Study on tobacco use and awareness among marginalized children.

Background : The current study entailed a survey of children from the lower socioeconomic strata of rural and urban regions of the states of Maharashtra and Assam who are vulnerable to tobacco usage. More than 1700 children were checked for precancerous lesions and 1004 were surveyed for tobacco habits and awareness. Aims: The objective of the survey was to determine and report on all the variant factors affecting the use of tobacco among the underprivileged children population. The aim of the clinical check-up was to detect precancerous lesions in the tobacco-using children at an early treatable stage. Materials and Methods : Awareness lectures and ENT camps were conducted at 12 organizations/community centers. A cross-section of children were interviewed to understand tobacco use among them. All the children were screened for precancerous lesions. Children with suspicious oral lesions were sent for further evaluation at a nearby diagnostic cancer facility. The survey was conducted by trained social workers. Results : The percentage of tobacco users in urban Mumbai was quite low at 4.8% compared with rural Kasara (36%) and Assam (76%); and 74.6% of the children were aware that tobacco use was dangerous and harmful to health. The average age of initiation was 9 years. Out of the 1004 children surveyed, 253 were tobacco users and 79% were males. Of the 1700 children screened, 23.5% presented with precancerous oral lesions. Conclusion : This study addresses the tobacco habits of a typical sample of marginalized children in India and the need for effective interventions aiming at reducing the burden of tobacco-related cancers by controlling at the point of initiation.

Severe muscle weakness due to hyperkalemia.

Hyperkalemia is a commonly encountered electrolyte disturbance in patients with renal insufficiency. It develops very rapidly when potassium is supplemented while a patient is on a potassium-sparing diuretic. Most often it remains asymptomatic and manifests in the form of electrocardiographic changes. Muscle weakness and paralysis although described is seldom observed in clinical practice. We report one such case.

Surface changes of the erythrocytes membrane in alcoholics--a study of lectin binding.

Erythrocytes from 30 alcoholic patients as well as age and sex matched healthy control were examined, for hemagglutination titre, against, a purified galactose specific lectin from the latex of Pedilanthus tithymalodies. Mean hemagglutinin titre was significantly elevated (P < 0.001) in alcoholics as compared to controls. The results indicate that alcohol abuse is associated with adoptive cell surface changes on erythrocytes, measurable by its lectin binding capacity.

Approach to aerosol therapy in management of asthma at primary care level.

Present day management of bronchial asthma focuses on use of inhaled drugs. To find out the acceptability of aerosol therapy at primary care level, a questionnaire survey was conducted on practical acceptance of aerosol therapy in management of asthma. Seven clinically relevant questions were asked regarding management modalities followed in bronchial asthma. Amongst the group of general practitioners (n = 60) studied, it was found that in treatment of chronic stable asthma inhaled steroids are used by only 50% and inhaled bronchodilators by 86.7%, whereas 93.3% use oral bronchodilators and 60% use oral steroids to treat the same. During exacerbation injectable bronchodilators are preferred to inhaled drugs. Poor compliance to aerosol therapy was reported by 33.3%. Reasons for non-compliance are discussed, important ones are cost and technique. Spacer was reported to be useful by 20% and lung functions are carried out occasionally by only 5% of practitioners.