Prevention of initiation of smokeless tobacco (SLT) consumption among rural children

Background: India Global Youth Tobacco Survey 2019 observed that 8.5% of the young age group (13-15 years) consume tobacco (9.6 % are boys and 7.4 % are girls). No interventional studies among adolescents were conducted before the initiation of the SLT use. Aims & Objectives: To estimate the prevalence of consumption of tobacco and non-tobacco products and to provide school based interventions to bring behavioral changes. Materials and Methods: An interventional study was carried out in Primary Schools. For estimation of the prevalence of tobacco and non tobacco use all the students of 1st to 5th while for the interventions, 4th and 5th standard were selected. Baseline data and change in the behavior at the end of one year was collected. FGD with key informants were also conducted. Descriptive Statistics was conducted. Results: The prevalence of smokeless tobacco consumption and non-tobacco product was found to be 1.3% and 36.5% respectively. After intervention 40.5% students had quit non tobacco products. Findings of FGD suggested that children should not be sent to purchase tobacco products on behalf of their parents. Conclusion: School based intervention and sensitization of the field workers along with knowing their perceptions for the predictors of consumption could be useful.

Reasons for the delay in the initiation of treatment and initial default among drug-resistant tuberculosis patients in Ahmedabad corporation area

The emergence of drug-resistant tuberculosis (DR-TB) has become a significant health problem in India. Delays in diagnosis and treatment initiation are frequently observed among patients with DR-TB, resulting in an increased risk of disease complications and high mortality and pretreatment lost to follow-up rates. To understand the factors associated with delays between the diagnosis and treatment, the study was carried out in Ahmedabad Municipal Corporation Area. A total of 177 DR-TB patients diagnosed in the year 2014 who had a delay in the initiation of treatment, and 23 initial defaulters were studied using a structured questionnaire. Fifty-four DOTS providers were also interviewed. Of 177 patients, 62.15% initiated treatment between 7 and 15 days and nearly 12% of them started the treatment after a month. The median duration of delay was 12 days (range: 8–144 days and interquartile range: 9–20 days). The most common reason for the delay in the initiation and initial default was the social and personal factors (48.80%), and in 34 (20%) of the patients, the delay was attributed to the effect of the previous treatment.

A case of melanoma in xeroderma pigmentosum.

Xeroderma pigmentosum (XP) was first described in 1874 by Hebra and Kaposi. [1] It is a rare autosomal recessive disorder characterized by photosensitivity, pigmentary changes, premature skin aging, and malignant tumor development due to cellular hypersensitivity to ultraviolet radiation resulting from a defect in DNA repair. The basic defect in XP is in nucleotide excision repair (NER), leading to deficient repair of damaged DNA. A 12-year-old boy presented with a large growth over the right side of the forehead. The lesion was first noticed before two years as a 2 x 2 cm 2 mass. It was slowly growing and attained the present size of 10 x 8 x 7 cm 3 . The surface showed ulceration with areas of hemorrhage and blackish pigmentation. Also, the patient had hyperpigmented macules over the skin since early childhood. The macules appeared initially over the face and later developed over the other areas of the body. The macules were more over the sun exposed areas. He also had photophobia and both eyes showed corneal opacities. Histopathological examination of the excised growth showed features consistent with melanoma. This case is being presented because of its rare association with xeroderma pigmentosum patients in India.

Study of incidence of measles and vaccination coverage in Ahmedabad urban slums.

Measles incidence and vaccination coverage survey was carried out in Ahmedabad urban slums in February 2000. A total of 3073 children between 9 to 59 months were studied. The incidence rate of measles was 11.2% (95% C.I-10.04-12.36). Measles vaccination coverage was only 59.88%. There was no gender difference in vaccine coverage or measles incidence rate. Diarrhoea was the most common complication observed among both vaccinated and unvaccinated children and it was significantly more among unvaccinated children. Among 1840 vaccinated children only 529 (28.75%) children received vitamin A along with measles vaccination.

Prevalence of tuberculosis infection among children in slums of Ahmedabad.

Children below 15 yrs. of age without BCG scar were chosen for the tuberculin testing. Total 210 children were tested in 30 selected clusters (7 children in each cluster). Median age of the surveyed children was 6.33. Prevalence of infection in children was found to be 30.4% as 64 children out of 210 showed positive result (had induration > or = 10mm in size). Average ARI in the 0-14 yrs of age group was 5.4%. Tuberculosis is still one of the commonest problems in the urban slums. It is important to evaluate the epidemiology of tuberculosis in the changing face of century.