Search

Background: We explored the association between ionizing radiation (IR) from pre-natal and post-natal radio-diagnostic procedures and brain cancer risk within the MOBI-kids study. Methods: MOBI-kids is an international (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, New Zealand, Spain, The Netherlands) case-control study including 899 brain tumor (645 neuroepithelial) cases aged 10-24 years and 1,910 sex-, age-, country-matched controls. Medical radiological history was collected through personal interview. We estimated brain IR dose for each procedure, building a look-up table by age and time period. Lifetime cumulative doses were calculated using 2 and 5 years lags from the diagnostic date. Risk was estimated using conditional logistic regression. Neurological, psychological and genetic conditions were evaluated as potential confounders. The main analyses focused on neuroepithelial tumors. Results: Overall, doses were very low, with a skewed distribution (median 0.02 mGy, maximum 217 mGy). ORs for post-natal exposure were generally below 1. ORs were increased in the highest dose categories both for post and pre-natal exposures: 1.63 (95% CI 0.44-6.00) and 1.55 (0.57-4.23), respectively, based on very small numbers of cases. The change in risk estimates after adjustment for medical conditions was modest. Conclusions: There was little evidence for an association between IR from radio-diagnostic procedures and brain tumor risk in children and adolescents. Though doses were very low, our results suggest a higher risk for pre-natal and early life exposure, in line with current evidence. © 2020

Introduction: We used data from MOBI-Kids, a 14-country international collaborative case–control study of brain tumors (BTs), to study clinical characteristics of the tumors in older children (10 years or older), adolescents and young adults (up to the age of 24). Methods: Information from clinical records was obtained for 899 BT cases, including signs and symptoms, symptom onset, diagnosis date, tumor type and location. Results: Overall, 64% of all tumors were low-grade, 76% were neuroepithelial tumors and 62% gliomas. There were more males than females among neuroepithelial and embryonal tumor cases, but more females with meningeal tumors. The most frequent locations were cerebellum (22%) and frontal (16%) lobe. The most frequent symptom was headaches (60%), overall, as well as for gliomas, embryonal and ‘non-neuroepithelial’ tumors; it was convulsions/seizures for neuroepithelial tumors other than glioma, and visual signs and symptoms for meningiomas. A cluster analysis showed that headaches and nausea/vomiting was the only combination of symptoms that exceeded a cutoff of 50%, with a joint occurrence of 67%. Overall, the median time from first symptom to diagnosis was 1.42 months (IQR 0.53–4.80); it exceeded 1 year in 12% of cases, though no particular symptom was associated with exceptionally long or short delays. Conclusions: This is the largest clinical epidemiology study of BT in young people conducted so far. Many signs and symptoms were identified, dominated by headaches and nausea/vomiting. Diagnosis was generally rapid but in 12% diagnostic delay exceeded 1 year with none of the symptoms been associated with a distinctly long time until diagnosis. © 2020, The Author(s).

Background: Skin diseases are a common problem in community. Fixed-dose combinations (FDCs) are defined as a combination of two or more active ingredients within a single dosage form. In skin diseases, FDCs are used frequently in different dosage forms. Aim and Objective: This study aims to study and assess the prescribing pattern and cost analysis with emphasis on FDCs in dermatologic practice. Materials and Methods: A cross-sectional, observational study was carried out at the outpatient Department of Dermatology at GCS Medical College, Hospital and Research Centre. Prescriptions of 500 patients were analyzed for common skin conditions and prescribing patterns. All the data were compiled into Microsoft Office Excel and a descriptive statistical analysis was carried out. Results: Males and females were 259 (51.8%) and 241 (48.2%), respectively, with a mean age of 33 ± 16.6 years. Most of them had infectious diseases (26%). Out of total 1933 prescribed drugs, 724 (37.4%) were FDCs and 1209 (62.5%) were single drug. The average number of FDCs per prescription was 1.44 ± 0.61. Out of 724 FDCs, oral formulations were 245 (33.8%) and topical was 479 (66.1%). Vitamins and minerals were the most common class of drugs prescribed (22.6%) as FDCs. In comparison, the mean cost of FDCs was found to be significant as with single drugs (P < 0.05). Conclusion: Infectious diseases are the most common skin ailments. Use of FDCs in skin conditions is very common, particularly in topical formulations. Similarly, nutrients prescribed in skin conditions are also usually in the form of FDCs.

Introduction: Excessive Daytime Sleepiness (EDS) and sleep problems are common in patients with schizophrenia. The symptom of EDS in schizophrenia can be attributed to various causes including neurobiological changes, sleep disorders, medication or as a symptom of schizophrenia itself. EDS as a symptom in schizophrenia has been understudied. Aim: To assess the prevalence of EDS and to the study the same in patients with first episode and chronic schizophrenia. Materials and Methods: In this cross-sectional study 100 patients suffering from schizophrenia as per International Classification of Diseases (ICD-10) criteria were evaluated for sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and EDS using the Epworth Sleepiness Scale (ESS). The severity of illness was assessed by Positive and Negative Symptom Scale for Schizophrenia (PANSS) while cognition was assessed using the Frontal Assessment Battery (FAB) and the Trail Making Test A and B. The data was statistically analysed. Results: A total of 100 patients (72 male and 28 female) aged 18 to 64years (mean age 30.63 years) were studied. Poor sleep quality (PSQI > 6) was exhibited by 83% of patients. Excessive daytime sleepiness (ESS > 7) was found in 32% of patients. There was no statistically significant difference in various parameters according to the age, duration of illness or gender. However, first episode patients differed in having better sleep quality than patients with chronic schizophrenia (p=0.0002). Cognition was not affected by sleep quality. Conclusion: A high prevalence of sleepiness and poor sleep quality was noted in the entire sample but it did not have any correlation with age and gender. It also did not affect the cognitive test scores. Further research in this area is warranted.

The rapid increase in mobile phone use in young people has generated concern about pos- sible health effects of exposure to radiofrequency (RF) and extremely low frequency (ELF) electromagnetic fields (EMF). MOBI-Kids, a multinational case-control study, investigates the potential effects of childhood and adolescent exposure to EMF from mobile communi- cations technologies on brain tumor risk in 14 countries. The study, which aims to include approximately 1,000 brain tumor cases aged 10-24 years and two individually matched controls for each case, follows a common protocol and builds upon the methodological experience of the INTERPHONE study. The design and conduct of a study on EMF expo- sure and brain tumor risk in young people in a large number of countries is complex and poses methodological challenges.This manuscript discusses the design of MOBI-Kids and describes the challenges and approaches chosen to address them, including: (1) the choice of controls operated for suspected appendicitis, to reduce potential selection bias related to lowresponse rates among population controls; (2) investigating a young study population spanning a relatively wide age range; (3) conducting a large, multinational epidemiologi- cal study, while adhering to increasingly stricter ethics requirements; (4) investigating a rare and potentially fatal disease; and (5) assessing exposure to EMF from communication technologies. Our experience in thus far developing and implementing the study protocol indicates that MOBI-Kids is feasible and will generate results that will contribute to the understanding of potential brain tumor risks associated with use of mobile phones and other wireless communications technologies among young people. © 2014.