Early age of onset of mood,anxiety and alcohol use disorders is associated with sociodemographic characteristics and health outcomes in adults: results from a cross-sectional national survey

Purpose

This cross-sectional study investigated distribution, sociodemographic correlates, and health outcomes in early versus late age of onset (AOO) of mood, anxiety, and alcohol use disorders in Singapore.

Methods

The Composite International Diagnostic Interview established lifetime diagnoses of major depressive, bipolar, generalized anxiety, obsessive compulsive and alcohol use disorders in a representative sample of residents aged 18 years and over (n = 6126). The AOO of the individual and any mental disorders were classified into early and late onset using median values as cut-offs. Data included socio-demographic and health background, health utility score, and productivity losses. Multivariable logistic regression analysis was conducted to assess sociodemographic correlates of early versus late AOO of any mental disorder while linear regression analysis investigated the associations between AOO of individual disorders with health utility score and productivity loss.

Results

Respondents’ mean (SD) age was 45.6 (16.5) years, comprising 50.5% women and majority of Chinese ethnicity (75.8%). The median AOO for any of the five studied disorders was 21 years (IQR: 15–29). Lowest AOO was observed for obsessive compulsive disorder (Median: 14, IQR: 11–26). Those aged 35 years and over (versus 18–34) were less likely to have earlier AOO [35–49 years (OR: 0.287; 95% CI: 0.154–0.534); 50–64 years (OR:0.156; 95% CI: 0.068–0.361) and 65 and over (OR:0.112; 95% CI:0.027–0.461)], while Malay ethnicity (versus Chinese) (OR: 2.319; 95% CI: 1.384–3.885) and being never married (versus married) (OR: 2.731; 95% CI: 1.493–4.993) were more likely to have early AOO for any mental disorder. Sample with early (versus late) AOO had a lower health utility score (β =  − 0.06,95% CI: − 0.08 to − 0.03) and higher number of days cut down on the type of work (β = 1.61,95% CI: 0.12–3.10) in those with any mental disorders.

Conclusion

This study showed that half of the adults with mood, anxiety or alcohol use disorders in Singapore experienced their illness onset by 21 years of age. Early AOO is associated with sociodemographic background and poor health outcomes. Prevention, early detection, and interventions to improve health outcomes in mental disorders should consider the sociodemographic profile and age at first onset of symptoms in the population.

     

Comparison of PD-L1 Expression in Oral Squamous Cell Carcinoma and Premalignant Lesions of Oral Cavity

Objective: Objectives of this study were to compare  expression of Programmed Death-Ligand 1(PD-L1) protein in oral squamous cell carcinoma (OSCC) and oral potentially malignant disorder (OPMD) cases; and to compare the PD-L1 protein expression in histological grades of OSCC and also in OPMD’s with Dysplasia and without Dysplasia. Materials & Methods: In this study,  25 cases of Oral squamous cell carcinoms, 25 cases of Oral Potentially Malignant Disorders and 10 cases of non-neoplastic oral mucosa (control) cases were included. FFPE blocks of OSCC and OPMD cases were contributed by Department of Pathology, Histopathology Division,Pakistan Institute of Medical Sciences, Islamabad. Immunohistochemical staining of cases with PD-L1 monoclonal antibody (1:100; Dako) was carried out at Histopathology division , PMC Labs,  Peshawar Medical College,Peshawar, Riphah International University, Islamabad . Epithelial cells (membranous and cytoplasmic) positivity was observed for PD-L1 Antibody. Data was analyzed in SPSS version20. For qualitative variables frequencies and percentages were calculated whereas for quantitative variables means and standard deviations were recorded. The Chi-square test was applied to evaluate the significant difference in categorical variables . p-value of ≤0.05 was taken as significant. Results: PD-L1 expression in OSCC cases turned out to be 48% (n=12/25) as compared to 8% of OPMD cases (n=2/25) with a significant p value of 0.002 and all non-neoplastic oral mucosa cases were negative. PD-L1 expression in high grade OSCC cases was quite high (61% n=11/18) as compared to low grade OSCC (14% n=1/7) cases with a significant p value of 0.035. Conclusion: A statistically significant increased PD-L1 expression was noted in  OSCC as compared to OPMD. Expression of PD-L1 was more intense in high grade OSCC cases. The relation of PD-L1 expression to age ,gender or location of OSCC and OPMD cases , and presence of dysplasia in OPMD cases was statistically not significant.     

IL-22: a promising candidate to inhibit viral-induced liver disease progression and hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is a growing concern all over the world. With the number of patients rising exponentially with each passing day, HCC is a problem that needs immediate attention. Currently, available treatment strategies focus on controlling the damage after the development of HCC. The options available from chemo- and radio-embolization to surgical resection and transplantation are not efficacious as required due to the complex nature of the disease. Liver regeneration and tissue healing are the subject of great interest today. Interleukin-22 (IL-22) is a cytokine with the ability to regenerate and therefore reverse the injuries caused by a wide range of agents. IL-22 acts via STAT molecule and controls the activity of a wide variety of cell survival and proliferation genes. Experimental data has given a positive insight into the role of IL-22 in inhibition of viral and alcohol-induced hepatocellular carcinoma. A further insight into the nature of IL-22 and the factors that can be manipulated in controlling the activity of IL-22 can help to counter the menace caused by the devastating effects of HCC.     

DNA damage in workers exposed to lead using comet assay

Lead (Pb) is a ubiquitous and toxic metal. Secondary Pb recovery unit workers are prone to possible occupational Pb exposure. Hence, this investigation was conducted to assess the genotoxic effect of Pb exposure in these workers. In the study, 45 workers were monitored for DNA damage in blood leucocytes. Simultaneously 36 subjects were used as control group in this study. All the subjects were estimated for Pb content in whole blood by ICP-MS. The alkali single cell gel electrophoresis assay (comet assay) was adopted for detecting the DNA damage. The air inside the premises of the unit had Pb concentrations of 4.2 microg/m(3). The level of DNA damage was determined as the percentage of cells with comets. The mean Pb content was found to be significantly higher in the study group (248.3 microg/l) when compared with the controls (27.49 microg/l). Significantly more cells with DNA damage (44.58%) were observed in the study group than in the control persons (21.14%). Smoking had a significant effect on DNA damage in the control group whereas an insignificant effect was noticed in the exposed workers. Study as well as the control group failed to show a significant effect on DNA damage with age (P>0.05). Pb content and years of exposure significantly correlated with DNA damage in the study group (r=0.602, r=0.690; P<0.01). The increased levels of DNA damage observed in the exposed workers, justifies the use of the comet assay for the evaluation of genotoxic effects in humans exposed to Pb.     

Evaluation of genetic damage in workers employed in pesticide production utilizing the Comet assay

The use of pesticides has been increasing in recent years, resulting in the need for increased production of pesticides. However, some pesticides may represent a hazard to human health, especially by causing cancer. Genotoxicity tests form an important part of cancer research and risk assessment of potential carcinogens. Therefore, in the current study the potential DNA damage associated with exposure to pesticides of Indian pesticide production workers was assessed using the single cell gel electrophoresis assay or Comet assay. Blood leukocytes of a group of 54 pesticide workers and an equal number of control subjects were examined for genotoxicity in this study. The two groups had similar mean ages and smoking prevalences. The mean comet tail length was used to measure DNA damage. The exposed workers had significantly greater mean comet tail lengths than those of controls (mean +/- SD 19.17 +/- 2.467 versus 8.938 +/- 2.889, P < 0.001). Smokers had significantly larger mean tail lengths than non-smokers (19.75 +/- 2.52 versus 18.26 +/- 2.13, P = 0.024). Analysis of covariance showed that occupational exposure (P < 0.05) and smoking (P < 0.05) had significant effects on mean tail length, whereas age and gender had no effect on DNA damage. The present study suggests that occupational exposure to pesticides and smoking can cause DNA damage. This investigation confirms the sensitivity of the Comet assay.     

Post-partum follow-up of women with gestational diabetes mellitus: effectiveness,determinants, and barriers

Background: Despite the recommendations for postpartum blood glucose monitoring post gestational diabetes mellitus (GDM); scientific evidence reveals that these recommendations may not be fully complied to. This study aimed to follow-up women up to 2 years post-delivery with pregnancies complicated by GDM and healthy controls to assess this fact.

Methods: Women with GDM (n?=?78) and normal glucose tolerant (n?=?89) delivered in 2014 were followed up for 2 years. They were informed and enquired via telephone about their blood glucose screening, physical activity, postpartum complications, and current weight status of mother and baby.

Results: Women with previous GDM were older and reported higher body weight 2 years post-delivery. At the 2?year follow-up, n?=?11 (14.1%) participants had developed diabetes, all with previous GDM. Both weight at birth (3.8?±?0.5?kg) and at 2-year (10.7?±?2.3?kg) for the babies born to GDM mothers was significantly higher than the NGT group babies (2.6?±?0.63 and 7.1?±?1.4?kg; p?Conclusions: The high incidence of T2DM in women with previous GDM is an alarming finding. Given this trend, systematic follow-up programs are needed to reduce obesity and diabetes risk.