Gastroschisis annual incidence, mortality, and trends in extreme Southern Brazil

Abstract Objective: To analyze gastroschisis annual incidence, mortality rates, and trends in the Brazilian state of Rio Grande do Sul from the year 2000 to the year 2017. Method: Population-based study with the analysis of the temporal trend of gastroschisis annual incidence and mortality rates. Data were obtained from the Live Birth Information System and the Mortality Information System, with the analysis performed by polynomial regression modeling. Results: There were 2,612,532 live births, 705 hospitalizations, and 233 deaths due to gastroschisis. The annual incidence of gastroschisis was 2.69 per 10,000 live births. The annual incidence rate increased by 85% in the total period (p = 0.003), and mortality was 33% in the 2000-2017 period. Maternal age < 25 years was a risk factor for gastroschisis (p < 0.001). Children were more likely to be born weighing < 2,500 g (p < 0.001) and with a gestational age < 37 weeks (p < 0.001). The annual incidence trend was to increase, and the mortality trend was to decrease. Conclusion: Similar to what has been described in several regions/countries, there was a trend showing an 85% increase in the annual incidence of gastroschisis (p = 0.003) and the mortality was 33% with a trend of decreasing (p = 0.002).

Incidence & management practices of snakebite: A retrospective study at Sub-District Hospital, Dahanu, Maharashtra, India

This study was undertaken to know the incidence and management practices of snakebite envenomation at the First Referral Unit - Sub-District Hospital, Dahanu, Maharashtra, India. Retrospective analysis of snakebite case records (n=145) was carried out for one-year period (January to December 2014). The annual incidence of snakebite was 36 per 100,000 population with case fatality rate of 4.5 per cent. Venomous snakebites were 76 per cent and non-venomous snakebites were 24 per cent. Overall, snakebites were more common in males (52.4%) than females (47.6%). Majority of the snakebites (66%) were in the age group of 18-45 yr. Seasonal variation was observed with highest snakebites in monsoon (58%). Lower extremities were the most common site of bites (63%). Neurotoxic and vasculotoxic envenomation were reported in 19 and 27 per cent snakebite cases, respectively. Anti-snake venom (ASV) was administered at an average dose of 7.5±0.63 vials (range 2-40, median 6). There was no uniform protocol followed for ASV administration as per the National Snakebite Management Protocol of Government of India (2009).

Incidence of seizures due to degenerative phase of neurocysticercosis: A study in a cohort of primary school children in south India

@#Objective: To study the incidence of seizures due to degenerative phase of neurocysticercosis (NCC) in a cohort of primary school children in south India. Methods: The study cohort included 7,408 (age 5-15 years, boys 44.5% and girls 55.5%) children registered on roles on the date of start of study. The children were followed through first to fifth standard for new-onset of seizures. The data collected included demographic data, date of seizure, any antecedent events, seizure semiology, neurologic findings, 40 minutes EEG findings, and contrast CT brain findings. This analysis is limited to seizures due to degenerative phase of NCC. The average annual incidence rates (AAIR) and 95% confidential intervals (CI) were calculated. Results: During the study period, of the 58 children with new-onset seizure, 19 (32.7%) had seizure due to degenerative phase of NCC [mean age 9.42 years; range7-13 years; 8 boys and 11 girls]. Contrast CT scans in all the 19 children showed solitary cysticercus granuloma (SCG). The common seizure type by mode of onset was focal. The AAIR of seizure disorder was 36.64 (95%CI 22.1-57.2) per 100,000. All the children received antiepileptic drug treatment and four weeks of albendazole and steroids. The seizure disorder resolved with the resolution of the lesion on follow-up CT scan and AEDs were withdrawn. Conclusions: In this highly selective cohort of primary school children from low economic strata, the AAIR of seizure disorder due to degenerative phase of NCC, SCG was high. Seizure disorder due to SCG has an enduring predisposition for seizure recurrence and need AEDs for the period of resolution of lesion and AEDs could safely be withdrawn with the resolution of the lesion.

Epidemiologic Study on Kawasaki Disease in Korea, 2007-2014: Based on Health Insurance Review & Assessment Service Claims

The aim of this study is to assess the actual epidemiologic features of Kawasaki disease (KD) in Korea using the data from Health Insurance Review & Assessment Service (HIRA) claims from 2007 to 2014. We investigated HIRA claims of patients who had KD (International Classification of Diseases-10, M30.3) as a major diagnosis and were given intravenous immunoglobulin (IVIG) from 2007 to 2014. A total of 39,082 patients were reported during the period. The male-to-female ratio was 1.42 and the median age was 28 months. The incidence rates were 168.3 per 100,000 population aged 0 to 4 years in 2007, 159.1 in 2008, 167.3 in 2009, 190.4 in 2010, 188.2 in 2011, 190.2 in 2012, 210.4 in 2013 and 217.2 in 2014. These rates were much higher than those in the previous studies in Korea. KD occurred more often in early summer (May, June and July) and winter (December and January). The annual incidence rate of KD had been increasing every year, reaching 217.2 per 100,000 population aged 0 to 4 years in 2014. It is the second highest incidence rate of KD in the world after Japan.

Domestic Accidents in an Urban Health Training Centre.

The present study was carried out to characterize the occurrence of domestic accidents and to find out the common local practices to manage domestic accidents. It was a longitudinal study conducted in the health training centre area of Community Medicine Department, RIMS, Imphal having a total households of 712 with a population of 4241. Each family was visited two monthly for a period of one year. Domestic accident was taken as an unintentional injury or injuries occurring at home and its premises. Data were recorded in a semi-structured and pre-tested questionnaire and face to face interview was conducted from the affected individuals or from the available eldest adult or responsible person belonging to the particular household in case of children. There were a total of 2257 males and 1948 females comprising of 53.7% and 43.3% of the study populations respectively. Two hundred and eighty seven domestic accidents were recorded during the study period with the annual incidence rate of 68.3 per 1000 population per year. The occurrence of domestic accidents was significantly higher in the age group 6-14 years (49.5%) and people living in kutcha houses (57.1%). Cuts and lacerations (57.1%) was the most common accident encountered followed by falls (18.5%), burn and scald (13.6%). In majority of these accidents, health care providers were not consulted as the accidents were not usually severe. The study reported no disability and mortality resulting from domestic accidents. The practices of the people to manage domestic accidents like application of lime, toothpaste and turmeric paste to open wounds are potentially hazardous. However, they are aware of some of the basic first aid procedures like immobilization of bone injury and application of pressure to stop bleeding.

A Study for Incidence of Childhood Leukemia in Kyongnam Province, Korea / 대한소아혈액종양학회지

PURPOSE: Of the cancers in childhood, leukemia is the most frequent one. For the desirable control of childhood leukemia, the basic data for the incidence has a great importance. The authors made a report about the incidence of leukemia in childhood, which analyzed the data from 126 cases in Kyongnam province, Korea, during 1991~1995. METHODS: The data were obtained from 126 new cases of childhood leukemia who had been living in the Kyongnam province and were diagnosed at the 26 university hospitals or general hospitals in the Kyongnam area and other cities from 1991 to 1995. RESULTS: The age-and-sex adjusted annual incidence rate per 100,000 population during 1991~1995 varied from 1.82 to 2.86, and cumulative annual incidence rate was 2.41 (male 2.26 and female 2.57 respectively). Male to female sex ratio was 1:1 in total cases. By the major types of childhood leukemia, the cases were composed of acute lymphocytic leukemia 70.6%, acute myelocytic leukemia 26.9% and chronic myelocytic leukemia 2.5%. The cumulative annual incidence rate per 100,000 population (crude rate) during 1991~1995 were 2.77 in Ulsan city, 2.62 in Chinju city and 2.34 in the whole area of Kyongnam province. CONCLUSION: It was concluded that the age-and-sex adjusted annual incidence rate per 100,000 of childhood in Kyongnam province was 2.41, which was lower than that in Pusan city in the same period. And, there was no significant difference of the cumulative annual incidence rate between Ulsan area and Chinju area in the same period.

An Analytic Study for Incidence of Childhood Leukemia in Pusan City, Korea / 대한소아혈액종양학회지

BACKGROUND: Cancer is the second cause of childhood death following accident, and leukemia is the most frequent childhood cancer in Korea. For the desirable control of childhood leukemia, of which the mortality is still high, the basic data for the incidence has a great importance. This is the second report from the data during 1991~1995 following the first one that analyzed the data from 328 cases of childhood leukemia during 1981~1990 in the same area, Pusan city, Korea. METHODS: The data were obtained from 138 new cases(84 males and 54 females from 0 to 15 years old) of childhood leukemia who had been living in the city of Pusan and were admitted to the 4 university hospitals and 11 general hospitals from 1991 to 1995. The cases were confirmed by CBC and bone marrow examination. RESULTS: The crude annual incidence rate per 100,000 population varied 1.50~5.30, 2.59~6.00 and 1.58~2.61 in the age group of 0~4 years, 5~9 years and 10~14 years, respectively. The standardized annual incidence rate per 100,000 population varied from 2.05 to 3.46(male 2.96~4.89, female 0.98~3.57). Sex ratio(male to female) was 1.58:1, 1.44:1, and 1.82:1 in total cases, ALL and AML, respectively, while incalculable in CML. By the major types of childhood leukemia, the cases were composed of 105 ALL (76.1%), 31 AML(22.5%), 2 CML(1.4%). CONCLUSION: It was concluded that the annual incidence rate of childhood leukemia per 100,000 population in Pusan city during 1991~1995 was similar to that of previous report during 1981~1990, while the proportion of ALL had tendency to increase up to that of United States, in contrast to the low proportions of ALL in the previous reports.

National Survey of Injury and Poisoning on a Representative Sample Population of Koreans / 예방의학회지

Despite the public health importance of injury and poisoning in terms of its high mortality and incidence, epidemiologic information to be utilized are scarce in Korea. This study was carried out in 1990 on a representative sample population (about 55,000 persons) along with the 6th National Tuberculosis prevalence survey in order to estimate the magnitude of injury and poisoning occurrence and to identify its epidemiologic characteristics which can be aided for establishing preventive strategy pre-tested and structured questionnaire was used by trained interviewer to collect data including general information of the person, various information on the injury and poisoning during the past one year such as time and place of its occurrence, its nature and external causes, type of medical institute attended, duration of treatment and outcome of the accident occurred. In analysis of the data collected incidence rates per 1000 persons by sex, age group and its nature as well as external causes and relative frequencies were calculated. The result obtained are as follows; 1. The incidence rate per 1000 was 30 for both sexes, 39 for male and 22 for female, male being 1.8 times more frequent than female. Age adjusted incidences were not much different from the crude rates. Age group specific rate curve showed binodal shape in both sexes, small peaks in preschool children and higher peaks in older ages. The incidence rate per 1000 people by area was highest in Jeon-bug province (57/1000) and the lowest in Daegu city (11/1000). 2. The place where the injuries occurred were road in 46%, with the boundary of house in 25 %, and working place in 12%. The injuries and poisoning had occurred more frequently during the months from March to August of the year than other months. 3. The relatively frequent injuries by its nature were contusion with intact skin surface (19%), fracture of upper limb (13%), open wound of head neck and trunk (12%) and fracture of lower limb (11%) among males: contusion with intact skin surface (28%), sprains and strains of joints and adjacent muscle(14%), fracture of upper limb(10%) and fracture of lower limb (9%) among females. Higher incidence rate among males than females were fracture of skull(4.5times) open wound and fractures of limbs (2-3 times). Age specific rate of injuries and poisoning by its nature showed increasing pattern by age in fractures of upper and lower limbs and sprains & strains of joints whereas the age group of 30's showed highest incidence in open wounds of upper limb. Fractures of radius and ulna in upper limb, fractures of tibia & fibula and ankle in lower limb were most frequent among fractures of upper and lower limbs. The frequent injuries among sprains and strains of joints and adjacent muscles were that of ankle, foot and back and among open wound were that of head and fingers. 4. Relative frequency of injuries and poisoning by external causes showed following order: other accidents(25%), accidental falls (23%), motor vehicle accident (22%) and other road vehicle accident (l4%) among males and accidental falls (37%), motor vehicle accident (24%) and other accident (l8%) among females. The external causes revealing higher incidences among males than females, were other road vehicle accident (4.8times), vehicle accident not elsewhere classifiable (4.4 times), accidental poisoning (4.4 times), accidents due to natural and environmental factors (2.8times), and suicide & self-inflicted injuries (2.8 times). Age specific incidence by external causes for frequent injuries showed that incidence of other accident steadily increased from 10's till age 50's; motor vehicle traffic accident increased from age 20's and dropped after age 60's; on the other hand accidental fall increased strikingly by age. The most frequent external causes among motor vehicle traffic accidents was motor vehicle traffic accident involving collision with pedestrian (69%), pedal cycle accident (30%) and other road vehicle accident (71%) among other road vehicle accidents; falls on same level from slipping, tripping or standing (44%) and other falls from one level to another among accidental falls; accidents caused by machinery (32%) for male and striking against or struck accidentally by objects or person for female among other accidents. 5. seventy nine percent of the injuries and poisonings were treated in general hospital or hospital/clinic. The duration of treatment ranged from a few days to 123 weeks; the majority (52%) took under 2 weeks, 36% for 3-8 weeks and 40% over 21 weeks. 6. The accident resulted in full recovery of normal healthy state in 62%, residual functional defects in 21% and on process of treatment in 16%.