European Journal of Molecular & Clinical Medicine

Women are more vulnerable to mental disorders like depression during postpartum.  Depression if untreated during postnatal period may adversely affects both mother and child health.
Aims and objectives:
1.         To estimate the proportion of postnatal depression among women attending Maternal and Child Health Clinic in Teaching Hospital.
2.         To determine the risk factors associated with postnatal depression among women attending Maternal and Child Health Clinic in Teaching Hospital.
Methodology: A hospital based cross sectional study was conducted in Maternal and Child Health clinic in Teaching hospital among 100 postnatal women. A predesigned and pretested questionnaire was administered to postnatal women to screen for depression by EDPS.
Results: Among 100 study subjects 60% of them belonged to 21-25 years age group and 70% had first pregnancy at the age of 15-20yrs.
Conclusion: The proportion of depression was 15% among postnatal women and predictors of postnatal depression were women with more than one living child and who had female child in the recent delivery. 

Surgical Site Infections (SSI) is one of the most commonly reported nosocomial infection which has an adverse impact on the hospital as well as on the patient.
Objectives:

To study the prevalence of Surgical Site Infections.
To identify the risk factors associated with the development of SSIs.
To identify the etiological pathogens and their antimicrobial susceptibility

Methodology: We conducted a one year cross sectional study on SSI in
IOG. 152 post lscs cases who developed SSI were included in the study. Factors like age, duration of surgery, co-morbidities, type of skin suture, pathogen and their antimicrobial sensitivity associated with SSI and their outcomes were studied. Swabs were collected from the infected surgical wounds and processed by the conventional microbiological methods. Antimicrobial susceptibility was done by Kirby-Bauer disc diffusion method and interpretation done by CLSI guidelines 2020.
Results: Among the 6650 cases of LSCS done in our hospital in the year 2021, 152 cases developed surgical site infection. Of which 67% of the population comprise of the age group 18-30 yrs, anemia, diabetes, hypetension were the predominant risk factors associated with SSI. About 37% of the cases needed wound resuturing remaining 63% of the cases were medically managed. The common pathogen encountered with SSI were E. coli, Klebsiella and MRSA. Around 82% of the organism were sensitive to Amikacin and 48% of them were sensitive to Gentamycin, about 43% of the pathogen were resistant to Ampicillin.
Conclusions: The overall prevelance of SSI in our hospital was 2.28% in the year 2021. Early diagnosis and prompt treatment of risk factors like anemia, diabetes and hypertension may prevent SSI and improve outcomes in infected cases. Decrease in the duration of surgery, decreases the incidence of SSI. Empirical use of antibiotics based on the common organism encountered and their sensitivity patters improves the outcome of SSI. Peroidic surveillance of SSI and measures to prevent it to be done on regular basis

Pregnancy and puerperium increases the risk of venous thromboembolism 4- to 5-fold over that in the non-pregnant state. Compared to non-pregnant, pregnant women have a two and a half times increased risk of developing pulmonary embolism. Venous thromboembolism is often fatal. Depending on reports estimate that 10%–30% of patients had mortality within 30 days. The purpose of this study is to estimate the prevalence of thromboembolism in pregnancy and puerperium, risk factors, need for anticoagulants, maternal and fetal outcome in a Govt. Tertiary care center in Chennai.
Materials and Methods: A prospective Descriptive study was conducted in Dept of Obstetrics & Gynaecology, Govt. Kilpauk Medical college, Chennai during February 2019-september 2019 among 200 antenatal and postnatal mothers. Descriptive statistics, Chi Square test were used. A p value of <0.05 was considered statistically significant.
Results: In BMI up to 23 having thromboembolism of 0%, in BMI from 24-29, incidence was thromboembolism of 9.5% and in BMI of 33-36 having thromboembolism of 0%. In patients having BMI between 24-29, risk of thromboembolism was observed high. Hence BMI was considered significant risk factor. One patient developed pulmonary embolism in postnatal period, emergency CTPA done, given LMWH for 3 months & patient revived.
Conclusions: BMI more than 26, multiparity, previous history of surgery, immovability, varicose veins, gestational hypertension, anemia, APLA positive and Eclampsia were the significant risk factors. Since pregnancy is a hyper-coagulable state, by identifying these risk factors and initiating LMWH, we can prevent the complications of DVT. Hence maternal morbidity and mortality can be reduced.

Hypertension is an important public health problem and it has no obvious
signs or symptoms making the persons unaware of condition. World Health
Organization (WHO) has stated that around 1.3 billion people around the world suffers
from hypertension and less than one in five have their blood pressure under control
Methods: A cross sectional study, Study setting: Community medicine department of
Tertiary care center. Study population: The study population included all the sanitary
workers in tertiary care center. Study duration 2 months. Sample size: 311 Results:
Only 10.7% of the workers were current tobacco users, while almost 15% were current
alcohol users. More than three fourth of the study participants were physically active.
More than 50% of the participants were obese (≥ 25.00 kg/m2). Abdominal obesity was
present in about 35% of the participants. Prevalence of hypertension among the
sanitary workers was 36.6% (95% CI: 31.3-41.3%). Only 34 (10.9%) participants were
aware of their hypertension status and 80 (25.7%) of the participants were newly
diagnosed to have hypertension. Prehypertension was present in 114 out of 277
participants (41.1%; 95% CI: 35.3-47.2%) without any known history of hypertension.
Among the 34 patients with known history of hypertension, only 12 (35.3%) belonged to
controlled status category. Current tobacco users had 1.61 times higher prevalence of
hypertension when compared to those who are not current users and this was
statistically significant (P = 0.003). Current alcohol users had significant association
with hypertension (aPR-1.25; P = 0.02). Conclusions: The current study found that
more than one-third of the sanitary workers had hypertension. However, almost threefourth
of the hypertensives were not aware about their status.

Suicidal behaviour in medical students might be brought on by mental pressures and the adoption of inadequate coping mechanisms.
Objective: The purpose of this study is to assess the prevalence, risk factors, and effects of coping strategy elements on suicidal behaviour among medical students.
 Methodology:Medical College students participated in a three-month institution-based cross-sectional survey from October to December 2022. Using the stratified random sampling procedure, a total of 350 study participants were chosen and then distributed proportionally to each academic year. The Patient Health Questionnaire-9, Suicidal Behaviors Questionnaire-Revised, and sociodemographic information were then included in a self-administered questionnaire that the participants were required to complete (SBQ-R). The risk factors and their correlation with suicidal conduct were identified using the chi-square test and the student t test.
Results: A total of 62 (17.7%) respondents reported having suicidal behaviour and an SBQ-R cutoff score greater than 7. The age range of the participants was 18 to 35 years, with a mean age of 22.28±  1.87 years . Depression, academic performance dissatisfaction, smoking and alcohol use were the found risk variables substantially linked to greater suicide conduct. (P<0.05) In the study population, psychological resilience (68.6%), religion, and humour (60.3%) were the coping mechanisms that were employed more frequently than supportive techniques (54%). Coping with mental disengagement and coping with supportive techniques were examined as a protective factor for suicide behaviour. Mental disengagement (denial, drug use, venting, behavioural disengagement, and self-blame) was a seldom employed coping strategy (21.7%) among medical students. ( (P<0.05)
 Conclusion: The prevalence of suicidal conduct among medical students is worrying, and research has shown that risk factors include depression, alcohol and tobacco use, as well as inadequate coping mechanisms. The data suggests that the initial steps in preventing suicidal conduct should be quantification of the problems, early treatment, and proactive student counselling to assist them adopt the proper coping mechanisms.

Background: To study the risk factors for recurrence of peptic ulcer disease.
Materials & methods: A total of 100 subjects were enrolled. The age group included was 15 to 80 years. Possible risk factors including nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin and alcohol were analysed. Recurrence rate were assessed. Student's t-test was used to compare means, chi-square test was performed. A P-value of <0.05 was considered statistically significant.
Results: PUD was diagnosed using endoscopy and histology in 80 (80%) and by clinical diagnosis in 20 (20%) patients. The recurrence rate of PUD was 28% which was seen in 28 patients.
Conclusion: The recurrence rate of PUD was 28%. The use of NSAID and H. pylori infection were risk factors for recurrence of PUD.

Background: Postoperative wound complications are of common occurrence. The incidence of postoperative wound infections ranging from <2% to 38%. Based on NNIS (National Nosocomial Infections Surveillance) system reports, surgical site infections are the third most frequently reported nosocomial infections among hospitalized patient, Aim is to compare the complications of laparotomy wound in elective and emergency surgery and to study the various determinants affecting it. 

Background: Birth weight is an important determinant of child survival and development. Low birth weight (LBW) is an index of our status of public health, maternal health and nutrition. The major challenge in the field of public health is to identify the factors influencing low birth weight and to institute remedial measures.
Aim: The aim of this study was attempted to assess incidence of low birth weight and its risk factors affecting low birth weight.
Materials and methods: A cross sectional study design was carried out in a tertiary care government hospital.A total of 1120 postnatal mothers who delivered in the hospital during study period were included in the study except still births. All babies were weighted on standard beam balance within 24 hours of delivery and mother’s height was measured by height measuring stand. The collected data was analyzed using statistical package for the social sciences (SPSS) version 22.
Results and analysis:incidence of LBW neo-born babies was 240/1120 (21.4%)where 104 (43.3%) were males and 136 (56.7%) were female babies. Mean age of the mothers was 23.52±3.16 years; mean weight noted was 58.94±10.09 kg and mean height was 159.1±7.15 cm. The study showed associations between birth weight and mother’s age, weight, height, hemoglobin (Hb) %, birth interval, income, bad obstetric history and complications
Discussion and conclusion: The incidence of low birth weight was found to be very high and it was associated with many risk factors related to maternal health and services. Hence it is recommended to improve maternal health through strengthening the existing maternal services at the basic level of community.

Many of the factors that contribute to health risks among adolescents are preventable if identified and changed as early as possible. Early intervention can alter patterns of behaviors that would have placed young people at risk in later life. Preventing risky behavior and promoting healthy choices among adolescents can yield positive health outcomes not just during adolescence but also during adulthood.
Objectives: To assess the awareness of Non-communicable diseases and their risk factors among school going adolescents of Jamnagar city.
Methodology: A school based cross sectional study was conducted among 960 school going adolescents from the private and government schools of Jamnagar city. Socio-demographic data was collected and awareness of risk factors of non-communicable diseases was assessed with the help of a predesigned, pre-tested, self-administered questionnaire.
Results: In the study 59.6% adolescents were boys and 53.3% were studying in private schools. More than 80% knew the types, symptoms and presentation of Cancer and Diabetes while 75.5% and 74.3% respectively knew about heart disease and hypertension. For heart diseases main risk factors reported were fatty diet (35.7%), lack of physical activity and excessive anxiety (31.4%), fast food consumption (30.9%) and alcohol consumption (29.9%). For diabetes fatty diet (34.8%), soft drinks (32.2%) and fast food (27.4%) were the main risk factors. Tobacco chewing (87.4%), alcohol consumption (73.3%) and smoking (73.0%) were the risk factors for various type of cancer. Excessive salt intake (57.2%), excessive anxiety and stress (53.7%) and lack of physical activity (29.8%) were the risk factors for hypertension. Only 20.1% had reasonable knowledge about types, symptoms and nature of non-communicable diseases.

SBP is still a serious complication with a dismal outlook. The prognosis of patients with decompensated cirrhosis and SBP remains dismal, with a death rate of 21-41%, despite the introduction of new preventive strategies such as early detection and treatment with albumin and new antibiotics. The incidence of spontaneous bacterial peritonitis lowers the survival rate to 31% after one year. To enhance prognosis in this situation, it is crucial to identify patients who are at a higher risk of passing away.

Background:Recently, there has been an interest in identifying non-lipid risk factors in the causation of metabolic syndrome.
Objectives: The present study was aimed to assess the significance of high sensitivity C-reactive protein (hs-CRP)and thyroid profile in patients with metabolic syndrome.
Materials and methods: Patients diagnosed with metabolic syndrome in the outpatient clinic of Department of Medicine were included. Those having ≥3 components of the metabolic syndrome criteria constituted the cases and those with less than three components constituted the controls. Various biochemical parameters were compared between cases and control.
Results: Mean hs-CRP was significantly higher among cases (2.9 ± 0.8mg/L) as compared to controls (1.1 ± 0.7 mg/L), p value 0.5). The clinical thyroid status of the cases was compared against that of control. Among those with metabolic syndrome, overt hypothyroidism was observed in 18.4% and 3% had subclinical hypothyroidism, while among controls, only 4.6% had overt hypothyroidism.
Conclusion: Patients with metabolic syndrome had significantly higher levels of hs-CRP. Though the mean TSH levels were similar, thyroid dysfunction was significantly more common in cases with metabolic syndrome

Low back pain is one of the most common ailments as it is very disabling, reducing the quality of life and very expensive. It generally occurs due to work or occupational activities.
Materials and Methods: Demographic details, details of past history, range of physical exercise, posture, smoking and alcohol consumption were taken from 168 patients belonging to lower socioeconomic group.
Results: Females were more affected than males and the most common age group was between 18-45 years. Most of the patients were students (14.3%), housewives (23.2%), laborers (26.8%), drivers (16.1%) and farmers (10.7%). Coffee consumption was seen regularly in 149 (88.7%) patients while only 8 (4.8%) neither drank coffee or tea. 98 (58.3%) regularly consumed alcohol and 59 (35.1%) smoked regularly. In 33 (19.6%) of the patients, the most probable cause of pain was excess physical exercise while 62 (36.9%) lifted heavy weights. 47 (28%) were highly stresses and 83 (49.4%) had long sitting hours. 11 (6.5%) had a family history of chronic back pain and 57 (33.9%) were obese.
Conclusion: Early diagnosis and identification of risk factors would help in better management of low back pain as the patient grows older.

Cholelithiasis remains one of the most common problems leading to surgical intervention. Over the past few decades several studies to determine the causes and risk factors of gall stone formation have been done. But some factors like Socioeconomic status, Alcohol intake, Smoking, Serum Cholesterol level, Family history, Total parenteral nutrition (TPN), Crohn’s disease are still considered controversial regarding the formation of gall stone. Therefore, this work has been done with a view to study its relation to the mentioned predisposing risk factors, So prophylactic plan like dietary improvement, change in life style (e.g. cessation of smoking & alcoholism) & others measures should be taken to avoid gallstone formation.

Purpose of the present research was to evaluate the clinical considerations as well as the outcome of laproscopic myomectomy in various uterine myomas.
Methodology: This was an observational study in women who have undergone laparoscopic myomectomy (LM) because of single symptomatic myoma >4 cm in diameter. We collected data about general features, surgical outcomes, intraoperative/ postoperative complications and time to return to normal activity.
Results: A total of 200 patients (mean age 36.7 ± 6.4 years) resulted eligible for the study. Myomas sized between 8 and 12 cm were linked to an increased amount of blood loss (significantly higher in intramural than subserosal myoma). The removal of intramural myomas >8 cm and the subserosal ones >12 cm required a significant longer surgical time. Patients returned 17.9 ± 9.5 days after surgery to their personal activities. Six cases (1.35 %) required conversion to laparotomy, and only in two cases blood transfusion was necessary.
Conclusion: Myomas size and type represent the best predictors of surgical difficulties and possible intrapostoperative complications. Intramural myomas >8 cm and subserosal ones >12 cm should be considered as a challenging procedure. LM remains the gold standard approach

Understanding the main risk factors can help develop preventive strategies with a geographical focus. The objective of the current observational study was to gather data on the factors of risk for severe lower respiratory infections (ALRI) in children under the age of five who were hospitalized in Mumbai, India.  A transactional observational study for case-control was conducted at Dr. Agarwal’s children hospital, Mumbai from September 2022 - November 2022 in 100 ALRI hospitalized below-5-year-old children along with 100 healthy newborns who were simultaneously picked from the immunization and well-baby clinics as controls. In this study, a hierarchy of the ALRI  risk factors is made clear., immunization, improper breastfeeding and weaning techniques, poor living conditions and hunger, prematurity, and caesarean birth. The first year of life turns out to be the most susceptible time in this regard. The study's definition of risk variables, though it uses a different hierarchical pattern, is consistent with prior publications. Adequate prenatal and vaccination care, good nutrition and breastfeeding support, limiting crowding, and avoiding infection from contacts with family members emerged as major preventative concepts. In a particular geographical context, efficient health education and accessibility to fundamental child and maternal health services, particularly for preterm and young infants, appeared to be necessary preventive measures against ALRI in preschool infants. 
Acute lower respiratory infection, Age under 5, Impacts, Risk factors 

Aim: To determine the role of risk factors for increased morbidity and mortality  in perforated peptic ulcer
Methods and materials: All patients aged 18 and above who had abdominal surgery for PPU were included in this research. Intravenous fluids, nasogastric suction, and intravenous antibiotics were then administered to the patients. After proper resuscitation, the perforation site was located and a laparotomy was performed via a midline incision. The hole was simply closed and reinforced with a pedicle omental patch. Peritoneal lavage with 4 to 5 litres of normal saline was performed. An intraperitoneal drain is placed at the discretion of the operating surgeon. All patients were placed on a double antibiotic regimen that included Ceftriaxone (1gm bid), Metronidazole (500 mg tid), and Omeprazole (20 mg bid). Patients were monitored for up to six months following surgery. The research covered morbidity and mortality during the hospital stay as well as the following 6-month follow-up

Back ground: WHO defines stroke as “the rapid development of clinical signs and symptoms of a focal neurological disturbance which lasts for more than 24 hours or leading to death with vascular origin as the cause. Stroke is a clinical syndrome, which describes a sudden neurological deficit of presumed vascular origin.The risk factors for stroke are diabetes mellitus, smoking, alcohol and hypertension. Colour doppler ultrasound is one of the important tool for the evaluation of exracranial insufficiency of the carotid arteries. This study was performed to assess the carotid arteries with the help of color doppler in carotid artery disease. Aims and objectives: To elaborate the color Doppler evaluation of extracranial carotid arteries and risk factors in predicting cerebro vascular accident in patients with carotid atheromatous disease. Materials and Methods: Of the 102 patients who had come to our department during the study period with symptoms of cerebrovascular disease such as transient episodes of neurological dysfunction, sudden weakness or numbness, hemiparesis, focal neurological deficits, sudden loss of consciousness, altered sensorium, aphasia, slurring of speech, diminution or loss of vision were included into the study. CT scan of brain and color doppler evaluation for the extracranial carotid arteries was done for all the patients to assess the atheromatous disease of extracranial carotid arteries and comparison with brain changes in cerebrovascular disease patients.

Background: Dry eye disease (DED) is a common ocular surface disorder that is now days considered as a public health problem due to its impact on vision-related quality of life of the affected subjects.According to the recent official report of the International Dry Eye Workshop (DEWS 2017), that based on summary of the findings of current research, DED was defined as “a multifactorial disease of the tears and ocular surface that is associated with hyperosmolarity of tear film which in turn leads to inflammation and damage of the ocular surface that accompanied with ocular symptoms of discomfort, fatigue and disturbance in visioin” Aim & Objective: Method: Study design: A cross-sectional study. Study setting: Department of ophthalmology at tertiary care centre. Study duration: Dec 2020 to June 2021,Study population: The study population included all Subjects with current or previous diagnosis of DED were included in the study Sample size: 769 Results: The mean age of all participants was 43.61 ± 18.57 years with a range of 18 to 90 years. Of all study population, 405 (52.7%) subjects were females and 364 (47.3%) were males. Of the study population, 131 (17%) reported having diabetes milletus (DM), 161 (20.9%) reported having hypertension (HTN). DED was significantly more prevalent in older age group > 45 years (p = 0.002) and in females than males in all age groups (p = 0.00). Conclusions: The prevalence of DED is high in the study population. Older age and female gender were associated risk factors with the development of DED.

Background: Hepatitis C virus (HCV) is a blood borne virus that was first identified in 1989. HCV affects the liver, with some infected individuals developing cirrhosis of the liver and liver cancer. HCV is spread primarily by blood-to-blood contact associated with injection drug use, poorly sterilized medical equipment, needle stick injuries in healthcare, and transfusions. Methods: cross-sectional study, Study setting: Medicine department of Tertiary care center. Study population: The study population included all the cases of hepatitis C virus infection admitted in tertiary care center. Sample size: 30. Results:  majority of cases were found in 31-45 years age group e.g. 16 cases (53.33%) followed by46-60 years age group 9 cases (30%), >60 years age group 3 cases (10%) and 2 cases found in 12-30 years age group. majority of cases were males e.g. 21 cases (70%) and 9 cases were females (30%). majority of cases had a history of injectable drug users e.g. 9 cases (30%) followed by 8 cases reported history of multiple sex partners (26.66%), 5 cases on dialysis required regular blood transfusion (16.67%), thalassemia found in 5 cases required regular blood transfusion (13.33%) and sickle cell anemia reported by 3 cases. There is statistically significant association between age and hepatitis C virus infection mortality. Conclusions: majority of cases were found in 31-45 years age group, most common in males, There is statistically significant association between age and hepatitis C virus infection mortality.

The most common cancer among males in eastern and western Europe is prostate cancer, which accounts for roughly 190,000 new cases yearly or 15% of all cancers in men. The condition's origins are mostly unclear, while hormonal variables and nutritional habits may indirectly contribute; several genes that may be connected to hereditary prostate cancer (HPC) have been found. Increased serum prostate-specific antigen (PSA) levels and/or questionable digital rectal examination (DRE) results can point to prostate cancer. Nonetheless, a definite prostate biopsy was required for a conclusive confirmation. The best course of action is determined by the patient's condition, overall health, disease severity, and first PSA stage. Radical prostatectomy and radiation treatment (with or without hormone deprivation therapy) might be the best options in the cases mentioned of local disease . In patient with well or poorly differentiated tumors and a mortality rate of fewer than 10 years, the observant delay is recommended as the preferred approach. In 80–85% of instances of progressive disease, hormone deprivation therapy is the preferred treatment when paired with radiation for advanced or metastatic or bulky illness. It is helpful but not therapeutic in these cases. Although Docetaxel has recently been shown to increase life expectancy and overall survival (2 to 2.5 months), individuals who acquire hormone-refractory prostate cancer illness (HRPC) must be examined for treatment

Background: Stroke is one of the leading causes of death and disability worldwide. The aim of the study was to find out the incidence of different types of strokes and the associated risk factors .
Methods: The study dealt with 100 patients of stroke who were admitted to Rangaraya Medical college ,Andhra Pradesh. Each patient was analyzed in detail about clinical presentation and the investigations were aimed to establish the pathologic type of stroke and estimation of risk factors.
Results: Stroke incidence was more in males (Male: Female= 2.57:1). Maximum incidence of stroke was in 6th decade (34%) followed by 5th decade (25%). Among modifiable risk factors, history of hypertension was the commonest (79%) followed by Diabetes (62% patients) ,smoking (15%)  and ,alcohol(15%)exclusively, found in males. Facial weakness was the most common presentation (88%) followed by hemiparesis(85%). Chest X-ray was abnormal in 17% patients, abnormal ECG was found in 36% patients .
Conclusions: Apart from control of hypertension and diabetes, abnormal lipid profile remains an important modifiable risk factor for stroke. Keywords: Stroke, Risk factor

Background::Hypertension is a major public health problem among India. It is a important area of research due to its high prevalence and being major risk factor for cardiovascular diseases and other complications.

Background:
SARS-CoV 2 virus infection present as varying degree of severity with many post viral complications.Although initial research was focused on the epidemiology, risk factors, clinical syndrome and treatment options; sufficient data is needed on sequelae of the patients who got discharged. The present study aimed to identify long term outcomes of COVID 19 recovered patients to safeguard their life in future.
Methods: The present longitudinal study included all 443 COVID 19 recovered patients who were admitted during the second wave at our tertiary care hospital from 1^stApril to 25^th May, 2021 and interviewed telephonically with series of questionnaire. Baseline demographic profile, comorbidities, clinical characteristics and investigatory findings were obtained from the hospital records and analysed for the long term symptoms and outcomes.
Results: Over a mean follow up period of 152 days, around 6% of the patients who recovered after acute COVID 19 infection died after the discharge. More than two third of patients were male. Diabetes and hypertension were most common comorbidities among the study population. Most common persistent symptoms was fatigue among the recovered population at follow up. Multivariate logistic regression analysis against the odds of post discharge mortality  revealed patients receiving advanced respiratory support  (AOR 5.2, 95% CI 1.8-15.1) and ICU stay during the hospitalisation (AOR 6.67, 95% CI 1.18-37.7) were predictors of post discharge mortality. 
Conclusion:  Fatigue was the most common symptoms observed after 5 months of discharge from acute COVID 19 infection. Overall post discharge mortality was 6% and admission in ICU and use of advanced respiratory support were associated mortality among recovered patients

Background: Diabetes mellitus (DM) is a chronic, debilitating disease constitutes a global health threat and burden, especially in developing countries. The objective of the study was to assess the prevalence of diabetes mellitus type-2 and its associated risk factors.

INTRODUCTION: Tuberculosis is one of the oldest disease and affected globally involving lungs but also studies have shown that tuberculosis affects  bone marrow which causes significant haematological abnormalities These haematological changes acts as a potential marker for the diagnosis and persistent excretion of acid fast bacilli,which is associated with failure of these indices to return to normal.In addition ,these changes have correlation with severity of clinical findings of pulmonary tuberculosis.
AIMS AND OBJECTIVES:To evaluate haematological parameters  among pulmonary tuberculosis patient.
MATERIALS AND METHODS:This is a case control study was carriesd out for a period of 1year from January 2018 to April 2019. A total of 50 patients who are diagnosed with Pulmonary Tuberculosis were taken up as cases.  The control group consisted of 50 healthy individuals who were selected by purposive sampling. About 2 ml  EDTA tube was used for haematological analysis. Sysmex haematology analyser with 6 part  as well as peripheral smear examination was used for analysis. The remaining 2 ml of blood was used for determining ESR by westergren tube method.

Purpose: The present study was aimed to determine the prevalence of risk factors in younger patients (age <45 years) presenting with ami.
Methods: In this observational, cross-sectional study, a total of 150 patients were studied between april 2020 and june 2021 for the risk factors of ami. Patients with characteristic electrocardiographic changes suggestive of coronary artery disease, within 15-44 years of age were included and data regarding baseline clinical characteristics were reported.
Results: Maximum patients (82%) were in the age group of 35-44 years where males (73.3%) outnumbered females (26.7%).Among all the risk factors, dyslipidemia (77.3%) was the most prevalent, and significantly higher in smokers, obese (body mass index ≥25) and diabetic patients. Major complication was arrhythmia (45.3%), and anterior wall myocardial infarction was the most prevalent pattern of myocardial infarction (61.3%). Majority of patients had two risk factors and maximum number of patients i.e, 141 (94%) were discharged from hospital after treatment while 9 (6%) died.
Conclusion: The present study revealed that dyslipidemia was the major modifiable risk factor of ami in the younger population followed by sedentary lifestyle, obesity, tobacco chewing, smoking, diabetes mellitus, systemic hypertension, and family history where majority of patients had two risk factors

Background: Diarrhea is widely recognized as a major cause of childhood morbidity and
mortality in many developing countries, particularly in India. According to World Health
Organization (WHO) report, diarrheal diseases are still leading causes of mortality and
morbidity in children under five years of age.
Objective: The present study attempts to estimate the association between maternal factors
and prevalence of Acute Diarrhoeal Diseases in children below 5 years of age in Indian
settings.
Methods: This community-based, cross-sectional epidemiological and single-center study
conducted in the rural field practice area attached to Department of Community Medicine of
Topiwala National Medical College, Mumbai, Maharashtra, India from March 2017 to
February 2018 was aimed to estimate the association between maternal factors and
prevalence of Acute Diarrhoeal Diseases in children below 5 years of age in Indian settings.
Ethics approval was obtained from Ethics Committee for Academic Research Projects
(ECARP). Research tools included a pre-structured questionnaire. Baseline information of
study area was taken from the Primary Health Centre. Data was entered in Microsoft Excel
spreadsheet to perform analysis.
Results: In our study, 340 mothers who used to take bath daily of which 61(17.9%) had
diarrhoeal episodes, whereas out of 30 mothers who do not take bath daily, 15(50%) had
diarrhoeal episodes. Further, 340 mothers of children who used to wash their hands daily
before the meals of which 58(15.8%) children had diarrhoeal episodes, whereas out of 30
mothers who did not wash their hands before meals, 18(60%) children had diarrhoeal
episodes
Conclusion: The present study indicated that maternal factors bear a significant impact on
morbidity caused by diarrhea.

Introduction: Pterygium is one of the very common ophthalmic disorders with an unknown etiology and pathogenesis. Growth of pterygium into the cornea can result in visual impairment, astigmatism, loss of corneal transparency, visual axis obstruction.
Materials and methods: This cross sectional study was done on 500 patients, where demographic details was taken from all the patients including living environment, status, time outdoors, familial history, drug abuse, history of smoking, type of work and education, use of glasses. All of them underwent regular ophthalmic examinations including systemic and comprehensive examination as well as refraction.
Results: The prevalence of Pterygium was 12.6%. 35.6% of the patients were females and 64.4% were males. 51.2% belonged to the 30-39 year age group. 33.3% were farmers and 54% were manual labourers, 61.9%) of the patients had passed their high school while 28.6% were illiterate, 73% had no familial history of pterygium, 61.9% were regular smokers and 25.4% were occasional smokers. 36.5% of the patients had hypertension and 25.4% were obese.
Conclusion: Pterygium formation in our geographical area is quite high and the most common risk factor is exposure to sunlight. Male gender, hypertension and smoking also appear to be associated risk factors. Use of sunglasses may help in reduction of the prevalence of Pterygium.

Vitamin D (Vit D) deficiency has been studied among various Indian populations with conflicting results. There is a paucity of data connecting the link between Vit D deficiency among the doctors who are particularly at risk of developing and causes of increase in insulin resistance, hypertension, inflammation, and increased cardiovascular risk. Also, the association between Vit D deficiency and diabetes mellitus, hypertension, hyperlipidemia, and cardiovascular diseases is unclear. Given these observations, we would like to study the prevalence of Vit D deficiency among the doctors of Belagavi city of India.
Materials and Method: It was a cross-sectional study. The study was conducted by the department of General Medicine, Belagavi Institute of Medical Sciences Belagavi, during the period from April 2016 to March 2017. All the doctors residing in Belagavi city were included in the present study after meeting appropriate exclusion criteria. The detailed history, risk factors, and laboratory finding was noted. The informed consent was taken from each participant before inclusion in the study.
Results: 100 doctors aged between 40 to 70 years were studied. The male-to-female ratio was 62:38. Predominantly males were in the age range of 41-50 years of age. The mean age for men was 51 years with SD 6.36 years and for women were 49 years with SD 6.07 years. Cardiovascular risk factors such as diabetes was seen in 58%, hypertension in 63%, and hyperlipidemia seen in 33%.
Conclusion: The prevalence of vitamin D deficiency observed in our study was 40%. There was a significant association between diabetes mellitus and hypertension in vitamin D deficiency compared with vit D sufficiency individuals. Vitamin d deficiency is commonly seen in all age groups, therefore, strategies such as increasing awareness, and educating the masses about adequate exposure to sunlight. The need for dietary rich in vitamin D sources and fortification of foods with Vitamin D.

Background: Acute malnutrition is a public health problem of epidemic proportions.
Feeding approaches for infants who are under 6 months of age with severe acute
malnutrition should prioritize establishing, or re-establishing, effective exclusive
breastfeeding by the mother or other caregiver. The aim of this study is to identify the
various risk factors and determinants of severe acute malnutrition as defined by WHO
growth reference standards in infants aged below 6 months of age at district hospital in
Rajasthan.
Materials& Methods: A prospective observational study was conducted in the
Department of Pediatrics, District hospital, Dholpur, Rajasthan, India during one year
period. 30 comprised infants with SAM as defined by current WHO guidelines:
weight‐ for‐ length Z‐ score (WLZ) <−3 and/or bilateral nutritional oedema (WHO,
2013); the other comprised age‐ and sex‐ matched infants who were not severely
malnourished (control group) defined as WLZ≥−2to<2and mid‐ upper‐ arm
circumference (MUAC)≥125 mm.
Results:Mean age of Cases and Controls was 16.03±1.18 and 20.38±1.23 weeks
respectively. Mean length of infants was 60.3±3.12 cm in cases and 67.7±2.78 cm in
control group, which was statistically significant (P<0.05*). The statistically significant
of MUAC (mm) in between groups, which was shorter arm circumferences in
malnourished infants. The duration of exclusive breast feeds was less (8.9±1.86 weeks)
as compared to control group (20.8±4.36 weeks), which was statistically significant
(P<0.05*).Mothers of the SAM infants were significantly lighter, shorter, and had lower
MUAC than control mothers.
Conclusion: The study findings will help to increase the knowledge about the factors
associated with severe acute malnutrition. There is a statistical correlation of Severe
Acute Malnutrition with rural area, maternal Illiteracy and low socioeconomic status,
and failure of exclusive breast feeding for 6 months.

Background: Hypocalcaemia is a common complication following thyroid surgery,
cause of which is multifactorial. The aim of this study was to identify risk factors for
development of post-operative hypocalcaemia in cases of total thyroidectomy, near total
thyroidectomy, and completion thyroidectomy with or without neck dissection.
Materials and Methods: From 1st November 2020 to 31st October 2021, 40 consecutive
patients undergoing total thyroidectomy, near-total, sub-total or completion
thyroidectomy at Govt Medical College & Hospital, Suryapet were enrolled in this
prospective study, longitudinal, cohort study. The primary endpoints were the
occurrence of post-operative hypocalcaemia as by defined as a nadir corrected serum
calcium less than 8.0 mg/dL or symptomatic hypocalcaemia.
Results: 40 patients were analyzed. The average age was 42.53±15.86 years with 86.7%
female. The most common indications for surgery were benign thyroid disease (80%).
27 patients (67.5%) experienced postoperative hypocalcaemia with 14 (35 %) requiring
intravenous calcium infusion. Risk factors for postoperative hypocalcaemia included
inadvertent parathyroid removal during surgery further exemplified by the fact that
there is lesser incidence of post-operative hypocalcaemia in patients undergoing near
total thyroidectomy.
Conclusion: Patients undergoing total thyroidectomy and in whom parathyroid could
not be identified and preserved or auto transplanted may benefit from more vigilant
pre-operative preparation and postoperative calcium and vitamin D supplementation.

Introduction: Severe fever with thrombocytopenia syndrome is found to be gradually
increasing every year and it is reported to be caused by group of viruses which belong
to the group of Phlebovirus genus in Bunyaviridae family. The prime goal of this study
is to determine the risk factors in patients with SFTS and to reduce the severity of SFTS
through early intervention.
Materials and Methods: A total of 65 laboratory-confirmed cases and the complete
medical records were thoroughly checked and clinical and laboratory features were
compared. All significance tests were two-tailed and P values < 0.05 were considered
statistically significant.
Results: The major clinical manifestations of SFTS were fever (100%), fatigue (76.5%),
diarrhoea (49.02%), myalgia (47.1%), nausea (43.14%) and vomiting (31.4%). The
symptoms of central nervous system characterized by conscious disturbance were found
in 37 cases (56.9%). Bone marrow examinations were performed in 29 patients and
heteromorphic lymphocyte and haemophagocytosis could be observed in SFTS patients.
Conclusion: The identified clinical and laboratory parameters might predict severe
outcome and various novel treatment strategies such as effective vaccine or antiinflammatory
therapy are in much of necessity in people living in a SFTS prone areas

Background: Non-communicable disease (NCD) is a medical condition of non-infectious and non-transmissible nature. NCDs may be chronic diseases of long duration and slow progression. This study was carried out to assess the socio-demographic profile and risk factors of non-communicable diseases using WHO stepwise approach among adults.
Methods: A cross-sectional study was carried out among 400 adults during the period from 1st September 2015 to 31st August 2016. Study tools included a WHO stepwise approach questionnaire, Sphygmomanometer, weighing scale, non-stretchable tape and stethoscope. The data was entered and tabulated in MS-Excel 2007 and statistical analysis was performed by using Statistical Package for the Social Sciences (SPSS 22.0) and p<0.05 is considered as statistical significance.
Results: Majority belonged to 50-59 years, of which 280 (70%) were illiterates. About 319(79.8%) were married, most of them resided in nuclear families with 350 (87.5%).Many were engaged in unskilled labor mainly agricultural activities with 196(49%) and unemployment 113(28.3%). Majority was from upper lower class, followed by lower class.
Conclusion: Proportion of tobacco smoking among the study participants was 123(30.8%) in which 118(29.5%) were males and the association between smoking and gender was statistically significant. Alcohol use (59.5%) which was high among the rural population of Wardhanapet, in which males consume more amount of alcohol than females and these difference present at significant levels. Overall physical activity is high among the study participants as heavy workers were found to be (28.8%) and these differences with gender were present at significant level.

Aim: To evaluate fatty liver disease and cardiovascular diseases in type 2 diabetic patients
using ultrasonography.
Methodology: The prospective and observational study was conducted in the Department of
Radiology, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Himachal
Pradesh for the period 9 months. 300 patients diagnosed with type 2 diabetes and ultrasound
abdomen showing fatty changes in liver without any other co-morbidities were included.
Patients were divided in three groups according to the duration of the diagnosis of diabetes.
The distributions of different groups were GROUP A- less than 5 years, GROUP B-in
between 5 to 10 years and GROUP C-more than 10 years. A brief history was taken of the
patient’s complaints and then the patients Random blood sugar and BMI values, as mentioned
in the patient’s case paper were recorded and then ultrasonographic evaluation of the study
subjects was performed by a single radiologist and the following parameters were examined
after obtaining informed consent-Liver echogenicity, Portal Vein Doppler study, Mesenteric
fat pad thickness and Carotid Artery Doppler study. Study method was Interview schedule
questionnaire, OPD records, bedside tickets, physical examination and laboratory
measurements.
Results: Out of the 300 patients, 145 (48.3%) were males, and 155 (51.7%) were females.
Majority (39%) of the patients belonged to 50-60 years of age group followed by 25.7%
patients in the age group of 40-50 years. 18.3% belonged to 60-70 tears of age, 10.7% were
less than 40 years, and 6.3% belonged to more than 70 years of age. Out of the 300 cases, 225
(75%) cases had fatty liver and 75 (25%) cases had non-fatty liver. Out of the included
patients, 33.4% (100) were in group A, 40% (120) were in group B, and 26.6% (80) were in
group C. Out of 300 patients, 70 (23.3%) cases had ischemic changes, but majority of patients
(230, 76.7%) did not have ischemic changes.
Conclusion: Liver ultrasound examination should be considered in every patient with newly
diagnosed type 2 diabetes because the prevalence of NAFLD is extremely high in this group
of patients. It can be said that there was an association between cardiovascular risk factors
and NAFLD in patients with type 2 diabetes mellitus.

Background & Method: The aim of the study is to study the Complications and Associated Risk Factors of Dengue in Children. Dengue sero positive patients are selected and examined clinically for hepatomegaly and jaundice and subjected to complete blood count, liver function tests, ultrasound abdomen, PT, APTT, Widal, HBsAg, HCV and analysed. Bilirubin reacts with sulphanilic acid to produce an azo compound, the colour of which could be measured at 546 nm and this gives an estimate of concentration of bilirubin.
 
Result: In this study, Dengue has affected male and female children almost equally. Thrombocytopenia has occurred in 74% of patients with probable dengue, 98% with warning signs and 100% in severe dengue.
 
Conclusion: In developing country like India, incidence of dengue outbreaks is increasing. Hepatic involvement of varying degrees has been reported. As hepatic dysfunction in dengue is transient and reversible, early identification of the same would help to reduce life threatening complications. Dengue is a self-limiting disease that is caused by viral infection. Dengue must be well treated even if patients are asymptomatic. Complications of Dengue can be manifested in many organs, including neurological, Gastrointestinal, Hematology, Cardiac & Renal systems

Background:
     Overweight and obesity constitute a global pandemic with devastating consequences that affect >2 billion people. Obesity plays a central role in morbidity and mortality of diseases of multiple organs and systems, and it is a major contributor to the growing incidence of type 2 diabetes. There is now sufficient level of evidence for the association between overweight and type 2 diabetes, among which are the most common type 2 diabetes worldwide.  Obesity results from a combination of personal and societal factors, but is often viewed as a character flaw rather than a medical condition. This leads to stigma and discrimination towards obese individuals and decreases the likelihood of effective intervention. Conditions related to obesity are increasingly common, such as metabolic syndrome, impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), all of which indicate high risk for type 2 diabetes (T2DM). Sedentary lifestyle, unhealthy diet, and excessive alcohol intake also account for the burden of type 2 diabetes by promoting obesity. The risk of specific type 2 diabetes is also directly influenced, regardless of the magnitude of adiposity, by physical inactivity, consumption of red meat, processed meat and ultra-processed foods, dairy products, alcohol, whole grain cereals, nuts, vegetables, and fruits. The study aimed: To assess the effect of obesity and its associated risk factors on patients with type 2 diabetes who attend in primary health care center in Makkah al-Mokarramah 2021. Method: A cross-sectional study was conducted among patients with type 2 diabetes and obesity who registered in the chronic disease clinic attended diabetes centre in Makkah at Saudi Arabia in 2021. Our total participants were (300).Results: the total number of participants was 300 were males and female. The participants were classified into 3 age groups, most of them were (54.3%)in the <30 years fallowed by 39-50 years were(29.3%),  regarding gender of  participated male were (70.3%), follow by female were(29.7 %), type of treatment do you use for diabetes, results show a significant relation between BMI and what type of treatment do you use for diabetes, also complications from diabetes, results show a significant relation between BMI and complications from diabetes, Physical activities or exercise, results show a significant relation between BMI and Physical activities or exercise. Eating a portion of fruit, results a significant relation between BMI and Eating a portion of fruit, eating a portion of vegetables, results show a significant relation between BMI and Eating a portion of vegetables Conclusion: Obesity is a highly prevalent comorbidity in type 2 diabetic patients.  Some modifiable risk factors were identified. Multidisciplinary effort is warranted to reduce obesity among type 2 diabetic patients.  appears to be a better indicator of diabetic risk than BMI. The combination of a low-calorie diet, increased physical activity, and behavioral therapy as the first-line intervention for weight loss should be stressed for the effective management of T2diabetic patients.

Background: Retinopathy of prematurity (ROP) is a potentially blinding disorder of the neonates seen mostly in preterm neonates.
Objective: To study the incidence, risk factors, clinical profile and immediate outcome of neonates with ROP after screening.
Method: A prospective observational study was carried out among 336 neonates at Gandhi Medical College, Bhopal from January 2018 to June 2019. After recording detailed history of mother and neonate, eye examination and screening were performed.  Prevalence, epidemiology, clinical profile, risk factors and outcomes of ROP were assessed.
Results: The incidence of ROP in the present study was 19.94%, 31.3% babies developed stage 1 ROP, 26.8% developed stage 2 ROP, 23.3% had stage 3 ROP, 13.4% had stage 4 ROP and 5.97% had stage 5 ROP. Of the 67 babies who developed ROP 35.82% babies had spontaneous regression of ROP and developed mature retina whereas 64.18% babies required treatment of ROP.
Conclusion: Our study concludes that low birth weight, gestational age, oxygen administration, duration of oxygen exposure, mechanical ventilation, respiratory distress syndrome, surfactant use, sepsis, blood transfusion, bronchopulmonary dysplasia, and apnoea are the risk factors which play a significant role in development of ROP.

Background: Hypophosphatemia is a metabolic disorder that can have significant
consequences and is frequently undiagnosed in critically ill children. While
hypophosphatemia is typically characterized by nonspecific symptoms such as
weariness and irritation, severe hypophosphatemia (less than 1.0 mg/dl) can result
in much more severe complications including such decreased diaphragmatic
contractility and cardiac arrhythmias.
Aim of the Study: Determine the prevalence of hypophosphatemia in critically ill
children, as well as the clinical consequences and risk factors associated with the
condition throughout patients' admission in the PICU.
Patients and Methods: A case-control study that was conducted over a period of one
year, from July 2019 to June 2021, at PICU of Pediatrics Department, Zagazig
University Hospitals.The study included 180 subjects that were classified into two
groups, each of 90 subjects as follows; patients group, which included 90 cases, and
the control group, which included 90 healthy infants and children.
Results: There was a statistically significant difference in weight, height percentile,
ESR and CRP, hemoglobin level, TLC, PT, INR, alkaline phosphatase a serum,
serum creatinine, PH, serum phosphorus level, presence of hypophosphatemia
(20%), number of patients with hypophosphatemia, percent change in serum
phosphorus, as well as percent change in serum phosphorus between the studied
groups.
Conclusion: In our investigation, the obvious probable source of hypophosphatemia
was prolonged TPN decision-making as well as sepsis. In the PICU, mild to moderate
hypophosphatemia occurred. Hypophosphatemia was related with an increased
length of stay in the PICU and poor outcomes.

Background: Cholangiocarcinoma, including intra-and extrahepatic cholangiocarcinoma,
is a rare but highly lethal cancer. Despite effort in finding the risk factors of
cholangiocarcinoma, the causes of most cholangiocarcinoma remain unknown.There are
considerable geographic and demographic variations in the incidence of
cholangiocarcinoma. Although it comprises only 10-15% of hepatobiliary neoplasms, its
incidence is increasing. There are several established risk factors for CC and few are
modifiable which will help in reducing the incidence.
Aims and Objectives: To study the Prevalence and risk factors of cholangiocarcinoma at
GMC Budaun.
Material and Methods: All types of cholangiocarcinoma cases above age of 40 years
admitted to Department of Surgery, GMC Budaun U.P., were studied for risk factors over a
period of two years.
Results: An incidence of cholangiocarcinoma was 0.032% in present study. Peak incidence
of cholangiocarcinoma was 4th to 6th decade of life with mean age of 61.92 years. out of
26 patients 13 patients (50%) were smoker and in those 13 patients 12 (92%) were smoking
for more than 10 years and 13 patients (100%) were smoking more than 10 cigarettes or
bidi per day. 18 patients were using chulha (69%) for cooking meals with coal as a primary
fuel.
Conclusion: In conclusion, we found associations with PSC, smoking and alcohol
consumption; however, further studies are needed to establish the risk factors in our
country Long term exposure to pesticides in patients, who are chronic smoker and exposed
to smoke from chulha are at higher risk of developing CCA than others in this socioeconomic
scenario.

Background: Children have a more diverse and larger number of risk factors for arterial ischemic stroke (AIS) that differ significantly from adults which are predominated by hypertension, diabetes, and atherosclerosis. The aim of the present study was to inspect and conclude the most common risk factors and causes of AIS in children. Patients and methods:  A prospective cohort study included 24 patients admitted to Pediatric Department, Faculty of Medicine, Zagazig University Hospitals. Full history taking, clinical and neurological examination and routine laboratory examination were performed. Neurological outcomes were graded by the site neurologists as no deficit, mild, moderate, or severe deficits and patients were followed up.  Results: More than one half 58.3% of arterial ischemic stroke patients had single infraction, mainly at left side 45.8%, affected mainly Anterior circulation (58.3%). The vascular imaging artropathy subtype of Arterial Ischemic Stroke patients nearly two fifths was arteropathy type (12.5%) , Moyamoya, the same percent was arterial dissection. The outcome of treatment arterial ischemic stroke patients 37.5% of them became normal early. After follow up period one half of them became normal. Unfortunately 16.7% had severe deficit at early follow up and still at late follow up period. About1 patient(4.2%) died pre discharge, 2 patients (8.3%) died post discharge, 2 patients (8.3%) related to ischemia, other patient (4.2%) unrelated ischemia. Conclusion: Cardiac lesion is the most risk factors  associated  with arterial ischemic stroke, followed by arterioropathy, prothrombin disorder and diabetes.

Background and objective:Hearing impairment is often associated with pregnancy
infections such as Toxoplasma, Rubella, Cytomegalovirus (TORC). The aimswere to
determine the prevalence of hearing impairment using Otoacoustic Emissions (OAE) and
analyze the associated risk factors in neonates with dual/multiple TORC infections.
Materials and Methods:This cross-sectionalstudy was conducted from
SeptemberuntilNovember 2019. Infants admitted in the intermediate room during the
period were included in the study and underwent OAE to evaluate the presence of hearing
impairment.Infants with OAE refer tested with TORC examination. Prevalence of hearing
impairment with dual/multiple TORC infections was calculated and the Odds Ratio for
specific risk factors was measured using Fisher’s exact test.
Results: Over the period, 50 babies were screened. Forty-three babies (86%) presented
normal hearing at OAE. Seven babies (14%) response OAE refer. Out of 7 infants, one
infant classified OAE refer had early discharged, the six of them undergo TORC
examination. Out of 6 infants, 5 of them represented dual/multiple TORC infections. By
univariant analysis,the most higher risk factor for hearing impairment and dual/multiple
TORC infection was the premature rupture of membrane OR 41; 95% CI 3,65 – 46,03.
Correlation between dual/multiple TORC infection and hearing impairment was
significant statistically, p=0.001, R = 0.826.

Based on questionnaires and level of 25(OH)D in 466 children under 1 year factors for rickets was identified. Reliable factors were iron deficiency anemia during pregnancy, toxemia of pregnancy of the mother and the lack of vitamin D during first year of life of a child, lack of outdoor stay (less then 20 minutes per day), frequent colds, not effective traditional prevention of rickets vitamin D.

This study was conducted to estimate the prevalence and distinguish kinds and related factors
of Mental Disorders among elderly people attending Geriatric Clinic, Baghdad, Iraq.
Methodology: A cross-sectional study conducted and a systematic random sampling technique
was used to select 320 elderly people. We collected data on basic demographics and associated
risk factors using a questionnaire filled through self-reported questionnaire. Mental disorders
(MDs) were defined according to Kessler Psychological Distress Scale (K10) with a cutoff score
of 20+. Accredited tools used by WHO were utilized to identify mental disorders kinds. Results:
The prevalence of MDs in the study sample was 24.4%. The prevalence of MDs types were:
Depression 16.6%, anxiety 12.8%, dementia 5.3%, substance abuse 2.5%, suicide thoughts
5.6%, and suicide attempts 2.5%. Logistic regression analysis was used to examine the
determinant factors of elderly MDs revealed the following significant factors: Aging, smokers,
living depends on others, loneliness and social isolation, visual impairment, economic state
deterioration, neglect and mishandling, and chronic diseases are the determinant factors of
elderly MDs. Conclusions: Mental disorders are wide spread among elderly people and
enhanced elderly mental health care services should be provided

Globally, oral cancer is the sixth most common cancer and it is associated with a mortality
rate up to 50%. Oral cancer usually encompasses tumours derived from the lips, anterior
two-thirds of the tongue, buccal mucosa, hard palate, the floor of mouth, upper and lower
alveolar ridges, retromolar trigone, and sublingual area. An approximate age-standardized
to world population (ASR (W) for oral cavity and lip cancer according to the World Health
Organization (WHO) the topmost is South East Asia with incidence of 6.4 per 100000,
followed by Europe and East Mediterranean (4.6 cases per 100000), America (4.1 per
100000), Africa (2.7 per 100000), and Western Pacific area (2.0 per 100000).Oral
squamous cell carcinoma has multifactorial pathogenesis which includes smoking, alcohol
consumption, and HPV and others. Oral cancer has multifactorial etiology, mainly
smoking, tobacco, alcohol consumption, betel quid chewing and high-risk human
papillomavirus (HPV). Worldwide, the prevalence of HPV infection is 3% in oral cavity
cancer and has a significant role in the management of oral squamous cell carcinoma
(OSCC) as HPV-related oral cancers have shown better prognosis.
The risks of oral cancer in many developing countries had increased mainly by the habits
of using betel quid chewing, tobacco and alcohol consumption.Human papillomavirus is a
major concern and a public burden in a clinical setting all over the world. The sites
frequently involved in HPV related cancers are tonsils and base of the tongue.

Introduction: Squamous cell carcinoma (SCC)s specifically of the tongue usually is seen in the senile population with a long standing tobacco habit. But recently the trend has changed to incidence of TSCC in younger adults with no risk factors. Hence we aim to conduct a systemic review and metanalyse to assess the prevalence and risk factors of tongue carcinoma in the younger group of patients. Materials and methods: We conducted the search for the data from the online sources like the “EMBASE”, “Pubmed”, “Scopus” and other sources. Only human studies were collected. Terms searched were CBCT, microtomography, permanent teeth, and root canal morphology. The data extraction and meta-analysis were based on the PRISMA guidelines. Out of the 109 articles, only 23 were selected based on the inclusion and exclusion criteria. For the assessment of the risk factors and the variables the statistical analysi s was done keeping p<0.05 as significant. Results: we observed that most of the subjects were at ages 30-50 years. The majority of reports were <40 years of age. Almost equal gender distribution was seen. No association between the habits was seen in the younger adults.

Background: Preeclampsia is related to the inability to adapt to the physiological changes of pregnancy that result in decreased maternal organ perfusion. This complex clinical syndrome in preeclampsia can affect all organ systems such as the hemodynamic system, kidney, retina, and blood chemistry, which is manifested by increased blood pressure and protein urine.
Purpose: This study aimed to determine the correlation of the factors causing preeclampsia with blood pressure and protein urine.
Methods: This correlational study using the 127 respondents, sampling purposive sampling techniques, the independent variable factor in preeclampsia (age, genetics, history of diabetes mellitus, history of hypertension), and the independent variable blood pressure and protein urine. The measuring instrument used is a sheet checklist and analyzed by Spearman rank.
Results: The results showed the risk of preeclampsia in the age factor of 40.9% occurred in the 28-35-year-old respondents; 100% of patients had no history/genetic preeclampsia, 100% of respondents did not have a history of diabetes mellitus, and 88.9% did not have a history of hypertension. Systole blood pressure increased moderately and high by 26.0% and 22.0%, while diastolic blood pressure increased moderately and high by 26.0% and 11.0%. Respondents had positive proteinuria of 52%. The results of the analysis are not found a significant correlation between the factors of age, genetics, history of diabetes, and history of hypertension with blood pressure and preeclampsia protein urine on respondents.
Conclusion: History of hypertension associated with blood pressure and proteinuria in preeclampsia. History of hypertension is related to the condition of the blood vessels that manifest hypertension and decreased renal function (protein urine). Therefore, it is recommended in women with a history of hypertension to control blood pressure and perform routine prenatal care during pregnancy to prevent further complications.

This article details the condition of newborn babies from mothers with epilepsy.
The frequency and nature of epilepsy in children born to mothers with epilepsy are
described. Risk factors for the development of epilepsy in children born to mothers with
epilepsy were determined.

Background: Preeclampsia is related to the inability to adapt to the physiological changes of pregnancy that result in decreased maternal organ perfusion. This complex clinical syndrome in preeclampsia can affect all organ systems such as the hemodynamic system, kidney, retina, and blood chemistry, which is manifested by increased blood pressure and protein urine.
Purpose: This study aimed to determine the correlation of the factors causing preeclampsia with blood pressure and protein urine.
Methods: This correlational study using the 127 respondents, sampling purposive sampling techniques, the independent variable factor in preeclampsia (age, genetics, history of diabetes mellitus, history of hypertension), and the independent variable blood pressure and protein urine. The measuring instrument used is a sheet checklist and analyzed by Spearman rank.
Results: The results showed the risk of preeclampsia in the age factor of 40.9% occurred in the 28-35-year-old respondents; 100% of patients had no history/genetic preeclampsia, 100% of respondents did not have a history of diabetes mellitus, and 88.9% did not have a history of hypertension.Systole blood pressure increased moderately and high by 26.0% and 22.0%, while diastolic blood pressure increased moderately and high by 26.0% and 11.0%. Respondents had positive proteinuria of 52%. The results of the analysis are not found a significant correlation between the factors of age, genetics, history of diabetes, and history of hypertension with blood pressure and preeclampsia protein urine on respondents.
Conclusion: History of hypertension associated with blood pressure and proteinuria in preeclampsia. History of hypertension is related to the condition of the blood vessels that manifest hypertension and decreased renal function (protein urine). Therefore, it is recommended in women with a history of hypertension to control blood pressure and perform routine prenatal care during pregnancy to prevent further complications.

Uterine fibroids is the most common benign gynecological disease, the pathogenesis of which is not fully understood. We examined 152 women in the II clinic of the T ashkent Medical Academy. The saturation of the body with vitamin D (25 ( OH ) D ) and its relationship with concomitant obesity in patients with uterine fibroids and healthy women were studied . In less than half of women with symptomatic myoma, deficiency and severe deficiency of vitamin D prevails with concomitant obesity of varying degrees . Studying the relationship between vitamin D deficiency and excess body weight in this pathology makes it possible to predict the development of the disease, the nature of the course and the risk of possible complications.

Hepatitis C is a disease caused by enveloped, RNA virus belongs to Flaviviridae family. It causes inflammation of the liver that lead to liver cirrhosis and finally hepatocellular carcinoma. Its genome consists of open reading frame (ORF) codes for structural and non-structural proteins. The ORF have 5´ and 3´ UTR regions. Hepatitis C virus is cause of post transfusion hepatitis. Symptoms of HCV include fatigue, dark urine, belly pain, joint pain, itchy skin, sore muscles and jaundice. It is a blood-borne transmitted agent. Use of unsafe therapeutic injections also leads to HCV infection. Diagnosis of HCV infection can be done by various methods like Enzyme Immunoassay (EIA) and Recombinant Immunoblot Assay (RIBA). The aim of this study is to estimate seroprevalence of Hepatitis-C in both sexes and different age groups in hospital based general population. And to study the trends of HCV infections in a tertiary hospital located at Northern India.
A prospective study was conducted for four months (January-April) at Tertiary Hospital in Northern India. Total numbers of 1643 blood samples were screened for the presence of anti-HCV antibodies in patient’s serum. Samples were tested by HCV TRI-DOT rapid test. Positive samples were retested by SD BIOLINE HCV rapid test and confirmed by ELISA.Out of 1643, 102 (6.2%) samples were HCV positive. Among seropositive samples, 48 were males (2.9%) and 54 were females (3.2%). HCV seropositivity was shown by 40 IPD patients (2.4%), 52 OPD patients (3.1%) and 10 ICU patients (0.6%). Among departments, patients from Recovery showed (0.6%), General ward (1.0%), Private room (0.2%), Neurology lab (0.1%) and Emergency (0.3%) showed HCV seropositivity. On analyzing age-wise seropositivity, it was found that maximum seropositivity was seen in 30-40 years (2.9%) followed by >55 years (1.4%), 40-55 years (1.2%) and<30 years (0.5%). Analysis of patients on the basis of risk factors showed that 17 had history of surgical operation (1.0%), 18 had history of blood transfusion (1.0%), 6 had history of dental procedure (0.3%), 25 showed history of injecting drug use (1.5%), 21 used contaminated syringes (1.2%) and 15 patients was under haemodialysis (0.9%). Professional health worker should protect themselves while handling infected blood. Counselling and testing should be done for those who are at risk for infection.

Background and objective: Acute kidney injury (AKI) is a common complication in patients undergoing major abdominal surgery. Various recent studies reported an incidence of AKI after surgery ranging from 6.7 to 32%. Risk factors for AKI in this setting may be procedure-related factors, post-operative complications and several patient-related include age, gender, comorbid disease Diabetes Melitus (DM), Hypertension (HT), Cardiovascular disease (CVD), and physical status. This study aimed to explore the risk factors of AKI in major abdominal surgery
Methods: We conducted a systematic literature search from PubMed and Cochrane Library. We included articles describing AKI in the setting of major abdominal surgery, published from 2015 until now, and cohort study design. This review was registered with PROSPERO (CRD42020216405)
Results: From 478 articles, 4 articles met our inclusion criteria describing AKI outcomes in varied population 683-3751. Prevalence of AKI 8,8 %. Age patient risk AKI in major abdominal surgery with Mean difference was 3.04 (95% CI = 1.83-4.25; P <0.00001). Meta-analysis of the four studies showed that Male had a pooled Odds ratio (OR) of 1.79 (95% CI = 1.04-3.08; P = 0.04) , DM OR 1.64 (95% CI 1.36-2.03; P <0.00001), HT pooled OR 1.90 (95% CI = 1.30-2.78; P = 0.0009), CVD has an OR of 1.58 (95% CI = 0.91-2.75; P = 0.10), physical status ASA≥ 3 (The American Society of Anesthesiologists) score has pooled OR 1.70 (95% CI = 1.16-2.49; P = 0.007)
945
Conclusion: Risk factors of AKI in major abdominal surgery setting are higher significantly in male, and patient with comorbid disease DM and HT had a significantly high risk of AKI, as well as physical status score ASA > 3.

The aim was to study the prevalence and risk factors of dental disease development in
pregnant women living in different Uzbekistan regions. The prevalence and intensity of dental
caries among pregnant women are 1.3 times higher in the Urgenchdistrict of the Khorezm
region compared to the Kibray district of the Tashkent region. These figures increase with
each subsequent pregnancy. The same pattern is observed for periodontal and oral mucosa
diseases. The most significant medical and biological factors contributing to the development
of dental diseases in pregnant women were age, several pregnancies, intergenerational period,
course and terms of pregnancy, the presence of extragenital diseases. Among medical and
social risk factors, the most significant were education, living conditions, oral hygiene,
sanitary culture, and medical activity of pregnant women.

Abstract: The article is devoted to one of the most important problems of our time
— children whose behavior contradicts generally accepted social norms and rules, i.e.
from the point of view of the risk of their actions in relation to society. The principal
probability of leaving a teenager in the "field of deviance" is determined by the presence of
risk factors, the essence of which allows us to identify the quality of self-esteem, the level of
anxiety, aggressiveness and affillation as criteria for the development of social competence
of children at risk. The article discusses the concept of "children at risk", explains the
reasons for getting children into the "risk group". Also, the author describes the main
value orientations of this group, especially in the development of adolescents included in it.

The authors conducted a study on the risk factors for glomerulonephritis in children. Some regional features of glomerulonephritis in children have been established: the frequency is significantly higher among rural children; comorbid forms predominate in the clinical picture; chronic glomerulonephritis prevails in the structure of renal diseases; in virus-associated glomerulonephritis, the role of aggressive risk factors is the pathological course of pregnancy (OR-2.45, CI 99%, P<0.001), operative delivery (OR-1.33, CI 95%, P<0.01), TORCH infection of parents (OR-1.93; DI 95%, P<0.01), ECD and atopic dermatitis in the child (OR-1.43; DI 95%, P<0.01), frequent SARS in the anamnesis (OR-1.09; DI 95%, P<0.01), hemorrhagic vasculitis (within the last 3 months) (OSH-1.17; CI 95%, P<0.01), insect Allergy (OSH-1.27; CI 95%, P<0.01), chickenpox (within the last 3 months) (OSH-1.06; CI 95%, P<0.01), hypothermia (OSH-1.24; CI 95%, P<0.01) and a severe history (OSH-1.36; CI 95%, P<0.01).

Depression in postpartum is a high prevalence psychiatric illness that is weakening. This thesis aimed at examining the preceding reports. We have stated that studies examining postpartum depression risks by searching the database, Scopus, PubMed, ScienceDirect, Update and Proquest, published in 2000-2015 papers on postpartum depression factors in Farsi and English have been reviewed. A mixture of keywords included postpartum depression and risk factors or obstetric history, social and biological factors. Search strategy The literature review indicated that postpartum depression risk factors were observed in the field of economic and social factors, obstetric and biologic history, mental illness style and history. Data can be used in this study to develop a screening method for women with a high risk and to develop preventive programmes.

Relevance: The high prevalence, high risk of social maladjustment as a result of the consequences of acute cerebrovascular accident and, accordingly, one of the main causes of mortality gives cerebrovascular pathology a special status, as evidenced by numerous publications. the task was to identify in the studied patients the entire spectrum of clinical manifestations corresponding to the lesions of the brain structures supplied by the blood vessels of VBD and to determine the presence of a statistically significant dependence of clinical manifestations of COPD. As well as the identification of risk factors and their influence on the rehabilitation of patients with stroke in the vertebrobasilar system.
Patients with IS in VBD and COPD - 62 people (group I) - 29 men and 33 women aged 50 to 74 years (59.8 ± 5.8). Patients with IS in VBD - 64 people (group II). Of these, 31 were men and 33 were women aged 51 to 80 years (62.4 ± 5.4). All patients received traditional treatment in the most acute and acute periods of IS, patients with COPD received COPD treatment in parallel with traditional IS therapy. in group I, BMI averaged 29.3 ± 5.8 kg / m2, in men - 28.9 ± 6.3 kg / m2, in women - 29.9 ± 5.1 kg / m2 (the difference is not significant, p = 0.58), while 11 patients (17.7%) had a normal BMI, 1 patient (1.6%) had a body weight deficit, 26 patients (41.9%) had preobesity, 15 patients (24, 2%) had first degree obesity, 9 patients (14.5%) had second degree obesity. Accordingly, preobesity or obesity was recorded in 50 patients of group I (80.65%) (Figure 3.3)
And in group II, BMI averaged 28.7 ± 6.1 kg / m2, in men - 27.8 ± 5.7 kg / m2, in women - 30.1 ± 5.6 kg / m2 (the difference is not significant, p = 0.6), while 17 patients (26.6%) had a normal BMI, 3 patients (4.7%) were found to be underweight, 29 patients (45.3%) had preobesity, 8 patients (12 , 5%) had first degree obesity, 7 patients (10.9%) had second degree obesity. Accordingly, preobesity or obesity was recorded in 44 patients of group II (68.8%). In patients of group I, among the clinical manifestations of IS in PBS, ataxia prevailed, which occurred in 35 patients (56.5%), including hemiataxia, which occurred in 20 patients (31.3%). Paresis and paralysis of the limbs were detected in 31 patients (50%). Complaints about a subjective feeling of unsteadiness, instability in an upright position, and imbalance occurred in 25 patients (40.3%). Dysarthria also occurred in 25 cases (40.3%). Nystagmus was detected in 22 cases (35.5%), rotational dizziness (vertigo) - in 20 cases (32.3%), depression of consciousness - in 21 cases (33.9%). Symptoms such as hemianopsia and ophthalmoparesis occurred each in 14 cases (22.6%). Sensory disorders were detected in 12 patients (19.4%), autonomic disorders - in 8 patients (12.9%), diplopia - in 8 patients (12.9%), dysphagia - in 7 patients (11.3%) , aphasia and headache - 6 patients each (9.7% each), dysphonia - 7 patients (11.3%), confusion and visual agnosia - 4 patients each (6.5% each), respiratory failure - 3 patients (4.8%). There were also 2 cases (3.2% each) of amnesia, ignorance syndrome and a feeling of generalized weakness.

The disturbance of neuropsychological processes during pregnancy and parturition may cause postpartum depressions in vulnerable individuals. Pre-natal and psychological and instrumental needs are indicated to be poorly met in western society and this crisis can interfere with neurophysiological factors to undermine the functioning of maternal psychology. In relation to neuropsychological women's wellbeing in the time of the transition, the effects of developmental factors and psychological and physical stressors are addressed. The psychobiological shift from pregnancy to successful post-natal parenting, the reconstruction of family and job roles, can be assisted, disregarded and derailed in the environmental milieu. Determining how psychosocial factors impact the link between violence and postpartum depression (PPD) history. Women have received B48 hours of live-born child care from four urban hospitals in Utah. The history has been collected by self-reporting during enrollment of physical or sexual assault. There have also been collected psychosocial covariates, including stressors and depression. Pregnancy stressors were classified using the Pregnancy Risk Assessment System's "stressor" questions. A pre-defined Edinburgh Postnatal Depression Scale score of C12 for 6-8 weeks after partition was taken as the key result indicator. Psycho-social threats were widespread among 1,038 women tested: 11.7% violence history, pregnancy strainors–financial 49.1%, emotions 35%, partnership-associated 19.8%, and traumas 10.3% and history of depression 16.7%. Interestingly, the experience of violence was just one of women with a moderate degree of stressors. Missuse and pregnancy stressors are normal and affect the probability of PPD positive testing.

Abstract: Objective: to study the risk factors, clinical and pathogenetic features for the
subtypes of ischemic stroke at a young age in a comparative aspect. During 2017-2019, 74
patients with ischemic stroke (IS) or transient ischemic attack (TIA) were under
observation, 48 men and 26 women. All patients were divided into 2 groups: I-st (main)
group included 33 patients aged 20 - 44 years (aged of 40.5 ± 3.1 years); II-nd
(comparative) group - 41 patients age group over 60 years (aged of 67,9±3,9 years).
According to the TOAST criteria, a stroke of an unknown etiology occurred in young
people (49%), in old-aged - cardioembolic (39%) and atherothrombotic subtypes (31%).
Among the risk factors for ischemic stroke in young people revealed a combination of bad
habits, and in the old-aged category, such modulated factors as arterial hypertension, 2nd
type of diabetes mellitus, hypercholesterolemia are revealed. These findings confirm the
urgency of the problem of cerebral infarction of a young age and the need for further
implementation of the latest examination methods and a deeper study of the cardiovascular
system.

Background: Tuberculosis (TB) is still a global problem. The high incidence of TB is due to the less than optimal TB risk factor interventions. This study aims to analyze the risk factors for TB incidence in the coastal area of the lake, Towuti District, East Luwu Regency.
Methods: This study used a case-control design conducted in the coastal area of the lake, Towuti District, with a sample of 34 cases and 94 controls. Bivariate analysis and logistic regression were used to analyze the risk factors for the incidence of tuberculosis.
Results: The results showed that the significant risk factors for TB incidence were family history (OR = 13,920; 95% CI: 4,36–51,23), household contacts (OR = 3.04; 95% CI: 1.188–7,809), close contact (OR = 8.382; 95% CI: 2.969–24, 852), home ventilation (OR = 14.357; 95% CI: 1.585–669.82), income (OR = 2.609; 95% CI: 1.033–6.675) . Home ventilation is the most dominant risk factor for TB incidence in the coastal area of the lake in Towuti District.
Conclusion: TB disease control strategies based on risk factors need to be implemented in coastal areas.

Based on questionnaires and level of 25(OH)D in 466 children under 1 year factors for rickets was
identified. Reliable factors were iron deficiency anemia during pregnancy, toxemia of pregnancy of the mother and the lack of vitamin D during first year of life of a child, lack of outdoor stay (less then 20 minutes per day), frequent colds, not effective traditional prevention of rickets vitamin D.

Congenital anomalies are the structural and functional irregularities at birth. In this progressive study, all the neonates who are admitted to the Neonatal Intensive Care Unit during the three year period from 1st June 2017 to 31 May 2020.
Aim: The study aims to examine the prevalence, type, and epidemiological factors of congenital anomalies among the population of Ladakh India.
Subject and methods: All the neonates during the study period were examined by pediatrics and questionnaire filled by the consent of the family. A total of 936 parents of neonates was agreed to participate in this study and among them, 524 are male neonate and 412 was female.
Results: Four and a half percent were diagnosed as being congenital malformed and the common system affected by congenital anomalies in the digestive system followed by the mucso-skeletal system. In this study, based on the logistic regression consanguineous marriage with OR of 9.862 (4.221; 23.041), P= <0.001, familial congenital anomalies in the family with OR of 17.008 (4.343; 66.606), P=0.001, an anaemic mother with OR of .124 (.029; .538). P = .005, Apgar score with .033 (.016: .067), P-value of <0.001 and paternal smoking with OR of 13.305 (5.558: 31.854) with P value of <0.001 had shown a very good significant correlation with the congenital anomalies.
Conclusion: The occurrence and distribution of congenital anomalies in Ladakh were reported. More active prenatal screening and the possible role of genomics study are major importance to uncovering the susceptibilities.

Pregnancy has some physiological changes which complicate the process of diagnosis and treatment. Over 200 million people suffer from anaemia especially among women of reproductive age. Anaemia is a major health problem among pregnant and non-pregnant women. Anaemia during pregnancy is considered as a public health problem especially in developing countries. The World Health Organization (WHO) defined anaemia during pregnancy as a haemoglobin concentration of less than 11g/dl. In severe anaemia, the haemoglobin level is 6g/dl. Anaemia threatens both mother and foetus. The causes may be multifactorial, such as nutrient deficiency, parasitic infections or chronic infections. It may also be due to acute blood loss. It may also depend on geographical location and economic status. The effects of anaemia on mothers are tiredness, weakness, dizziness and affects the immune system. In children, it may cause preterm delivery, low birth weight. On both the mother and the fetus it can cause mortality and morbidity. Intake of balanced diet and awareness programmes on anaemia is a measure to prevent anaemia. This study is to evaluate the awareness and prevalence of anaemia among pregnant women. A cross-sectional survey was conducted containing a set of self-developed questionnaires. The data was collected and analysed using SPSS software. The results are analysed and tabulated. The result was gained as follows, 25% of the participated population‟s haemoglobin level is less than 11, 75.89% of the population participated are aware that anaemia can affect pregnant women, 66.07% of the population agree that haemoglobin level less than 11 can cause anaemia. From the study, it is obvious that there is an awareness between the effects of anaemia during pregnancy.

Oral cancer is one of the most common major debilitating diseases affecting the world community.It is one the most commonest form of cancer in south asia especially countries like India,pakistan,bangladesh are most affected.This occurs mainly due to habits like smoking,gutkha and paan chewing and areca nut.most of people affected were between age groups third and sixth decades,so they are also prone for the systemic diseases.this will further complicate both the treatment plan,treatment.added to this, their postoperative complications and prognosis all depends on comorbid conditions like systemic diseases.so the aim of the study is identify the prevalence and risk factors associated with oral cancer .This is an Retrospective study.In this study a total 86000 patients records were analysed and after fulfilling the inclusion and exclusion criteria,a total of 53 patients from Department of Oral Oncology , Saveetha Dental College, who were diagnosed as oral cancer were considered for this study.Subjective and objective observations are recorded that includes age, gender, habits and systemic diseases of oral cancer patients. Period of study is from June 2019 to March 2020.All the datas of the patients were reviewed by an external reviewer and were tabulated.Statistics done with Chi Square test using SPSS.The results obtained in this study indicates that habits 39% and systemic diseases 45% were associated with oral cancer.Habits and systemic diseases are strongly correlated with oral cancer, these are risk factors for prevalence of oral cancer. Within the limitations of the study there are significant risk factors like habits and systemic diseases that are associated with the causation of oral cancer which has direct implications on the severity of disease and this will also enable us to pave the way for providing better comprehensive treatment for oral cancer.

Background:
      Diabetes mellitus and obesity are key risk factors for long-term complications associated with type 2 diabetes mellitus. Previous studies have shown that the prevalence of diabetes mellitus and obesity is high in the KSA. However, none of these studies has focused on the investigation of diabetes mellitus and obesity in Makkah patients with type 2 diabetes mellitus. Obesity and diabetes mellitus are known to contribute directly or indirectly to the development of long-term complications of type 2 diabetes mellitus. Obesity is a serious public health concern all over the world. In KSA obesity is on rise and if proper intervention and preventive strategies were not adopted of obesity will prove fatal. Obesity among type 2 diabetic patients has proven to have adverse effects in management and control of diabetes and a considerable proportion of type 2 diabetic patients have been reported to be obese in different settings, which increase the risk of complications among them.
Aim of the study: To assesment of the prevalence and associated risk factors of obestiy among type II diabetic patients in the primary health care center in Makkah Al-Mukarramah 2019.
Method: A cross-sectional study was conducted at AL-Eskan PHC, among type II diabetic patients and obesity attending in the AL-Eskan PHC Makkah among a random sample of type 2 diabetic and obesity patients registered in the chronic disease clinic. Our total sample size will be 200 patients
. Results:  the majority of our participants were have increase BMI (obese) were constitutes (59.0 %), while normal BMI participants were constitute (40.0 %). the majority of our study are male’s gender in our study was (59.0%). the majority nationality Saudi was (87.0%)
Conclusion: Physical activity probably contains a larger role in promoting health in weighty populations than antecedently thought and should confer substantial reductions in sickness burden. Future analysis might examine prospectively whether or not increase in physical activity in unhealthy weighty adults will cause a healthier standing.

Knee osteoarthritis (KOA) accounts for nearly four-fifths of osteoarthritis (OA) worldwide and increases with obesity and age¹Osteoarthritis (OA) is one of the most common causes of pain and disability, representing a significant burden for the individual and for society
Methods: A community based cross sectional study was conducted to find out the prevalence of Knee Osteoarthritis among rural population of age group above 40 years and also to find out the association between risk factors and prevalence of Knee OA with the sample of 370 by simple random sampling
Result: The prevalence of  knee osteoarthritis was found to be 31.6% in our study The  prevalence was found to be highest in the age group70 and above. The prevalence  of knee OA in females was more than the males. The lifestyle risk factor like DM and BMI ≥25 was found to be significantly associated with knee OA. (p <0.05).
Conclusion:The prevalence of knee osteoarthritis was found to be highest among elderly (>70) population, more common in females, significantly associated with obesity