Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
Visit old site
Home Print this page Email this page Small font size Default font size Increase font size
Users Online: 195


 
 Table of Contents  
RESEARCH LETTER
Year : 2016  |  Volume : 8  |  Issue : 4  |  Page : 191-193

Seasonal variation of rectal foreign bodies: Data from nationwide inpatient sample


Department of Internal Medicine, Reading Health System, West Reading, Pennsylvania, USA

Date of Web Publication8-Apr-2016

Correspondence Address:
Paras Karmacharya
Reading Health System, 6th Avenue and Spruce Street, West Reading, Pennsylvania 19611
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1947-2714.179959

Rights and Permissions
  Abstract 

Background: Seasonality is noted in various aspects of human behavior and functioning which have led to an increasing interest in their seasonality in the recent years. Aims: We aimed to examine the seasonal variation in the incidence of rectal foreign bodies in the US using a large inpatient database. Methods: We used the Nationwide Inpatient Sample database to identify patients aged ≥18 years admitted with a primary diagnosis of the rectal foreign body from 2009 to 2011. We used the Edward's recognition and estimation of cyclic trend method to study the seasonal variation of the incidence of rectal foreign body and Z-test to compare the seasonal incidences. Results: A total of 3359 hospitalizations with primary diagnosis of the rectal foreign body were reported from 2009 to 2011. The peak incidence of rectal foreign bodies was seen in October (peak/low ratio 1.20, 95% confidence interval [CI]: 1.10-1.32). Conclusion: Data on seasonal variation of rectal foreign bodies are extremely limited. Further studies would be required to verify whether our findings of a higher incidence in the fall season are reflective of acute changes in the length of the days, climate, sleep-wake cycle, or decreased sexual intercourse at this time of the year. High suspicion at this time of the year may help promptly diagnose and avoid unnecessary investigations.

Keywords: Nationwide Inpatient Sample, rectal foreign body, seasonal variation


How to cite this article:
Pathak R, Karmacharya P, Alweis RL. Seasonal variation of rectal foreign bodies: Data from nationwide inpatient sample. North Am J Med Sci 2016;8:191-3

How to cite this URL:
Pathak R, Karmacharya P, Alweis RL. Seasonal variation of rectal foreign bodies: Data from nationwide inpatient sample. North Am J Med Sci [serial online] 2016 [cited 2019 Nov 22];8:191-3. Available from: http://www.najms.org/text.asp?2016/8/4/191/179959


  Introduction Top


Seasonality is noted in various aspects of human behavior and functioning which have led to an increasing interest in their seasonality in the recent years. Rectal foreign body insertion has been extensively described in the literature, with the earliest description dating back as long as the sixteenth century (Haft and Benjamin) and earliest case report published in 1919. The incidence is increasing [1] with up to 589 cases reported in the literature, and many more unreported cases presenting to the hospital. [2] A variety of human behaviors such as sexual gratification (most common), criminal assault or accident, and self-treatment of anorectal disease have been implicated. [2],[3] Various theories on the effect of climatic changes including changes in air pressure, temperature, solar activity, and humidity have been postulated to affect human behavior and disorders relating to these. [4] We aimed to examine the seasonal variation in the incidence of rectal foreign bodies in the US using a large inpatient database.


  Methods Top


We used the Nationwide Inpatient Sample (NIS) database to identify patients aged ≥18 years admitted with the primary diagnosis of the rectal foreign body (International Classification of Diseases, 9 th Revision, Clinical Modification code 937) from 2009 to 2011. NIS is the largest publicly available all-payer inpatient care database in the United States and is sponsored by the Agency for Healthcare Research and Quality as a part of Healthcare Cost and Utilization Project. We used the Edwards recognition and estimation of cyclic trend method [5] to study the seasonal variation of the incidence of rectal foreign body and Z-test to compare the seasonal incidences. Edwards's method was used to generate a fitted curve to a time series of monthly frequencies and generate the estimates of the seasonal intensity of occurrence (peak-to-low ratio).


  Results Top


A total of 3359 hospitalizations with the primary diagnosis of rectal foreign body were reported from 2009 to 2011. The peak incidence of rectal foreign bodies was seen in October (peak/low ratio 1.20, 95% CI: 1.10-1.32) [Figure 1] and [Table 1].
Figure 1: Seasonal trend for rectal foreign body admissions, 2009-2011

Click here to view
Table 1: Monthly distribution of rectal foreign body admissions, 2009-2011

Click here to view



  Discussion Top


Seasonal variation has been increasingly studied in various human behaviors. One of the first studied patterns was a higher number of suicides [6] and hospitalizations for affective disorders [7] described in the spring, followed by the fall. Similarly, the onset of affective episode in bipolar patient [8] and use of electroconvulsive therapy [7] were also found to be more common during the same time. Our study found the highest incidence of rectal foreign body admissions in autumn. Rapid changes in the length of the days might disturb the circadian and sleep-wake cycles and lead to disruptive behaviors in the at-risk individuals. Furthermore, interestingly, one of the studies found the highest frequency of sexual intercourse in spring and summer; and lowest frequency in winter. [9] Whether rectal foreign body insertion as a means of sexual gratification occurs due to less sexual activity in the fall is a hypothesis that would require further study.


  Conclusion Top


Data on seasonal variation of the rectal foreign bodies are extremely limited. Further studies would be required to verify whether our findings of a higher incidence in the fall season are reflective of acute changes in the length of the days, climate, sleep-wake cycle, or decreased sexual intercourse at this time of the year. High suspicion at this time of the year may help promptly diagnose and avoid unnecessary investigations.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Kurer MA, Davey C, Khan S, Chintapatla S. Colorectal foreign bodies: A systematic review. Colorectal Dis 2010;12:851-61.  Back to cited text no. 1
    
2.
Yoshie N, Nakao A, Ishimaru E, Terashima M, Yamada T, Kotani J. Unusual rectal foreign bodies: A case report and review of published works. Acute Med Surg 2014;1:61.  Back to cited text no. 2
    
3.
Kasotakis G, Roediger L, Mittal S. Rectal foreign bodies: A case report and review of the literature. Int J Surg Case Rep 2012;3:111-5.  Back to cited text no. 3
    
4.
de Graaf R, van Dorsselaer S, ten Have M, Schoemaker C, Vollebergh WA. Seasonal variations in mental disorders in the general population of a country with a maritime climate: Findings from the Netherlands mental health survey and incidence study. Am J Epidemiol 2005;162:654-61.  Back to cited text no. 4
    
5.
Brookhart MA, Rothman KJ. Simple estimators of the intensity of seasonal occurrence. BMC Med Res Methodol 2008;8:67.  Back to cited text no. 5
    
6.
Hakko H, Räsänen P, Tiihonen J. Seasonal variation in suicide occurrence in Finland. Acta Psychiatr Scand 1998;98:92-7.  Back to cited text no. 6
    
7.
Eastwood MR, Peacocke J. Seasonal patterns of suicide, depression and electroconvulsive therapy. Br J Psychiatry 1976;129:472-5.  Back to cited text no. 7
[PUBMED]    
8.
Faedda GL, Tondo L, Teicher MH, Baldessarini RJ, Gelbard HA, Floris GF. Seasonal mood disorders. Patterns of seasonal recurrence in mania and depression. Arch Gen Psychiatry 1993;50:17-23.  Back to cited text no. 8
    
9.
Fortenberry JD, Orr DP, Zimet GD, Blythe MJ. Weekly and seasonal variation in sexual behaviors among adolescent women with sexually transmitted diseases. J Adolesc Health 1997;20:420-5.  Back to cited text no. 9
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1]


This article has been cited by
1 Pneumatic oscillating microsagittal saw: a novel method for removal of a rectal foreign body
Alistair J. McCombe,Adam J. Frankel,Bradley Morris
ANZ Journal of Surgery. 2018;
[Pubmed] | [DOI]
2 A Particular Use of Endobag®: Extraction of Rectal Foreign Bodies
G. Terrosu,V. Cherchi,S. Calandra,A. Esposito,M. Marino,D. Berretti,A. Risaliti
Case Reports in Medicine. 2017; 2017: 1
[Pubmed] | [DOI]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
Introduction
Methods
Results
Discussion
Conclusion
References
Article Figures
Article Tables

 Article Access Statistics
    Viewed1397    
    Printed37    
    Emailed0    
    PDF Downloaded187    
    Comments [Add]    
    Cited by others 2    

Recommend this journal