Awareness about pictorial warnings on tobacco products and its impact on tobacco consumers in coastal Karnataka

Background: Tobacco use is a major risk factor for many chronic diseases, including cancer. India revised the pictorial warnings on all tobacco products in 2018, but its impact on tobacco consumers after the revision is less studied. Aim and Objective: To assess the awareness of the revised pictorial warnings on tobacco products and the impact of it on tobacco consumers in a coastal town. Methods: This cross-sectional study was conducted from 1st to 31st March 2021 among 185 adult tobacco consumers in a coastal town in Karnataka after obtaining ethical clearance and informed consent. The data was analysed using SPSS version 16.0 by descriptive statistics, Chi-square, Fisher’s exact test and binary logistic regression analysis. Results: Majority (95.7%) were males and 96.2% had seen the pictorial warning on the tobacco products. The commonly consumed tobacco products were panmasala (44.9%), gutka (38.9%), cigarette (31.4%) and bidi (15.1%). The mean age of initiation of consuming tobacco products was 24.8 years and mean duration of the habit was 17 years. Conclusions: A majority (96.2%) have seen the pictorial warnings on the tobacco products and significant predictors for reducing tobacco consumption were those who inferred the pictorial warnings as tobacco is injurious to health and cancerous

Clinicopathological study of benign breast diseases in Bundelkhand regions

Background: Benign breast diseases are a neglected entity despite the fact that it constitutes the majority of breast complaints and that the vast majority of the lesions that occur in the breast are benign. Aims and Objectives: The aims and objectives of the study are to analyze the percentage of incidence, age distribution, and other associated factors of benign breast diseases. Materials and Methods: The prospective study was conducted on 100 cases of benign breast diseases in Maharani Laxmi Bai Medical College, Jhansi, between January 2021 and June 2022. Results: Lump was found in all participants (100%) in which incidence of painless and painful lump was for 94% and 6%, respectively. 6% lump was found to be associated with non-cyclical mastalgia and 2% lump had having association with discharge. Milky discharge (1%) was found in the case of galactocele and serous discharge (1%) was found in duct ectasia. Benign breast diseases were found most commonly in premenopausal women (97%) in comparison to post-menopausal women (3%). Breast lump was investigated by fine needle aspiration cytology which was consistent with a lump of fibroadenoma and fibroadenosis in 95% of cases. Rest 5% of breast lumps were non-consistent. 90% of cases were found of fibroadenoma. All patients underwent surgical line of management except for fibroadenosis which was managed conservatively. Cases of breast abscess, fibroadenoma, duct ectasia, and galactocele admitted in hospital, for which mean hospital stay was 4.28 plus or minus 6.21 days. Conclusion: The most common benign breast disease encountered in clinical practice is fibroadenoma followed by fibroadenosis. They are most common in 15–25-year age group and its presentation is found to be more in married woman

Clarithromycin: overview and its current clinical utility in the treatment of respiratory tract infections

Upper respiratory tract infection (URTI) is a common reason for medical consultation all over the world. Streptococcus A (Strep A) and other infections can cause sore throat as well as pharyngitis or tonsillitis. It may also result in post-infection sequelae, including acute post-streptococcal glomerulonephritis, acute rheumatic fever, and rheumatic heart disease.  As a result, there is a need for an antibiotic that is effective, easy to administer, has a favorable sensitivity pattern, and preferably has some additional pharmacodynamic properties that complement the basic antibacterial profile. Clarithromycin is a macrolide antibacterial agent with broad-spectrum activity against respiratory pathogens. It is especially active against atypical Chlamydia pneumoniae, Mycoplasma pneumoniae, and Legionella spp. It is well absorbed and stable at gastric pH. It is metabolized by the cytochrome P450 enzymes and forms 14-hydroxy clarithromycin, which is more active than the parent compound, especially against Hemophilus influenzae. It acts by preventing protein synthesis by binding to the 50S subunit of bacterial ribosomes. In dosages of 500 to 1000 mg/day for 5 to 14 days, clarithromycin is effective in the treatment of community-acquired upper and lower respiratory tract infections in hospital and community settings. It exerts significant anti-inflammatory, immunomodulatory, and post-antibiotic effects. It provides a viable option for the treatment of community-acquired respiratory tract infections, in both children and adults.  

Abusive yet affectionate husbands: Conflicting perceptions of domestic violence experiences of wives living in urban slum communities of Mumbai, India

Background: The prevalence of intimate partner violence (IPV) contributed to reproductive health problems worldwide. Data on coping mechanism of women within domestic violence (DV) were unexplored.Methods: The objective of the paper was to explore the perceived cause of DV and coping mechanism of women who reported affectionate nature of husband. A community-based intervention study was carried out in urban slums to screen women with an unmet need for family planning. Women reported of DV in the past one year preceding the survey were counselled on marital communication and family planning methods. During these sessions, women shared their views on the cause of DV and their coping mechanism.Results: The narratives of the sessions threw light into the cause of DV, which includes decision-making, the influence of significant others and fewer time couples spent with each other. Affectionate nature and violence by husbands created a conflict of emotions. Fear of loss of the relationship and socio-cultural attitude made them remain in the relationship.Conclusions: The wives develop an emotional attachment with their partners and do not want to leave the relationship. They create a space within the abusive relationship; enjoy limited functionings, a bonus of affections and demoting violence from the partner without taking a chance to lose the relationship

Is antegrade K-wire pinning better than retrograde pinning for distal radius fracture? A comparative study

Background: The treatment of distal end radius has undergone tremendous changes over the years due to better understanding of the fracture anatomy, mechanism of injury and development of newer techniques and implants. The objective of treatment of distal end radius fracture is to restore the anatomy and to obtain early function. Percutaneous pinning is a minimally invasive technique to maintain the reduction and prevent re-displacement of the fracture fragments. Sato et al. introduced a technique of fixation for the unstable extra-articular distal radial fractures by manual reduction and antegrade intra-medullary pinning.Methods: A retrospective study with a sample size of 30, where 15 of the selected patients had undergone antegrade fixation and the rest 15 had undergone retrograde fixation.Results: Patients were evaluated for functional and radiological outcomes after a mean follow up of one year. No statistically significant difference was found between the two methods.Conclusions: Both the procedures were effective in managing the distal radius fracture with preservation of fracture hematoma. However soft tissue complications were less in antegrade pinning as compared to retrograde.

Sporadic hemangioblastoma of the filum terminale: Case report and review of literature

Hemangioblatomas are low grade, highly vascular tumors usually associated with VHL syndrome and most commonly occurs in the cerebellum. They very rarely occur in the spinal nerve roots and an origin in the filum terminale is exceptionl. A 47 year old man presented with low back pain, paresthesias and stiffness of the both lower limbs. He also had urinary retention and constipation. MRI showed an enhancing mass at the L5 vertebral level with multiple dilated and tortuous vessels at both poles of the tumor. Digital subtraction angiogram showed the tumor to be supplied by the anterior spinal artery and dural branches of lumbar arteries. At surgery, a well-defined tumor with orange red hue was found to be arising from the filum terminale. The tumor was excised en bloc. Histopathological examination showed hemangioblastoma which was confirmed with immunohistochemistry. Clinical symptoms improved significantly after surgery. A sporadic hemangioblastoma arising from the filum terminale should be considered as a rare cause of back pain and sciatica. Total excision of the tumor usually cures the patient

A study on the impact of CYP2C19 genotype and platelet reactivity assay on patients undergoing PCI

AbstractBackgroundA thorough understanding of the patient's genotype and their functional response to a medication is necessary for improving event free survival. Several outcome studies support this view particularly if the patient is to be started on clopidogrel due to the prevalence of clopidogrel resistance. Such guided therapy has reduced the incidence of Major Adverse Cardiac Events (MACE) after stent implantation.MethodsBetween August 2013 and August 2014, 200 patients with coronary artery disease undergoing percutaneous coronary intervention (PCI) were prescribed any one of the anti-platelet medications such as clopidogrel, prasugrel or ticagrelor and offered testing to detect CYP2C19 gene mutations along with a platelet reactivity assay (PRA). Intended outcome was modification of anti-platelet therapy defined as either dose escalation of clopidogrel or replacement of clopidogrel with prasugrel or ticagrelor for the patients in clopidogrel arm, and replacement of ticagrelor or prasugrel with clopidogrel if those patients were non-carrier of mutant genes and also if they demonstrated bleeding tendencies in the ticagrelor and prasugrel arms.ConclusionClopidogrel resistance was observed to be 16.5% in our study population. PRA was useful in monitoring the efficacy of thienopyridines. By having this test, one can be safely maintained on clopidogrel in non-carriers, or with increased dose of clopidogrel in intermediate metabolizers or with newer drugs such as ticagrelor or prasugrel in poor metabolizers. Patients on ticagrelor and prasugrel identified as non-carriers of gene mutations for clopidogrel metabolism could be offered clopidogrel resulting in economic benefits to the patients. Patients at high risk of bleeding were also identified by the PRA

Ten Years Risk Prediction of Cardiovascular Disease among Adults in Rural Area of Dakshina Kannada, Karnataka

Background: Cardiovascular disease (CVD), one of the non-communicable diseases, has become a major public health problem and it is a leading cause of morbidity and mortality in both developing and developed countries. The important CVD risk factors are obesity, hypertension, diabetes, hyperlipidaemia, unhealthy diet, physical inactivity and tobacco use. Cardiovascular risk approach is feasible and cost-effective tool, which helps to identify those at high risk for developing CVDs, so that immediate preventive measures or action can be taken to reduce the risk. Objectives: estimate the ten-year risk of developing cardiovascular disease using Framingham heart risk assessment score. Materials and Methods: A community-based, cross-sectional study was conducted among adults residing in a rural area of Dakshina Kannada District for a period of 6 months from July 2013 to December 2013. The data was collected using pretested semi structured questionnaire through interview methods. Anthropometric measurement and blood investigation (fasting blood sugar and lipid profile) was done. The Framingham Risk Score is a gender-specific algorithm used to estimate the 10-year cardiovascular risk of an individual Results: Among 712 study participants, 95 (13.3%) and 20 (2.8%) participants had intermediate and high risk of developing cardiovascular disease in 10 years respectively. The proportion of intermediate CVD risk prediction and high-risk predication was more in males as compared to females. Conclusion: The cardiovascular risk factors like obesity, physical inactivity, diabetes and hypertension are widely prevalent among adults in rural areas. The high-risk prediction for developing CVD among study participants in next 10 years was 2.8%. Keywords: Cardiovascular risk factors, Framingham risk score, 10 years CVD risk prediction, Prevalenc