ABSTRACT
Background: Tobacco is one of the major behavioral risk factors for noncommunicable diseases in India. Tobacco control depends on public awareness regarding prevalent antitobacco measures. Objectives: The present study documents the understanding of young adults(<25 years) regarding the antitobacco laws and their perception regarding interventions for effective tobacco control. Methods: A cross‑sectional study was conducted in two districts of Haryana. A semistructured questionnaire was used to assess tobacco use, participants’ awareness of sections 4, 5, 6 (a), and 8 of the Cigarette and Other Tobacco Products Act (COTPA, 2003), sources of information about antitobacco laws, and their implementation. The perception of participants about the effectiveness of laws and provisions was assessed using a three‑point Likert scale. Results: Of the 1470 participants, 517 (35.2%) smoked or used smokeless products. They reported the media (84.6%) to be the most critical source of information about antitobacco laws, followed by the health department (57.6%) and family/peer group (44.9%). Most participants were aware of the prohibition of smoking in offices or banks, educational institutions, hospitals, and other public places. Both tobacco users and nonusers perceived health education programs to be an effective intervention to reduce tobacco use (P < 0.01). Conclusion: The awareness regarding COTPA has increased among the general population. The media could be a powerful tool to counteract the pro‑tobacco cues in society. The need of the hour is to focus on improving compliance with antitobacco laws at the population level to achieve a tobacco‑free India.
ABSTRACT
Background: Major illness requiring hospitalization in poor family makes the family poorer with further tragic outcomes. In that view, Rashtriya Swasthya Bima Yojna (RSBY) by GOI and Mukhyamantri Amrutam (MA) Yojna by Gujarat Government were launched for Below Poverty Line families. Aims & Objectives: To assess knowledge and utilization regarding these two schemes amongst the registered families. Material & Methods: A community-based survey was carried out in a block of Gandhinagar using 30 clusters sampling. Sample size was calculated taking RSBY utilization rate 2.0%. Results: 98.4% had RSBY card & 83.7% had MA card. Common reasons for not having card were either “card not issued/people did not go to collect card” or “were unaware about the schemes/ card”. Only 1.5% families had valid RSBY cards. Knowledge regarding both the schemes (when & where to use, benefit amount etc.) was very poor (20- 25%). RSBY & MA utilization among valid card holders for last 1 year was 1.2% & 0.2% per enrolled member respectively in last 1 year. In both RSBY & MA, 30 – 40% beneficiaries had out of pocket expenditure, mainly towards transport & food. Few had towards medicines and/or investigations. However, most were satisfied with the services. Conclusion: Looking to the poor knowledge, it is important to carry out IEC activities to make people aware about the schemes which will help increase the utilization.
ABSTRACT
Background: Second-hand smoke (SHS) has enormous adverse health impacts with grave health implications for the next generation. Section 4 of Indian legislation, Cigarettes and Other Tobacco Products Act, prohibits smoking at public places, thus protecting people from SHS. Objective: The objective of present study was to assess the exposure to SHS at home and working areas in Punjab, India. Methods: The present cross-sectional study was conducted from December 2015 to March 2016. A three-stage sampling technique was used for collecting data from three randomly selected districts representing three major regions of Punjab, India. A sample size of 510 individuals was divided equally into an urban and rural area with proportionate sampling on the basis of subsets of age groups and gender. The questionnaire based on tobacco questions for the survey, a subset of key questions from global adult tobacco survey was used. Results: At home, the odds of exposure to SHS exposure was higher (odds ratio [OR] = 2.2, 95% confidence interval [CI] = 0.6�3) in urban area, females, low educational status, and nongovernment employee as compared to their counterparts. At workplace, (OR = 3.9 and 95% CI = 1.11�.3) SHS exposure was higher in rural area, among males, primary and middle education and nongovernment or self-employed occupation. Conclusion: SHS exposure was low in Punjab, India especially in females as compared to other states of the country. The socio-economic disadvantaged groups and people with low education were more likely to experience exposure to SHS at workplace, which should be targeted to reduce tobacco consumption.
ABSTRACT
Percutaneous balloon valvotomy was performed in 21 cases (aged 6 to 62 years) with moderate to severe aortic valve stenosis, using either single (16 cases) or double balloon (5 cases) technique. All patients had basal transaortic pressure gradient 50 mmHG or above. A majority of patients had significant haemodynamic improvement immediately following balloon dilatation. The mean systolic transaortic pressure gradient reduced from 94 mmHg (range 50 to 160) to 42 mmHg (range 14 to 82; P less than 0.05) immediately after the dilatation. The final gradient was less than 40 mmHg in 11 cases. The mean cardiac index improved from 3.86 L/min/M2 (range 2.8 to 5.2) to 4.14 L/min/M2 (range 3.4 to 5.6; P:NS) following the procedure. There was no death or major complication related to the intervention. There was a procedure-related mild aortic regurgitation in 4 cases. We conclude that percutaneous balloon dilatation is an effective, safe, low cost, nonsurgical method for treating patients with aortic valve stenosis.