Obesity is a global health crisis affecting developing nations, including India. The management of obesity continues to evolve with newer drugs, metabolic and bariatric surgery and endoscopic interventions, requiring family physicians and specialists to adapt their clinical practice accordingly. There is an urgent need for a standardized algorithm to diagnose, stage, and treat obesity. The Endocrine Society of India (ESI) and the Obesity Surgeons Society of India (OSSI) appointed a steering committee to develop an evidence-based algorithm for managing patients with obesity in India. This was put to vote by 80 specialists (38 from OSSI and 42 from ESI) in a physical meeting. A proposed stage-wise algorithm based on Edmonton Obesity Staging System, Asian definition of obesity, and resources in India, received 100
Obesity in India is rising rapidly, with higher body fat at lower BMI and younger age compared to Western populations, leading to earlier onset of type 2 diabetes and cardiovascular disease in a resource-constrained health system. Protocols for obesity care therefore need to address region-specific challenges and ensure culturally acceptable, feasible treatment options. The Obesity and Metabolic Surgery Society of India (OSSI) and the Endocrine Society of India (ESI) jointly developed India-specific obesity management protocols using a modified Delphi consensus. A protocol development team generated 73 statements based on literature review and expert experience. Seventy-eight experts (38 OSSI, 40 ESI) participated; 100
e22517 Background: Tracheal, Bronchus, and Lung Cancer (TBL) are the primary causes of death and disability in the United States, accounting for nearly 25% of all neoplasm-related deaths. Among various risk factors, occupational exposure (OE) to carcinogens is a growing concern. Methods: Using Standardized global burden of disease methodologies, we estimated death, disability adjusted life years (DALYs), years lived with disability (YLDs), due to TBL cancer attributable to OC stratified by age, sex, year and location across the USA from 1990-2021. Results: From 1990-2021, the annual percentage change (APC) showed a general decline, with total number of deaths decreasing by -0.35%, DALYs by -0.86%, and YLDs by -0.17%. At the regional level, notable variations were observed: Alaska experienced the highest increase in death APC due to arsenic exposure +0.97%, while all states showed a decrease attributable to asbestos. Nevada recorded the highest increase in death APC from beryllium exposure (+0.09%) with a general increasing trend across all states. Both Wyoming and Nevada observed a +0.02% increase due to cadmium exposure. South Dakota saw a +0.17% increase due to chromium, and Alabama recorded a +0.43% increase from diesel engine exhaust. A declining trend was noted for nickel across all states. Utah had a +0.23% increase due to exposure to polycyclic aromatic hydrocarbons (PAH), and Alaska showed a significant rise of +1.19% from silica exposure. Age-wise, those 55 and older saw reductions in APC for deaths (-0.28%), DALYs (-0.75%), and YLDs (-0.09%). The 20-54 year age group noted more pronounced declines in death (-2.87%), DALYs (-2.95%), and YLDs (-2.28%). Gender analysis revealed that females had increased APC for deaths (+0.92%), DALYs (+0.35%), and YLDs (+1.15%), while males exhibited a declining trend. Conclusions: The study demonstrates an overall reduction in health burdens from 1990-2021, marked by declines in deaths, DALYs, and YLDs. Despite these gains, regional and demographic disparities highlight the continued impact of OE, particularly in states like Alaska and Nevada, and among different age groups and genders. These findings stress the need for targeted policies and improved safety standards to address persistent occupational health risks and achieve equitable health outcomes. Annual percentage of change in total number of deaths, DALYs and YLDs due to TBL cancer attributable to occupational carcinogens from 1990-2021. TBL cancer Attributable to OC APC (%), (1990-2021)Deaths APC (%),(1990-2021), (DALYs) APC (%),(1990-2021), (YLDs) Arsenic -0.43 -0.67 +0.05 Asbestos -0.35 -0.93 -0.22 Beryllium +0.04 -0.19 +0.55 Cadmium -0.35 -0.59 +0.13 Chromium -0.24 -0.48 +0.25 Diesel engine exhaust +0.11 -0.13 +0.61 Nickel -0.55 -0.79 -0.08 Polycyclic aromatic hydrocarbons (PAH) -0.18 -0.42 +0.32 Silica -0.59 -0.83 -0.12
Objective: To estimate the prevalence of common oral mucosal lesions among adults with major systemic diseases and to quantify associations with diabetes, autoimmune disease, chronic kidney disease (CKD), HIV infection, polypharmacy, and xerogenic medications. Materials and Methods: In a prospective cross-sectional study at a university dental hospital (January–December 2024), 300 consecutive adults referred for oral medicine evaluation underwent standardized history, medication review, and mucosal examination by calibrated clinicians. Systemic conditions were confirmed from medical records. Primary outcomes were the presence of xerostomia (symptoms plus unstimulated whole saliva <0.1 mL/min), candidiasis (clinical ± smear), oral lichen planus (OLP), lichenoid drug reaction (LDR), leukoplakia, traumatic ulcer, recurrent aphthous stomatitis (RAS), angular cheilitis, atrophic glossitis, oral hairy leukoplakia (OHL), and uremic stomatitis. Bivariate associations used Fisher’s exact test; adjusted associations used multivariable logistic regression. Oral health–related quality of life (OHIP14) and pain VAS (0–100) were exploratory outcomes. Results: Mean age was 49.9 ± 14.2 years; 57.0% were female. Systemic conditions included diabetes (39.0%), hypertension (44.0%), CKD (9.0%), autoimmune disease (5.3%), anemia (11.7%), and HIV (2.3%). Xerostomia (27.0%) and candidiasis (13.7%) were most frequent, followed by traumatic ulcer (13.3%), RAS (12.0%), OLP (8.3%), leukoplakia (4.7%), and LDR (4.0). Xerogenic medications were strongly associated with xerostomia (OR 3.03; p<0.001). OLP showed a marked association with autoimmune disease (OR 29.89; p<0.001). Tobacco use trended toward association with leukoplakia (OR 3.09; p=0.054). Adjusted models confirmed significant effects of xerogenic medications on xerostomia (aOR 3.12; p<0.001), autoimmune disease on OLP (aOR 29.37; p<0.001), and tobacco on leukoplakia (aOR 3.22; p=0.036). Conclusion: Medications and systemic immune-mediated conditions strongly shape the oral lesion profile. Routine medication review and targeted screening for xerostomia, candidiasis, and OLP should be integrated into care of medically complex patients.
Skin diseases impact lives physiologically, socially and psychologically compromising quality of life (QoL). Nails are important epidermal appendages and their disorders contribute to a decrease in QoL. Hence, it is imperative to assess their impact. To study the modified DLQI in patients with nail disorders. A single-centre, questionnaire based cross-sectional study was conducted at a tertiary care outpatient department over 18 months. Patients with diagnosed nail disorders in the age group of 18-60 years, of either sex, were included in the study and administered a pre-validated questionnaire (designed based on the Dermatology Life Quality Index (DLQI) questionnaire and validated by a departmental pilot study). Based on the responses marked, the total score was calculated, and patients were categorised into specific band groups, namely, 0-1 = No effect on QoL, 2-5 = small effect, 6-10 = moderate effect, 11-20 very large effect and 21-30 = extremely large effect. Data were analysed using the Statistical Package for the Social Sciences version 22.2 and correlated with the clinicodemographic profile. A total of 200 patients completed the study. Onychomycosis was the most common presentation (52.5%), followed by acute paronychia (23.5%) and nail psoriasis (18%). Higher modified DLQI scores were found in females with fingernail involvement, students and housewives. The number of nails affected and the duration of nail disorders followed an inverted bell-shaped pattern, with higher modified DLQI scores observed at both the lower and higher extremes. Overall, the impact of nail disorders showed a moderate effect on mean modified DLQI with a mean (range) of 6.9 (6-10). Nail disorders, having a prolonged disease and treatment course had a moderate effect on the modified DLQI.
