Background: and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. Methods: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). Results: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. Conclusions During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.

The Kisalaya cohort was established in 2008, providing integrated antenatal care (ANC) and human immunodeficiency virus (HIV) testing in order to reduce adverse birth outcomes and pediatric HIV infections. The program used a mobile clinic model to deliver health education, ANC, and HIV/sexually transmitted infection testing and management to pregnant women in rural communities in southern India. This cohort includes pregnant women residing in 144 villages of the Mysuru taluk (a rural region) who received ANC through the mobile clinic and delivered their infants between 2008 and 2011. Of the 1,940 women registered for ANC at primary healthcare centers during this time period, 1,675 (75.6%) were enrolled in the Kisalaya cohort. Once women enrolled in the Kisalaya cohort gave birth, the cohort expanded to include the mother-infant dyads with a retention rate of 100% at follow-up visits at 15 days and at 6 months post-delivery. The baseline data collected during the Kisalaya study included both questionnaire-based data and laboratory-based investigations. Presently, a study entitled “Early life influences on adolescent mental health: a life course study of the Kisalaya birth cohort in south India” is in the process of data collection (2019-2020).

The Kisalaya cohort was established in 2008, providing integrated antenatal care (ANC) and human immunodeficiency virus (HIV) testing in order to reduce adverse birth outcomes and pediatric HIV infections. The program used a mobile clinic model to deliver health education, ANC, and HIV/sexually transmitted infection testing and management to pregnant women in rural communities in southern India. This cohort includes pregnant women residing in 144 villages of the Mysuru taluk (a rural region) who received ANC through the mobile clinic and delivered their infants between 2008 and 2011. Of the 1,940 women registered for ANC at primary healthcare centers during this time period, 1,675 (75.6%) were enrolled in the Kisalaya cohort. Once women enrolled in the Kisalaya cohort gave birth, the cohort expanded to include the mother-infant dyads with a retention rate of 100% at follow-up visits at 15 days and at 6 months post-delivery. The baseline data collected during the Kisalaya study included both questionnaire-based data and laboratory-based investigations. Presently, a study entitled “Early life influences on adolescent mental health: a life course study of the Kisalaya birth cohort in south India” is in the process of data collection (2019-2020).

BACKGROUND: An inability to cope with threatening dental stimuli, i.e., sight, sound, and sensation of airotor, manifests as anxiety and behavioral management problems. Behavior modification techniques involving pre-exposure to dental equipment will give children a first-hand experience of their use, sounds, and clinical effects. The aim of this study was to compare the techniques of Tell-Show-Play-doh, a smartphone dentist game, and a conventional Tell-Show-Do method in the behavior modification of anxious children in the dental operatory. METHODS: Sixty children in the age group of 4-8 years, with Frankl's behavior rating score of 2 or 3, requiring Class I and II cavity restorations were divided into three groups. The groups were Group 1: Tell-Show-Play-doh; Group 2: smartphone dentist game; and Group 3: Tell-Show-Do technique and each group comprised of 20 children. Pulse rate, Facial Image Scale (FIS), Frankl's behavior rating scale, and FLACC (Face, Leg, Activity, Cry, Consolability) behavior scales were used to quantify anxious behavior. Operator compliance was recorded through a validated questionnaire. RESULTS: The results showed lower mean pulse rates, lower FIS and FLACC scores, higher percentage of children with Frankl's behavior rating score of 4, and better operator compliance in both the Tell-Show-Play-doh and smartphone dentist game groups than in the conventional Tell-Show-Do group. CONCLUSION: The Tell-Show-Play-doh and smartphone dentist game techniques are effective tools to reduce dental anxiety in pediatric patients.
Anxiety ; Behavior Rating Scale ; Behavior Therapy ; Child ; Compliance ; Dental Anxiety ; Dental Equipment ; Dentists ; Heart Rate ; Humans ; Leg ; Methods ; Pediatric Dentistry ; Sensation ; Smartphone ; Weights and Measures

BACKGROUND: Dental anxiety in children is a major barrier in patient management. If dental anxiety in pediatric patients is assessed during the first visit, it will not only aid in management but also help to identify patients who are in need of special care to deal with their fear. Nowadays, children and adults are highly interested in multimedia and are closely associated with them. Children usually prefer motion pictures on electronic devices than still cartoons on paper. Therefore, this study was conducted to evaluate a newly designed scale, the animated emoji scale (AES), which uses motion emoticons/animojis to assess dental anxiety in children during their first dental visit, and compare it with the Venham picture test (VPT) and facial image scale (FIS). METHODS: The study included 102 healthy children aged 4–14 years, whose dental anxiety was measured using AES, VPT, and FIS during their first dental visit, and their scale preference was recorded. RESULTS: The mean anxiety scores measured using AES, FIS, and VPT, represented as mean ± SD, were 1.78 ± 1.19, 1.93 ± 1.23, and 1.51 ± 1.84, respectively. There was significant difference in the mean anxiety scores between the three scales (Friedman test, P < 0.001). The Pearson's correlation test showed a very strong correlation (0.73) between AES and VPT, and a strong correlation between AES and FIS (0.88), and FIS and VPT (0.69), indicating good validity of AES. Maximum number of children (74.5%) preferred AES. CONCLUSION: The findings of this study suggest that the AES is a novel and child-friendly tool for assessing dental anxiety in children.
Adult ; Anxiety ; Child ; Dental Anxiety ; Humans ; Motion Pictures as Topic ; Multimedia ; Pediatric Dentistry ; Weights and Measures

Between 2006 and 2010, in 16 randomly selected villages in rural areas of Mysore district, in south India, 8,457 subjects aged 30 and above were screened for symptoms of chronic respiratory disease. Of the 8,457 subjects, 1,692 were randomly invited for further evaluation of lung function and chronic obstructive pulmonary disease (COPD) by spirometry, and 1,085 of these subjects underwent lung function assessments for prevalent COPD and its risk factors. These 1,085 subjects, who were then aged between 35 and 80 years, constituted the Mysuru stUdies of Determinants of Health in Rural Adults (MUDHRA) cohort. Among other findings, threshold of biomass fuel smoke exposure suitable for use as a dichotomous risk factor for the diagnosis of chronic bronchitis was established, with a minimum biomass smoke exposure index of 60 found to be significantly associated with an elevated risk of developing chronic bronchitis. Five years later (between 2014 and 2016), 869 of the 1,085 participants were followed up with repeat lung function assessments for incident COPD and all-cause mortality. A subset of these participants (n=200) underwent blood tests for vitamin D levels, antioxidant activity, an assessment for anxiety and depression, and another subset (n=98) underwent a bioplex assay for 40 serum cytokines.
Adult ; Anxiety ; Asthma ; Biomass ; Bronchitis, Chronic ; Cohort Studies ; Cytokines ; Depression ; Diagnosis ; Hematologic Tests ; Humans ; India ; Lung ; Lung Diseases ; Mortality ; Pulmonary Disease, Chronic Obstructive ; Risk Factors ; Smoke ; Smoking ; Spirometry ; Vitamin D

BACKGROUND: The sight of dental injection can bring about severe anxiety in children. Therefore, an alternative method that is convenient, effective, and keeps the needle hidden making it child friendly is necessary. The objective of the study was to compare the efficacy of a camouflaged syringe and conventional syringe on behavior and anxiety in 6–11-year-old children during local anesthesia administration. METHODS: The study was a randomized, crossover clinical study including 30 children. Children were separated into two groups. Group 1 consisted of 15 children aged 6–8 years while group 2 consisted of 15 children aged 9–11 years. This study involved two sessions wherein all the children were injected using conventional and camouflaged syringes in separate sessions. Their behavior was assessed using the Faces, Legs, Activity, Cry, Consolability (FLACC) behavior pain scale and anxiety was assessed by measuring changes in pulse rate. Patient and operator preferences were compared. RESULTS: The results showed a lower mean change in pulse rate and FLACC scores in the camouflaged group, suggesting a positive behavior and lesser anxiety with camouflaged syringes than with conventional syringes. CONCLUSIONS: The use of camouflaged syringes for anesthesia was demonstrated to be effective in improving the behavior of children and decreasing their anxiety, and is therefore recommended as an alternative to the use of conventional syringes for local anesthesia.
Anesthesia ; Anesthesia, Local ; Anxiety ; Child ; Clinical Study ; Heart Rate ; Humans ; Leg ; Methods ; Needles ; Pediatric Dentistry ; Syringes

Between 2006 and 2010, in 16 randomly selected villages in rural areas of Mysore district, in south India, 8,457 subjects aged 30 and above were screened for symptoms of chronic respiratory disease. Of the 8,457 subjects, 1,692 were randomly invited for further evaluation of lung function and chronic obstructive pulmonary disease (COPD) by spirometry, and 1,085 of these subjects underwent lung function assessments for prevalent COPD and its risk factors. These 1,085 subjects, who were then aged between 35 and 80 years, constituted the Mysuru stUdies of Determinants of Health in Rural Adults (MUDHRA) cohort. Among other findings, threshold of biomass fuel smoke exposure suitable for use as a dichotomous risk factor for the diagnosis of chronic bronchitis was established, with a minimum biomass smoke exposure index of 60 found to be significantly associated with an elevated risk of developing chronic bronchitis. Five years later (between 2014 and 2016), 869 of the 1,085 participants were followed up with repeat lung function assessments for incident COPD and all-cause mortality. A subset of these participants (n=200) underwent blood tests for vitamin D levels, antioxidant activity, an assessment for anxiety and depression, and another subset (n=98) underwent a bioplex assay for 40 serum cytokines.

Between 2006 and 2010, in 16 randomly selected villages in rural areas of Mysore district, in south India, 8,457 subjects aged 30 and above were screened for symptoms of chronic respiratory disease. Of the 8,457 subjects, 1,692 were randomly invited for further evaluation of lung function and chronic obstructive pulmonary disease (COPD) by spirometry, and 1,085 of these subjects underwent lung function assessments for prevalent COPD and its risk factors. These 1,085 subjects, who were then aged between 35 and 80 years, constituted the Mysuru stUdies of Determinants of Health in Rural Adults (MUDHRA) cohort. Among other findings, threshold of biomass fuel smoke exposure suitable for use as a dichotomous risk factor for the diagnosis of chronic bronchitis was established, with a minimum biomass smoke exposure index of 60 found to be significantly associated with an elevated risk of developing chronic bronchitis. Five years later (between 2014 and 2016), 869 of the 1,085 participants were followed up with repeat lung function assessments for incident COPD and all-cause mortality. A subset of these participants (n=200) underwent blood tests for vitamin D levels, antioxidant activity, an assessment for anxiety and depression, and another subset (n=98) underwent a bioplex assay for 40 serum cytokines.
Adult* ; Anxiety ; Asthma ; Biomass ; Bronchitis, Chronic ; Cohort Studies ; Cytokines ; Depression ; Diagnosis ; Hematologic Tests ; Humans ; India* ; Lung ; Lung Diseases ; Mortality ; Pulmonary Disease, Chronic Obstructive ; Risk Factors ; Smoke ; Smoking ; Spirometry ; Vitamin D

Given that the germline mutations of BRCA1 and BRCA2 confer genetic susceptibility to cancer, the genetic variations, polymorphisms or mutations are widely analyzed in Western countries. However, in Asian population, the prevalence of BRCA1 and BRCA2 polymorphisms is very limited. In Asia, breast cancer occurs in women early with an age of onset under 50 years. This review comprises the incidence of BRCA1 and BRCA2 polymorphisms in the Japanese, Korean and Malaysian population. Founder mutations of BRCA1 and BRCA2 were also compared to mark the genetic difference in these populations. The mutational analysis performed to analyze the entire coding region of BRCA1 and BRCA2 include the next generation sequencing and full sequencing of all exons and intron-exon junctions. From the diagnosis of triple negative breast cancer (TNBC) patients, TNBC is associated with the lack of tailored therapies and the treatment option available for TNBC patients is mainly chemotherapy. The poor prognosis of TNBC leads to determine the predictive biomarkers in order to develop treatment efficacy. This review will address the current clinical therapies available to treat TNBC patients.