Population attributable risk for multimorbidity among adult women in India: Do smoking tobacco, chewing tobacco and consuming alcohol make a difference?

Background The present study aims to estimate the prevalence and correlates of multimorbidity among women aged 15–49 years in India. Additionally, the population attributable risk for multi-morbidity in reference to those women who smoke tobacco, chew tobacco, and consume alcohol is estimated. Methods The data was derived from the National Family Health Survey which was conducted in 2015–16. The effective sample size for the present paper 699,686 women aged 15–49 years in India. Descriptive statistics along with bivariate analysis were used to do the preliminary analysis. Additionally, binary logistic regression analysis was used to fulfil the objectives. Results About 1.6% of women had multimorbidity in India. The prevalence of multimorbidity was high among women from southern region of India. Women who smoke tobacco, chew tobacco and consume alcohol had 87% [AOR: 1.87CI: 1.65, 2.10], 18% [AOR: 1.18; CI: 1.10, 1.26] and 18% [AOR: 1.18; CI: 1.04, 1.33] significantly higher likelihood to suffer from multi-morbidity than their counterparts respectively. Population Attributable Risk for women who smoke tobacco was 1.2% (p<0.001), chew tobacco was 0.2% (p<0.001) and it was 0.2% (p<0.001) among women who consumed alcohol. Conclusion The findings indicate the important role of lifestyle and behavioural factors such as smoking and chewing tobacco and consuming alcohol in the prevalence of multimorbidity among adult Indian women. The subgroups identified as at increased risk in the present study can be targeted while making policies and health decisions and appropriate comorbidity management can be implemented.

THE BANALITY OF IMMUNITY, DEATH AND DISTRESS OF TOBACCO SMOKING --("STRIKE THE RIGHT”)

WHO stated that Tobacco Control is "To protect present and future generations from the devastating health, social, environmental and out-turn of exposure to tobacco smoke”. Tobacco plants are indigenous to American abstinent and they knew of its cultivation thousands of years ago. Christopher Columbus brought this plant to European countries. Portuguese traders brought tobacco plants to India Tobacco put to use in the forms of smoking, chewing, or snorting. Bronchial accounts for more than 50% of all male deaths from malignant disease. It is four times more common in men than in women. Cigarette smoking for most cases of bronchial carcinoma, and the increased risk is directly proportional to the amount smoked and to the tar content of the cigarettes. Smoking puffs of any kind, disclosed to nicotine, have pernicious consequences on immune system. Nicotine escalates cortisol concentration, while curtail B cell antibody development and T cells' response to antigens. Smoking bumps one and the other innate and adaptive immunity and operates challenge roles in synchronize immunity

Relationship between Tobacco Smoking And Dental Fear Among Adolescents of 15-18 Year Age in Pakistan

Aim: To assess the relationship between dental fear and smoking among adolescents of 15-18 year of age in Pakistan Method: This study was a prospective crossectional survey design which was conducted in Lahore. After taking permission from the school’s head, data was collected from the male students of grade 9th, 10th, 11th and 12th using questionnaire and later on one of their parents was approached to fill the questionnaire. For this purpose, only one school was targeted. Sample size was of 200 participants whereas parents of all the student participants participated in the study. Results: The results of chi-square revealed that dental fear was quite high among male students, occasional use of tobacco, and use of mouthwash minimum thrice a day. It was also found that students of those parents whose occupational level was low reported higher dental fear. Conclusion: It was found that adolescent male students were found to have more dental fear who smoke tobacco as compared to those who do not smoke. It is important to ask about smoking habits as well as dental fear when examining oral health maintenance of adolescents. Keywords: Smoking, Tobacco, Adolescents, Dental fear

Pregnant Women Who Smoke May Be at Greater Risk of Adverse Effects from Bushfires

Bushfires substantially increase the environmental health risks for people living in affected areas, especially the disadvantaged (e.g., those experiencing health inequities due to their socio-economic status, racial/ethnic backgrounds, geographic location and/or sexual orientation) and those with pre-existing health conditions. Pregnant women exposed to bushfire smoke are at a greater risk of adverse pregnancy and foetal outcomes, especially if they smoke tobacco, which may compound the toxic impacts. Bushfires may also exacerbate mental stress, leading to an increase in smoking. There are gaps in the evidence and more research is required on the combined effect of bushfire smoke and tobacco smoke on pregnant populations.

Midwakh (pipe) and seizure: The overlooked link

Objective: Numerous drugs and medications from various pharmacological classes can lead to seizures as an unwanted side effect. Midwakh is a pipe commonly used to smoke tobacco blend in small quantities. Midwakh use is increasing, especially among young people. Case Presentation: A 17-year-old patient with a history of seizures was provoked by smoking midwakh, despite having no previous disease history. Conclusion: Although the patient had a negative workup for epilepsy, midwakh should be classified as an epileptogenic drug. More studies need to be conducted on the effects of midwakh on the neurological system.

CHARACTERISTICS AND SPREAD PATTERN OF LARYNGEAL CARCINOMA : A TERTIARY CARE STUDY

INTRODUCTION Laryngeal cancer is the eighteenth most common cancer in the UK. It has strong socioeconomic association, wide geographical variations. This study is highly relevant in India where factors like poor socio-economic conditions, oral consumption of tobacco in its various forms, alcohol, smoking habits in form of beedi and cigarette, lack of awareness about cancer, negligence towards the symptom of voice change and primary treatment from quacks , are highly prevalent. MATERIALS AND METHODOLOGY This prospective cohort study was carried out at Tertiary care Hospital over a period of 1 year 4 months( April 2018 to July 2019). Patients attending at our OPD with symptoms of horseness, dysphagia, stridor and other symptoms of Laryngeal Carcinoma were subjected to detailed clinical examination including FOL to confirm the presence of any growth. All patients with growth or vocal cord irregularity or any suspicious lesions underwent biopsy. Socio-demographic, risk factors , characteristics of primary tumor- endoscopic, radiological and histopathological and spread pattern and node status analysed. RESULTS Major bulk of patients belonged to 55-74 years (combined). The mean age of diagnosis is 66.06 years.Males were affected more than females (7.57:1).Majority of patients were farmers (57%) and majority 45(75%) belonged to rural areas. Most patients belonged to low socioeconomic class 30 (50%).Smoke tobacco and smoke tobacco plus alcohol were the major risk factors for laryngeal carcinoma.Majority of patients presented with dysphagia (75%), followed by foreign body sensation (72%), hoarseness (67%), Neck swelling (50%). Cartilage invasion was present among 25% of cases , Both pre-epiglottic and paraglottic space involvement was around 18% and exolaryngeal spread present in 8% of cases.Among them 100% cases delayed symptom recognition was present. 50% cases was attributed due to socio-demographic pattern, 33% due to pshycosocial and behavioural (anxiety) and 13% due to delay in practitioner referral.Among Proliferative and Ulceroproliferative N+ is more than N0.Both moderately differentiated and poorly differentiated had more percentage of N+.In Supraglottic tumor Pre-epiglottic space, Paraglottic Space and cartilage invasion was present in equal proportions. In glottic tumor cartilage invasion and exolaryngeal spread was more common. CONCLUSION Supraglottic tumor being common have tendency for lymphatic spread. It mainly presents with dysphagia and hoarseness later. Majority of patients were diagnosed in stage III and stage IV. This is not desirable and causes for delayed diagnosis must be addressed publicly. Early stage tumor have excellent prognosis with advent of radiotherapy and surgical morbidities can be avoided. The HPE reveals high grade of differentiation is associated with low node status. CT features serve as an excellent tool in identifying spread and node involvement and also management protocol.