negin Eissazade, Michael Ekholuenetale, Temitope Cyrus Ekundayo, Noha Mousaad Elemam, Muhammed Elhadi, Ahmed O. Elmehrath, Omar Abdelsadek Abdou Elmeligy, Mehdi Emamverdi, Theophilus I. Emeto, Hawi Leul Esayas, Habitu Birhan Eshetu, Farshid Etaee, Adeniyi Francis Fagbamigbe, Shahriar Faghani, Ildar Ravisovich Fakhradiyev, Ali Fatehizadeh, Mobina Fathi, Alireza Feizkhah, Ginenus Fekadu, Mohammad Fereidouni, Seyed-Mohammad Fereshtehnejad, João C. Fernandes, Pietro Ferrara, Getahun Fetensa, Irina Filip, Florian Fischer, Behzad Foroutan, Masoud Foroutan, Takeshi Fukumoto, Balasankar Ganesan, Belete Negese Belete Gemeda, Seyyed-Hadi Ghamari, MohammadReza Ghasemi, Maryam Gholamalizadeh, Tiffany K. Gill, Richard F. Gillum, Mohamad Goldust, Mahaveer Golechha, Pouya Goleij, Davide Golinelli, Houman Goudarzi, Shi-Yang Guan, Yang Guo, Bhawna Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Rasool Haddadi, Najah R. Hadi, Rabih Halwani, Shafiul Haque, Ikramul Hasan, Reza Hashempour, Amr Hassan, Treska S. Hassan, Sara Hassanzadeh, Mohammed Bheser Hassen, Johannes Haubold, Khezar Hayat, Golnaz Heidari, Mohammad Heidari, Reza Heidari-Soureshjani, Claudiu Herteliu, Kamran Hessami, Kamal Hezam, Yuta Hiraike, Ramesh Holla, Mohammad-Salar Hosseini, Hong-Han Huynh, Bing-Fang Hwang, Segun Emmanuel Ibitoye, Irena M. Ilic, Milena D. Ilic, Arad Iranmehr, Farideh Iravanpour, Nahlah Elkudssiah Ismail, Masao Iwagami, Chidozie C.D. Iwu, Louis Jacob, Morteza Jafarinia, Abdollah Jafarzadeh, Kasra Jahankhani, Haitham Jahrami, Mihajlo Jakovljevic, Elham Jamshidi, Chinmay T. Jani, Manthan Dilipkumar Janodia, Sathish Kumar Jayapal, Shubha Jayaram, Jayakumar Jeganathan, Jost B. Jonas, Abel Joseph, Nitin Joseph, Charity Ehimwenma Joshua, K. Vaishali, Billingsley Kaambwa, Ali Kabir, Zubair Kabir, Vidya Kadashetti, Feroze Kaliyadan, Fatemeh Kalroozi, Vineet Kumar Kamal, Amit Kandel, Himal Kandel, Srikanta Kanungo, Jafar Karami, Ibraheem M. Karaye, Hanie Karimi, Hengameh Kasraei, Sina Kazemian, Sewnet Adem Kebede, Leila Keikavoosi-Arani, Mohammad Keykhaei, Yousef Saleh Khader, Himanshu Khajuria, Faham Khamesipour, Ejaz Ahmad Khan, Imteyaz A. Khan, Maseer Khan, Md Jobair Khan, Moien A.B. Khan, Muhammad Arslan Khan, Haitham Khatatbeh, Moawiah Mohammad Khatatbeh, Sorour Khateri, Hamid Reza Khayat Kashani, Min Seo Kim, Adnan Kisa, Sezer Kisa, Hyun Yong Koh, Pavel Kolkhir, Oleksii Korzh, Ashwin Laxmikant Kotnis, Parvaiz A. Koul, Ai Koyanagi, Kewal Krishan, Mohammed Kuddus, Vishnutheertha Vishnutheertha Kulkarni, Narinder Kumar, Satyajit Kundu, Om P. Kurmi, Carlo La Vecchia, Chandrakant Lahariya, Tri Laksono, Judit Lám, Kamaluddin Latief, Paolo Lauriola, Basira Kankia Lawal, Thao Thi Thu Le, Trang Thi Bich Le, Munjae Lee, Seung Won Lee, Wei-Chen Lee, Yo Han Lee, Jacopo Lenzi, Miriam Levi, Wei Li, Virendra S. Ligade, Stephen S. Lim, Gang Liu, Xuefeng Liu, Erand Llanaj, Chun-Han Lo, Vanessa Sintra Machado, Azzam A. Maghazachi, Mansour Adam Mahmoud, Tuan A. Mai, Azeem Majeed, Pantea Majma Sanaye, Omar Mohamed Makram, Elaheh Malakan Rad, Kashish Malhotra, Ahmad Azam Malik, Iram Malik, Tauqeer Hussain Mallhi, Deborah Carvalho Malta, Mohammad Ali Mansournia, Lorenzo Giovanni Mantovani, Miquel Martorell, Sahar Masoudi, Seyedeh Zahra Masoumi, Yasith Mathangasinghe, Elezebeth Mathews, Alexander G. Mathioudakis, Andrea Maugeri, Mahsa Mayeli, John Robert Carabeo Medina, Gebrekiros Gebremichael Meles, José João Mendes, Ritesh G. Menezes, Tomislav Mestrovic, Irmina Maria Michalek, Ana Carolina Micheletti Gomide Nogueira de Sá, Ephrem Tesfaye Mihretie, Le Huu Nhat Minh, Reza Mirfakhraie, Erkin M. Mirrakhimov, Awoke Misganaw, Ashraf Mohamadkhani, Nouh Saad Mohamed, Faezeh Mohammadi, Soheil Mohammadi, Salahuddin Mohammed, Shafiu Mohammed, Syam Mohan, Anita Mohseni, Ali H. Mokdad, Sara Momtazmanesh, Lorenzo Monasta, Mohammad Ali Moni, Md Moniruzzaman, Yousef Moradi, Negar Morovatdar, Ebrahim Mostafavi, Parsa Mousavi, George Duke Mukoro, Admir Mulita, Getaneh Baye Mulu, Efrén Murillo-Zamora, Fungai Musaigwa, Ghulam Mustafa, Sathish Muthu, Firzan Nainu, Vinay Nangia, Sreenivas Narasimha Swamy, Zuhair S. Natto, Perumalsamy Navaraj, Biswa Prakash Nayak, Athare Nazri-Panjaki, Hadush Negash, Mohammad Hadi Nematollahi, Dang H. Nguyen, Hau Thi Hien Nguyen, Hien Quang Nguyen, Phat Tuan Nguyen, Van Thanh Nguyen, Robina Khan Niazi, Taxiarchis Konstantinos Nikolouzakis, Lawrence Achilles Nnyanzi, Mamoona Noreen, Chimezie Igwegbe Nzoputam, Ogochukwu Janet Nzoputam, Bogdan Oancea, In-Hwan Oh, Hassan Okati-Aliabad, Osaretin Christabel Okonji, Patrick Godwin Okwute, Andrew T. Olagunju, Matthew Idowu Olatubi, Isaac Iyinoluwa Olufadewa, Michal Ordak, Nikita Otstavnov, Mayowa O. Owolabi, P.A. Mahesh, Jagadish Rao Padubidri, Anton Pak, Reza Pakzad, Raffaele Palladino, Adrian Pana, Ioannis Pantazopoulos, Paraskevi Papadopoulou, Shahina Pardhan, Ashwaghosha Parthasarathi, Ava Pashaei, Jay Patel, Aslam Ramjan Pathan, Shankargouda Patil, Uttam Paudel, Shrikant Pawar, Paolo Pedersini, Umberto Pensato, David M. Pereira, Jeevan Pereira, Maria Odete Pereira, Renato B. Pereira, Mario F.P. Peres, Arokiasamy Perianayagam, Simone Perna, Ionela-Roxana Petcu, Parmida Sadat Pezeshki, Hoang Tran Pham, Anil K. Philip, Michael A. Piradov, Indrashis Podder, Vivek Podder, Dimitri Poddighe, Elton Junio Sady Prates, Ibrahim Qattea, Amir Radfar, Pourya Raee, Alireza Rafiei, Alberto Raggi, Fakher Rahim, Mehran Rahimi, Mahban Rahimifard, Vafa Rahimi-Movaghar, Md Obaidur Rahman, Mohammad Hifz Ur Rahman, Mosiur Rahman, Muhammad Aziz Rahman, Amir Masoud Rahmani, Mohamed Rahmani, Shayan Rahmani, Vahid Rahmanian, Premkumar Ramasubramani, Nemanja Rancic, Indu Ramachandra Rao, Sina Rashedi, Ahmed Mustafa Rashid, Nakul Ravikumar, Salman Rawaf, Elrashdy Moustafa Mohamed Redwan, Nazila Rezaei, Negar Rezaei, Nima Rezaei, Mohsen Rezaeian, Daniela Ribeiro, Mónica Rodrigues, Jefferson Antonio Buendia Rodriguez, Leonardo Roever, Esperanza Romero-Rodríguez, Aly M.A. Saad, Basema Saddik, Saeid Sadeghian, Umar Saeed, Azam Safary, Mahdi Safdarian, Sher Zaman Safi, Amene Saghazadeh, Dominic Sagoe, Fatemeh Saheb Sharif-Askari, Narjes Saheb Sharif-Askari, Amirhossein Sahebkar, Harihar Sahoo, Mohammad Ali Sahraian, Mirza Rizwan Sajid, Sateesh Sakhamuri, Joseph W. Sakshaug, Mohamed A. Saleh, Leili Salehi, Sana Salehi, Amir Salek Farrokhi, Sara Samadzadeh, Saad Samargandy, Noosha Samieefar, Abdallah M. Samy, Nima Sanadgol, Rama Krishna Sanjeev, Monika Sawhney, Ganesh Kumar Saya, Art Schuermans, Subramanian Senthilkumaran, Sadaf G. Sepanlou, Yashendra Sethi, Mahan Shafie, Humaira Shah, Izza Shahid, Samiah Shahid, Masood Ali Shaikh, Sadaf Sharfaei, Manoj Sharma, Maryam Shayan, Hatem Samir Shehata, Aziz Sheikh, Jeevan K. Shetty, Jae Il Shin, Reza Shirkoohi, Nebiyu Aniley Shitaye, K.M. Shivakumar, Velizar Shivarov, Parnian Shobeiri, Soraya Siabani, Migbar Mekonnen Sibhat, Emmanuel Edwar Siddig, Colin R. Simpson, Ehsan Sinaei, Harpreet Singh, Inderbir Singh, Jasvinder A. Singh, Paramdeep Singh, Surjit Singh, Md Shahjahan Siraj, Abdullah Al Mamun Sohag, Ranjan Solanki, Solikhah Solikhah, Yonatan Solomon, Mohammad Sadegh Soltani-Zangbar, Jing Sun, Mindy D. Szeto, Rafael Tabarés-Seisdedos, Seyyed Mohammad Tabatabaei, Mohammad Tabish, Ensiyeh Taheri, Azin Tahvildari, Iman M. Talaat, Jacques J.L. Lukenze Tamuzi, Ker-Kan Tan, Nathan Y. Tat, Razieh Tavakoli Oliaee, Arian Tavasol, Mohamad-Hani Temsah, Pugazhenthan Thangaraju, Samar Tharwat, Nigusie Selomon Tibebu, Jansje Henny Vera Ticoalu, Tala Tillawi, Tenaw Yimer Tiruye, Amir Tiyuri, Marcos Roberto Tovani-Palone, Manjari Tripathi, Guesh Mebrahtom Tsegay, Abdul Rohim Tualeka, Sree Sudha Ty, Chukwudi S. Ubah, Saif Ullah, Sana Ullah, Muhammad Umair, Srikanth Umakanthan, Era Upadhyay, Seyed Mohammad Vahabi, Asokan Govindaraj Vaithinathan, Sahel Valadan Tahbaz, Rohollah Valizadeh, Shoban Babu Varthya, Tommi Juhani Vasankari, Narayanaswamy Venketasubramanian, Georgios-Ioannis Verras, Jorge Hugo Villafañe, Vasily Vlassov, Danh Cao Vo, Yasir Waheed, Abdul Waris, Brhane Gebrehiwot Welegebrial, Ronny Westerman, Dakshitha Praneeth Wickramasinghe, Nuwan Darshana Wickramasinghe, Barbara Willekens, Beshada Zerfu Woldegeorgis, Melat Woldemariam, Hong Xiao, Dereje Y. Yada, Galal Yahya, Lin Yang, Fereshteh Yazdanpanah, Dong Keon Yon, Naohiro Yonemoto, Yuyi You, Mazyar Zahir, Syed Saoud Zaidi, Moein Zangiabadian, Iman Zare, Mohammad A. Zeineddine, Dawit T. Zemedikun, Naod Gebrekrstos Zeru, Chen Zhang, Hanqing Zhao, Chenwen Zhong, Magdalena Zielińska, Mohammad Zoladl, Alimuddin Zumla, Cui Guo, and Lai-shan Tam
Subjects: Immune-mediated inflammatory disease, Incidence, Global burden of disease study, Trend, Medicine (General), R5-920
Abstract: Summary: Background: The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. Methods: We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. Findings: In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of −0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = −0.41), inflammatory bowel disease (AAPC = −0.72), multiple sclerosis (AAPC = −0.26), psoriasis (AAPC = −0.77), and atopic dermatitis (AAPC = −0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. Interpretation: The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively. Funding: The Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation. The project funded by Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (2022QN38).
Published: 2023
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4. Evaluation of Cardiometabolic Markers in Helicobacter pylori Infection: A Case-control Study

Author: MR Arpitha, HN Dinesh, N Sreenivas, S Meera, MG Lokesh, and Shubha Jayaram
Subjects: cardiovascular disease, gastritis, gram negative bacteria, lipid profile, Medicine
Abstract: Introduction: Helicobacter pylori (H. pylori) is a Gram negative bacterium that naturally colonises the gastric epithelium and causes chronic gastritis. H. pylori infection affects gastric physiology and alters the lipid metabolism pathways. Highsensitivity C-Reactive Protein (hs-CRP) is a useful marker for risk assessment of future cardiovascular events. Many studies have proposed a link between cardiometabolic markers like lipid profile and hs-CRP with H. pylori infection but very limited studies are available to explain the effect of H. pylori infection on these cardiometabolic markers. Aim: To analyse the cardiometabolic markers (lipid profile and hs-CRP) in H. pylori infection. Materials and Methods: This case-control study was conducted from November 2018 to June 2019 in the Department of Biochemistry in association with the Department of Surgery, Mysore Medical College and Research Institute, Mysore, Karnataka, India. Fifty cases and 50 control subjects were enrolled. Fasting Total Cholesterol (TC), Triglycerides (TG), High Density Lipoprotein Cholesterol (HDL-C), Low Density Lipoprotein Cholesterol (LDL-C), Very Low Density Lipoprotein Cholesterol (VLDL-C), hs-CRP, and Atherogenic Index of Plasma (AIP) were analysed. Statistical analysis was performed using Student’s t-test. Results: The gender distribution was almost same in the two groups. The mean age in the case group was 47.34±12.08 years, while that in the control group was 46.2±14.8 years. There was an increase in TC, LDL-C, VLDL-C, and TG in cases`, but it was not statistically significant. Serum HDL-C level was 34.59±9.79 mg/ dL and 41.62±10.29 mg/dL for cases and controls respectively and it was statistically significant. hs-CRP level was significantly increased in the case group (5.51±4.59 mg/L) when compared to the control (2.63±2.0 mg/L). AIP was also significantly high in the cases (0.246±0.219) than the controls (0.106±0.22). Conclusion: Significant decrease in HDL-C and increase in hs-CRP levels in cases show evidence of dyslipidaemia and atherogenic risk. hs-CRP also showed a significant correlation with AIP. Hence, these cardiometabolic markers may have a role in identifying individuals at higher risk for cardiovascular diseases in cases.
Published: 2022
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5. Women’s groups and COVID-19: An evidence review on savings groups in Africa [version 1; peer review: 2 approved]

Author: Sapna Desai, Rebecca Walcott, Thomas de Hoop, Leigh Anderson, Olayinka Adegbite, Osasuyi Dirisu, Sybil Chidiac, Julia Hakspiel, Jenna Grzeslo, Emily Janoch, Chinmaya Holla, Shubha Jayaram, Krishna Jafa, Tabitha Mulyampiti, Grace Majara, Eva Noble, Eve Namisango, David Panetta, Bukola Onyishi, Munshi Sulaiman, and Garima Siwach
Subjects: Gender Equality, Women's Groups, Savings Groups, Africa, Nigeria, Uganda, eng, Medicine
Abstract: The coronavirus disease 2019 (COVID-19) pandemic and some of the associated policy responses have resulted in significant gendered impacts that may reverse recent progress in gender equality, including in sub-Saharan Africa. This paper presents emerging evidence from studies in diverse contexts in sub-Saharan Africa —with a deep dive into Nigeria and Uganda—on how COVID-19 has affected women’s groups, especially savings groups, and how these groups have helped mitigate the gendered effects of the pandemic’s and the associated policy responses’ consequences up until April 2021. The synthesis presents evidence that savings groups found ways to continue operating, provided leadership opportunities for women during the pandemic, and mitigated some of the negative economic consequences of COVID-19 on individual savings group members. Savings, credit, and group support from other members all likely contributed to the ability of groups to positively affect the resilience of women’s group member during COVID-19. Households with a female member in a savings group in Nigeria and Uganda have coped with the crisis better than those not in savings groups. While savings groups have shown the potential for resilience during the pandemic, they often faced financial challenges because of decreased savings, which sometimes resulted in the depletion of group assets. Savings groups also contributed to community responses and provided women a platform for leadership. These findings are consistent with a recent evidence synthesis on how past covariate shocks affected women’s groups and their members. We conclude the paper by presenting various policy recommendations to enable savings groups to achieve improvements in women’s empowerment and economic outcomes, and research recommendations to address some of the current evidence gaps on how COVID-19 is affecting women’s groups and their members.
Published: 2022
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6. The global, regional, and national burden of benign prostatic hyperplasia in 204 countries and territories from 2000 to 2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Atalel Fentahun Awedew, Hannah Han, Behzad Abbasi, Mohsen Abbasi-Kangevari, Muktar Beshir Ahmed, Omar Almidani, Erfan Amini, Jalal Arabloo, Ayele Mamo Argaw, Seyyed Shamsadin Athari, Daniel Atlaw, Maciej Banach, Amadou Barrow, Akshaya Srikanth Bhagavathula, Vijayalakshmi S Bhojaraja, Boris Bikbov, Belay Boda Abule Bodicha, Nadeem Shafique Butt, Florentino Luciano Caetano dos Santos, Omid Dadras, Xiaochen Dai, Linh Phuong Doan, Sahar Eftekharzadeh, Ali Fatehizadeh, Tushar Garg, Teferi Gebru Gebremeskel, Motuma Erena Getachew, Seyyed-Hadi Ghamari, Syed Amir Gilani, Mahaveer Golechha, Veer Bala Gupta, Vivek Kumar Gupta, Simon I Hay, Mohammad-Salar Hosseini, Mehdi Hosseinzadeh, Ayesha Humayun, Irena M Ilic, Milena D Ilic, Nahlah Elkudssiah Ismail, Mihajlo Jakovljevic, Shubha Jayaram, Seyed Behzad Jazayeri, Alelign Tasew Jema, Ali Kabir, Ibraheem M Karaye, Yousef Saleh Khader, Ejaz Ahmad Khan, Iván Landires, Sang-woong Lee, Shaun Wen Huey Lee, Stephen S Lim, Stany W Lobo, Azeem Majeed, Mohammad-Reza Malekpour, Narges Malih, Ahmad Azam Malik, Entezar Mehrabi Nasab, Tomislav Mestrovic, Irmina Maria Michalek, Gedefaye Nibret Mihrtie, Mohammad Mirza-Aghazadeh-Attari, Awoke Temesgen Misganaw, Ali H Mokdad, Mariam Molokhia, Christopher J L Murray, Sreenivas Narasimha Swamy, Son Hoang Nguyen, Ali Nowroozi, Virginia Nuñez-Samudio, Mayowa O Owolabi, Shrikant Pawar, Norberto Perico, David Laith Rawaf, Salman Rawaf, Reza Rawassizadeh, Giuseppe Remuzzi, Amirhossein Sahebkar, Chethan Sampath, Jeevan K Shetty, Migbar Mekonnen Sibhat, Jasvinder A Singh, Ker-Kan Tan, Gebremaryam Temesgen, Musliu Adetola Tolani, Marcos Roberto Tovani-Palone, Sahel Valadan Tahbaz, Rohollah Valizadeh, Bay Vo, Linh Gia Vu, Lin Yang, Fereshteh Yazdanpanah, Arzu Yigit, Vahit Yiğit, Ismaeel Yunusa, Mazyar Zahir, Theo Vos, M Ashworth Dirac, Awedew, Atalel Fentahun, Han, Hannah, Abbasi, Behzad, Abbasi-Kangevari, Mohsen, Ahmed, Muktar Beshir, Mihrtie, Gedefaye Nibret, and GBD 2019 Benign Prostatic Hyperplasia Collaborators
Subjects: Male, Psychiatry and Mental health, Health (social science), Prostatic Hyperplasia, Humans, Bayes Theorem, Quality-Adjusted Life Years, Geriatrics and Gerontology, Global Health, Family Practice, Aged, Global Burden of Disease
Abstract: © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Benign prostatic hyperplasia is a common urological disease affecting older men worldwide, but comprehensive data about the global, regional, and national burden of benign prostatic hyperplasia and its trends over time are scarce. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated global trends in, and prevalence of, benign prostatic hyperplasia and disability-adjusted life-years (DALYs) due to benign prostatic hyperplasia, in 21 regions and 204 countries and territories from 2000 to 2019. Methods: This study was conducted with GBD 2019 analytical and modelling strategies. Primary prevalence data came from claims from three countries and from hospital inpatient encounters from 45 locations. A Bayesian meta-regression modelling tool, DisMod-MR version 2.1, was used to estimate the age-specific, location-specific, and year-specific prevalence of benign prostatic hyperplasia. Age-standardised prevalence was calculated by the direct method using the GBD reference population. Years lived with disability (YLDs) due to benign prostatic hyperplasia were estimated by multiplying the disability weight by the symptomatic proportion of the prevalence of benign prostatic hyperplasia. Because we did not estimate years of life lost associated with benign prostatic hyperplasia, disability-adjusted life-years (DALYs) equalled YLDs. The final estimates were compared across Socio-demographic Index (SDI) quintiles. The 95% uncertainty intervals (UIs) were estimated as the 25th and 975th of 1000 ordered draws from a bootstrap distribution. Findings: Globally, there were 94·0 million (95% UI 73·2 to 118) prevalent cases of benign prostatic hyperplasia in 2019, compared with 51·1 million (43·1 to 69·3) cases in 2000. The age-standardised prevalence of benign prostatic hyperplasia was 2480 (1940 to 3090) per 100 000 people. Although the global number of prevalent cases increased by 70·5% (68·6 to 72·7) between 2000 and 2019, the global age-standardised prevalence remained stable (–0·770% [–1·56 to 0·0912]). The age-standardised prevalence in 2019 ranged from 6480 (5130 to 8080) per 100 000 in eastern Europe to 987 (732 to 1320) per 100 000 in north Africa and the Middle East. All five SDI quintiles observed an increase in the absolute DALY burden between 2000 and 2019. The most rapid increases in the absolute DALY burden were seen in the middle SDI quintile (94·7% [91·8 to 97·6]), the low-middle SDI quintile (77·3% [74·1 to 81·2]), and the low SDI quintile (77·7% [72·9 to 83·2]). Between 2000 and 2019, age-standardised DALY rates changed less, but the three lower SDI quintiles (low, low-middle, and middle) saw small increases, and the two higher SDI quintiles (high and high-middle SDI) saw small decreases. Interpretation: The absolute burden of benign prostatic hyperplasia is rising at an alarming rate in most of the world, particularly in low-income and middle-income countries that are currently undergoing rapid demographic and epidemiological changes. As more people are living longer worldwide, the absolute burden of benign prostatic hyperplasia is expected to continue to rise in the coming years, highlighting the importance of monitoring and planning for future health system strain. Funding: Bill & Melinda Gates Foundation. Translation: For the Amharic translation of the abstract see Supplementary Materials section.
Published: 2022

7. A study of inflammatory markers and their correlation with PASI score in psoriasis – A case control study

Author: Neela B. Mannangi, Bassavaraj Devaranavadagi, Shubha Jayaram, Balachandra S. Ankad, and Shankarprasad D.S.
Subjects: General Medicine, General Biochemistry, Genetics and Molecular Biology
Abstract: Introduction and Aim: Psoriasis is one of the salient dermatological disorder and a chronic recurrent cutaneous disease. Research shows that immunological cells and cytokines play a principal causative role for skin lesions and comorbid systemic effects in these patients. Like other autoimmune diseases, psoriasis is also a multifactorial disorder which is triggered either by injury, trauma, infections, medications, and psychological stress. Among the cytokines, hs-CRP acts as both inflammatory and cardiovascular marker. It is markedly increased in psoriasis patients, there by leading to subsequent co-morbidities in these patients. The aim of present study was to estimate inflammatory markers viz-TNF-?, IL-2, IFN-? and hs-CRP in psoriasis patients and controls and correlate these inflammatory markers with PASI score in psoriasis patients. Further to correlate hs-CRP with TNF-?, IL-2, IFN-? in these patients. Materials and Methods: The study is conducted at a tertiary level hospital and is designed as a Case Control study design conducted from January 2019 to January 2021. 110 subjects having diagnosed as psoriasis were included as cases and 110 controls. Inflammatory markers were estimated by ELISA method. Statistical analysis was done. Results: The study showed that inflammatory markers in cases with psoriasis were significantly elevated when compared with controls. The inflammatory markers were proportionately altered from mild to severe in psoriasis patients but were not statistically significant. The hs-CRP showed negative significant correlation with IFN –?. Conclusion: The present study concludes that the inflammatory markers are significantly increased in psoriasis patients, and this is correlated with PASI score. These simple biomarkers are of utmost importance in the clinical scenario for better treatment and prognosis and thereby reducing comorbidities in these patients.
Published: 2022

8. Women's groups and COVID-19: An evidence review on savings groups in Africa

Author: Olayinka Adegbite, Leigh Anderson, Sybil Chidiac, Osasuyi Dirisu, Jenna Grzeslo, Julia Hakspiel, Chinmaya Holla, Emily Janoch, Krishna Jafa, Shubha Jayaram, Grace Majara, Tabitha Mulyampiti, Eve Namisango, Eva Noble, Bukola Onyishi, David Panetta, Garima Siwach, Munshi Sulaiman, Rebecca Walcott, Sapna Desai, and Thomas de Hoop
Subjects: Immunology and Microbiology (miscellaneous), Health Policy, Public Health, Environmental and Occupational Health, Medicine (miscellaneous), Biochemistry, Genetics and Molecular Biology (miscellaneous), health care economics and organizations
Abstract: The coronavirus disease 2019 (COVID-19) pandemic and some of the associated policy responses have resulted in significant gendered impacts that may reverse recent progress in gender equality, including in sub-Saharan Africa. This paper presents emerging evidence from studies in diverse contexts in sub-Saharan Africa —with a deep dive into Nigeria and Uganda—on how COVID-19 has affected women’s groups, especially savings groups, and how these groups have helped mitigate the gendered effects of the pandemic’s and the associated policy responses’ consequences up until April 2021. The synthesis presents evidence that savings groups found ways to continue operating, provided leadership opportunities for women during the pandemic, and mitigated some of the negative economic consequences of COVID-19 on individual savings group members. Savings, credit, and group support from other members all likely contributed to the ability of groups to positively affect the resilience of women’s group member during COVID-19. Households with a female member in a savings group in Nigeria and Uganda have coped with the crisis better than those not in savings groups. While savings groups have shown the potential for resilience during the pandemic, they often faced financial challenges because of decreased savings, which sometimes resulted in the depletion of group assets. Savings groups also contributed to community responses and provided women a platform for leadership. These findings are consistent with a recent evidence synthesis on how past covariate shocks affected women’s groups and their members. We conclude the paper by presenting various policy recommendations to enable savings groups to achieve improvements in women’s empowerment and economic outcomes, and research recommendations to address some of the current evidence gaps on how COVID-19 is affecting women’s groups and their members.
Published: 2022

9. The global burden of cancer attributable to risk factors, 2010–19 : A systematic analysis for the Global Burden of Disease Study 2019

Author: Khanh Bao Tran, Justin J Lang, Kelly Compton, Rixing Xu, Alistair R Acheson, Hannah Jacqueline Henrikson, Jonathan M Kocarnik, Louise Penberthy, Amirali Aali, Qamar Abbas, Behzad Abbasi, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Hedayat Abbastabar, Michael Abdelmasseh, Sherief Abd-Elsalam, Ahmed Abdelwahab Abdelwahab, Gholamreza Abdoli, Hanan Abdulkadir Abdulkadir, Aidin Abedi, Kedir Hussein Abegaz, Hassan Abidi, Richard Gyan Aboagye, Hassan Abolhassani, Abdorrahim Absalan, Yonas Derso Abtew, Hiwa Abubaker Ali, Eman Abu-Gharbieh, Basavaprabhu Achappa, Juan Manuel Acuna, Daniel Addison, Isaac Yeboah Addo, Oyelola A Adegboye, Miracle Ayomikun Adesina, Mohammad Adnan, Qorinah Estiningtyas Sakilah Adnani, Shailesh M Advani, Sumia Afrin, Muhammad Sohail Afzal, Manik Aggarwal, Bright Opoku Ahinkorah, Araz Ramazan Ahmad, Rizwan Ahmad, Sajjad Ahmad, Sohail Ahmad, Sepideh Ahmadi, Haroon Ahmed, Luai A Ahmed, Muktar Beshir Ahmed, Tarik Ahmed Rashid, Wajeeha Aiman, Marjan Ajami, Gizachew Taddesse Akalu, Mostafa Akbarzadeh-Khiavi, Addis Aklilu, Maxwell Akonde, Chisom Joyqueenet Akunna, Hanadi Al Hamad, Fares Alahdab, Fahad Mashhour Alanezi, Turki M Alanzi, Saleh Ali Alessy, Abdelazeem M Algammal, Mohammed Khaled Al-Hanawi, Robert Kaba Alhassan, Beriwan Abdulqadir Ali, Liaqat Ali, Syed Shujait Ali, Yousef Alimohamadi, Vahid Alipour, Syed Mohamed Aljunid, Motasem Alkhayyat, Sadeq Ali Ali Al-Maweri, Sami Almustanyir, Nivaldo Alonso, Shehabaldin Alqalyoobi, Rajaa M Al-Raddadi, Rami H Hani Al-Rifai, Salman Khalifah Al-Sabah, Ala'a B Al-Tammemi, Haya Altawalah, Nelson Alvis-Guzman, Firehiwot Amare, Edward Kwabena Ameyaw, Javad Javad Aminian Dehkordi, Mohammad Hosein Amirzade-Iranaq, Hubert Amu, Ganiyu Adeniyi Amusa, Robert Ancuceanu, Jason A Anderson, Yaregal Animut Animut, Amir Anoushiravani, Ali Arash Anoushirvani, Alireza Ansari-Moghaddam, Mustafa Geleto Ansha, Benny Antony, Maxwell Hubert Antwi, Sumadi Lukman Anwar, Razique Anwer, Anayochukwu Edward Anyasodor, Jalal Arabloo, Morteza Arab-Zozani, Olatunde Aremu, Ayele Mamo Argaw, Hany Ariffin, Timur Aripov, Muhammad Arshad, Al Artaman, Judie Arulappan, Raphael Taiwo Aruleba, Armin Aryannejad, Malke Asaad, Mulusew A Asemahagn, Zatollah Asemi, Mohammad Asghari-Jafarabadi, Tahira Ashraf, Reza Assadi, Mohammad Athar, Seyyed Shamsadin Athari, Maha Moh'd Wahbi Atout, Sameh Attia, Avinash Aujayeb, Marcel Ausloos, Leticia Avila-Burgos, Atalel Fentahun Awedew, Mamaru Ayenew Awoke, Tewachew Awoke, Beatriz Paulina Ayala Quintanilla, Tegegn Mulatu Ayana, Solomon Shitu Ayen, Davood Azadi, Sina Azadnajafabad, Saber Azami-Aghdash, Melkalem Mamuye Azanaw, Mohammadreza Azangou-Khyavy, Amirhossein Azari Jafari, Hosein Azizi, Ahmed Y Y Azzam, Amirhesam Babajani, Muhammad Badar, Ashish D Badiye, Nayereh Baghcheghi, Nader Bagheri, Sara Bagherieh, Saeed Bahadory, Atif Amin Baig, Jennifer L Baker, Ahad Bakhtiari, Ravleen Kaur Bakshi, Maciej Banach, Indrajit Banerjee, Mainak Bardhan, Francesco Barone-Adesi, Fabio Barra, Amadou Barrow, Nasir Z Bashir, Azadeh Bashiri, Saurav Basu, Abdul-Monim Mohammad Batiha, Aeysha Begum, Alehegn Bekele Bekele, Alemayehu Sayih Belay, Melaku Ashagrie Belete, Uzma Iqbal Belgaumi, Arielle Wilder Bell, Luis Belo, Habib Benzian, Alemshet Yirga Berhie, Amiel Nazer C Bermudez, Eduardo Bernabe, Akshaya Srikanth Bhagavathula, Neeraj Bhala, Bharti Bhandari Bhandari, Nikha Bhardwaj, Pankaj Bhardwaj, Krittika Bhattacharyya, Vijayalakshmi S Bhojaraja, Soumitra S Bhuyan, Sadia Bibi, Awraris Hailu Bilchut, Bagas Suryo Bintoro, Antonio Biondi, Mesfin Geremaw Birega Birega, Habitu Eshetu Birhan, Tone Bjørge, Oleg Blyuss, Belay Boda Abule Bodicha, Srinivasa Rao Bolla, Archith Boloor, Cristina Bosetti, Dejana Braithwaite, Michael Brauer, Hermann Brenner, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Christina Maree Buchanan, Norma B Bulamu, Maria Teresa Bustamante-Teixeira, Muhammad Hammad Butt, Nadeem Shafique Butt, Zahid A Butt, Florentino Luciano Caetano dos Santos, Luis Alberto Cámera, Chao Cao, Yin Cao, Giulia Carreras, Márcia Carvalho, Francieli Cembranel, Ester Cerin, Promit Ananyo Chakraborty, Periklis Charalampous, Vijay Kumar Chattu, Odgerel Chimed-Ochir, Jesus Lorenzo Chirinos-Caceres, Daniel Youngwhan Cho, William C S Cho, Devasahayam J Christopher, Dinh-Toi Chu, Isaac Sunday Chukwu, Aaron J Cohen, Joao Conde, Sandra Cortés, Vera Marisa Costa, Natália Cruz-Martins, Garland T Culbreth, Omid Dadras, Fentaw Teshome Dagnaw, Saad M A Dahlawi, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Parnaz Daneshpajouhnejad, Anna Danielewicz, An Thi Minh Dao, Reza Darvishi Cheshmeh Soltani, Aso Mohammad Darwesh, Saswati Das, Dragos Virgil Davitoiu, Elham Davtalab Esmaeili, Fernando Pio De la Hoz, Sisay Abebe Debela, Azizallah Dehghan, Biniyam Demisse, Fitsum Wolde Demisse, Edgar Denova-Gutiérrez, Afshin Derakhshani, Meseret Derbew Molla, Diriba Dereje, Kalkidan Solomon Deribe, Rupak Desai, Markos Desalegn Desalegn, Fikadu Nugusu Dessalegn, Samuel Abebe A Dessalegni, Gashaw Dessie, Abebaw Alemayehu Desta, Syed Masudur Rahman Dewan, Samath Dhamminda Dharmaratne, Meghnath Dhimal, Mostafa Dianatinasab, Nancy Diao, Daniel Diaz, Lankamo Ena Digesa, Shilpi Gupta Dixit, Saeid Doaei, Linh Phuong Doan, Paul Narh Doku, Deepa Dongarwar, Wendel Mombaque dos Santos, Tim Robert Driscoll, Haneil Larson Dsouza, Oyewole Christopher Durojaiye, Sareh Edalati, Fatemeh Eghbalian, Elham Ehsani-Chimeh, Ebrahim Eini, Michael Ekholuenetale, Temitope Cyrus Ekundayo, Donatus U Ekwueme, Maha El Tantawi, Mostafa Ahmed Elbahnasawy, Iffat Elbarazi, Hesham Elghazaly, Muhammed Elhadi, Waseem El-Huneidi, Mohammad Hassan Emamian, Luchuo Engelbert Bain, Daniel Berhanie Enyew, Ryenchindorj Erkhembayar, Tegegne Eshetu, Babak Eshrati, Sharareh Eskandarieh, Juan Espinosa-Montero, Farshid Etaee, Azin Etemadimanesh, Tahir Eyayu, Ifeanyi Jude Ezeonwumelu, Sayeh Ezzikouri, Adeniyi Francis Fagbamigbe, Saman Fahimi, Ildar Ravisovich Fakhradiyev, Emerito Jose A Faraon, Jawad Fares, Abbas Farmany, Umar Farooque, Hossein Farrokhpour, Abidemi Omolara Fasanmi, Ali Fatehizadeh, Wafa Fatima, Hamed Fattahi, Ginenus Fekadu, Berhanu Elfu Feleke, Allegra Allegra Ferrari, Simone Ferrero, Lorenzo Ferro Desideri, Irina Filip, Florian Fischer, Roham Foroumadi, Masoud Foroutan, Takeshi Fukumoto, Peter Andras Gaal, Mohamed M Gad, Muktar A Gadanya, Abduzhappar Gaipov, Nasrin Galehdar, Silvano Gallus, Tushar Garg, Mariana Gaspar Fonseca, Yosef Haile Gebremariam, Teferi Gebru Gebremeskel, Mathewos Alemu Gebremichael, Yohannes Fikadu Geda, Yibeltal Yismaw Gela, Belete Negese Belete Gemeda, Melaku Getachew, Motuma Erena Getachew, Kazem Ghaffari, Mansour Ghafourifard, Seyyed-Hadi Ghamari, Mohammad Ghasemi Nour, Fariba Ghassemi, Ajnish Ghimire, Nermin Ghith, Maryam Gholamalizadeh, Jamshid Gholizadeh Navashenaq, Sherief Ghozy, Syed Amir Gilani, Paramjit Singh Gill, Themba G Ginindza, Abraham Tamirat T Gizaw, James C Glasbey, Justyna Godos, Amit Goel, Mahaveer Golechha, Pouya Goleij, Davide Golinelli, Mohamad Golitaleb, Giuseppe Gorini, Bárbara Niegia Garcia Goulart, Giuseppe Grosso, Habtamu Alganeh Guadie, Mohammed Ibrahim Mohialdeen Gubari, Temesgen Worku Gudayu, Maximiliano Ribeiro Guerra, Damitha Asanga Gunawardane, Bhawna Gupta, Sapna Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Mekdes Kondale Gurara, Alemu Guta, Parham Habibzadeh, Atlas Haddadi Avval, Nima Hafezi-Nejad, Adel Hajj Ali, Arvin Haj-Mirzaian, Esam S Halboub, Aram Halimi, Rabih Halwani, Randah R Hamadeh, Sajid Hameed, Samer Hamidi, Asif Hanif, Sanam Hariri, Netanja I Harlianto, Josep Maria Haro, Risky Kusuma Hartono, Ahmed I Hasaballah, S M Mahmudul Hasan, Hamidreza Hasani, Seyedeh Melika Hashemi, Abbas M Hassan, Soheil Hassanipour, Khezar Hayat, Golnaz Heidari, Mohammad Heidari, Zahra Heidarymeybodi, Brenda Yuliana Herrera-Serna, Claudiu Herteliu, Kamal Hezam, Yuta Hiraike, Mbuzeleni Mbuzeleni Hlongwa, Ramesh Holla, Marianne Holm, Nobuyuki Horita, Mohammad Hoseini, Md Mahbub Hossain, Mohammad Bellal Hossain Hossain, Mohammad-Salar Hosseini, Ali Hosseinzadeh, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Mowafa Househ, Junjie Huang, Fernando N Hugo, Ayesha Humayun, Salman Hussain, Nawfal R Hussein, Bing-Fang Hwang, Segun Emmanuel Ibitoye, Pulwasha Maria Iftikhar, Kevin S Ikuta, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Mustapha Immurana, Kaire Innos, Pooya Iranpour, Lalu Muhammad Irham, Md Shariful Islam, Rakibul M Islam, Farhad Islami, Nahlah Elkudssiah Ismail, Gaetano Isola, Masao Iwagami, Linda Merin J, Abhishek Jaiswal, Mihajlo Jakovljevic, Mahsa Jalili, Shahram Jalilian, Elham Jamshidi, Sung-In Jang, Chinmay T Jani, Tahereh Javaheri, Umesh Umesh Jayarajah, Shubha Jayaram, Seyed Behzad Jazayeri, Rime Jebai, Bedru Jemal, Wonjeong Jeong, Ravi Prakash Jha, Har Ashish Jindal, Yetunde O John-Akinola, Jost B Jonas, Tamas Joo, Nitin Joseph, Farahnaz Joukar, Jacek Jerzy Jozwiak, Mikk Jürisson, Ali Kabir, Salah Eddine Oussama Kacimi, Vidya Kadashetti, Farima Kahe, Pradnya Vishal Kakodkar, Laleh R Kalankesh, Leila R Kalankesh, Rohollah Kalhor, Vineet Kumar Kamal, Farin Kamangar, Ashwin Kamath, Tanuj Kanchan, Eswar Kandaswamy, Himal Kandel, HyeJung Kang, Girum Gebremeskel Kanno, Neeti Kapoor, Sitanshu Sekhar Kar, Shama D Karanth, Ibraheem M Karaye, André Karch, Amirali Karimi, Bekalu Getnet Kassa, Patrick DMC Katoto, Joonas H Kauppila, Harkiran Kaur, Abinet Gebremickael Kebede, Leila Keikavoosi-Arani, Gemechu Gemechu Kejela, Phillip M Kemp Bohan, Maryam Keramati, Mohammad Keykhaei, Himanshu Khajuria, Abbas Khan, Abdul Aziz Khan Khan, Ejaz Ahmad Khan, Gulfaraz Khan, Md Nuruzzaman Khan, Moien AB Khan, Javad Khanali, Khaled Khatab, Moawiah Mohammad Khatatbeh, Mahalaqua Nazli Khatib, Maryam Khayamzadeh, Hamid Reza Khayat Kashani, Mohammad Amin Khazeei Tabari, Mehdi Khezeli, Mahmoud Khodadost, Min Seo Kim, Yun Jin Kim, Adnan Kisa, Sezer Kisa, Miloslav Klugar, Jitka Klugarová, Ali-Asghar Kolahi, Pavel Kolkhir, Farzad Kompani, Parvaiz A Koul, Sindhura Lakshmi Koulmane Laxminarayana, Ai Koyanagi, Kewal Krishan, Yuvaraj Krishnamoorthy, Burcu Kucuk Bicer, Nuworza Kugbey, Mukhtar Kulimbet, Akshay Kumar, G Anil Kumar, Narinder Kumar, Om P Kurmi, Ambily Kuttikkattu, Carlo La Vecchia, Arista Lahiri, Dharmesh Kumar Lal, Judit Lám, Qing Lan, Iván Landires, Bagher Larijani, Savita Lasrado, Jerrald Lau, Paolo Lauriola, Caterina Ledda, Sang-woong Lee, Shaun Wen Huey Lee, Wei-Chen Lee, Yeong Yeh Lee, Yo Han Lee, Samson Mideksa Legesse, James Leigh, Elvynna Leong, Ming-Chieh Li, Stephen S Lim, Gang Liu, Jue Liu, Chun-Han Lo, Ayush Lohiya, Platon D Lopukhov, László Lorenzovici, Mojgan Lotfi, Joana A Loureiro, Raimundas Lunevicius, Farzan Madadizadeh, Ahmad R Mafi, Sameh Magdeldin, Soleiman Mahjoub, Ata Mahmoodpoor, Morteza Mahmoudi, Marzieh Mahmoudimanesh, Rashidul Alam Mahumud, Azeem Majeed, Jamal Majidpoor, Alaa Makki, Konstantinos Christos Makris, Elaheh Malakan Rad, Mohammad-Reza Malekpour, Reza Malekzadeh, Ahmad Azam Malik, Tauqeer Hussain Mallhi, Sneha Deepak Mallya, Mohammed A Mamun, Ana Laura Manda, Fariborz Mansour-Ghanaei, Borhan Mansouri, Mohammad Ali Mansournia, Lorenzo Giovanni Mantovani, Santi Martini, Miquel Martorell, Sahar Masoudi, Seyedeh Zahra Masoumi, Clara N Matei, Elezebeth Mathews, Manu Raj Mathur, Vasundhara Mathur, Martin McKee, Jitendra Kumar Meena, Khalid Mehmood, Entezar Mehrabi Nasab, Ravi Mehrotra, Addisu Melese, Walter Mendoza, Ritesh G Menezes, SIsay Derso Mengesha, Laverne G Mensah, Alexios-Fotios A Mentis, Andry Yasmid Mera Mera-Mamián, Tuomo J Meretoja, Mehari Woldemariam Merid, Amanual Getnet Mersha, Belsity Temesgen Meselu, Mahboobeh Meshkat, Tomislav Mestrovic, Junmei Miao Jonasson, Tomasz Miazgowski, Irmina Maria Michalek, Gelana Fekadu Worku Mijena, Ted R Miller, Shabir Ahmad Mir, Seyed Kazem Mirinezhad, Seyyedmohammadsadeq Mirmoeeni, Mohammad Mirza-Aghazadeh-Attari, Hamed Mirzaei, Hamid Reza Mirzaei, Abay Sisay Misganaw, Sanjeev Misra, Karzan Abdulmuhsin Mohammad, Esmaeil Mohammadi, Mokhtar Mohammadi, Abdollah Mohammadian-Hafshejani, Reza Mohammadpourhodki, Arif Mohammed, Shafiu Mohammed, Syam Mohan, Mohammad Mohseni, Nagabhishek Moka, Ali H Mokdad, Alex Molassiotis, Mariam Molokhia, Kaveh Momenzadeh, Sara Momtazmanesh, Lorenzo Monasta, Ute Mons, Ahmed Al Montasir, Fateme Montazeri, Arnulfo Montero, Mohammad Amin Moosavi, Abdolvahab Moradi, Yousef Moradi, Mostafa Moradi Sarabi, Paula Moraga, Lidia Morawska, Shane Douglas Morrison, Jakub Morze, Abbas Mosapour, Ebrahim Mostafavi, Seyyed Meysam Mousavi, Haleh Mousavi Isfahani, Amin Mousavi Khaneghah, Christine Mpundu-Kaambwa, Sumaira Mubarik, Francesk Mulita, Daniel Munblit, Sandra B Munro, Efrén Murillo-Zamora, Jonah Musa, Ashraf F Nabhan, Ahamarshan Jayaraman Nagarajan, Shankar Prasad Nagaraju, Gabriele Nagel, Mohammadreza Naghipour, Mukhammad David Naimzada, Tapas Sadasivan Nair, Atta Abbas Naqvi, Sreenivas Narasimha Swamy, Aparna Ichalangod Narayana, Hasan Nassereldine, Zuhair S Natto, Biswa Prakash Nayak, Rawlance Ndejjo, Sabina Onyinye Nduaguba, Wogene Wogene Negash, Seyed Aria Nejadghaderi, Kazem Nejati, Sandhya Neupane Kandel, Huy Van Nguyen Nguyen, Robina Khan Niazi, Nurulamin M Noor, Maryam Noori, Nafise Noroozi, Hasti Nouraei, Ali Nowroozi, Virginia Nuñez-Samudio, Chimezie Igwegbe Nzoputam, Ogochukwu Janet Nzoputam, Bogdan Oancea, Oluwakemi Ololade Odukoya, Onome Bright Oghenetega, Ropo Ebenezer Ogunsakin, Ayodipupo Sikiru Oguntade, In-Hwan Oh, Hassan Okati-Aliabad, Akinkunmi Paul Okekunle, Andrew T Olagunju, Tinuke O Olagunju, Babayemi Oluwaseun Olakunde, Isaac Iyinoluwa Olufadewa, Emad Omer, Abidemi E Emmanuel Omonisi, Sokking Ong, Obinna E Onwujekwe, Hans Orru, Stanislav S Otstavnov, Abderrahim Oulhaj, Bilcha Oumer, Oluwatomi Funbi Owopetu, Babatunji Emmanuel Oyinloye, Mahesh P A, Alicia Padron-Monedero, Jagadish Rao Padubidri, Babak Pakbin, Keyvan Pakshir, Reza Pakzad, Tamás Palicz, Adrian Pana, Anamika Pandey, Ashok Pandey, Suman Pant, Shahina Pardhan, Eun-Cheol Park, Eun-Kee 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Melinda Gates Foundation, Kuwait University (Kuwait), Ministry of Higher Education (Malasia), Lega Italiana per la Lotta ai Tumori, Health Effects Institute (Estados Unidos), Unión Europea. Comisión Europea. European Research Council (ERC), Unión Europea. Comisión Europea. H2020, Fundação para a Ciência e Tecnologia (Portugal), African-German Network of Excellence in Science (AGNES), Federal Ministry of Education & Research (Alemania), Alexander von Humboldt Foundation, Novo Nordisk Foundation, National Institute for Health Research (Reino Unido), National Health and Medical Research Council (Australia), Romanian National Authority for Scientific Research and Innovation, Romanian Ministry of Research Innovation and Digitalization, Ministry of Education, Science and Technological Development (Serbia), Sigrid Jusélius Foundation, Finnish Cancer Foundation, Datta Meghe Institute of Medical Sciences (India), Xiamen University (Malasia), Manipal Academy of Higher Education (India), Panjab University (India), Sistema Nacional de Investigación (Panamá), Secretaría Nacional de Ciencia, Tecnología e Innovación (Panamá), Ministry of Science and Technology (Taiwan), Lung Foundation Australia, National Natural Science Foundation of China, Wellcome Trust, UNSW Sydney (Australia), ICMR - National Institute of Epidemiology (India), University of Tasmania (Australia), National Council for Scientific and Technological Development (Brasil), Coordenação de Aperfeicoamento de Pessoal de Nível Superior (Brasil), Institute for Advanced Studies in Basic Sciences (Irán), Ain Shams University (Egipto), International Center of Medical Sciences Research (Islamabad), National Institutes of Health (Estados Unidos), University of Oxford (Reino Unido), National Institute of Genetic Engineering and Biotechnology (Irán), Marga und Walter Boll - Stiftung, Ministero della Salute (Italia), IRCCS Materno Infantile Burlo Garofolo (Italia), King College London, Wellcome Trust/DBT India Alliance (India), Public Health, University of St Andrews. School of Medicine, and University of St Andrews. Population and Behavioural Science Division
Subjects: Male, DEATHS, DALY, cancer, risk factors, Medizin, systematic analysis, Global Health, Risk Assessment, Cancer prevention, Global Burden of Disease, RC0254, Risk-attributable cancer deaths, SDG 3 - Good Health and Well-being, RA0421, Risk Factors, RA0421 Public health. Hygiene. Preventive Medicine, Quality-Adjusted Life Year, Neoplasms, cancer, Humans, Global Burden of Disease Study, UK, Medicine(all), MCC, RC0254 Neoplasms. Tumors. Oncology (including Cancer), Risk Factor, Smoking, COVID-19, 3rd-DAS, General Medicine, Disability-adjusted life-years, SOCIAL DETERMINANTS, Risk assessments, risk factor, Cardiovascular and Metabolic Diseases, 3121 General medicine, internal medicine and other clinical medicine, OBESITY, Cancer burden, Neoplasm, Female, LIFE-STYLE, Quality-Adjusted Life Years, HEALTH, RA, Human, RC
Abstract: Background: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01-4·94) deaths and 105 million (95·0-116) DALYs for both sexes combined, representing 44·4% (41·3-48·4) of all cancer deaths and 42·0% (39·1-45·6) of all DALYs. There were 2·88 million (2·60-3·18) risk-attributable cancer deaths in males (50·6% [47·8-54·1] of all male cancer deaths) and 1·58 million (1·36-1·84) risk-attributable cancer deaths in females (36·3% [32·5-41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6-28·4) and DALYs by 16·8% (8·8-25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9-42·8] and 33·3% [25·8-42·0]). Interpretation: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. We are grateful to the surveillance systems, including cancer registries, that generated and shared observed cancer burden data. S M Aljunid acknowledges the Department of Health Policy and Management, College of Public Health, Kuwait University for the approval and support to participate in this research project. H Ariffin acknowledges support from the Ministry of Higher Education, Malaysia (grant FRGS/1/2021/SKK0/UM/01/1). F Barra acknowledges support from Lega Italiana per la Lotta contro i Tumori - LILT - Bando 5 x 1000 anno 2019. L Belo and M Carvalho acknowledge the support from FCT in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of UCIBIO and the project LA/P/0140/2020 of i4HB. A J Cohen was supported by the Health Effects Institute, Boston, MA, USA. J Conde acknowledges financial support from the European Research Council - ERC Starting Grant 848325. V M Costa acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. T C Ekundayo was supported by the African-German Network of Excellence in Science (AGNES), the Federal Ministry of Education and Research (BMBF) and the Alexander von Humboldt Foundation (AvH). N Ghith acknowledges support from a grant from Novo Nordisk Foundation (NNF16OC0021856). J C Glasbey is support by a Doctoral Research Fellowship from the National Institute of Health Research (NIHR300175). V K Gupta and V B Gupta acknowledge funding support from National Health and Medical Research Council (NHMRC), Australia. C Herteliu, A Pana, and M Ausloos acknowledge partial support by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. C Herteliu is also partially supported by a grant of the Romanian Ministry of Research Innovation and Digitalization, MCID, project number ID-585-CTR-42-PFE-2021. S Hussain was supported from Operational Programme Research, Development and Education–Project, Postdoc2MUNI (number CZ.02.2. 69/0.0/0.0/18_053/0016952). M Jakovljevic acknowledges partial support through the grant OI 175 014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. J H Kauppila acknowledges research grants from Sigrid Jusélius Foundation and the Finnish Cancer Foundation. M N Khatib acknowledges support from Datta Meghe Institute of Medical Sciences (deemed-to-be-university). Y J Kim was supported by the Research Management Centre, Xiamen University Malaysia [XMUMRF/2020-C6/ITCM/0004]. S L Koulmane Laxminarayana acknowledges institutional assistance by Manipal Academy of Higher Education, Manipal. K Krishan is supported by the UGC Centre of Advanced Study (Phase II), awarded to the Department of Anthropology, Panjab University, Chandigarh, India. I Landires is a member of the Sistema Nacional de Investigación (SNI), which is supported by Panama’s Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT). M-C Li was supported by the Ministry of Science and Technology, Taiwan (MOST 110-2314-B-003-001). G Liu acknowledges support from the CREATE Hope scientific fellowship from Lung Foundation Australia. J Liu acknowledges support from the National Natural Science Foundation (72122001). J A Loureiro was supported by Scientific Employment Stimulus (FCT; CEECINST/00049/2018). E Mathews is supported by a Clinical and Public Health Early Career Fellowship (grant number IA/CPHE/17/1/503345) from the DBT India Alliance/Wellcome Trust Department of Biotechnology, India Alliance (2018–2023). T J Meretoja was supported by an unrestricted grant from Cancer Foundation Finland sr. S Mohammed acknowledges a fellowship grant from Alexander von Humboldt Foundation, outside the submitted work. M Molokhia is supported by the National Institute for Health Research Biomedical Research Center at Guy’s and St Thomas’ National Health Service Foundation Trust and King’s College London. L Monasta received support from the Italian Ministry of Health at the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste - Italy (RC 34/2017). U Mons is supported by the Marga and Walter Boll Foundation, Kerpen, Germany. M A Moosavi acknowledges the financial support of National Institute of Genetics Engineering and Biotechnology (NIGEB). J Musa acknowledges support from the NIH/FICK43TW011416 for research-protected time for cervical cancer research and career development at University of Jos. V Nuñez-Samudio is a member of the Sistema Nacional de Investigación (SNI), which is supported by Panama’s Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT). O O Odukoya acknowledges support by the Fogarty International Center of the National Institutes of Health under the award number K43TW010704 for research-protected time. The content is solely the responsibility of all the authors and does not necessarily represent the official views of the National Institutes of Health. A S Oguntade acknowledges funding by a doctoral scholarship from the Nuffield Department of Population Health, University of Oxford (Oxford Population Health). J R Padubidri acknowledges Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal for their constant support in research collaborations. R G Pestell acknowledges support from NIH grant W81XWH1810605 Breast Cancer Research, Breakthrough Grant R21 CA235139-01. Z Z Piracha acknowledges the International Center of Medical Sciences Research (ICMSR), Islamabad (44000), Pakistan. R A Radhakrishnan acknowledges support from Wellcome Trust/DBT India Alliance - IA/CPHI/18/1/503927. U Saeed acknowledges the International Center of Medical Sciences Research (ICMSR), Islamabad, Pakistan. A M Samy acknowledges the support from Ain Shams University and the Egyptian Fulbright Mission Program. F Sha was supported by the Shenzhen Science and Technology Program (grant number KQTD20190929172835662). H R Shahsavari acknowledges the Institute for Advanced Studies in Basic Sciences (IASBS) Research Council. A Shetty acknowledges Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal for all the academic support. D A S Silva acknowledges financing in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brazil (CAPES)—Finance Code 001 and D A S Silva is supported in part by CNPq-Brazil (309589/2021-5). L M L R Silva was supported by project CENTRO-04-3559-FSE-000162, Fundo Social Europeu (FSE). Am Singh is supported by the International Graduate Research Scholarship, University of Tasmania. R Suliankatchi Abdulkader acknowledges support from ICMR—National Institute of Epidemiology. B Unnikrishnan acknowledges Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal. H Xiao acknowledges support from the Public Health Sciences Division of the Fred Hutchinson Cancer Research Center. X Xu is supported by the University of New South Wales (Australia) Scientia Program. C Yu was supported by the National Natural Science Foundation of China (grant number 82173626) and Wuhan Medical Research Program of Joint Fund of Hubei Health Committee (grant number WJ2019H304). Sí
Published: 2022

10. Global, regional, and national burden of hepatitis B, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Brittney S Sheena, Lindsey Hiebert, Hannah Han, Helen Ippolito, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Hedayat Abbastabar, Amir Abdoli, Hiwa Abubaker Ali, Mesafint Molla Adane, Oyelola A Adegboye, Qorinah Estiningtyas Sakilah Adnani, Shailesh M Advani, Muhammad Sohail Afzal, Saira Afzal, Mohamad Aghaie Meybodi, Bahman Ahadinezhad, Bright Opoku Ahinkorah, Sajjad Ahmad, Tauseef Ahmad, Sepideh Ahmadi, Haroon Ahmed, Muktar Beshir Ahmed, Tarik Ahmed Rashid, Gizachew Taddesse Akalu, Addis Aklilu, Tayyaba Akram, Hanadi Al Hamad, Fares Alahdab, Adugnaw Zeleke Alem, Dejene Tsegaye Alem, Fadwa Alhalaiqa Naji Alhalaiqa, Robert Kaba Alhassan, Liaqat Ali, Muhammad Ashar Ali, Yousef Alimohamadi, Vahid Alipour, Motasem Alkhayyat, Sami Almustanyir, Rajaa M Al-Raddadi, Haya Altawalah, Saeed Amini, Hubert Amu, Robert Ancuceanu, Catalina Liliana Andrei, Tudorel Andrei, Amir Anoushiravani, Adnan Ansar, Anayochukwu Edward Anyasodor, Jalal Arabloo, Morteza Arab-Zozani, Ayele Mamo Argaw, Zeleke Gebru Argaw, Muhammad Arshad, Anton A Artamonov, Tahira Ashraf, Daniel Atlaw, Floriane Ausloos, Marcel Ausloos, Sina Azadnajafabad, Mohammadreza Azangou-Khyavy, Amirhossein Azari Jafari, Ghasem Azarian, Sayna Bagheri, Saeed Bahadory, Atif Amin Baig, Maciej Banach, Nastaran Barati, Amadou Barrow, Abdul-Monim Mohammad Batiha, Diana Fernanda Bejarano Ramirez, Uzma Iqbal Belgaumi, Alemshet Yirga Berhie, Devidas S Bhagat, Nikha Bhardwaj, Pankaj Bhardwaj, Krittika Bhattacharyya, Vijayalakshmi S Bhojaraja, Ali Bijani, Antonio Biondi, Belay Boda Abule Bodicha, Hunduma Amensisa Bojia, Archith Boloor, Cristina Bosetti, Dejana Braithwaite, Nikolay Ivanovich Briko, Zahid A Butt, Luis Alberto Cámera, Raja Chandra Chakinala, Promit Ananyo Chakraborty, Jaykaran Charan, Shu Chen, Jee-Young Jasmine Choi, Sonali Gajanan Choudhari, Fazle Rabbi Chowdhury, Dinh-Toi Chu, Sheng-Chia Chung, Paolo Angelo Cortesi, Benjamin C Cowie, Garland T Culbreth, Omid Dadras, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Fernando Pio De la Hoz, Sisay Abebe Debela, Mohammed Gebre Dedefo, Feleke Mekonnen Demeke, Takele Gezahegn G Demie, Getu Debalkie Demissie, Meseret Derbew Molla, Abebaw Alemayehu Desta, Deepak Dhamnetiya, Mandira Lamichhane Dhimal, Meghnath Dhimal, Mojtaba Didehdar, Linh Phuong Doan, Fariba Dorostkar, Thomas M Drake, Fatemeh Eghbalian, Michael Ekholuenetale, Iman El Sayed, Maysaa El Sayed Zaki, Muhammed Elhadi, Mohamed A Elmonem, Aisha Elsharkawy, Shymaa Enany, Daniel Berhanie Enyew, Ryenchindorj Erkhembayar, Sharareh Eskandarieh, Firooz Esmaeilzadeh, Sayeh Ezzikouri, Hossein Farrokhpour, Getahun Fetensa, Florian Fischer, Masoud Foroutan, Mohamed M Gad, Abhay Motiramji Gaidhane, Shilpa Gaidhane, Natalie C Galles, Silvano Gallus, Teferi Gebru Gebremeskel, Eyob Alemayehu Gebreyohannes, Keyghobad Ghadiri, Kazem Ghaffari, Mansour Ghafourifard, Seyyed-Hadi Ghamari, Ahmad Ghashghaee, Ali Gholami, Abdolmajid Gholizadeh, Aima Gilani, Amit Goel, Mahaveer Golechha, Pouya Goleij, Davide Golinelli, Giuseppe Gorini, Yitayal Ayalew Goshu, Max G Griswold, Mohammed Ibrahim Mohialdeen Gubari, Bhawna Gupta, Sapna Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Rasool Haddadi, Rabih Halwani, Saeed S Hamid, Samer Hamidi, Asif Hanif, Shafiul Haque, Harapan Harapan, Arief Hargono, Sanam Hariri, Ahmed I Hasaballah, S M Mahmudul Hasan, Soheil Hassanipour, Hadi Hassankhani, Simon I Hay, Khezar Hayat, Golnaz Heidari, Claudiu Herteliu, Demisu Zenbaba Heyi, Kamal Hezam, Ramesh Holla, Mohammad-Salar Hosseini, Mostafa Hosseini, Mehdi Hosseinzadeh, Mihaela Hostiuc, Mowafa Househ, Junjie Huang, Nawfal R Hussein, Ivo Iavicoli, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Lalu Muhammad Irham, Jessica Y Islam, Nahlah Elkudssiah Ismail, Kathryn H Jacobsen, Farhad Jadidi-Niaragh, Amirreza Javadi Mamaghani, Shubha Jayaram, Ranil Jayawardena, Rime Jebai, Ravi Prakash Jha, Nitin Joseph, Farahnaz Joukar, Billingsley Kaambwa, Ali Kabir, Zubair Kabir, Rohollah Kalhor, Himal Kandel, Tesfaye K Tesfaye Kanko, Rami S Kantar, Ibraheem M Karaye, Bekalu Getnet Kassa, Phillip M Kemp Bohan, Mohammad Keykhaei, Yousef Saleh Khader, Himanshu Khajuria, Gulfaraz Khan, Imteyaz A Khan, Junaid Khan, Moien AB Khan, Javad Khanali, Amir M Khater, Mahalaqua Nazli Khatib, Mahmoud Khodadost, Abdullah T Khoja, Omid Khosravizadeh, Jagdish Khubchandani, Gyu Ri Kim, Hanna Kim, Min Seo Kim, Yun Jin Kim, Jonathan M Kocarnik, Ali-Asghar Kolahi, Rajasekaran Koteeswaran, G Anil Kumar, Carlo La Vecchia, Dharmesh Kumar Lal, Iván Landires, Savita Lasrado, Jeffrey V Lazarus, Caterina Ledda, Doo Woong Lee, Sang-woong Lee, Yeong Yeh Lee, Miriam Levi, Jiarui Li, Stephen S Lim, Stany W Lobo, Platon D Lopukhov, Joana A Loureiro, Jennifer H MacLachlan, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, Azeem Majeed, Alaa Makki, Mohammad-Reza Malekpour, Reza Malekzadeh, Ahmad Azam Malik, Fariborz Mansour-Ghanaei, Mohammad Ali Mansournia, Francisco Rogerlândio Martins-Melo, Philippa C Matthews, Walter Mendoza, Ritesh G Menezes, Tuomo J Meretoja, Amanual Getnet Mersha, Tomislav Mestrovic, Ted R Miller, Le Huu Nhat Minh, Andreea Mirica, Seyyedmohammadsadeq Mirmoeeni, Erkin M Mirrakhimov, Sanjeev Misra, Prasanna Mithra, Babak Moazen, Ashraf Mohamadkhani, Mokhtar Mohammadi, Shafiu Mohammed, Nagabhishek Moka, Ali H Mokdad, Jalal Moludi, Sara Momtazmanesh, Lorenzo Monasta, Ghobad Moradi, Maliheh Moradzadeh, Rahmatollah Moradzadeh, Paula Moraga, Ebrahim Mostafavi, Sumaira Mubarik, Malaisamy Muniyandi, Christopher J L Murray, Mohsen Naghavi, Mukhammad David Naimzada, Sreenivas Narasimha Swamy, Zuhair S Natto, Biswa Prakash Nayak, Javad Nazari, Ionut Negoi, Serban Mircea Negru, Seyed Aria Nejadghaderi, Sandhya Neupane Kandel, Huong Lan Thi Nguyen, Che Henry Ngwa, Robina Khan Niazi, Chukwudi A Nnaji, Jean Jacques Noubiap, Ali Nowroozi, Virginia Nuñez-Samudio, Bogdan Oancea, Chimedsuren Ochir, Oluwakemi Ololade Odukoya, In-Hwan Oh, Andrew T Olagunju, Babayemi Oluwaseun 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Subjects: Liver Cirrhosis, Hepatology, Seroepidemiologic Studies, 3121 General medicine, internal medicine and other clinical medicine, Liver Neoplasms, Gastroenterology, Humans, Bayes Theorem, HBV, Global burden of diseases, HCC, Cirrhosis, Child, Hepatitis B, Global Burden of Disease
Abstract: Publisher Copyright: © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: Combating viral hepatitis is part of the UN Sustainable Development Goals (SDGs), and WHO has put forth hepatitis B elimination targets in its Global Health Sector Strategy on Viral Hepatitis (WHO-GHSS) and Interim Guidance for Country Validation of Viral Hepatitis Elimination (WHO Interim Guidance). We estimated the global, regional, and national prevalence of hepatitis B virus (HBV), as well as mortality and disability-adjusted life-years (DALYs) due to HBV, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. This included estimates for 194 WHO member states, for which we compared our estimates to WHO elimination targets. Methods: The primary data sources were population-based serosurveys, claims and hospital discharges, cancer registries, vital registration systems, and published case series. We estimated chronic HBV infection and the burden of HBV-related diseases, defined as an aggregate of cirrhosis due to hepatitis B, liver cancer due to hepatitis B, and acute hepatitis B. We used DisMod-MR 2.1, a Bayesian mixed-effects meta-regression tool, to estimate the prevalence of chronic HBV infection, cirrhosis, and aetiological proportions of cirrhosis. We used mortality-to-incidence ratios modelled with spatiotemporal Gaussian process regression to estimate the incidence of liver cancer. We used the Cause of Death Ensemble modelling (CODEm) model, a tool that selects models and covariates on the basis of out-of-sample performance, to estimate mortality due to cirrhosis, liver cancer, and acute hepatitis B. Findings: In 2019, the estimated global, all-age prevalence of chronic HBV infection was 4·1% (95% uncertainty interval [UI] 3·7 to 4·5), corresponding to 316 million (284 to 351) infected people. There was a 31·3% (29·0 to 33·9) decline in all-age prevalence between 1990 and 2019, with a more marked decline of 76·8% (76·2 to 77·5) in prevalence in children younger than 5 years. HBV-related diseases resulted in 555 000 global deaths (487 000 to 630 000) in 2019. The number of HBV-related deaths increased between 1990 and 2019 (by 5·9% [–5·6 to 19·2]) and between 2015 and 2019 (by 2·9% [–5·9 to 11·3]). By contrast, all-age and age-standardised death rates due to HBV-related diseases decreased during these periods. We compared estimates for 2019 in 194 WHO locations to WHO-GHSS 2020 targets, and found that four countries achieved a 10% reduction in deaths, 15 countries achieved a 30% reduction in new cases, and 147 countries achieved a 1% prevalence in children younger than 5 years. As of 2019, 68 of 194 countries had already achieved the 2030 target proposed in WHO Interim Guidance of an all-age HBV-related death rate of four per 100 000. Interpretation: The prevalence of chronic HBV infection declined over time, particularly in children younger than 5 years, since the introduction of hepatitis B vaccination. HBV-related death rates also decreased, but HBV-related death counts increased as a result of population growth, ageing, and cohort effects. By 2019, many countries had met the interim seroprevalence target for children younger than 5 years, but few countries had met the WHO-GHSS interim targets for deaths and new cases. Progress according to all indicators must be accelerated to meet 2030 targets, and there are marked disparities in burden and progress across the world. HBV interventions, such as vaccination, testing, and treatment, must be strategically supported and scaled up to achieve elimination. Funding: Bill & Melinda Gates Foundation.
Published: 2022

11. The global burden of adolescent and young adult cancer in 2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Elysia M Alvarez, Lisa M Force, Rixing Xu, Kelly Compton, Dan Lu, Hannah Jacqueline Henrikson, Jonathan M Kocarnik, James D Harvey, Alyssa Pennini, Frances E Dean, Weijia Fu, Martina T Vargas, Theresa H M Keegan, Hany Ariffin, Ronald D Barr, Yana Arturovna Erdomaeva, D Sanjeeva Gunasekera, Yetunde O John-Akinola, Tyler G Ketterl, Tezer Kutluk, Marcio Henrique Malogolowkin, Prashant Mathur, Venkatraman Radhakrishnan, Lynn Ann Gloeckler Ries, Carlos Rodriguez-Galindo, Garik Barisovich Sagoyan, Iyad Sultan, Behzad Abbasi, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Hedayat Abbastabar, Michael Abdelmasseh, Sherief Abd-Elsalam, Amir Abdoli, Haimanot Abebe, Aidin Abedi, Hassan Abidi, Hassan Abolhassani, Hiwa Abubaker Ali, Eman Abu-Gharbieh, Basavaprabhu Achappa, Juan Manuel Acuna, Isaac Akinkunmi Adedeji, Oyelola A Adegboye, Qorinah Estiningtyas Sakilah Adnani, Shailesh M Advani, Muhammad Sohail Afzal, Mohamad Aghaie Meybodi, Bahman Ahadinezhad, Bright Opoku Ahinkorah, Sajjad Ahmad, Sepideh Ahmadi, Muktar Beshir Ahmed, Tarik Ahmed Rashid, Yusra Ahmed Salih, Wajeeha Aiman, Gizachew Taddesse Akalu, Hanadi Al Hamad, Fares Alahdab, Abdulhadi A AlAmodi, Fahad Mashhour Alanezi, Turki M Alanzi, Adugnaw Zeleke Alem, Dejene Tsegaye Alem, Yosef Alemayehu, Fadwa Naji Alhalaiqa, Robert Kaba Alhassan, Saqib Ali, Gianfranco Alicandro, Vahid Alipour, Syed Mohamed Aljunid, Motasem Alkhayyat, Sunitha Alluri, Nihad A Almasri, Sadeq Ali Al-Maweri, Sami Almustanyir, Rajaa M Al-Raddadi, Nelson Alvis-Guzman, Edward Kwabena Ameyaw, Saeed Amini, Hubert Amu, Robert Ancuceanu, Catalina Liliana Andrei, Tudorel Andrei, Fereshteh Ansari, Alireza Ansari-Moghaddam, Davood Anvari, Anayochukwu Edward Anyasodor, Jalal Arabloo, Morteza Arab-Zozani, Ayele Mamo Argaw, Muhammad Arshad, Judie Arulappan, Armin Aryannejad, Zatollah Asemi, Mohammad Asghari Jafarabadi, Mohammad Reza Atashzar, Prince Atorkey, Alok Atreya, Sameh Attia, Avinash Aujayeb, Marcel Ausloos, Leticia Avila-Burgos, Atalel 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Foundation, NIH - National Cancer Institute (NCI) (Estados Unidos), Epidemiologie, and RS: NUTRIM - R3 - Respiratory & Age-related Health
Subjects: adolescent cancer, global burden of disease, epidemiology, Adult, Male, Adolescent, 3122 Cancers, UNITED-STATES, Disability-Adjusted Life Year, Adolescents, Socioeconomic Factor, Global Health, Global Burden of Disease, Young Adult, Life Expectancy, SDG 3 - Good Health and Well-being, Risk Factors, WORLDWIDE, Neoplasms, Cause of Death, Prevalence, Humans, 1112 Oncology and Carcinogenesis, Oncology & Carcinogenesis, Mortality, Cancer burden analyses, Cancer, ACUTE LYMPHOBLASTIC-LEUKEMIA, disease, Global burden, OUTCOMES, CHILDHOOD-CANCER, Incidence, Risk Factor, the GBD 2019 methodology, Disability-Adjusted Life Years, GBD 2019 Adolescent Young Adult Cancer Collaborators, CARE, Cancer control efforts, Socioeconomic Factors, Oncology, Neoplasm, Female, Young adults, Human
Abstract: Funding: J A Loureiro acknowledges support from Base Funding UIDB/00511/2020 of the LEPABE funded by national funds through the FCT/MCTES (PIDDAC) and Scientific Employment Stimulus (FCT) [CEECINST/00049/2018]. Background: In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15–39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods: Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15–39 years to define adolescents and young adults. Findings: There were 1·19 million (95% UI 1·11–1·28) incident cancer cases and 396 000 (370 000–425 000) deaths due to cancer among people aged 15–39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59·6 [54·5–65·7] per 100 000 person-years) and high-middle SDI countries (53·2 [48·8–57·9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14·2 [12·9–15·6] per 100 000 person-years) and middle SDI (13·6 [12·6–14·8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23·5 million (21·9–25·2) DALYs to the global burden of disease, of which 2·7% (1·9–3·6) came from YLDs and 97·3% (96·4–98·1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation: Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Funding: Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities, St Baldrick's Foundation, and the National Cancer Institute. publishersversion published
Published: 2022

12. Age–sex differences in the global burden of lower respiratory infections and risk factors, 1990–2019: results from the Global Burden of Disease Study 2019

Author: Hmwe Hmwe Kyu, Avina Vongpradith, Sarah Brooke Sirota, Amanda Novotney, Christopher E Troeger, Matthew C Doxey, Rose G Bender, Jorge R Ledesma, Molly H Biehl, Samuel B Albertson, Joseph Jon Frostad, Katrin Burkart, Fiona B Bennitt, Jeff T Zhao, William M Gardner, Hailey Hagins, Dana Bryazka, Regina-Mae Villanueva Dominguez, Semagn Mekonnen Abate, Michael Abdelmasseh, Amir Abdoli, Gholamreza Abdoli, Aidin Abedi, Vida Abedi, Tadesse M Abegaz, Hassan Abidi, Richard Gyan Aboagye, Hassan Abolhassani, Yonas Derso Abtew, Hiwa Abubaker Ali, Eman Abu-Gharbieh, Ahmed Abu-Zaid, Kidist Adamu, Isaac Yeboah Addo, Oyelola A Adegboye, Mohammad Adnan, Qorinah Estiningtyas Sakilah Adnani, Muhammad Sohail Afzal, Saira Afzal, Bright Opoku Ahinkorah, Aqeel Ahmad, Araz Ramazan Ahmad, Sajjad Ahmad, Ali Ahmadi, Sepideh Ahmadi, Haroon Ahmed, Jivan Qasim Ahmed, Tarik Ahmed Rashid, Mostafa Akbarzadeh-Khiavi, Hanadi Al Hamad, Luciana Albano, Mamoon A Aldeyab, Bezatu Mengistie Alemu, Kefyalew Addis Alene, Abdelazeem M Algammal, Fadwa Alhalaiqa Naji Alhalaiqa, Robert Kaba Alhassan, Beriwan Abdulqadir Ali, Liaqat Ali, Musa Mohammed Ali, Syed Shujait Ali, Yousef Alimohamadi, Vahid Alipour, Adel Al-Jumaily, Syed Mohamed Aljunid, Sami Almustanyir, Rajaa M Al-Raddadi, Rami H Hani Al-Rifai, Saif Aldeen S AlRyalat, Nelson Alvis-Guzman, Nelson J Alvis-Zakzuk, Edward Kwabena Ameyaw, Javad Javad Aminian Dehkordi, John H Amuasi, Dickson A Amugsi, Etsay Woldu Anbesu, Adnan Ansar, Anayochukwu Edward Anyasodor, Jalal Arabloo, Demelash Areda, Ayele Mamo Argaw, Zeleke Gebru Argaw, Judie Arulappan, Raphael Taiwo Aruleba, Mulusew A Asemahagn, Seyyed Shamsadin Athari, Daniel Atlaw, Engi F Attia, Sameh Attia, Avinash Aujayeb, Tewachew Awoke, Tegegn Mulatu Ayana, Martin Amogre Ayanore, Sina Azadnajafabad, Mohammadreza Azangou-Khyavy, Samad Azari, Amirhossein Azari Jafari, Muhammad Badar, Ashish D Badiye, Nayereh Baghcheghi, Sara Bagherieh, Atif Amin Baig, Maciej Banach, Indrajit Banerjee, Mainak Bardhan, Francesco Barone-Adesi, Hiba Jawdat Barqawi, Amadou Barrow, Azadeh Bashiri, Quique Bassat, Abdul-Monim Mohammad Batiha, Abate Bekele Belachew, Melaku Ashagrie Belete, Uzma Iqbal Belgaumi, Akshaya Srikanth Bhagavathula, Nikha Bhardwaj, Pankaj Bhardwaj, Parth Bhatt, Vijayalakshmi S Bhojaraja, Zulfiqar A Bhutta, Soumitra S Bhuyan, Ali Bijani, Saeid Bitaraf, Belay Boda Abule Bodicha, Nikolay Ivanovich Briko, Danilo Buonsenso, Muhammad Hammad Butt, Jiao Cai, Paulo Camargos, Luis Alberto Cámera, Promit Ananyo Chakraborty, Muluken Genetu Chanie, Jaykaran Charan, Vijay Kumar Chattu, Patrick R Ching, Sungchul Choi, Yuen Yu Chong, Sonali Gajanan Choudhari, Enayet Karim Chowdhury, Devasahayam J Christopher, Dinh-Toi Chu, Natalie L Cobb, Aaron J Cohen, Natália Cruz-Martins, Omid Dadras, Fentaw Teshome Dagnaw, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, An Thi Minh Dao, Sisay Abebe Debela, Biniyam Demisse, Fitsum Wolde Demisse, Solomon Demissie, Diriba Dereje, Hardik Dineshbhai Desai, Abebaw Alemayehu Desta, Belay Desye, Sameer Dhingra, Nancy Diao, Daniel Diaz, Lankamo Ena Digesa, Linh Phuong Doan, Milad Dodangeh, Deepa Dongarwar, Fariba Dorostkar, Wendel Mombaque dos Santos, Haneil Larson Dsouza, Eleonora Dubljanin, Oyewole Christopher Durojaiye, Hisham Atan Edinur, Elham Ehsani-Chimeh, Ebrahim Eini, Michael Ekholuenetale, Temitope Cyrus Ekundayo, Eman D El Desouky, Iman El Sayed, Maysaa El Sayed Zaki, Muhammed Elhadi, Ahmed Mahmoud Rabie Elkhapery, Amir Emami, Luchuo Engelbert Bain, Ryenchindorj Erkhembayar, Farshid Etaee, Mohamad Ezati Asar, Adeniyi Francis Fagbamigbe, Shahab Falahi, Aida Fallahzadeh, Anwar Faraj, Emerito Jose A Faraon, Ali Fatehizadeh, Pietro Ferrara, Allegra Allegra Ferrari, Getahun Fetensa, Florian Fischer, Joanne Flavel, Masoud Foroutan, Peter Andras Gaal, Abhay Motiramji Gaidhane, Santosh Gaihre, Nasrin Galehdar, Alberto L Garcia-Basteiro, Tushar Garg, Mesfin Damtew Gebrehiwot, Mathewos Alemu Gebremichael, Yibeltal Yismaw Gela, Belete Negese Belete Gemeda, Bradford D Gessner, Melaku Getachew, Asmare Getie, Seyyed-Hadi Ghamari, Mohammad Ghasemi Nour, Ahmad Ghashghaee, Ali Gholamrezanezhad, Abdolmajid Gholizadeh, Rakesh Ghosh, Sherief Ghozy, Pouya Goleij, Mohamad Golitaleb, Giuseppe Gorini, Alessandra C Goulart, Girma Garedew Goyomsa, Habtamu Alganeh Guadie, Zewdie Gudisa, Rashid Abdi Guled, Sapna Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Alemu Guta, Parham Habibzadeh, Arvin Haj-Mirzaian, Rabih Halwani, Samer Hamidi, Md Abdul Hannan, Mehdi Harorani, Ahmed I Hasaballah, Hamidreza Hasani, Abbas M Hassan, Shokoufeh Hassani, Hossein Hassanian-Moghaddam, Hadi Hassankhani, Khezar Hayat, Behzad Heibati, Mohammad Heidari, Demisu Zenbaba Heyi, Kamal Hezam, Ramesh Holla, Sung Hwi Hong, Nobuyuki Horita, Mohammad-Salar Hosseini, Mehdi Hosseinzadeh, Mihaela Hostiuc, Mowafa Househ, Soodabeh Hoveidamanesh, Junjie Huang, Nawfal R Hussein, Ivo Iavicoli, Segun Emmanuel Ibitoye, Kevin S Ikuta, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Mustapha Immurana, Nahlah Elkudssiah Ismail, Masao Iwagami, Jalil Jaafari, Elham Jamshidi, Sung-In Jang, Amirreza Javadi Mamaghani, Tahereh Javaheri, Fatemeh Javanmardi, Javad Javidnia, Sathish Kumar Jayapal, Umesh Jayarajah, Shubha Jayaram, Alelign Tasew Jema, Wonjeong Jeong, Jost B Jonas, Nitin Joseph, Farahnaz Joukar, Jacek Jerzy Jozwiak, Vaishali K, Zubair Kabir, Salah Eddine Oussama Kacimi, Vidya Kadashetti, Laleh R Kalankesh, Rohollah Kalhor, Ashwin Kamath, Bhushan Dattatray Kamble, Himal Kandel, Tesfaye K Kanko, Ibraheem M Karaye, André Karch, Samad Karkhah, Bekalu Getnet Kassa, Patrick DMC Katoto, Harkiran Kaur, Rimple Jeet Kaur, Leila Keikavoosi-Arani, Mohammad Keykhaei, Yousef Saleh Khader, Himanshu Khajuria, Ejaz Ahmad Khan, Gulfaraz Khan, Imteyaz A Khan, Maseer Khan, Md Nuruzzaman Khan, Moien AB Khan, Yusra H Khan, Moawiah Mohammad Khatatbeh, Mina Khosravifar, Jagdish Khubchandani, Min Seo Kim, Ruth W Kimokoti, Adnan Kisa, Sezer Kisa, Niranjan Kissoon, Luke D Knibbs, Sonali Kochhar, Farzad Kompani, Hamid Reza Koohestani, Vladimir Andreevich Korshunov, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Kewal Krishan, Barthelemy Kuate Defo, G Anil Kumar, Om P Kurmi, Ambily Kuttikkattu, Dharmesh Kumar Lal, Judit Lám, Iván Landires, Caterina Ledda, Sang-woong Lee, Miriam Levi, Sonia Lewycka, Gang Liu, Wei Liu, Rakesh Lodha, László Lorenzovici, Mojgan Lotfi, Joana A Loureiro, Farzan Madadizadeh, Ata Mahmoodpoor, Razzagh Mahmoudi, Marzieh Mahmoudimanesh, Jamal Majidpoor, Alaa Makki, Elaheh Malakan Rad, Ahmad Azam Malik, Tauqeer Hussain Mallhi, Yosef Manla, Clara N Matei, Alexander G Mathioudakis, Richard James Maude, Entezar Mehrabi Nasab, Addisu Melese, Ziad A Memish, Oliver Mendoza-Cano, Alexios-Fotios A Mentis, Tuomo J Meretoja, Mehari Woldemariam Merid, Tomislav Mestrovic, Ana Carolina Micheletti Gomide Nogueira de Sá, Gelana Fekadu Worku Mijena, Le Huu Nhat Minh, Shabir Ahmad Mir, Reza Mirfakhraie, Seyyedmohammadsadeq Mirmoeeni, Agha Zeeshan Mirza, Moonis Mirza, Mohammad Mirza-Aghazadeh-Attari, Abay Sisay Misganaw, Awoke Temesgen Misganaw, Esmaeil Mohammadi, Mokhtar Mohammadi, Arif Mohammed, Shafiu Mohammed, Syam Mohan, Mohammad Mohseni, Nagabhishek Moka, Ali H Mokdad, Sara Momtazmanesh, Lorenzo Monasta, Md Moniruzzaman, Fateme Montazeri, Catrin E Moore, Abdolvahab Moradi, Lidia Morawska, Jonathan F Mosser, Ebrahim Mostafavi, Majid Motaghinejad, Haleh Mousavi Isfahani, Seyed Ali Mousavi-Aghdas, Sumaira Mubarik, Efrén Murillo-Zamora, Ghulam Mustafa, Sanjeev Nair, Tapas Sadasivan Nair, Houshang Najafi, Atta Abbas Naqvi, Sreenivas Narasimha Swamy, Zuhair S Natto, Biswa Prakash Nayak, Seyed Aria Nejadghaderi, Huy Van Nguyen Nguyen, Robina Khan Niazi, Antonio Tolentino Nogueira de Sá, Hasti Nouraei, Ali Nowroozi, Virginia Nuñez-Samudio, Chimezie Igwegbe Nzoputam, Ogochukwu Janet Nzoputam, Bogdan Oancea, Chimedsuren Ochir, Oluwakemi Ololade Odukoya, Hassan Okati-Aliabad, Akinkunmi Paul Okekunle, Osaretin Christabel Okonji, Andrew T Olagunju, Isaac Iyinoluwa Olufadewa, Ahmed Omar Bali, Emad Omer, Eyal Oren, Erika Ota, Nikita Otstavnov, Abderrahim Oulhaj, Mahesh P A, Jagadish Rao Padubidri, Keyvan Pakshir, Reza Pakzad, Tamás Palicz, Anamika Pandey, Suman Pant, Shahina Pardhan, Eun-Cheol Park, Eun-Kee Park, Fatemeh Pashazadeh Kan, Rajan Paudel, Shrikant Pawar, Minjin Peng, Gavin Pereira, Simone Perna, Navaraj Perumalsamy, Ionela-Roxana Petcu, David M Pigott, Zahra Zahid Piracha, Vivek Podder, Roman V Polibin, Maarten J Postma, Hamid Pourasghari, Naeimeh Pourtaheri, Mirza Muhammad Fahd Qadir, Mathieu Raad, Mohammad Rabiee, Navid Rabiee, Saber Raeghi, Alireza Rafiei, Fakher Rahim, Mehran Rahimi, Vafa Rahimi-Movaghar, Azizur Rahman, Md Obaidur Rahman, Mosiur Rahman, Muhammad Aziz Rahman, Amir Masoud Rahmani, Vahid Rahmanian, Pradhum Ram, Kiana Ramezanzadeh, Juwel Rana, Priyanga Ranasinghe, Usha Rani, Sowmya J Rao, Sina Rashedi, Mohammad-Mahdi Rashidi, Azad Rasul, Zubair Ahmed Ratan, David Laith Rawaf, Salman Rawaf, Reza Rawassizadeh, 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H., Vongpradith, A., Sirota, S. B., Novotney, A., Troeger, C. E., Doxey, M. C., Bender, R. G., Ledesma, J. R., Biehl, M. H., Albertson, S. B., Frostad, J. J., Burkart, K., Bennitt, F. B., Zhao, J. T., Gardner, W. M., Hagins, H., Bryazka, D., Dominguez, R. -M. V., Abate, S. M., Abdelmasseh, M., Abdoli, A., Abdoli, G., Abedi, A., Abedi, V., Abegaz, T. M., Abidi, H., Aboagye, R. G., Abolhassani, H., Abtew, Y. D., Abubaker Ali, H., Abu-Gharbieh, E., Abu-Zaid, A., Adamu, K., Addo, I. Y., Adegboye, O. A., Adnan, M., Adnani, Q. E. S., Afzal, M. S., Afzal, S., Ahinkorah, B. O., Ahmad, A., Ahmad, A. R., Ahmad, S., Ahmadi, A., Ahmadi, S., Ahmed, H., Ahmed, J. Q., Ahmed Rashid, T., Akbarzadeh-Khiavi, M., Al Hamad, H., Albano, L., Aldeyab, M. A., Alemu, B. M., Alene, K. A., Algammal, A. M., Alhalaiqa, F. A. N., Alhassan, R. K., Ali, B. A., Ali, L., Ali, M. M., Ali, S. S., Alimohamadi, Y., Alipour, V., Al-Jumaily, A., Aljunid, S. M., Almustanyir, S., Al-Raddadi, R. M., Al-Rifai, R. H. 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Krishan, K, Kuate Defo, B, Kumar, G, Kurmi, O, Kuttikkattu, A, Lal, D, Lam, J, Landires, I, Ledda, C, Lee, S, Levi, M, Lewycka, S, Liu, G, Liu, W, Lodha, R, Lorenzovici, L, Lotfi, M, Loureiro, J, Madadizadeh, F, Mahmoodpoor, A, Mahmoudi, R, Mahmoudimanesh, M, Majidpoor, J, Makki, A, Malakan Rad, E, Malik, A, Mallhi, T, Manla, Y, Matei, C, Mathioudakis, A, Maude, R, Mehrabi Nasab, E, Melese, A, Memish, Z, Mendoza-Cano, O, Mentis, A, Meretoja, T, Merid, M, Mestrovic, T, Micheletti Gomide Nogueira de Sa, A, Mijena, G, Minh, L, Mir, S, Mirfakhraie, R, Mirmoeeni, S, Mirza, A, Mirza, M, Mirza-Aghazadeh-Attari, M, Misganaw, A, Mohammadi, E, Mohammadi, M, Mohammed, A, Mohammed, S, Mohan, S, Mohseni, M, Moka, N, Mokdad, A, Momtazmanesh, S, Monasta, L, Moniruzzaman, M, Montazeri, F, Moore, C, Moradi, A, Morawska, L, Mosser, J, Mostafavi, E, Motaghinejad, M, Mousavi Isfahani, H, Mousavi-Aghdas, S, Mubarik, S, Murillo-Zamora, E, Mustafa, G, Nair, S, Nair, T, Najafi, H, Naqvi, A, Narasimha Swamy, S, Natto, Z, Nayak, B, Nejadghaderi, S, Nguyen, H, Niazi, R, Nogueira de Sa, A, Nouraei, H, Nowroozi, A, Nunez-Samudio, V, Nzoputam, C, Nzoputam, O, Oancea, B, Ochir, C, Odukoya, O, Okati-Aliabad, H, Okekunle, A, Okonji, O, Olagunju, A, Olufadewa, I, Omar Bali, A, Omer, E, Oren, E, Ota, E, Otstavnov, N, Oulhaj, A, P A, M, Padubidri, J, Pakshir, K, Pakzad, R, Palicz, T, Pandey, A, Pant, S, Pardhan, S, Park, E, Pashazadeh Kan, F, Paudel, R, Pawar, S, Peng, M, Pereira, G, Perna, S, Perumalsamy, N, Petcu, I, Pigott, D, Piracha, Z, Podder, V, Polibin, R, Postma, M, Pourasghari, H, Pourtaheri, N, Qadir, M, Raad, M, Rabiee, M, Rabiee, N, Raeghi, S, Rafiei, A, Rahim, F, Rahimi, M, Rahimi-Movaghar, V, Rahman, A, Rahman, M, Rahmani, A, Rahmanian, V, Ram, P, Ramezanzadeh, K, Rana, J, Ranasinghe, P, Rani, U, Rao, S, Rashedi, S, Rashidi, M, Rasul, A, Ratan, Z, Rawaf, D, Rawaf, S, Rawassizadeh, R, Razeghinia, M, Redwan, E, Reitsma, M, Renzaho, A, Rezaeian, M, Riad, A, Rikhtegar, R, Rodriguez, J, Rogowski, E, Ronfani, L, Rudd, K, Saddik, B, Sadeghi, E, Saeed, U, Safary, A, Safi, S, Sahebazzamani, M, Sahebkar, A, Sakhamuri, S, Salehi, S, Salman, M, Samadi Kafil, H, Samy, A, Santric-Milicevic, M, Sao Jose, B, Sarkhosh, M, Sathian, B, Sawhney, M, Saya, G, Seidu, A, Seylani, A, Shaheen, A, Shaikh, M, Shaker, E, Shamshad, H, Sharew, M, Sharhani, A, Sharifi, A, Sharma, P, Sheidaei, A, Shenoy, S, Shetty, J, Shiferaw, D, Shigematsu, M, Shin, J, Shirzad-Aski, H, Shivakumar, K, Shivalli, S, Shobeiri, P, Simegn, W, Simpson, C, Singh, H, Singh, J, Singh, P, Siwal, S, Skryabin, V, Skryabina, A, Soltani-Zangbar, M, Song, S, Song, Y, Sood, P, Sreeramareddy, C, Steiropoulos, P, Suleman, M, Tabatabaeizadeh, S, Tahamtan, A, Taheri, M, Taheri Soodejani, M, Taki, E, Talaat, I, Tampa, M, Tandukar, S, Tat, N, Tat, V, Tefera, Y, Temesgen, G, Temsah, M, Tesfaye, A, Tesfaye, D, Tessema, B, Thapar, R, Ticoalu, J, Tiyuri, A, Tleyjeh, I, Togtmol, M, Tovani-Palone, M, Tufa, D, Ullah, I, Upadhyay, E, Valadan Tahbaz, S, Valdez, P, Valizadeh, R, Vardavas, C, Vasankari, T, Vo, B, Vu, L, Wagaye, B, Waheed, Y, Wang, Y, Waris, A, West, T, Wickramasinghe, N, Xu, X, Yaghoubi, S, Yahya, G, Yahyazadeh Jabbari, S, Yon, D, Yonemoto, N, Zaman, B, Zandifar, A, Zangiabadian, M, Zar, H, Zare, I, Zareshahrabadi, Z, Zarrintan, A, Zastrozhin, M, Zeng, W, Zhang, M, Zhang, Z, Zhong, C, Zoladl, M, Zumla, A, Lim, S, Vos, T, Naghavi, M, Brauer, M, Hay, S, Murray, C, HUS Comprehensive Cancer Center, and Department of Oncology
Subjects: Adult, Male, Global Health, Time, Global Burden of Disease, SDG 3 - Good Health and Well-being, Risk Factors, RA0421, RA0421 Public health. Hygiene. Preventive Medicine, Humans, Ambient air-quality, Child, Respiratory Tract Infections, Aged, Aged, 80 and over, MCC, Sex Characteristics, Malnutrition, Pyridinolcarbamate, Bayes Theorem, 3rd-DAS, 3142 Public health care science, environmental and occupational health, Infectious Diseases, 3121 General medicine, internal medicine and other clinical medicine, Child, Preschool, Female, Particulate Matter, Quality-Adjusted Life Years, Covid-19, LRI
Abstract: Funding: Bill & Melinda Gates Foundation. Background: The global burden of lower respiratory infections (LRIs) and corresponding risk factors in children older than 5 years and adults has not been studied as comprehensively as it has been in children younger than 5 years. We assessed the burden and trends of LRIs and risk factors across all age groups by sex, for 204 countries and territories. Methods: In this analysis of data for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we used clinician-diagnosed pneumonia or bronchiolitis as our case definition for LRIs. We included International Classification of Diseases 9th edition codes 079.6, 466–469, 470.0, 480–482.8, 483.0–483.9, 484.1–484.2, 484.6–484.7, and 487–489 and International Classification of Diseases 10th edition codes A48.1, A70, B97.4–B97.6, J09–J15.8, J16–J16.9, J20–J21.9, J91.0, P23.0–P23.4, and U04–U04.9. We used the Cause of Death Ensemble modelling strategy to analyse 23 109 site-years of vital registration data, 825 site-years of sample vital registration data, 1766 site-years of verbal autopsy data, and 681 site-years of mortality surveillance data. We used DisMod-MR 2.1, a Bayesian meta-regression tool, to analyse age–sex-specific incidence and prevalence data identified via systematic reviews of the literature, population-based survey data, and claims and inpatient data. Additionally, we estimated age–sex-specific LRI mortality that is attributable to the independent effects of 14 risk factors. Findings: Globally, in 2019, we estimated that there were 257 million (95% uncertainty interval [UI] 240–275) LRI incident episodes in males and 232 million (217–248) in females. In the same year, LRIs accounted for 1·30 million (95% UI 1·18–1·42) male deaths and 1·20 million (1·07–1·33) female deaths. Age-standardised incidence and mortality rates were 1·17 times (95% UI 1·16–1·18) and 1·31 times (95% UI 1·23–1·41) greater in males than in females in 2019. Between 1990 and 2019, LRI incidence and mortality rates declined at different rates across age groups and an increase in LRI episodes and deaths was estimated among all adult age groups, with males aged 70 years and older having the highest increase in LRI episodes (126·0% [95% UI 121·4–131·1]) and deaths (100·0% [83·4–115·9]). During the same period, LRI episodes and deaths in children younger than 15 years were estimated to have decreased, and the greatest decline was observed for LRI deaths in males younger than 5 years (–70·7% [–77·2 to –61·8]). The leading risk factors for LRI mortality varied across age groups and sex. More than half of global LRI deaths in children younger than 5 years were attributable to child wasting (population attributable fraction [PAF] 53·0% [95% UI 37·7–61·8] in males and 56·4% [40·7–65·1] in females), and more than a quarter of LRI deaths among those aged 5–14 years were attributable to household air pollution (PAF 26·0% [95% UI 16·6–35·5] for males and PAF 25·8% [16·3–35·4] for females). PAFs of male LRI deaths attributed to smoking were 20·4% (95% UI 15·4–25·2) in those aged 15–49 years, 30·5% (24·1–36·9) in those aged 50–69 years, and 21·9% (16·8–27·3) in those aged 70 years and older. PAFs of female LRI deaths attributed to household air pollution were 21·1% (95% UI 14·5–27·9) in those aged 15–49 years and 18·2% (12·5–24·5) in those aged 50–69 years. For females aged 70 years and older, the leading risk factor, ambient particulate matter, was responsible for 11·7% (95% UI 8·2–15·8) of LRI deaths. Interpretation: The patterns and progress in reducing the burden of LRIs and key risk factors for mortality varied across age groups and sexes. The progress seen in children younger than 5 years was clearly a result of targeted interventions, such as vaccination and reduction of exposure to risk factors. Similar interventions for other age groups could contribute to the achievement of multiple Sustainable Development Goals targets, including promoting wellbeing at all ages and reducing health inequalities. Interventions, including addressing risk factors such as child wasting, smoking, ambient particulate matter pollution, and household air pollution, would prevent deaths and reduce health disparities. Publisher PDF
Published: 2022

13. Prevalence of NAFLD and Its Association with Insulin Resistance in First Degree Relatives of Type 2 Diabetes

Author: Shekar Ma, Shubha Jayaram, Thejashwini A, Nanjaraj Cp, Shashikumar Mr, Sumaiya Anjum, Savitha Nageshappa, and Srikanta B Manjegowda
Subjects: medicine.medical_specialty, Insulin resistance, business.industry, Internal medicine, medicine, General Medicine, Type 2 diabetes, First-degree relatives, medicine.disease, Association (psychology), business
Published: 2020

14. Vitamin d and parathyroid hormone levels and their association with insulin resistance in type 2 diabetes subjects

Author: Srikanta Bm, Savitha Nageshappa, Meera S, Deepa K, Shekar Ma, and Shubha Jayaram
Subjects: medicine.medical_specialty, business.industry, Insulin, medicine.medical_treatment, Parathyroid hormone, Type 2 diabetes, medicine.disease, vitamin D deficiency, Endocrinology, Insulin resistance, Diabetes mellitus, Internal medicine, Vitamin D and neurology, Medicine, Outpatient clinic, business, hormones, hormone substitutes, and hormone antagonists
Abstract: Vitamin D deficiency is associated with metabolic diseases like Type-2 diabetes mellitus, obesity and insulin resistance. Previous studies have evaluated the effects of vitamin D and parathyroid hormone (PTH) separately in isolation rather than studying the combined effects of both hormones together as a reflection of the status of the PTH-Vitamin D axis. Low vitamin D coupled with increased PTH may be a better indicator, which is the novelty of the present study. A total of 151 Type 2 diabetic subjects attending the outpatient clinics of endocrinology department of MMC&RI, Mysore, were chosen for the study. Vitamin D, PTH, calcitonin and Insulin levels were analysed using chemiluminescence Immuno assay techniques. Comparison was made between normal (vitamin D >20ng/ml) and vitamin D deficient (vitamin D
Published: 2020

15. Study of iron markers and their relationship with HbA1c level in type 2-DM-Bagalkot tertiary care centre

Author: Shubha Jayaram, Mahantesh Bhutal, Sunitha H. Pujar, and Neela Mannangi
Subjects: chemistry.chemical_classification, medicine.medical_specialty, biology, medicine.diagnostic_test, Transferrin saturation, business.industry, Insulin, medicine.medical_treatment, Case-control study, Type 2 Diabetes Mellitus, medicine.disease, Ferritin, Endocrinology, chemistry, Transferrin, Internal medicine, Diabetes mellitus, biology.protein, Serum iron, Medicine, business
Abstract: Diabetes Mellitus (DM) is one of the most prevalent endocrine disorders in the world. It comprises a group of common metabolic disorders that share common phenotype of hyperglycemia. Impaired insulin release in Type 2DM is linked to various trace elements like iron, magnesium, chromium etc. Systemic iron overload leads to increased oxidative stress which results in abnormal glucose metabolism. The defects in insulin-producing and insulin-sensitive tissues caused by iron-dependent catalysis is via the Fenton’s reaction of reactive oxygen radical species. Present study was undertaken to assess level of serum ferritin, free iron concentration, TIBC, transferrin saturation in type 2 Diabetes mellitus patients with good and poor glycaemic control and find out correlation between serum ferritin, free iron concentrations with glycaemic control. The study was conducted between January-August 2018 at SNMC & HSK Hospital Bagalkot. It’s a case control study. Sample size included 120 subjects out of which 60 are diagnosed Type 2DM (cases) attending medicine OPD at SNMC & HSK, RC Bagalkot and 60 Healthy control appropriately matched for age and sex. The glucose parameters and serum iron, ferritin, TIBC, Transferrin saturation and Hb were high in cases compared to controls and was statistically significant. Serum iron and ferritin showed positive correlation with impaired glycaemic control. From this study it suggests that vital role of iron is metabolically deranged in diabetic patients.
Published: 2020

16. Study of Atherogenic Index of Plasma (AIP) and Other Lipid Indices in Helicobacter Pylori Infection

Author: Lokesh M. G, Sreenivas N, Shubha Jayaram, Deepa K, Arpitha Mr, and Meera S
Subjects: medicine.medical_specialty, Helicobacter pylori infection, Index (economics), business.industry, Internal medicine, Medicine, General Medicine, business, Gastroenterology
Published: 2019

17. Global, regional, and national burden of stroke and its risk factors, 1990–2019 : a systematic analysis for the Global Burden of Disease Study 2019

Author: Mosiur Rahman, Rehab Salah, Mario F P Peres, Licia Iacoviello, Benjamin A Stark, Mahalaqua Nazli Khatib, Amir Radfar, Kamarul Imran Musa, Yannick Béjot, Deanna Anderlini, Carlos Cantú-Brito, Feng Sha, V. E. Nwatah, Pradip Gyanwali, Boris Bikbov, Bartosz Miazgowski, Sindhura Lakshmi Koulmane Laxminarayana, Ali Bijani, Imteyaz A Khan, Yaser Mokhayeri, Bogdan Oancea, Tarang Parekh, Martin Dichgans, Linh Gia Vu, Naohiro Yonemoto, Ahmad Ghashghaee, Marcos Roberto Tovani-Palone, Gebiyaw Wudie Tsegaye, Mona Pathak, Maciej Banach, Marissa B Reitsma, Derrick A Bennett, Treska S Hassan, Allen Seylani, Gdiom Gebreheat Abady, Islam Y. Elgendy, Hassan Mehmood Lak, Ismael R. Campos-Nonato, Sorin Hostiuc, Sheikh Mohammed Shariful Islam, Alessandra C. Goulart, Silvia Schiavolin, Simona Sacco, Atif Amin Baig, Azeem Majeed, Sahar Eftekharzadeh, Badr Hasan Sobaih, Archith Boloor, Aimé Bonny, Graeme J. Hankey, Jiregna Darega Gela, Mohamed I Hegazy, Pedram Keshavarz, Segun Emmanuel Ibitoye, Maseer Khan, Hatem Abdelaziz Mohamed Wafa, Hualiang Lin, Enayet Karim Chowdhury, Simon I. Hay, Vanessa De la Cruz-Góngora, Xuefeng Liu, Arokiasamy Perianayagam, Maryam Zamanian, Sezer Kisa, Preetam Bhalchandra Mahajan, Junmei Miao Jonasson, Alberto Raggi, Shubha Jayaram, Tahira Ashraf, Ejaz Ahmad Khan, Matthias Endres, Masoumeh Sadeghi, Dominique Vervoort, Hanadi Al Hamad, Mowafa Househ, Elena V. Gnedovskaya, Johan Ärnlöv, Andrea Sylvia Winkler, Yousef Khader, Mikhail Sergeevich Zastrozhin, Yuming Guo, Yunquan Zhang, Sami Almustanyir, Lalit Dandona, Amir Masoud Rahmani, Chythra R Rao, Giancarlo Lucchetti, Irena Ilic, Suzanne Barker-Collo, Priya Rathi, Emerito Jose A. Faraon, Mohamad-Hani Temsah, Reza Ghanei Gheshlagh, Gyu Ri Kim, Carlos A Castañeda-Orjuela, Alaa Makki, Yun Jin Kim, Vida Abedi, Shanshan Li, Kewal Krishan, David Flood, Abdollah Mohammadian-Hafshejani, Michele Romoli, Gregory A. Roth, Jagdish Khubchandani, Isabela M. Benseñor, Rupak Desai, Mohammed Shannawaz, Aziz Sheikh, Claudiu Herteliu, Xiaoyue Xu, Santi Martini, Kenji Shibuya, Jasvinder A. Singh, Ravi Prakash Jha, Kairat Davletov, Mahya Beheshti, Rahmatollah Moradzadeh, Ismaeel Yunusa, Maria Inês Schmidt, Koustuv Dalal, Sohail Ahmad, Patrick D. M. C. Katoto, Oladimeji Adebayo, Nima Hafezi-Nejad, Ranil Jayawardena, Giampiero Mazzaglia, Mitra Abbasifard, Usman Iqbal, Hamid Yimam Hassen, Alireza Rafiei, Catherine O. Johnson, Mark Thomaz Ugliara Barone, Simona Giampaoli, Gaetano Isola, Ricardo Lutzky Saute, Mandira Lamichhane Dhimal, Vishnu Renjith, Farshad Farzadfar, Irina Filip, Daniel Diaz, André Karch, Samer Hamidi, Diego Augusto Santos Silva, David Colozza, Gbenga A. Kayode, Dinh-Toi Chu, Truong-Minh Pham, Arielle Wilder Bell, Aziz Rezapour, David Laith Rawaf, Anasthasia Zastrozhina, Yves Miel H Zuniga, Ivo Iavicoli, Adrian Pana, Salman Rawaf, Pankaj Bhardwaj, Omid Dadras, Anayat Ullah, Gina Agarwal, Shafiu Mohammed, Bing-Fang Hwang, Eyayou Girma Tadesse, Charles D.A. Wolfe, Sanjay Basu, Michael Brauer, Tanuj Kanchan, Ahmad Azam Malik, Brigid Unim, Min Seo Kim, Kia Vosoughi, Tomasz Miazgowski, Warren D. Lo, Vivek Podder, Dana Bryazka, Chuanhua Yu, Hassan Magdy Abd El Razek, Rufus Akinyemi, Zhi-Jiang Zhang, Ettore Beghi, Xiaochen Dai, Meghnath Dhimal, Mehrnoosh Samaei, Sathish Kumar Jayapal, Bay Vo, Amanual Getnet Mersha, Rajaa Al-Raddadi, Savita Lasrado, Jalal Arabloo, Pablo M. Lavados, Samaneh Akbarpour, Khezar Hayat, Ritesh G. Menezes, Vahid Alipour, Sowmya J. Rao, Mariam Molokhia, Trang Huyen Nguyen, Aletta E. Schutte, Zahra Kamiab, Lidia Morawska, Mohammad Ali Moni, Bo Norrving, Tommi Vasankari, Bruno Ramos Nascimento, Ai Koyanagi, Tissa Wijeratne, Rizwan Kalani, Chenwen Zhong, Bright Opoku Ahinkorah, Sepideh Ahmadi, Bruce Bartholow Duncan, Andrzej Rynkiewicz, Pradyumna Agasthi, Saeed Shahabi, Adnan Kisa, Fares Alahdab, Vafa Rahimi-Movaghar, Adnan Ansar, Matilde Leonardi, Ali Koolivand, Jefferson Antonio Buendia Rodriguez, Leonardo Roever, Daniel Asfaw Erku, Alok Atreya, Jean Jacques Noubiap, Dhaval Kolte, Shajedur Rahman Shawon, Michael Ekholuenetale, Navid Manafi, Narayanaswamy Venketasubramanian, Syed Amir Gilani, Mohamed M. Gad, Christopher J L Murray, Louis Jacob, Robert Ancuceanu, Simona Costanzo, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, Nazanin Rajai, Muhammed Elhadi, Abdelrahman Ibrahim Abushouk, Alireza Zandifar, Walter Muruet, Jagadish Rao Padubidri, Promit Ananyo Chakraborty, Hans Orru, Mikk Jürisson, Rajeev Gupta, Kurnia Dwi Artanti, Till Bärnighausen, Mark Woodward, Masao Iwagami, Brijesh Sathian, Bingyu Li, Vijay Krishnamoorthy, Ahamarshan Jayaraman Nagarajan, Sherief Ghozy, Amanda G. Thrift, Michael A. Piradov, Florian Fischer, Mayowa O. Owolabi, Lorenzo G. Mantovani, Aman Yesuf Endries, Sara Sheikhbahaei, Stefan Lorkowski, Muhammed Shahriar Zaman, Ali Yadollahpour, Abdiwahab Hashi, Sreenivas Narasimha Swamy, Krittika Bhattacharyya, Hiroshi Yatsuya, Mika Kivimäki, Olayinka Stephen Ilesanmi, Irmina Maria Michalek, Ruxandra Irina Negoi, Alberico L. Catapano, Gholamreza Bazmandegan, Ahmed Al Montasir, Fakher Rahim, Amirhossein Sahebkar, Syed Mohamed Aljunid, Giang Thu Vu, G Anil Kumar, Juan Jesus Carrero, Hiroyasu Iso, Abdallah M. Samy, Stefan Stortecky, Reza Malekzadeh, Ashwin Kamath, Nevine El Nahas, Ayesha Humayun, Miguel A Barboza, Sheng-Chia Chung, Carlo La Vecchia, Oluwakemi Ololade Odukoya, Rita Krishnamurthi, Masood Ali Shaikh, Milena Ilic, Lalit Yadav, Nahlah Elkudssiah Ismail, Abdel Douiri, Yousef Mohammad, Jason H Y Wu, Sahar Saeedi Moghaddam, Ramesh Holla, Sadaf G. Sepanlou, Itamar S. Santos, Jost B. Jonas, Dian Kusuma, Atte Meretoja, Yasir Waheed, Ben Lacey, Zahra Aryan, Mulugeta Molla Birhanu, Moien Ab Khan, K. M. Saif-Ur-Rahman, Ramin Zand, Anna Aleksandrovna Skryabina, Sung In Jang, Rakhi Dandona, Emanuele D'Amico, Priyanga Ranasinghe, Jaykaran Charan, Bhaskaran Unnikrishnan, Davide Sattin, Akram Pourshams, Markus P. Schlaich, Arief Hargono, Samaneh Asgari, Ovidiu Baltatu, Ippazio Cosimo Antonazzo, Sandhya Neupane Kandel, Nizal Sarrafzadegan, Jakub Morze, Man Mohan Mehndiratta, Manjari Tripathi, Panniyammakal Jeemon, Rohollah Kalhor, Yogeshwar Kalkonde, Soraya Siabani, Sojib Bin Zaman, Seyed Sina Naghibi Irvani, Shilpa Gaidhane, Sahel Valadan Tahbaz, Yihienew Mequanint Bezabih, Samath D Dharmaratne, Ingan Ukur Tarigan, Vivek Gupta, Klara Dokova, Alireza Vakilian, Vardhmaan Jain, Akshaya Srikanth Bhagavathula, Sarah Wulf Hanson, Umar Farooque, Mohammad Ali Mansournia, Vera Marisa Costa, Alessandro Gialluisi, Valery L. Feigin, Himal Kandel, Suzanne Polinder, Nermin Ghith, Deepak Dhamnetiya, Michael H. Criqui, Asif Hanif, Ahmed Abualhasan, Veer Bala Gupta, Mahaveer Golechha, Bach Xuan Tran, Jason A. Anderson, Catherine Bisignano, Kazumasa Yamagishi, Zahid A Butt, Budi Aji, Baye Dagnew, Rasmus Havmoeller, Victor Volovici, Jitendra Singh, Paramjit Gill, Saverio Stranges, Eun Cheol Park, Andrew T Olagunju, Milena Santric-Milicevic, Woldesellassie M. Bezabhe, Sheikh M. Alif, Junjie Huang, Foad Abd-Allah, Yvonne Teuschl, Rajkumar Doshi, Nelson Alvis-Guzman, Marcel Ausloos, Mohsen Naghavi, Yusra Ahmed Salih, Mohsen Abbasi-Kangevari, Maarten J. Postma, Ghozali Ghozali, Yanzhong Wang, Ali H. Mokdad, Valentin Yurievich Skryabin, Nitin Joseph, Andre M. N. Renzaho, Muhammad Aziz Rahman, Mohammad Athar, Rustam Al-Shahi Salman, Albertino Damasceno, Fatemeh Pashazadeh Kan, Marcello Tonelli, Florentino Luciano Caetano dos Santos, Sonali G. Choudhari, Abdullah Hamid Feroze, Walter D. Johnson, Ro-Ting Lin, Francesca Giulia Magnani, Hermann Brenner, Shaimaa I. El-Jaafary, Tea Lallukka, Niveen M E Abu-Rmeileh, Jacek Jerzy Jozwiak, GBD 2019 Stroke Collaborators, Feigin, V. L., Stark, B. 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Rawaf, S, Reitsma, M, Renjith, V, Renzaho, A, Rezapour, A, Rodriguez, J, Roever, L, Romoli, M, Rynkiewicz, A, Sacco, S, Sadeghi, M, Moghaddam, S, Sahebkar, A, Saif-Ur-Rahman, K, Salah, R, Samaei, M, Samy, A, Santos, I, Santric-Milicevic, M, Sarrafzadegan, N, Sathian, B, Sattin, D, Schiavolin, S, Schlaich, M, Schmidt, M, Schutte, A, Sepanlou, S, Seylani, A, Sha, F, Shahabi, S, Shaikh, M, Shannawaz, M, Shawon, M, Sheikh, A, Sheikhbahaei, S, Shibuya, K, Siabani, S, Silva, D, Singh, J, Skryabin, V, Skryabina, A, Sobaih, B, Stortecky, S, Stranges, S, Tadesse, E, Tarigan, I, Temsah, M, Teuschl, Y, Thrift, A, Tonelli, M, Tovani-Palone, M, Tran, B, Tripathi, M, Tsegaye, G, Ullah, A, Unim, B, Unnikrishnan, B, Vakilian, A, Tahbaz, S, Vasankari, T, Venketasubramanian, N, Vervoort, D, Vo, B, Volovici, V, Vosoughi, K, Vu, G, Vu, L, Wafa, H, Waheed, Y, Wang, Y, Wijeratne, T, Winkler, A, Wolfe, C, Woodward, M, Wu, J, Hanson, S, Xu, X, Yadav, L, Yadollahpour, A, Jabbari, S, Yamagishi, K, Yatsuya, H, Yonemoto, N, Yu, C, Yunusa, I, Zaman, M, Zaman, S, Zamanian, M, Zand, R, Zandifar, A, Zastrozhin, M, Zastrozhina, A, Zhang, Y, Zhang, Z, Zhong, C, Zuniga, Y, Murray, C, Value, Affordability and Sustainability (VALUE), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), and Microbes in Health and Disease (MHD)
Subjects: Male, Aging, 030204 cardiovascular system & hematology, Stroke data, GUIDELINES, 3124 Neurology and psychiatry, Body Mass Index, Global Burden of Disease, 0302 clinical medicine, RA0421, Risk Factors, Epidemiology, Strokes, YOUNG-ADULTS, Prevalence, 80 and over, Aetiology, 610 Medicine & health, Stroke, POPULATION, 1103 Clinical Sciences, 1109 Neurosciences, Cause of death, Aged, 80 and over, education.field_of_study, Mortality rate, Incidence (epidemiology), Incidence, 1. No poverty, Articles, Hälsovetenskaper, Middle Aged, Stroke types, ddc, 3. Good health, ISCHEMIC-STROKE, Income, Female, Quality-Adjusted Life Years, Life Sciences & Biomedicine, Adult, medicine.medical_specialty, GBD, Population, Clinical Sciences, Clinical Neurology, 03 medical and health sciences, Clinical Research, MIDDLE-INCOME COUNTRIES, Health Sciences, medicine, Humans, Risk factor, education, GBD 2019 Stroke Collaborators, Cerebral Hemorrhage, Aged, Ischemic Stroke, Global burden, Science & Technology, Neurology & Neurosurgery, HYPERTENSION, business.industry, MORTALITY, Prevention, 3112 Neurosciences, Neurosciences, 1103 Clinical Sciences, SERVICES, Subarachnoid Hemorrhage, medicine.disease, PREVENTION, Brain Disorders, Good Health and Well Being, Attributable risk, Human medicine, Neurology (clinical), Neurosciences & Neurology, business, 1109 Neurosciences, 030217 neurology & neurosurgery, Demography, 2.4 Surveillance and distribution, RC
Abstract: Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12·2 million (95% UI 11·0–13·6) incident cases of stroke, 101 million (93·2–111) prevalent cases of stroke, 143 million (133–153) DALYs due to stroke, and 6·55 million (6·00–7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8–12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1–6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0–73·0), prevalent strokes increased by 85·0% (83·0–88·0), deaths from stroke increased by 43·0% (31·0–55·0), and DALYs due to stroke increased by 32·0% (22·0–42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0–18·0), mortality decreased by 36·0% (31·0–42·0), prevalence decreased by 6·0% (5·0–7·0), and DALYs decreased by 36·0% (31·0–42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0–24·0) and incidence rates increased by 15·0% (12·0–18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5–3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5–3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57–8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97–3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01–1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7–90·8] DALYs or 55·5% [48·2–62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3–48·6] DALYs or 24·3% [15·7–33·2]), high fasting plasma glucose (28·9 million [19·8–41·5] DALYs or 20·2% [13·8–29·1]), ambient particulate matter pollution (28·7 million [23·4–33·4] DALYs or 20·1% [16·6–23·0]), and smoking (25·3 million [22·6–28·2] DALYs or 17·6% [16·4–19·0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries. Funding Bill & Melinda Gates Foundation.
Published: 2021

18. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019: Update From the GBD 2019 Study

Author: Roth, Gregory A, Mensah, George A, Johnson, Catherine O, Addolorato, Giovanni, Ammirati, Enrico, Baddour, Larry M, Barengo, Noël C, Beaton, Andrea Z, Benjamin, Emelia J, Benziger, Catherine P, Bonny, Aimé, Brauer, Michael, Brodmann, Marianne, Cahill, Thomas J, Carapetis, Jonathan, Catapano, Alberico L, Chugh, Sumeet S, Cooper, Leslie T, Coresh, Josef, Criqui, Michael, DeCleene, Nicole, Eagle, Kim A, Emmons-Bell, Sophia, Feigin, Valery L, Fernández-Solà, Joaquim, Fowkes, Gerry, Gakidou, Emmanuela, Grundy, Scott M, He, Feng J, Howard, George, Hu, Frank, Inker, Lesley, Karthikeyan, Ganesan, Kassebaum, Nicholas, Koroshetz, Walter, Lavie, Carl, Lloyd-Jones, Donald, Lu, Hong S, Mirijello, Antonio, Temesgen, Awoke Misganaw, Mokdad, Ali, Moran, Andrew E, Muntner, Paul, Narula, Jagat, Neal, Bruce, Ntsekhe, Mpiko, Moraes de Oliveira, Glaucia, Otto, Catherine, Owolabi, Mayowa, Pratt, Michael, Rajagopalan, Sanjay, Reitsma, Marissa, Ribeiro, Antonio Luiz P, Rigotti, Nancy, Rodgers, Anthony, Sable, Craig, Shakil, Saate, Sliwa-Hahnle, Karen, Stark, Benjamin, Sundström, Johan, Timpel, Patrick, Tleyjeh, Imad M, Valgimigli, Marco, Vos, Theo, Whelton, Paul K, Yacoub, Magdi, Zuhlke, Liesl, Murray, Christopher, Fuster, Valentin, GBD-NHLBI-JACC Global, Burden of, Cardiovascular Diseases, Writing Group, Gregory A, Roth George, A Mensah, Catherine O, Johnson, Giovanni, Addolorato, Enrico, Ammirati, Larry M, Baddour Noel, C Barengo, Andrea, Beaton, Emelia J, Benjamin Catherine, P Benziger, Aime, Bonny, Michael, Brauer, Marianne, Brodmann, Thomas J, Cahill Jonathan, R Carapetis, Alberico L, Catapano, Sumeet, Chugh, Leslie T, Cooper, Josef, Coresh, Michael H, Criqui Nicole, K DeCleene, Kim A, Eagle, Sophia, Emmons-Bell, Valery L, Feigin, Joaquim, Fernández-Sola, F Gerry, R Fowkes, Emmanuela, Gakidou, Scott M, Grundy Feng, J He, George, Howard, Frank, Hu, Lesley, Inker, Ganesan, Karthikeyan, Nicholas J, Kassebaum Walter, J Koroshetz, Carl, Lavie, Donald, Lloyd-Jones, Hong S, Antonio, 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Navid, Manafi, Mohammad, Ali, Mansournia, Lorenzo, Mantovani, G, Santi, Martini, Manu, R, Mathur, Giampiero, Mazzaglia, Suresh, Mehata, Man, Mohan, Mehndiratta, Toni, Meier, Ritesh, G, Menezes, Atte, Meretoja, Tomislav, Mestrovic, Bartosz, Miazgowski, Tomasz, Miazgowski, Irmina, Maria, Michalek, Ted, Miller, R, Erkin, M, Mirrakhimov, Hamed, Mirzaei, Babak, Moazen, Masoud, Moghadaszadeh, Yousef, Mohammad, Dara, K, Mohammad, Shafiu, Mohammed, Mohammed, A, Mohammed, Yaser, Mokhayeri, Mariam, Molokhia, Ahmed, A, Montasir, Ghobad, Moradi, Rahmatollah, Moradzadeh, Paula, Moraga, Lidia, Morawska, Ilais, Moreno, Velásquez, Jakub, Morze, Sumaira, Mubarik, Walter, Muruet, Kamarul, Imran, Musa, Ahamarshan, Nagarajan, J, Mahdi, Nalini, Vinay, Nangia, Atta, Abba, Naqvi, Sreeniva, Narasimha, Swamy, Bruno, R, Nascimento, Vinod, Nayak, C, Javad, Nazari, Milad, Nazarzadeh, Ruxandra, I, Negoi, Sandhya, Neupane, Kandel, Huong, L, Nguyen, T, Molly, R, Nixon, Norrving, Bo, Jean, Jacque, Noubiap, Brice, Nouthe, E, Christoph, Nowak, Oluwakemi, O, Odukoya, Felix, Ogbo, A, Andrew, T, Olagunju, Hans, Orru, Alberto, Ortiz, Samuel, M, Ostroff, Jagadish, Rao, Padubidri, Palladino, Raffaele, Adrian, Pana, Songhomitra, Panda-Jona, Utsav, Parekh, Eun-Cheol, Park, Mojtaba, Parvizi, Fatemeh, Pashazadeh, Kan, Urvish, Patel, K, Mona, Pathak, Rajan, Paudel, Veincent, Christian, Pepito, F, Arokiasamy, Perianayagam, Norberto, Perico, Hai, Q, Pham, Thomas, Pilgrim, Michael, A, Piradov, Farhad, Pishgar, Vivek, Podder, Roman, V, Polibin, Akram, Poursham, Dimas, R, Pribadi, A, Navid, Rabiee, Mohammad, Rabiee, Amir, Radfar, Alireza, Rafiei, Fakher, Rahim, Vafa, Rahimi-Movaghar, Mohammad, Hifz, Rahman, Ur, Muhammad, Aziz, Rahman, Amir, Masoud, Rahmani, Ivo, Rakovac, Pradhum, Ram, Sudha, Ramalingam, Juwel, Rana, Priyanga, Ranasinghe, Sowmya, J, Rao, Priya, Rathi, Lal, Rawal, Wasiq, F, Rawasia, Reza, Rawassizadeh, Giuseppe, Remuzzi, Andre, M, Renzaho, N, Aziz, Rezapour, Seyed, Mohammad, Riahi, Ro, Roberts-Thomson, L, Leonardo, Roever, Peter, Rohloff, Michele, Romoli, Gholamreza, Roshandel, Godfrey, M, Rwegerera, Seyedmohammad, Saadatagah, Maha, M, Saber-Ayad, Siamak, Sabour, Simona, Sacco, Masoumeh, Sadeghi, Sahar, Saeedi, Moghaddam, Saeed, Safari, Amirhossein, Sahebkar, Sana, Salehi, Hamideh, Salimzadeh, Mehrnoosh, Samaei, Abdallah, M, Samy, Itamar, Santos, S, Milena, M, Santric-Milicevic, Nizal, Sarrafzadegan, Arash, Sarveazad, Thirunavukkarasu, Sathish, Monika, Sawhney, Mete, Saylan, Maria, I, Schmidt, Aletta, Schutte, E, Subramanian, Senthilkumaran, Sadaf, G, Sepanlou, Feng, Sha, Saeed, Shahabi, Izza, Shahid, Masood, A, Shaikh, Mahdi, Shamali, Morteza, Shamsizadeh, Shajedur, Md, Rahman, Shawon, Aziz, Sheikh, Mika, Shigematsu, Min-Jeong, Shin, Jae, Il, Shin, Rahman, Shiri, Ivy, Shiue, Kerem, Shuval, Soraya, Siabani, Tariq, J, Siddiqi, Diego, A, S, Silva, Jasvinder, Singh, A, Ambrish, Singh, Mtech, Valentin, Skryabin, Y, Anna, A, Skryabina, Amin, Soheili, Emma, E, Spurlock, Leo, Stockfelt, Stefan, Stortecky, Saverio, Strange, Rizwan, Suliankatchi, Abdulkader, Hooman, Tadbiri, Eyayou, G, Tadesse, Degena, Tadesse, B, Masih, Tajdini, Tariqujjaman, Md, Berhane, F, Teklehaimanot, Mohamad-Hani, Temsah, Ayenew, K, Tesema, Bhaskar, Thakur, Kavumpurathu, R, Thankappan, Rekha, Thapar, Amanda, G, Thrift, Binod, Timalsina, Marcello, Tonelli, Mathilde, Touvier, Marcos, R, Tovani-Palone, Avnish, Tripathi, Jaya, P, Tripathy, Thoma, Truelsen, C, Guesh, M, Tsegay, Gebiyaw, Tsegaye, W, Nikolaos, Tsilimpari, Biruk, S, Tusa, Stefanos, Tyrovola, Krishna, Kishore, Umapathi, Brigid, Unim, Bhaskaran, Unnikrishnan, Usman, Muthiah, Vaduganathan, Pascual, R, Valdez, Tommi, Vasankari, J, Diana, Z, Velazquez, Narayanaswamy, Venketasubramanian, Giang, T, Isidora, Vu, Vujcic, S, Yasir, Waheed, Yanzhong, Wang, Fang, Wang, Jingkai, Wei, Robert, G, Weintraub, Abrha, Weldemariam, H, Ronny, Westerman, Andrea, S, Winkler, Charle, Wiysonge, S, Charles, D, Wolfe, A, Befikadu, Legesse, Wubishet, Gelin, Xu, Ali, Yadollahpour, Kazumasa, Yamagishi, Lijing, L, Yan, Srikanth, Yandrapalli, Yuichiro, Yano, Hiroshi, Yatsuya, Tomas, Y, Yeheyis, Yigizie, Yeshaw, Christopher, S, Yilgwan, Naohiro, Yonemoto, Chuanhua, Yu, Hasan, Yusefzadeh, Geevar, Zachariah, Sojib, Bin, Zaman, Muhammed, Maryam, Zamanian, Ramin, Zand, Alireza, Zandifar, Afshin, Zarghi, Mikhail, S, Zastrozhin, Anasthasia, Zastrozhina, Zhi-Jiang, Zhang, Yunquan, Zhang, Wangjian, Zhang, Chenwen, Zhong, Zhiyong, Zou, Yves, Miel, Zuniga, H, Christopher, J, Murray, L, and Valentin, Fuster
Subjects: cardiovascular disease, global health, health policy, population health
Abstract: Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019. Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019. Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside high-income countries, and alarmingly, the age-standardized rate of CVD has begun to rise in some locations where it was previously declining in high-income countries. There is an urgent need to focus on implementing existing cost-effective policies and interventions if the world is to meet the targets for Sustainable Development Goal 3 and achieve a 30% reduction in premature mortality due to noncommunicable diseases.
Published: 2020

19. Estimation of Serum Electrolytes in Cases of Irritable Bowel Syndrome and Healthy Adults: A Comparative Study

Author: Sreenivas N, Swathi Kamal, Sudha B Sreenivas, Shubha Jayaram, and Dharmendra Bl
Subjects: medicine.medical_specialty, business.industry, Internal medicine, medicine, Serum electrolytes, General Medicine, medicine.disease, business, Gastroenterology, Irritable bowel syndrome
Published: 2019

20. Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019: A systematic analysis from the Global Burden of Disease Study 2019

Author: Mohsen Naghavi, Saman Esmaeilnejad, Irena Ilic, Chhabi Lal Ranabhat, Hubert Amu, Jalil Jaafari, Walter Mendoza, Yanzhong Wang, Atta Abbas Naqvi, Mahesh P A, Afshin Maleki, Songhomitra Panda-Jonas, Akila Prashant, Jessica Y Islam, Ali H. Mokdad, Rahmatollah Moradzadeh, Roman Shrestha, Muhammad Naveed, Andre M. N. Renzaho, Santi Martini, Reza Rawassizadeh, Chisom Joyqueenet Akunna, Tudorel Andrei, Jason A. Anderson, Martin McKee, Iffat Elbarazi, Golnaz Heidari, Abdollah Mohammadian-Hafshejani, Soewarta Kosen, Davood Anvari, Randah R. Hamadeh, G. K. Mini, Emerito Jose A. Faraon, Farhad Islami, Yasir Waheed, Fahad Alanezi, Maciej Banach, Sheikh Mohammed Shariful Islam, Ismaeel Yunusa, Suresh Mehata, Tarun Gupta, Mavra A Riaz, Derrick A Bennett, Nithin Kumar, Ali Soroush, Kurt Straif, Muhammad Aziz Rahman, Hasan Yusefzadeh, Avirup Guha, Catalina Liliana Andrei, Muhammed Shahriar Zaman, Arief Hargono, Sandhya Neupane Kandel, Adam E. Berman, Giulia Carreras, Ali Bijani, Christoph Nowak, Rafael Alves Guimarães, Aziz Sheikh, Kamal Hezam, Carlo Eduardo Medina-Solís, Simon I. Hay, Deborah Carvalho Malta, Rahman Shiri, Ashok Pandey, Ramesh Holla, Gyu Ri Kim, Aidin Abedi, Sharath Burugina Nagaraja, Andem Effiong, Samad Azari, Bhaskar Thakur, Mohsen Mazidi, Vahid Yazdi-Feyzabadi, Prashant Mathur, Bay Vo, Robert Ancuceanu, Eun-Kee Park, Mehdi Fazlzadeh, Thomas Hsiao, Richard G Pestell, Sindhura Lakshmi Koulmane Laxminarayana, Doo Woong Lee, Bayew Kelkay, Erkin M. Mirrakhimov, Hualiang Lin, Mohsen Bayati, Florian Fischer, Wei Liu, Stefan Stortecky, Javad Nazari, Fatemeh Pashazadeh Kan, Virginia Núñez-Samudio, Nitish Naik, Sreenivas Narasimha Swamy, Rajat Gupta, Rakhi Dandona, Hermann Brenner, Chandrashekhar T Sreeramareddy, Mohammad Ali Mansournia, Yuichiro Yano, Pankaj Bhardwaj, Samath D Dharmaratne, Constantine I. Vardavas, Gabriela Fernanda Gil, Azeem Majeed, Akram Pourshams, Nachimuthu Senthil Kumar, Florentino Luciano Caetano dos Santos, Juan Sanabria, Iván Landires, Parkes J Kendrick, Dinh-Toi Chu, Asma Tahir Awan, Khem Narayan Pokhrel, Siddharudha Shivalli, Omid Shafaat, Shankar Prasad Nagaraju, Manu Raj Mathur, Rachel L Updike, Mohammad Ebrahimi Kalan, Ryan David Kennedy, Alessandra Lugo, Olalekan A. Uthman, Tarek Tawfik Amin, Jiregna Darega Gela, Zhi-Jiang Zhang, Yeshambel T. Nigatu, Bedanta Roy, Arielle Wilder Eagan, Jalal Arabloo, Milena Ilic, Mehdi Hosseinzadeh, Jost B. Jonas, Dian Kusuma, Shahrzad Bazargan-Hejazi, Yo Han Lee, Mohammed Shannawaz, Mohammad Ali Moni, Valery L. Feigin, Himal Kandel, Lalit Dandona, Milena Santric-Milicevic, Jasvinder A. Singh, Till Bärnighausen, Neeraj Bhala, Sara Sheikhbahaei, Alireza Ansari-Moghaddam, Borhan Mansouri, Narayana Manjunatha, Giuseppe Gorini, Saif Ullah, Sheikh M. Alif, Giang Thu Vu, Ai Koyanagi, Mahaveer Golechha, Ingan Ukur Tarigan, Sumaira Mubarik, Naohiro Yonemoto, Ahmad Ghashghaee, Yves Miel H Zuniga, Bach Xuan Tran, Sorin Hostiuc, Catherine P. Benziger, Ritesh G. Menezes, Leonardo Roever, Xiaochen Dai, Meghnath Dhimal, Medhat Farwati, Chenwen Zhong, Seyed Sina Naghibi Irvani, G Anil Kumar, Jaya Prasad Tripathy, Amirhossein Sahebkar, Simiao Chen, Zubair Kabir, Meseret Derbew Molla, Tilahun Ali, Animut Tagele Tamiru, Negussie Boti Sidemo, Monika Sawhney, Bright Opoku Ahinkorah, Ruxandra Irina Negoi, Segun Emmanuel Ibitoye, Vin Gupta, Mona Pathak, Lorenzo Monasta, Andrew T Olagunju, Nermin Ghith, Nuwan Darshana Wickramasinghe, Kazumasa Yamagishi, Virendra Singh, Takahiro Tabuchi, Gholamreza Roshandel, Andre R. Brunoni, Hayley D. Tymeson, Madhur Verma, Eyayou Girma Tadesse, Adrian Pana, Isabela M. Benseñor, Abdullah Al Mamun, Jianrong Zhang, Hai Quang Pham, Mihaela Hostiuc, Sung-In Jang, Vinay Nangia, Luca Ronfani, Rizwan Suliankatchi Abdulkader, Dhirendra N Sinha, Josip Car, Sohail Ahmad, Rekha Thapar, Salman Rawaf, Joanna L Whisnant, Sanjay Basu, Abdallah M. Samy, Michal Grivna, Zahid A Butt, Abera Getachew Obsa, Mahdi Nalini, Ted R. Miller, Sanjeev Misra, Utsav Parekh, Budi Aji, Saeed Amini, João Pedro Silva, Felix Akpojene Ogbo, Mihajlo Jakovljevic, Demosthenes B. Panagiotakos, Baye Dagnew, Yousef Khader, Atif Amin Baig, Habib Benzian, Keivan Ahmadi, Marco Vacante, Brijesh Sathian, Akshaya Srikanth Bhagavathula, Savita Lasrado, Maryam Khayamzadeh, Darshan B B, Mohammad Rifat Haider, Yonas Akalu, Irmina Maria Michalek, Simone Vidale, Getie Lake Aynalem, Rosa A. S. Couto, Yigizie Yeshaw, Syed Mohamed Aljunid, Pradhum Ram, Shrikant Pawar, Kevin Welding, Suzanne Barker-Collo, Hamideh Salimzadeh, Luisa Sorio Flor, Priya Rathi, Hiba Jawdat Barqawi, Marcos Roberto Tovani-Palone, K M Shivakumar, Gebiyaw Wudie Tsegaye, Fares Alahdab, Vafa Rahimi-Movaghar, Om P Kurmi, Nataliya Foigt, André Karch, Marina Pinheiro, Basema Saddik, Paschalis Steiropoulos, Chuanhua Yu, Graeme J. Hankey, Panniyammakal Jeemon, Abdul-Aziz Seidu, Ramaiah Itumalla, Befikadu Legesse Wubishet, Vera Marisa Costa, Shanshan Li, Ambrish Singh, Yuming Guo, Reza Malekzadeh, Nikha Bhardwaj, Mikhail Sergeevich Zastrozhin, Maryam Zamanian, Onyema greg Chido-Amajuoyi, Ibtihal Fadhil, Sabina O Nduaguba, Turki Alanzi, Eun-Cheol Park, Nicholas Arian, Salah Eddin Karimi, Parnaz Daneshpajouhnejad, Minale Tareke, Paramjit Gill, Chukwudi A Nnaji, Haroon Ahmed, Irina Filip, Juwel Rana, Aziz Rezapour, Huong Lan Thi Nguyen, Ashish Badiye, Kewal Krishan, Nima Hafezi-Nejad, Masood Ali Shaikh, Tanuj Kanchan, Shilpashree Madhava Kunjathur, Reza Ghanei Gheshlagh, Thomas R. Hird, Yousef Mohammad, Soraya Siabani, Falk Schwendicke, Ziyad Al-Aly, Desta Debalkie Atnafu, Krittika Bhattacharyya, Mika Kivimäki, Ayodipupo Sikiru Oguntade, Zabihollah Yousefi, Neeti Kapoor, Syed Mahboob Shah, Kavumpurathu Raman Thankappan, Mika Shigematsu, Ben Lacey, Ireneous N. Soyiri, Amir Radfar, Lemma Getacher, Sameer Vali Gopalani, David Laith Rawaf, Amir Masoud Rahmani, Birhan Gebresillassie Gebregiorgis, Morenike Oluwatoyin Folayan, Salime Goharinezhad, Ambuj Roy, Ruth W Kimokoti, Nuworza Kugbey, Getinet Ayano, Mohammad Hifz Ur Rahman, Benny Antony, Katrin Burkart, Christopher J L Murray, Khalid F. AlHabib, Mariam Molokhia, Mansour Ghafourifard, Abebaw Alemayehu Desta, Tariku Tesfaye Bekuma, Shailesh Advani, Kiomars Sharafi, Kurnia Dwi Artanti, E S Abhilash, Ejaz Ahmad Khan, Sana Salehi, Dan J. Stein, Pankaj Chaturvedi, Mahmoud A. Alomari, Kawkab Shishani, Dejana Braithwaite, Jung-Chen Chang, Rajeev Gupta, Giovanni Damiani, Maha El Tantawi, Maria Sofia Sofia Cattaruzza, Amir Abdoli, Narayanaswamy Venketasubramanian, Rakibul M Islam, Ibrahim Abdelmageed Ginawi, Victor Aboyans, Ganesh Kumar Saya, Silvano Gallus, João Mauricio Castaldelli-Maia, Vardhmaan Jain, Masoud Foroutan, Janni Leung, Mohammad Abdollahi, Mohammed Zewdu Yimmer, Vahid Alipour, Wondwossen Niguse Asmare, Ravi Prakash Jha, Gerhard Sulo, Brigid Unim, Sheng-Chia Chung, Sadaf G. Sepanlou, Hamed Mirzaei, Anna Aleksandrovna Skryabina, In-Hwan Oh, Rannveig Sigurvinsdottir, Oladimeji Adebayo, Farshad Farzadfar, Anasthasia Zastrozhina, Shafiu Mohammed, Johan Sundström, Ali Kabir, Paolo Lauriola, Tilahun Belete Mossie, Sadia Bibi, Bartosz Miazgowski, Erin C Mullany, Keyvan Pakshir, Srikanta Banerjee, Mowafa Househ, Mohamed M. Gad, Leila R Kalankesh, Mikk Jürisson, Ismail Tareque, Albertino Damasceno, Musliu Adetola Tolani, Andrea Werdecker, Shane D. Morrison, Inga Dora Sigfusdottir, Marcel Ausloos, Monika Arora, Marissa B Reitsma, Filippos Filippidis, Biniyam Sahiledengle Geberemariyam, Bruno Piassi Sao Jose, Leeberk Raja Inbaraj, Antonio Biondi, Mohsen Abbasi-Kangevari, Junjie Huang, Mohammad Mahdi Zamani, Jean Jacques Noubiap, Emmanuela Gakidou, Valentin Yurievich Skryabin, Mayowa O. Owolabi, Shubha Jayaram, Hiroyasu Iso, Charles Ugochukwu Ibeneme, Molly R Nixon, Rachel Feldman, Liliana G Ciobanu, Kristina Edvardsson, Claudiu Herteliu, Andreea Mirica, Kindie Mitiku Kebede, Department of Public Health, Collaborators, GBD 2019 Chewing Tobacco, and Lacey, B
Subjects: Male, Health Status, Smoking Prevention, DETERMINANTS, Global Health, 01 natural sciences, Global Burden of Disease, SMOKELESS TOBACCO, 0302 clinical medicine, Risk Factors, Global health, Prevalence, 030212 general & internal medicine, 610 Medicine & health, RISK, High prevalence, WOMEN, Public Health, Global Health, Social Medicine and Epidemiology, Articles, Middle Aged, 3142 Public health care science, environmental and occupational health, Chewing tobacco, Smokeless tobacco, Population Surveillance, A990 Medicine and Dentistry not elsewhere classified, Female, Quality-Adjusted Life Years, Burden of disease, Adult, medicine.medical_specialty, Tobacco, Smokeless, Adolescent, WHO Framework Convention on Tobacco Control, VALIDATION, 03 medical and health sciences, Young Adult, Age Distribution, SDG 3 - Good Health and Well-being, Environmental health, medicine, Humans, 0101 mathematics, Sex Distribution, Chewing tobacco, Prevalence, Global Burden, Smokeless tobacco, business.industry, Public health, Smoking Tobacco, 010102 general mathematics, Public Health, Environmental and Occupational Health, Global Burden, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, STATES, Socioeconomic Factors, Smoking Cessation, business
Abstract: Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Findings In 2019, 273 center dot 9 million (95% uncertainty interval 258 center dot 5 to 290 center dot 9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 center dot 72% (4 center dot 46 to 5 center dot 01). 228 center dot 2 million (213 center dot 6 to 244 center dot 7; 83 center dot 29% [82 center dot 15 to 84 center dot 42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global agestandardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 center dot 21% [-1 center dot 26 to -1 center dot 16]), similar progress was not observed for chewing tobacco (0 center dot 46% [0 center dot 13 to 0 center dot 79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 center dot 94% [-1 center dot 72 to -0 center dot 14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Summary Background Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. Methods We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings In 2019, 273 & middot;9 million (95% uncertainty interval 258 & middot;5 to 290 & middot;9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 & middot;72% (4 & middot;46 to 5 & middot;01). 228 & middot;2 million (213 & middot;6 to 244 & middot;7; 83 & middot;29% [82 & middot;15 to 84 & middot;42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global age standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 & middot;21% [-1 & middot;26 to -1 & middot;16]), similar progress was not observed for chewing tobacco (0 & middot;46% [0 & middot;13 to 0 & middot;79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 & middot;94% [-1 & middot;72 to -0 & middot;14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. For complete list of authors see http://dx.doi.org/10.1016/S2468-2667(21)00065-7
Published: 2021

21. Global, regional, and national sex differences in the global burden of tuberculosis by HIV status, 1990–2019: results from the Global Burden of Disease Study 2019

Author: Akram Pourshams, Mostafa Dianatinasab, Alberto L. García-Basteiro, Seyed Sina Naghibi Irvani, Patrick D. M. C. Katoto, Daiane Borges Machado, Alireza Rafiei, Aziz Rezapour, Khaled Khatab, Chukwudi A Nnaji, Fatemeh Javanmardi, Asrat Arja, Asif Hanif, Arianna Maever L. Amit, Min Seo Kim, Tomislav Mestrovic, Razique Anwer, Gulrez Shah Azhar, Milena Ilic, Jost B. Jonas, Sreenivas Narasimha Swamy, Fisaha Haile Tesfay, Fakher Rahim, Christopher J L Murray, Molly H Biehl, Hesam Alizade, Souranshu Chatterjee, Jalal Arabloo, Mariam Molokhia, Sachin R Atre, Maciej Banach, Ashwin Kamath, Gebiyaw Wudie Tsegaye, Irina Filip, Mohammad Sadegh Rezai, Robert Reiner, Shrikant Pawar, Anasthasia Zastrozhina, Vardhmaan Jain, Shafiu Mohammed, Benn Sartorius, Sindhura Lakshmi Koulmane Laxminarayana, Harapan Harapan, Hiba Jawdat Barqawi, Tahvi Frank, Yasir Waheed, Seyed Hossein Yahyazadeh Jabbari, Shaun Wen Huey Lee, Jorge R. Ledesma, Yosef Alemayehu, Sajjad Ahmad, Deepak Dhamnetiya, Khezar Hayat, Preetam Bhalchandra Mahajan, Ramesh Holla, Atif Amin Baig, Azeem Majeed, Darshan B B, Catherine M. Antony, Allen Seylani, Avinash Kumar, Alimuddin Zumla, Irena Ilic, Sofia Androudi, Liaqat Ali, Rafael Lozano, Carl Abelardo T. Antonio, Sanjay M Pattanshetty, Bach Xuan Tran, Eduarda Fernandes, Marissa B Reitsma, Ramaiah Itumalla, Catrin E. Moore, Amir Masoud Rahmani, Daniel Diaz, Mohsen Naghavi, R V Polibin, Nithin Kumar, Archith Boloor, Norberto Perico, Vahit Yigit, Emma Elizabeth Spurlock, Zaheer-Ud-Din Babar, Veer Bala Gupta, Nima Rezaei, Arief Hargono, Maarten J. Postma, Jitendra Singh, Sandhya Neupane Kandel, Sapna Gupta, Omid Dadras, Takahiro Tabuchi, Sanjeev Misra, Salman Rawaf, Devasahayam J. Christopher, Francisco Rogerlândio Martins-Melo, Omid Shafaat, Florian Fischer, Satish Saroshe, Simon I. Hay, Mosiur Rahman, Mohammad Ali Moni, Sathish Kumar Jayapal, Jalil Jaafari, Walter Mendoza, Sepideh Ahmadi, Deepak Madi, Alexander Kwarteng, Omid Rezahosseini, Segun Emmanuel Ibitoye, Hassan Mehmood Lak, Iván Landires, Mahesh P A, Biniyam Sahiledengle Geberemariyam, Hayimro Edemealem Merie, Himanshu Khajuria, Kathryn H. Jacobsen, Magdalene K. Walters, Ali H. Mokdad, Sharath Burugina Nagaraja, Avina Vongpradith, Mehrnoosh Samaei, Shubha Jayaram, Beriwan Abdulqadir Ali, Giang Thu Vu, Chukwuma David Umeokonkwo, Adnan Kisa, Mehdi Hosseinzadeh, Danilo Buonsenso, Nitin Joseph, G Anil Kumar, Rekha Thapar, Sanjeev Nair, Eyayou Girma Tadesse, Joanna L Whisnant, Amanual Getnet Mersha, Savita Lasrado, Pintu Paul, Burcu Kucuk Bicer, Dharmesh Kumar Lal, Mowafa Househ, Vivek Gupta, Chandrashekhar T Sreeramareddy, Sanjay Basu, Andre M. N. Renzaho, Saira Afzal, Nahlah Elkudssiah Ismail, Akine Eshete Abosetugn, Jennifer M. Ross, Ai Koyanagi, Tushar Garg, Chythra R Rao, Sezer Kisa, Yigizie Yeshaw, Paschalis Steiropoulos, Brijesh Sathian, Zemenu Tamir, Amene Abebe Kerbo, Christine Lin, Dana Bryazka, Jason A. Anderson, Majid Pirestani, Austin Carter, Chuanhua Yu, Berhan Tsegaye, Elvis Enowbeyang Tarkang, Mareli M Claassens, Hmwe H Kyu, Lorenzo Ferro Desideri, Akila Prashant, Smriti Sinha, Linh Phuong Doan, Befikadu Legesse Wubishet, Fabio Barra, Rovshan Khalilov, Joshua A. Salomon, Virginia Núñez-Samudio, Imad I. Tleyjeh, David Laith Rawaf, Mikhail Sergeevich Zastrozhin, Dimas Ria Angga Pribadi, Kamal Hezam, Shilpashree Madhava Kunjathur, Nasir Salam, Wei-Chen Lee, Stephen S Lim, Bay Vo, Mahaveer Golechha, K. M. Saif-Ur-Rahman, Sahel Valadan Tahbaz, Muhammed Elhadi, Fatemeh Pashazadeh Kan, Fares Alahdab, Vafa Rahimi-Movaghar, Subramanian Senthilkumaran, Boris Bikbov, Addis Aklilu, Ritesh G. Menezes, Amare Belachew Dagnew, Ravi Prakash Jha, Tanuj Kanchan, Siamak Sabour, Theo Vos, Amir Radfar, Amir Emami, João Pedro Silva, Uzma Belgaumi, Vijay Kumar Chattu, Parnaz Daneshpajouhnejad, Ahmed Al Montasir, Oladimeji Adebayo, Rabia Hussain, Masoud Moghadaszadeh, Suma Nair, Ahmed I. Hasaballah, Félix Carvalho, Yun Jin Kim, Hanadi Al Hamad, Valentin Yurievich Skryabin, Mu'awiyyah Babale Sufiyan, Farahnaz Joukar, Krittika Bhattacharyya, Farshad Farzadfar, Hadi Hassankhani, Aso Mohammad Darwesh, Kefyalew Addis Alene, Himal Kandel, Susan M Sawyer, Soosanna Kumary Chattu, Keyghobad Ghadiri, Zahid A Butt, Mokhtar Mohammadi, Belay Tessema, Nikha Bhardwaj, Hossein Samadi Kafil, Kiomars Sharafi, Siyan Yi, Jianing Ma, Denis O Roshchin, Pankaj Bhardwaj, Jagdish Khubchandani, Rajaa Al-Raddadi, Shymaa Enany, Akshaya Srikanth Bhagavathula, Andrew T Olagunju, Parkes J Kendrick, Amador Goodridge, Zhi-Jiang Zhang, Mulusew A Asemahagn, Saeed Amini, Ziad A. Memish, Ruoyan Tobe-Gai, Ali Bijani, Nour Mheidly, Priyanga Ranasinghe, Abdallah M. Samy, Mahfuzar Rahman, Giuseppe Remuzzi, Abdullah T Khoja, Biswa Prakash Nayak, Samer Hamidi, Javad Nazari, Ramakrishnan Parthasarathi, Lalit Dandona, Molly R Nixon, Parvaiz A Koul, Mika Shigematsu, Gbenga A. Kayode, Rachel Feldman, Mohammad Rifat Haider, Nelson Alvis-Guzman, Mesfin Agachew Woldekidan, Deepa Jahagirdar, Kate E. LeGrand, Yusra Ahmed Salih, Nikolay Ivanovich Briko, Xuefeng Liu, Qorinah Estiningtyas Sakilah Adnani, Christian Garcia-Calavaro, Dinh-Toi Chu, Mihaela Hostiuc, Yohannes Tekalegn, Rajan Paudel, Prasanna Mithra, Narinder Kumar, Masood Ali Shaikh, Zubair Kabir, Natalia V. Bhattacharjee, Chisom Joyqueenet Akunna, Masoud Foroutan, Bogdan Oancea, Anayat Ullah, Saurabh Mehta, Abdollah Mohammadian-Hafshejani, Soewarta Kosen, Vahid Alipour, Tarik A. Rashid, Melese Abate Reta, Atta Abbas Naqvi, Emilie R Maddison, Mpiko Ntsekhe, Naohiro Yonemoto, Ahmad Ghashghaee, Mohamed Kamal Mesregah, Amadou Barrow, Ismaeel Yunusa, Gholamreza Roshandel, Ahamarshan Jayaraman Nagarajan, Hassan Abolhassani, Ahmad Azam Malik, Xiaochen Dai, Trang Huyen Nguyen, Eyal Oren, Bright Opoku Ahinkorah, Taklo Simeneh Yazie Yazie, Kewal Krishan, Ranjitha S Shetty, Emerito Jose A. Faraon, Jae Il Shin, Shafiul Haque, Veincent Christian Filipino Pepito, Sahar Eftekharzadeh, Bhawna Gupta, Platon D. Lopukhov, Abdiwahab Hashi, Amanda Novotney, Eman Abu-Gharbieh, Oluwakemi Ololade Odukoya, Anna Aleksandrovna Skryabina, Shoaib Hassan, Rakhi Dandona, Jaykaran Charan, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), and Collaborators, GBD 2019 Tuberculosis
Subjects: Male, PNEUMONIA, COUNTRIES, Tuberculosis, Population, HIV Infections, CHILDREN, Genders, Mortalities, Global Health, DIAGNOSIS, Microbiology, Global Burden of Disease, 1117 Public Health and Health Services, Acquired immunodeficiency syndrome (AIDS), Risk Factors, 1108 Medical Microbiology, Sex differences, INFECTION, medicine, Global health, Humans, education, Sex Characteristics, education.field_of_study, Global disease burdens, business.industry, Mortality rate, GBD 2019 Tuberculosis Collaborators, HIV, Bayes Theorem, 1103 Clinical Sciences, DIABETES-MELLITUS, medicine.disease, Verbal autopsy, Tuberculosis treatment, PREVALENCE, Infectious Diseases, Attributable risk, Coinfection, Female, INJURIES, GENDER, HEALTH, business, Demography
Abstract: Background Tuberculosis is a major contributor to the global burden of disease, causing more than a million deaths annually. Given an emphasis on equity in access to diagnosis and treatment of tuberculosis in global health targets, evaluations of differences in tuberculosis burden by sex are crucial. We aimed to assess the levels and trends of the global burden of tuberculosis, with an emphasis on investigating differences in sex by HIV status for 204 countries and territories from 1990 to 2019. Methods We used a Bayesian hierarchical Cause of Death Ensemble model (CODEm) platform to analyse 21 505 site-years of vital registration data, 705 site-years of verbal autopsy data, 825 site-years of sample-based vital registration data, and 680 site-years of mortality surveillance data to estimate mortality due to tuberculosis among HIV-negative individuals. We used a population attributable fraction approach to estimate mortality related to HIV and tuberculosis coinfection. A compartmental meta-regression tool (DisMod-MR 2.1) was then used to synthesise all available data sources, including prevalence surveys, annual case notifications, population-based tuberculin surveys, and tuberculosis cause-specific mortality, to produce estimates of incidence, prevalence, and mortality that were internally consistent. We further estimated the fraction of tuberculosis mortality that is attributable to independent effects of risk factors, including smoking, alcohol use, and diabetes, for HIV-negative individuals. For individuals with HIV and tuberculosis coinfection, we assessed mortality attributable to HIV risk factors including unsafe sex, intimate partner violence (only estimated among females), and injection drug use. We present 95% uncertainty intervals for all estimates. Findings Globally, in 2019, among HIV-negative individuals, there were 1·18 million (95% uncertainty interval 1·08–1·29) deaths due to tuberculosis and 8·50 million (7·45–9·73) incident cases of tuberculosis. Among HIV-positive individuals, there were 217 000 (153 000–279 000) deaths due to tuberculosis and 1·15 million (1·01–1·32) incident cases in 2019. More deaths and incident cases occurred in males than in females among HIV-negative individuals globally in 2019, with 342 000 (234 000–425 000) more deaths and 1·01 million (0·82–1·23) more incident cases in males than in females. Among HIV-positive individuals, 6250 (1820–11 400) more deaths and 81 100 (63 300–100 000) more incident cases occurred among females than among males in 2019. Age-standardised mortality rates among HIV-negative males were more than two times greater in 105 countries and age-standardised incidence rates were more than 1·5 times greater in 74 countries than among HIV-negative females in 2019. The fraction of global tuberculosis deaths among HIV-negative individuals attributable to alcohol use, smoking, and diabetes was 4·27 (3·69–5·02), 6·17 (5·48–7·02), and 1·17 (1·07–1·28) times higher, respectively, among males than among females in 2019. Among individuals with HIV and tuberculosis coinfection, the fraction of mortality attributable to injection drug use was 2·23 (2·03–2·44) times greater among males than females, whereas the fraction due to unsafe sex was 1·06 (1·05–1·08) times greater among females than males. Interpretation As countries refine national tuberculosis programmes and strategies to end the tuberculosis epidemic, the excess burden experienced by males is important. Interventions are needed to actively communicate, especially to men, the importance of early diagnosis and treatment. These interventions should occur in parallel with efforts to minimise excess HIV burden among women in the highest HIV burden countries that are contributing to excess HIV and tuberculosis coinfection burden for females. Placing a focus on tuberculosis burden among HIV-negative males and HIV and tuberculosis coinfection among females might help to diminish the overall burden of tuberculosis. This strategy will be crucial in reaching both equity and burden targets outlined by global health milestones. Funding Bill & Melinda Gates Foundation.
Published: 2021

22. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study

Author: Gregory A. Roth, George A. Mensah, Catherine O. Johnson, Giovanni Addolorato, Enrico Ammirati, Larry M. Baddour, Noël C. Barengo, Andrea Z. Beaton, Emelia J. Benjamin, Catherine P. Benziger, Aimé Bonny, Michael Brauer, Marianne Brodmann, Thomas J. Cahill, Jonathan Carapetis, Alberico L. Catapano, Sumeet S. Chugh, Leslie T. Cooper, Josef Coresh, Michael Criqui, Nicole DeCleene, Kim A. Eagle, Sophia Emmons-Bell, Valery L. Feigin, Joaquim Fernández-Solà, Gerry Fowkes, Emmanuela Gakidou, Scott M. Grundy, Feng J. He, George Howard, Frank Hu, Lesley Inker, Ganesan Karthikeyan, Nicholas Kassebaum, Walter Koroshetz, Carl Lavie, Donald Lloyd-Jones, Hong S. Lu, Antonio Mirijello, Awoke Misganaw Temesgen, Ali Mokdad, Andrew E. Moran, Paul Muntner, Jagat Narula, Bruce Neal, Mpiko Ntsekhe, Glaucia Moraes de Oliveira, Catherine Otto, Mayowa Owolabi, Michael Pratt, Sanjay Rajagopalan, Marissa Reitsma, Antonio Luiz P. Ribeiro, Nancy Rigotti, Anthony Rodgers, Craig Sable, Saate Shakil, Karen Sliwa-Hahnle, Benjamin Stark, Johan Sundström, Patrick Timpel, Imad M. Tleyjeh, Marco Valgimigli, Theo Vos, Paul K. Whelton, Magdi Yacoub, Liesl Zuhlke, Christopher Murray, Valentin Fuster, Noel C. Barengo, Andrea Beaton, Aime Bonny, Jonathan R. Carapetis, Sumeet Chugh, Michael H. Criqui, Nicole K. DeCleene, Joaquim Fernández-Sola, F. Gerry R. Fowkes, Nicholas J. Kassebaum, Walter J. Koroshetz, Awoke T. Misganaw, Ali H. Mokdad, Gláucia M.M. Oliveira, Catherine M. Otto, Mayowa O. Owolabi, Marissa B. Reitsma, Nancy A. Rigotti, Craig A. Sable, Saate S. Shakil, Karen Sliwa, Benjamin A. Stark, Imad I. Tleyjeh, Liesl J. Zuhlke, Mohsen Abbasi-Kangevari, Alireza Abdi, Aidin Abedi, Victor Aboyans, Woldu A. Abrha, Eman Abu-Gharbieh, Abdelrahman I. Abushouk, Dilaram Acharya, Tim Adair, Oladimeji M. Adebayo, Zanfina Ademi, Shailesh M. Advani, Khashayar Afshari, Ashkan Afshin, Gina Agarwal, Pradyumna Agasthi, Sohail Ahmad, Sepideh Ahmadi, Muktar B. Ahmed, Budi Aji, Yonas Akalu, Wuraola Akande-Sholabi, Addis Aklilu, Chisom J. Akunna, Fares Alahdab, Ayman Al-Eyadhy, Khalid F. Alhabib, Sheikh M. Alif, Vahid Alipour, Syed M. Aljunid, François Alla, Amir Almasi-Hashiani, Sami Almustanyir, Rajaa M. Al-Raddadi, Adeladza K. Amegah, Saeed Amini, Arya Aminorroaya, Hubert Amu, Dickson A. Amugsi, Robert Ancuceanu, Deanna Anderlini, Tudorel Andrei, Catalina Liliana Andrei, Alireza Ansari-Moghaddam, Zelalem A. Anteneh, Ippazio Cosimo Antonazzo, Benny Antony, Razique Anwer, Lambert T. Appiah, Jalal Arabloo, Johan Ärnlöv, Kurnia D. Artanti, Zerihun Ataro, Marcel Ausloos, Leticia Avila-Burgos, Asma T. Awan, Mamaru A. Awoke, Henok T. Ayele, Muluken A. Ayza, Samad Azari, Darshan B. B, Nafiseh Baheiraei, Atif A. Baig, Ahad Bakhtiari, Maciej Banach, Palash C. Banik, Emerson A. Baptista, Miguel A. Barboza, Lingkan Barua, Sanjay Basu, Neeraj Bedi, Yannick Béjot, Derrick A. Bennett, Isabela M. Bensenor, Adam E. Berman, Yihienew M. Bezabih, Akshaya S. Bhagavathula, Sonu Bhaskar, Krittika Bhattacharyya, Ali Bijani, Boris Bikbov, Mulugeta M. Birhanu, Archith Boloor, Luisa C. Brant, Hermann Brenner, Nikolay I. Briko, Zahid A. Butt, Florentino Luciano Caetano dos Santos, Leah E. Cahill, Lucero Cahuana-Hurtado, Luis A. Cámera, Ismael R. Campos-Nonato, Carlos Cantu-Brito, Josip Car, Juan J. Carrero, Felix Carvalho, Carlos A. Castañeda-Orjuela, Ferrán Catalá-López, Ester Cerin, Jaykaran Charan, Vijay Kumar Chattu, Simiao Chen, Ken L. Chin, Jee-Young J. Choi, Dinh-Toi Chu, Sheng-Chia Chung, Massimo Cirillo, Sean Coffey, Sara Conti, Vera M. Costa, David K. Cundiff, Omid Dadras, Baye Dagnew, Xiaochen Dai, Albertino A.M. Damasceno, Lalit Dandona, Rakhi Dandona, Kairat Davletov, Vanessa De la Cruz-Góngora, Fernando P. De la Hoz, Jan-Walter De Neve, Edgar Denova-Gutiérrez, Meseret Derbew Molla, Behailu T. Derseh, Rupak Desai, Günther Deuschl, Samath D. Dharmaratne, Meghnath Dhimal, Raja Ram Dhungana, Mostafa Dianatinasab, Daniel Diaz, Shirin Djalalinia, Klara Dokova, Abdel Douiri, Bruce B. Duncan, Andre R. Duraes, Arielle W. Eagan, Sanam Ebtehaj, Aziz Eftekhari, Sahar Eftekharzadeh, Michael Ekholuenetale, Nevine El Nahas, Islam Y. Elgendy, Muhammed Elhadi, Shaimaa I. El-Jaafary, Sadaf Esteghamati, Atkilt E. Etisso, Oghenowede Eyawo, Ibtihal Fadhil, Emerito Jose A. Faraon, Pawan S. Faris, Medhat Farwati, Farshad Farzadfar, Eduarda Fernandes, Carlota Fernandez Prendes, Pietro Ferrara, Irina Filip, Florian Fischer, David Flood, Takeshi Fukumoto, Mohamed M. Gad, Shilpa Gaidhane, Morsaleh Ganji, Jalaj Garg, Abadi K. Gebre, Birhan G. Gebregiorgis, Kidane Z. Gebregzabiher, Gebreamlak G. Gebremeskel, Lemma Getacher, Abera Getachew Obsa, Alireza Ghajar, Ahmad Ghashghaee, Nermin Ghith, Simona Giampaoli, Syed Amir Gilani, Paramjit S. Gill, Richard F. Gillum, Ekaterina V. Glushkova, Elena V. Gnedovskaya, Mahaveer Golechha, Kebebe B. Gonfa, Amir Hossein Goudarzian, Alessandra C. Goulart, Jenny S. Guadamuz, Avirup Guha, Yuming Guo, Rajeev Gupta, Vladimir Hachinski, Nima Hafezi-Nejad, Teklehaimanot G. Haile, Randah R. Hamadeh, Samer Hamidi, Graeme J. Hankey, Arief Hargono, Risky K. Hartono, Maryam Hashemian, Abdiwahab Hashi, Shoaib Hassan, Hamid Y. Hassen, Rasmus J. Havmoeller, Simon I. Hay, Khezar Hayat, Golnaz Heidari, Claudiu Herteliu, Ramesh Holla, Mostafa Hosseini, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Mowafa Househ, Junjie Huang, Ayesha Humayun, Ivo Iavicoli, Charles U. Ibeneme, Segun E. Ibitoye, Olayinka S. Ilesanmi, Irena M. Ilic, Milena D. Ilic, Usman Iqbal, Seyed Sina N. Irvani, Sheikh Mohammed Shariful Islam, Rakibul M. Islam, Hiroyasu Iso, Masao Iwagami, Vardhmaan Jain, Tahereh Javaheri, Sathish Kumar Jayapal, Shubha Jayaram, Ranil Jayawardena, Panniyammakal Jeemon, Ravi P. Jha, Jost B. Jonas, Jitendra Jonnagaddala, Farahnaz Joukar, Jacek J. Jozwiak, Mikk Jürisson, Ali Kabir, Tanvir Kahlon, Rizwan Kalani, Rohollah Kalhor, Ashwin Kamath, Ibrahim Kamel, Himal Kandel, Amit Kandel, André Karch, Ayele Semachew Kasa, Patrick D.M.C. Katoto, Gbenga A. Kayode, Yousef S. Khader, Mohammad Khammarnia, Muhammad S. Khan, Md Nuruzzaman Khan, Maseer Khan, Ejaz A. Khan, Khaled Khatab, Gulam M.A. Kibria, Yun Jin Kim, Gyu Ri Kim, Ruth W. Kimokoti, Sezer Kisa, Adnan Kisa, Mika Kivimäki, Dhaval Kolte, Ali Koolivand, Vladimir A. Korshunov, Sindhura Lakshmi Koulmane Laxminarayana, Ai Koyanagi, Kewal Krishan, Vijay Krishnamoorthy, Barthelemy Kuate Defo, Burcu Kucuk Bicer, Vaman Kulkarni, G. Anil Kumar, Nithin Kumar, Om P. Kurmi, Dian Kusuma, Gene F. Kwan, Carlo La Vecchia, Ben Lacey, Tea Lallukka, Qing Lan, Savita Lasrado, Zohra S. Lassi, Paolo Lauriola, Wayne R. Lawrence, Avula Laxmaiah, Kate E. LeGrand, Ming-Chieh Li, Bingyu Li, Shanshan Li, Stephen S. Lim, Lee-Ling Lim, Hualiang Lin, Ziqiang Lin, Ro-Ting Lin, Xuefeng Liu, Alan D. Lopez, Stefan Lorkowski, Paulo A. Lotufo, Alessandra Lugo, Nirmal K. M, Fabiana Madotto, Morteza Mahmoudi, Azeem Majeed, Reza Malekzadeh, Ahmad A. Malik, Abdullah A. Mamun, Navid Manafi, Mohammad Ali Mansournia, Lorenzo G. Mantovani, Santi Martini, Manu R. Mathur, Giampiero Mazzaglia, Suresh Mehata, Man Mohan Mehndiratta, Toni Meier, Ritesh G. Menezes, Atte Meretoja, Tomislav Mestrovic, Bartosz Miazgowski, Tomasz Miazgowski, Irmina Maria Michalek, Ted R. Miller, Erkin M. Mirrakhimov, Hamed Mirzaei, Babak Moazen, Masoud Moghadaszadeh, Yousef Mohammad, Dara K. Mohammad, Shafiu Mohammed, Mohammed A. Mohammed, Yaser Mokhayeri, Mariam Molokhia, Ahmed A. Montasir, Ghobad Moradi, Rahmatollah Moradzadeh, Paula Moraga, Lidia Morawska, Ilais Moreno Velásquez, Jakub Morze, Sumaira Mubarik, Walter Muruet, Kamarul Imran Musa, Ahamarshan J. Nagarajan, Mahdi Nalini, Vinay Nangia, Atta Abbas Naqvi, Sreenivas Narasimha Swamy, Bruno R. Nascimento, Vinod C. Nayak, Javad Nazari, Milad Nazarzadeh, Ruxandra I. Negoi, Sandhya Neupane Kandel, Huong L.T. Nguyen, Molly R. Nixon, Bo Norrving, Jean Jacques Noubiap, Brice E. Nouthe, Christoph Nowak, Oluwakemi O. Odukoya, Felix A. Ogbo, Andrew T. Olagunju, Hans Orru, Alberto Ortiz, Samuel M. Ostroff, Jagadish Rao Padubidri, Raffaele Palladino, Adrian Pana, Songhomitra Panda-Jonas, Utsav Parekh, Eun-Cheol Park, Mojtaba Parvizi, Fatemeh Pashazadeh Kan, Urvish K. Patel, Mona Pathak, Rajan Paudel, Veincent Christian F. Pepito, Arokiasamy Perianayagam, Norberto Perico, Hai Q. Pham, Thomas Pilgrim, Michael A. Piradov, Farhad Pishgar, Vivek Podder, Roman V. Polibin, Akram Pourshams, Dimas R.A. Pribadi, Navid Rabiee, Mohammad Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Vafa Rahimi-Movaghar, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, Amir Masoud Rahmani, Ivo Rakovac, Pradhum Ram, Sudha Ramalingam, Juwel Rana, Priyanga Ranasinghe, Sowmya J. Rao, Priya Rathi, Lal Rawal, Wasiq F. Rawasia, Reza Rawassizadeh, Giuseppe Remuzzi, Andre M.N. Renzaho, Aziz Rezapour, Seyed Mohammad Riahi, Ross L. Roberts-Thomson, Leonardo Roever, Peter Rohloff, Michele Romoli, Gholamreza Roshandel, Godfrey M. Rwegerera, Seyedmohammad Saadatagah, Maha M. Saber-Ayad, Siamak Sabour, Simona Sacco, Masoumeh Sadeghi, Sahar Saeedi Moghaddam, Saeed Safari, Amirhossein Sahebkar, Sana Salehi, Hamideh Salimzadeh, Mehrnoosh Samaei, Abdallah M. Samy, Itamar S. Santos, Milena M. Santric-Milicevic, Nizal Sarrafzadegan, Arash Sarveazad, Thirunavukkarasu Sathish, Monika Sawhney, Mete Saylan, Maria I. Schmidt, Aletta E. Schutte, Subramanian Senthilkumaran, Sadaf G. Sepanlou, Feng Sha, Saeed Shahabi, Izza Shahid, Masood A. Shaikh, Mahdi Shamali, Morteza Shamsizadeh, Md Shajedur Rahman Shawon, Aziz Sheikh, Mika Shigematsu, Min-Jeong Shin, Jae Il Shin, Rahman Shiri, Ivy Shiue, Kerem Shuval, Soraya Siabani, Tariq J. Siddiqi, Diego A.S. Silva, Jasvinder A. Singh, Ambrish Singh Mtech, Valentin Y. Skryabin, Anna A. Skryabina, Amin Soheili, Emma E. Spurlock, Leo Stockfelt, Stefan Stortecky, Saverio Stranges, Rizwan Suliankatchi Abdulkader, Hooman Tadbiri, Eyayou G. Tadesse, Degena B. Tadesse, Masih Tajdini, Md Tariqujjaman, Berhane F. Teklehaimanot, Mohamad-Hani Temsah, Ayenew K. Tesema, Bhaskar Thakur, Kavumpurathu R. Thankappan, Rekha Thapar, Amanda G. Thrift, Binod Timalsina, Marcello Tonelli, Mathilde Touvier, Marcos R. Tovani-Palone, Avnish Tripathi, Jaya P. Tripathy, Thomas C. Truelsen, Guesh M. Tsegay, Gebiyaw W. Tsegaye, Nikolaos Tsilimparis, Biruk S. Tusa, Stefanos Tyrovolas, Krishna Kishore Umapathi, Brigid Unim, Bhaskaran Unnikrishnan, Muhammad S. Usman, Muthiah Vaduganathan, Pascual R. Valdez, Tommi J. Vasankari, Diana Z. Velazquez, Narayanaswamy Venketasubramanian, Giang T. Vu, Isidora S. Vujcic, Yasir Waheed, Yanzhong Wang, Fang Wang, Jingkai Wei, Robert G. Weintraub, Abrha H. Weldemariam, Ronny Westerman, Andrea S. Winkler, Charles S. Wiysonge, Charles D.A. Wolfe, Befikadu Legesse Wubishet, Gelin Xu, Ali Yadollahpour, Kazumasa Yamagishi, Lijing L. Yan, Srikanth Yandrapalli, Yuichiro Yano, Hiroshi Yatsuya, Tomas Y. Yeheyis, Yigizie Yeshaw, Christopher S. Yilgwan, Naohiro Yonemoto, Chuanhua Yu, Hasan Yusefzadeh, Geevar Zachariah, Sojib Bin Zaman, Muhammed S. Zaman, Maryam Zamanian, Ramin Zand, Alireza Zandifar, Afshin Zarghi, Mikhail S. Zastrozhin, Anasthasia Zastrozhina, Zhi-Jiang Zhang, Yunquan Zhang, Wangjian Zhang, Chenwen Zhong, Zhiyong Zou, Yves Miel H. Zuniga, and Christopher J.L. Murray
Subjects: BMI, body mass index, GBD, Global Burden of Diseases, Injuries, and Risk Factors Study, IS, ischemic stroke, 030204 cardiovascular system & hematology, MV, mitral valve, SDI, sociodemographic index, Global Health, UI, uncertainty interval, Global Burden of Disease, GBD-NHLBI-JACC Global Burden of Cardiovascular Diseases Writing Group, 0302 clinical medicine, Cost of Illness, LDL, low-density lipoprotein, Case fatality rate, Global health, 030212 general & internal medicine, IKF, impaired kidney function, 1102 Cardiorespiratory Medicine and Haematology, Incidence (epidemiology), Health Policy, IHD, ischemic heart disease, 1. No poverty, AC, alcoholic cardiomyopathy, 3. Good health, HICs, high-income countries, Cardiovascular Diseases, DALYs, disability-adjusted life years, TMREL, theoretical minimum risk exposure level, Public Health, HHD, hypertensive heart disease, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, AF, atrial fibrillation, Population health, CVD, cardiovascular disease, LMICs, low- and middle-income countries, PM, particulate matter, 1117 Public Health and Health Services, 03 medical and health sciences, JACC State-of-the-Art Review, RHD, rheumatic heart disease, Environmental health, medicine, Humans, LPA, low physical activity, YLLs, years of life lost, Health policy, Disease burden, PAD, peripheral artery disease, business.industry, SBP, systolic blood pressure, Public health, CKD, chronic kidney disease, The Present and Future, AFL, atrial flutter, Correction, HAP, household air pollution, ICD, International Classification of Diseases, CAVD, calcific aortic valve disease, YLDs, years lived with disability, Years of potential life lost, CHA, congenital heart anomalies, Cardiovascular System & Hematology, Heart Disease Risk Factors, business, population health
Abstract: Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019. Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019. Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside high-income countries, and alarmingly, the age-standardized rate of CVD has begun to rise in some locations where it was previously declining in high-income countries. There is an urgent need to focus on implementing existing cost-effective policies and interventions if the world is to meet the targets for Sustainable Development Goal 3 and achieve a 30% reduction in premature mortality due to noncommunicable diseases., Central Illustration, Highlights • The burden of CVD, in number of DALYs and deaths, continues to increase globally. • CVD burden attributable to modifiable risk factors continues to increase globally. • Countries should invest in existing cost-effective public health programs and clinical interventions to target modifiable risks, promote healthy aging across the lifespan, and reduce disability and premature death due to CVD.
Published: 2020

23. Association of non-alcoholic fatty liver disease (NAFLD) and insulin resistance in type 2diabetes

Author: Sumaiya Anjum, Thejashwini A, Nanjaraj C.P, Shashikumar M.R, Shubha Jayaram, Savitha Nageshappa, Srikanta B.M, and Shekar M.A
Subjects: General Medicine, General Chemistry
Abstract: Background Non-alcoholic fatty liver disease NAFLD is one of the leading causes of nonalcoholic steatohepatitis NASH cirrhosis and hepatocellular carcinoma and is a major risk factor in hepatic insulin resistance IR. IR appears to be a common pathophysiological link between NAFLD and type 2 diabetes mellitus T2DM and limited information is available on the association of NAFLD with IR in T2DM individuals. We decided to determine whether there is association of NAFLD with IR in T2DM subjects.Material amp Methods Study involving 151 53 males 98 females T2DM subjects were screened for NAFLD using abdominal ultrasound scanning clinical assessment and biochemical parameters. IR was calculated using HOMA-IR. Association between NAFLD and IR was tested by Chi-square analysis. Significant difference between NAFLD and non-NAFLD subgroups was analyzed by t-test and z-test.Results The prevalence of NAFLD IR and hypertension in T2DM subjects were found to be 73 81 and 80 respectively. There was no significant difference in the prevalence of these between male amp female. However the prevalence of obesity and central obesity was significantly high in females. The comparison between NAFLD and non-NAFLD subgroups showed significantly high prevalence of IR hypertension obesity central obesity elevated SGPT and TG in NAFLD group. However there was no significant difference in mean values of serum biochemical parameters except TG VLDL and SGPT. NAFLD showed strong association with IR OR 13.ConclusionThe study indicated high prevalence of NAFLD and IR and strong association between them in diabetic population.
Published: 2020

24. ASSOCIATION OF BONE TURNOVER MARKERS WITH APOE4 ALLELE IN SUBJECTS WITH OSTEOPOROTIC FRACTURES

Author: Shubha Jayaram, Srikanta BManjegowda, Savitha Nageshappa, Basavaraj GSagar, and Meera S
Subjects: medicine.medical_specialty, Endocrinology, business.industry, Internal medicine, Osteoporosis Bone mineral density APOE β-crosslaps Osteocalcin, medicine, APOE4 Allele, lipids (amino acids, peptides, and proteins), business, Bone remodeling
Abstract: The available reports on the association of APOE4 allele with osteoporosis are not consistent. Also, there are limited studies on the association of APOE genotypes with bone turnover markers. Therefore, the present study aims to test the hypothesis; whether there is an association of APOE4 allele with osteoporosis and bone turnover markers. The current study involved 130 individuals of ≥50 years of age with osteoporotic fractures as cases and; age and gender-matched individuals without osteoporotic fractures as controls. The BMD was tested by ultrasound bone (heel) densitometry. The serum calcium, phosphorus & ALP were measured using automated chemistry analyzer. Serum β-crosslaps and osteocalcin were measured using automated immunoassay analyzer. APOE genotypes were determined by sequencing blood DNA using Sanger method. The results showed significantly reduced BMD in cases when compared to the controls (T-score of -3.05 vs. -1.57). Though, all the biochemical parameters except β-crosslaps were in clinically normal range, a statistically significant decrease in calcium and an increase in osteocalcin and β-crosslaps in cases were observed at p
Published: 2019
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25. HEPATITIS B PREVALENCE AMONG BLOOD DONORS AT A TERTIARY CARE CENTRE IN MYSORE

Author: Kunal Puri, Shubha Jayaram, and Sreenivas N
Subjects: medicine.medical_specialty, Prevalence, Transfusio n transmissible infections (TTI), Voluntary and Replacement blood donors, lcsh:R5-130.5, business.industry, Family medicine, medicine, Hepatitis B, business, medicine.disease, Tertiary care, lcsh:General works
Abstract: BACKGROUND: Blood transfusion is an essential element of a health care system. Safety of blood transfusion is of extreme importance in order to avoid any severe morbidity and mortality in the patient. By screening donated blood units, we get a clue of the prevalence of those infections among donor pop ulations and consequently the safety of collected donations. It also gives us an idea of the prevalence of the Transfusion transmissible infections ( TTIs) in the community. OBJECTIVES : To find out the sero - prevalence of TTIs namely HBV (Hepatitis B) in the blood donor population at MMC&RI, Mysore. To stratify sero prevalence of TTIs based on the age and sex of the donor population . METHODOLOGY: The present study was carried out in the Blood Bank , Mysore Medical College and Research Institute , Mysore during the period from November 2012 to May 2014 among 14075 blood donors. All the samples were screened for hepatitis B surface antigen (HBsAg) by ELISA method . RESULTS : Out of a total of 14075 blood donors , a total of 103 tested positive for TTIs . 94.08% were males and remaining 5.92% were females. A majority of donors were voluntary donors (85.79%) and a majority of the donors were between the age group of 18 - 39 years (78.17%). The prevalence rate of HBV in blood donors was 0.73%. The seroprevale nce in voluntary donors was 0.57% and in replacement donors was 1.75 % respectively. CONCLUSION : Voluntary blood donation is safe, compared to replacement as high prevalence of Hepatitis B is observed in replacement donors.
Published: 2015

26. STUDY OF SERUM ELECTROLYTES IN FEMALE THYROID PATIENTS : A CASE CONTROL STUDY

Author: Mamatha Samalad, Manjula R, Shubha Jayaram, Sangamesh Kashina Kunti, Neela Mannangi, Sreenivas N, Arti Ganiger, and Mahantesh Bhutal
Subjects: endocrine system, medicine.medical_specialty, endocrine system diseases, Free thyroid hormones (FT3, lcsh:R5-130.5, business.industry, Thyroid, Case-control study, hyperthyro id, Gastroenterology, medicine.anatomical_structure, K + and Cl - ), Internal medicine, medicine, Serum electrolytes, business, hormones, hormone substitutes, and hormone antagonists, lcsh:General works, FT4), Electrolytes (Na +
Abstract: NTRODUCTION : Thyroid hormone is a central regulator of body haemodynamic, thermoregulation and metabolism. The effect of thyroid hormones on lipid metabolism is well known, whereas the effect on electrolytes and minerals has not been well established and also the underlying mechanisms not well understood. Thyroid hormones regulate the activity of sodium potassium pumps in mo st of the tissues. The higher prevalence of thyroid disease in women suggests that estrogen might be involved in the pathophysiology of thyroid dysfunction. With this background the present study was undertaken to assess the alterations in the levels of serum electrolytes in hyperthyroid, hypothyroid & euthyroid female patients. MATERIAL AND METHODS : The present study was conducted in female patients who atte nded medicine outpatient D epartment of S. N. Medical C ollege & HSK H ospital , Bagalkot . Thyroid hormones were estimated by chemiluminiscence method . Electrolyte levels (Na + , k + & Cl - ) were measured by ion selective electrode method. Serum levels of free T3 T4 and TSH were obtained. Patients with history of intake of thyroid drugs, hypertensive, diabetes mellitus, obesity and all other causes for electrolyte abnormalities were excluded from the study. STATISTICS : All the values are expressed in mean ± SD . Unp aired ‘t’ test was applied. Pearson’s correlation was done to see the correlation between serum electrolytes and thyroid hormones using SPSS (version 16.0). RESULTS : In the present study mean age group of patients were between 20 - 60yrs. There were 90 femal e patients total in number. Out of which 30 patients were with hypothyroidism, another 30 were with hyperthyroidism and remaining 30 were with euthyroidism. Mean serum levels for thyroid function parameters and electrolytes are given in below table no.2 an d 3. DISCUSSION : Hypothyroidism is a very common condition and seen more in women than in men. The higher prevalence of thyroid disease in women suggests that estrogen might be involved in the pathophysiology of thyroid dysfunction. In our study the serum sodium levels were markedly decreased as compared to healthy controls. According to Saruta T et al Plasma Renin Activity (PRA) and Plasma Aldosterone (PA) may be suppressed in hypothyroidism probably due to dysfunction of juxtaglomerular cells and glomerul osa cells respectively. The suppression of PRA and PA in patients with hypothyroidism is related to exaggerated sodium excretion and decrease in potassium excretion. CONCLUSION : We conclude that significant decreased Na + and increased K + levels were seen in female hypothyroid patients compared to controls. Hence monitoring of serum levels of these electrolytes will be helpful during the management of hypothyroid patient
Published: 2015

27. SERUM ZINC LEVELS IN CHILDREN HOSPITALIZED WITH PNEUMONIA: A CASE CONTROL STUDY

Author: Manjunath S. N, Deepthi D, Sreenivas N, Savitha M. R, Shubha Jayaram, and Shylaja Dharmesh
Subjects: Pneumonia, medicine.medical_specialty, Serum zinc, business.industry, Emergency medicine, medicine, Case-control study, medicine.disease, Intensive care medicine, business
Published: 2014

28. Bridging the Skills Gap : Innovations in Africa and Asia

Author: Shubha Jayaram, Wambui Munge, Bob Adamson, David Sorrell, Nitika Jain, Shubha Jayaram, Wambui Munge, Bob Adamson, David Sorrell, and Nitika Jain
Subjects: Technical education--Asia, Technical education--Africa
Abstract: This volume seeks to examine the skills development agenda for youth by exploring two key questions for sustainable livelihoods: What are the skills needed for employability in developing countries, especially in Africa and Asia? And, what skills are currently possessed by students and secondary school leavers? An introductory chapter will set the stage for the discussion and analysis to follow by reviewing in broad terms the current research on relevant topics such as global youth unemployment, the relationship between skills and economic growth, and the expansion of secondary education. The following chapters synthesize a series of background studies focused on Africa, South Asia and South-East Asia, including both a general overview and an in-depth look at several countries. The chapters introduce innovative models for skills delivery, and highlight some of the key elements of successful skills models, including multi-stakeholder partnerships, updatedpedagogy, and innovative financing mechanisms. Each of the five core chapters of the book covers one theme, with the support of case studies to illustrate successes, challenges, and lessons in real world examples.
Published: 2017

29. Diagnosing the Skill Gap

Author: Michelle Engmann and Shubha Jayaram
Subjects: Economic growth, South asia, Geography, Informal sector, Vocational education, language, East africa, French, Employability, language.human_language, Supply and demand, Southeast asia
Abstract: Over the course of 2011–2013, Results for Development Institute (R4D) worked closely with five partners in Africa and Asia to understand the demand and supply side of the employability issue. Twelve focus countries were selected in each region for the research, covering Francophone Africa, East Africa, South Asia, and Southeast Asia (R4D, 2013).
Published: 2017

30. Soft Skills: What They Are and How to Foster Them

Author: Rose Musau and Shubha Jayaram
Subjects: ComputingMilieux_THECOMPUTINGPROFESSION, Informal sector, Social skills, Soft skills, ComputingMilieux_COMPUTERSANDEDUCATION, Flexibility (personality), Engineering ethics, Context (language use), Cognitive skill, Employability, Psychology, Skills management
Abstract: Soft skills, also known as behavioral or non-cognitive skills, are interpersonal skills that are increasingly seen as crucial to employability. While technical and cognitive skills are important in the workplace, transferable, non-cognitive skills such as communication, problem solving, punctuality, and flexibility are increasingly important – particularly for the informal economy (R4D, 2013a, 2013b). The significance of soft skills is gaining momentum particularly in the context of the post-2015 education debate, with an increased focus on what these skills encompass, how to measure them, and how to foster them. This chapter provides an overview of these issues, with two case studies presented to illustrate various mechanisms to foster these skills in youth.
Published: 2017

31. Developing skills for employability at the secondary level: Effective models for Asia

Author: Michelle Engmann and Shubha Jayaram
Subjects: Economic growth, Informal sector, business.industry, Universal Primary Education, Innovative financing, Public relations, Employability, Education, Skills management, Information and Communications Technology, Preparedness, ComputingMilieux_COMPUTERSANDEDUCATION, Cognitive skill, business
Abstract: Globally, enormous gains have been made towards the goal of universal primary education, leading to increased demands for secondary education. Consequently, more youth and young adults are now entering the formal and informal labour markets from the secondary level, which makes it important to ensure that secondary schools teach skills relevant to the world of work. This article reports on a Results for Development Institute (R4D) study that explored whether secondary education systems are adequately preparing young people for the workplace, and identified innovative models for delivering relevant skills at the secondary level. It found that employers are looking for three key types of skills: cognitive, non-cognitive, and technical. While technical and basic cognitive skills are still important in the workplace, transferrable and non-cognitive skills such as communication, problem-solving, punctuality, and flexibility are increasingly important, particularly for the informal economy. The article describes several innovative and effective models for skills development at the secondary level, and core principles for their success. These include innovative use of information and communications technology (ICT), multi-stakeholder partnerships, innovative financing mechanisms, and ensuring teacher and trainer preparedness. Moreover, a supportive policy environment is critical to ensure that such models are efficiently financed, effectively implemented, and sustainable over the long term.
Published: 2014

32. The study of lipid profile and other cardiovascular risk factors in children born to parents having premature ischemic heart disease

Author: Shubha Jayaram, Mysore R. Savitha, and Santhosh Krishnappa
Subjects: medicine.medical_specialty, medicine.diagnostic_test, business.industry, Internal medicine, Cardiovascular risk factors, medicine, Cardiology, Disease, business, Lipid profile, Ischemic heart
Abstract: Background: Most of the studies on cardiovascular risk factors are concentrated on adults. But atherosclerotic process begins in childhood and is influenced by genetics, diet and life style. Hence, present study was undertaken. The objectives of the study were to study lipid profile and other cardiovascular risk factors like hypertensive status, BMI(Body mass index) in children aged between 5years and 18 years born to parents having premature IHD(Ischemic heart disease), to study diet and life style factors in study group having family history of IHD, to study the sociodemographic profile of dyslipidemia.Methods: A 200 Cases of premature IHD were selected. Their children(n=200) in the age group of 5 to 18 years were selected and analysed for cardiovascular risk factors. They were compared with 200 normal children without any family history of IHD.Results: On comparison of mean lipid profile between cases and controls HDL cholesterol was very low amongst cases (p=0.001). The mean values of triglycerides and VLDL were very high amongst cases (p=0.001). The mean atherogenic index (AI) was high amongst cases (p=0.001). Prehypertension or hypertension was seen amongst 8.5% cases (p=0.004). Amongst the cases 19.5% had excess junk food intake (p=0.001). 51.5% of cases had sedentary life style (p=0.001).Conclusions: Children in our area born to parents with premature IHD have significant incidence of dyslipidaemia. There is an increased incidence of other cardiovascular risk factors like hypertension, excess junk food intake, sedentary life style in these children.
Published: 2019

33. An Interesting Case of Familial Homozygous Hypercholesterolemia—A Brief Review

Author: Sumangala Kadi, Shubha Jayaram, N. Sreenivasa, and Meera S
Subjects: Pediatrics, medicine.medical_specialty, education.field_of_study, business.industry, Clinical Biochemistry, Population, nutritional and metabolic diseases, Case Report, Familial hypercholesterolemia, medicine.disease, Premature atherosclerosis, medicine, lipids (amino acids, peptides, and proteins), Serum LDL Cholesterol, education, business, Familial homozygous hypercholesterolemia
Abstract: Familial hypercholesterolemia (FH) is a form of primary hyperlipoproteinemia, is an autosomal co-dominant disorder, characterized by an increase in serum LDL cholesterol concentrations, presence of xanthomas and premature atherosclerosis. Homozygous familial hypercholesterolemia is of rare occurence in which approximately 1 in 1 million persons in the general population are affected. Here we report an interesting case of familial homozygous hypercholesterolemia for its classical presentation and rarity.
Published: 2011

34. STUDY ON INFLUENCE OF GESTATIONAL AGE AND BIRTH WEIGHT ON CORD BLOOD THYROID STIMULATING HORMONE AND THYROXINE

Author: Sahithya C S, Shubha Jayaram, and Meera S
Subjects: endocrine system, Thyroid Stimulating Hormone (TSH), Thyroxine (T4), Perinatal factors, Cord blood, endocrine system diseases, business.industry, lcsh:R5-130.5, Birth weight, Gestational age, Physiology, Thyroid-stimulating hormone, Medicine, business, hormones, hormone substitutes, and hormone antagonists, lcsh:General works
Abstract: Congenital hypothyroidism is a more common pediatric endocrine disorder and also most common preventable cause of mental retardation. Early diagnosis by measuring Thyroid hormones thyroxine (T4), Thyroid Stimulating Hormone (TSH) levels and prompt treatment is crucial in improving intellectual outcome and for growth of the baby. There are several perinatal factors which influence cord blood TSH, T4 values which has to be considered while int erpreting the results. Umbilical cord blood samples were collected for assessment of TSH and T4 in 100 newborns. The influence of birth weight and gestational age on T4 & TSH levels was assessed. On comparing mean TSH and T4 levels among preterm and term i nfants, it was found that there was statistically significant difference in the mean TSH levels between term and preterm infants. Difference in mean T4 levels among low birth weight and normal birth weight infants was statistically significant. To conclude Birth weight & gestational age have influence on Cord blood TSH and T4 levels and a caution in their interpretation should be considered.
Published: 2015

35. Correlation of Serum Cystatin C with Atherogenic indices in obese individuals

Author: M H Rahul, Shubha Jayaram, Deepa K, Meera S, and Sudhir
Subjects: medicine.medical_specialty, biology, Cholesterol, business.industry, Cost effectiveness, medicine.disease, Obesity, chemistry.chemical_compound, Endocrinology, chemistry, Cystatin C, Sample size determination, Internal medicine, medicine, biology.protein, Population study, Analysis of variance, Cystatin, business
Abstract: Introduction: Human obesity is strongly associated with cardiovascular disease. Cystatin C is a naturally occurring protease inhibitor and marker of cardiovascular disease. The atherogenic indices are used as an index for cardiac risk stratification. Objectives: To estimate the serum levels of Cystatin C in individuals with normal BMI, and obese, aged between 20-39 Yrs and to compare the levels of Cystatin C among these individuals and to correlate the levels of serum Cystatin C with atherogenic index of plasma and other indices. Methodology: The study population was taken from healthy volunteers of Mysore city, aged between 20-39 years of either sex. The study population was divided into 2 groups based on BMI. Each group contains sample size of 60. Fasting serum sample was analyzed for Total Cholesterol, TG, LDL-Cholesterol and HDL cholesterol by enzymatic method and serum Cystatin-C by immune-turbidimetric method using auto-analyser. Statistical Analysis: Analysis of Variance [ANOVA] was used to compare the serum levels of Cystatin C in the two groups. To correlate the serum Cystatin C with atherogenic indices for predicting the cardiovascular risk factors, Pearson’s correlation co-efficient was worked out. Results: The mean serum cystatin C levels in normal BMI group are 0.7±0.03 mg/L, and in Obese group 1.15±0.09 mg/(p value less than 0.001).In the study serum Cystatin C showed a positive correlation with serum triglycerides (r=0.7), Atherogenic index of plasma(AIP ) (r=0.80), TCHOL: HDL (Castelli’s Risk Index I) (r=0.71), HDL: LDL(Castelli’s Risk Index II) (r=0.70) respectively and Atherogenic coefficient (AC) {(NonHDLc)/HDLc}( r=0.60) and negative correlation with serum HDL(r=-0.52) Conclusion: Several indices had been derived from lipid profiles to establish an index for predicting the risk of having coronary event. The atherogenic index of plasma was strongly correlated with the Cystatin C, hence AIP can be used as better index for predicting the preclinical cardiovascular disease because of cost effectiveness in estimation of Cystatin C.
Published: 2015

36. STUDY OF ANEMIA AMONG PROTEIN ENERGY MALNOURISHED CHILDREN IN MYSORE

Author: Nayana N. S, Shubha Jayaram, and Sreenivas N
Subjects: Pediatrics, medicine.medical_specialty, Complete haemogram, Protein energy malnutrition, Anemia, business.industry, lcsh:R5-130.5, medicine, medicine.disease, business, Children, lcsh:General works
Abstract: INTRODUCTION AND OBJECTIVES : Anemia in Protein energy malnutrition (PEM) is common and its pathogenesis is multifactorial. Since the clinico - pathological patterns are reflected by their underlying etiopathogenic factors, it is important to study the associated morbidity and mortalit y and to establish their causes for an effective management. The purpose of the present study is to determine the prevalence, patterns, clinico - pathological and morphological types of anemia in protein energy malnutrition children. The objectives of the st udy are: (1) To study the clinico - pathological and morphological patterns of anemia in PEM children of age group 6 month – 5 years. (2) To assess the resultant morbidity and mortality. (3) To determine the ideal parameter for iron deficiency anemia. METHOD S: This study was conducted on 75 clinically diagnosed Protein energy malnutrition patients of age group 6 months to 5 years. Detailed clinical history elicitation and thorough clinical examination was performed. Peripheral smears of these patients were ex amined. The complete hemogram including reticulocyte count was done. The special investigations like bone marrow study, Hb electrophoresis, iron studies and stool examination were done whenever required. RESULTS: In our study, anemia in PEM affected female population more than the males of age 36 - 47 months. Most of children had Grade III PEM and Microcytic hypochromic anemia was most prevalent. Most of the children had Iron deficiency anemia. This study also indicated that Serum iron assay and TIBC are the better indicators of iron deficiency anemia in patients with PEM and it is the investigation of choice when compared to serum ferritin as it gets falsely elevated in these patients with infections confirmed by elevated CRP level. INTERPRETATION AND CONCLUS ION: Malnutrition, Infection and Anemia show a synergistic relationship. So it necessitates prompt screening and early diagnosis through proper investigation, by utilization of available advanced technical modalities in order to initiate timely treatment a nd appropriate management.
Published: 2015

37. Correlation of Cystatin C with Atherogenic Indices in South Indian Obese Individuals

Author: M. H. Rahul, K Deepa, Varun Reddy, null Sudhir, and Shubha Jayaram
Published: 2015

38. Study of Cardiometabolic Markers Along with Lipid Indices in Psoriasis.

Author: Mannangi, Neela B., Basavaraj, Devaranavadgi, Balachandra, Ankad, and Shubha, Jayaram
Subjects: *PSORIASIS, *PSORIATIC arthritis, *DYSLIPIDEMIA, *LIPIDS, *URIC acid, *SKIN diseases, *BLOOD pressure
Abstract: Background: Psoriasis is one of the most common chronic inflammatory skin diseases which affects 2-4% of the general population. The results of epidemiological studies have demonstrated that the risk to develop cardiovascular disease (CVD) is higher in patients with severe psoriasis. The pathogenesis of atherosclerosis followed by CVD is inflammation dependent in psoriasis. Material and Methods: It is a cross sectional observation study conducted in a tertiary care hospital from January 2019 to January 2021. 110 patients with psoriasis were included in cases and 110 controls. Anthropometric markers viz. blood pressure (BP), abdominal circumference and cardiometabolic markers lipid profile, hs-CRP, uric acid, Lp(a) were estimated in both groups. The data obtained was subjected to appropriate statistical analysis.Results: Anthropometric markers BP (136.1 ± 14.0/ 81.4 ± 8.3; 125.0 ± 8.9/76.2± 5.5) and abdominal circumference (85.4±15.3; 44.7± 11.9), BMI (40.9±8.3;22.3±3.2) were statistically high in cases than controls. The cardiometabolic markers as Triglycerides (TG) ( 212.3 ± 39.5; 122.9 ± 43.2), Total cholesterol (241.0 ± 60.4; 155.0 ± 43.2), High Density Lipoprotein-Cholesterol (HDL-C) ( 34.9 ± 6.8; 43.5 ± 9.8), Low Density Lipoprotein-Cholesterol (LDL-C) (196.8 ± 43.1; 132.0 ± 10.0), uric acid ( 17.1 ± 7.2; 4.5 ± 1.0), hs-CRP ( 16.2 ± 7.7; 2.8 ± 1.3), Lipoprotein (a) [Lp(a)]( 41.3 ± 8.7; 25.1 ± 7.9) and lipid indices AIP (0.79 ± 0.12, 0.46 ± 0.11), CI-I (7.20 ± 2.43; 3.70 ± 1.13), CI-II ( 5.85 ± 1.70; 3.21 ± 0.83), AC ( 239.97 ± 60.44; 152.25 ± 35.05), LTI (6654.34 ± 39207.47; 92.29 ± 38.92) were significantly high in cases compared to controls.Conclusion: The present study found significant increase in cardiometabolic markers in psoriasis patients compared to controls. So, this study emphasizes the importance of screening of cardiometabolic markers and other metabolic comorbidities in psoriasis patients to help in early detection and treatment in order to reduce cardiovascular events. [ABSTRACT FROM AUTHOR]
Published: 2022

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