Effect of Tobacco Taxation on Smoking Prevalence and Smoking-Attributable Deaths in India

Background: Higher taxes are the single most effective way to encourage tobacco users to quit tobacco use and prevent youth from initiation. Objectives: The present study aims to estimate the effect of raising the tax on smoked tobacco products on its consumption and smoking‑attributable deaths in India. Materials and Methods: A mathematical model was developed which used the projected population of India, taxation rates on smoked tobacco products, smoking prevalence, and price elasticity of demand of cigarette and bidi from 2017 to 2025. Four scenarios of tax increment (0%, 25%, 50%, and 100%) on smoked tobacco products were created which were modeled to calculate smoking prevalence and smoking‑attributable deaths due to respiratory diseases, heart diseases, stroke tuberculosis, and cancer in country till 2025. Results: A relative decrease of 6.2% in the prevalence of smoking was observed between the existing tax rates and its increment to 100% over the last increment of 6%. Similarly, smoking‑attributable deaths (SAD) decreased by 6.04% on increasing the tax rates to 100% of the existing taxation rates. There has been a steady increase in SAD in scenario 1 which decreases effectively in scenario 4, which in turn leads to the saving of around 33,000 lives due to tobacco‑related diseases by 2025. Conclusion: The consumption of cigarettes and bidis can be reduced by raising the price of these products. The model will help policymakers in deciding to fix the tax and ultimately the price of cigarettes and bidi to reduce its consumption and smoking‑attributable mortality.

Rp-Hplc Method Development And Validation For The Combination Of Imiquimod And Salicylic Acid

Objective: The present study was undertaken to develop and validate an RP-HPLC method for the combination of imiquimod and salicylic acid Methods: The method was carried out on Nucleodur C18 (250 mm × 4.6 mm I.D., 5 ????m) using low-pressure gradient elution mode. The mobile phase was used as 30M potassium dihydrogen phosphate and acetonitrile (45:55) pH 6.5 adjusted using ortho-phosphoric acid. The concentration of solvents was 1-20 µg/ml and the volume of injection was 20 mcl with the flow rate of 1.0 ml/min. The absorption maxima of salicylic acid and imiquimod were found 234 nm and 226 nm, respectively. Results: The method was validated and showed the linearity greater than 0.99% and with precision (RSD%<1). The limit of detection (LOD) and limit of quantification (LOQ) of salicylic acid was found to be 0.09756 µg/ml and 0.2956 µg/ml, respectively, and imiquimod was found to be 0.044031 µg/ml and 0.13334 µg/ml, respectively. Conclusion: The method developed in the present study was found to be sensitive, specific, and can be applied for the simultaneous estimation of imiquimod and salicylic acid.

Microleakage Evaluation in Teeth Restored with Experimental Dental Nanocomposite

@#Introduction: The aim of this study was to evaluate the experimental nanocomposite (Kelfil) against microleakage when bonded with two different types of bonding systems. Methods: Sixty sound extracted human permanent incisors were divided into six groups randomly. Each tooth was prepared with standardised Class III cavity on each proximal surface. The teeth were immersed in Rhodamin B dye for ten hours and sectioned to analyse the depth of dye penetration. The depth of the dye penetration was measured in micrometres by using confocal laser scanning microscope (CLSM). Results: The depth of the dye penetration in the groups was compared by ANOVA test. The results showed comparable microleakage between different types of composites. Conclusion: The experimental nanocomposite (Kelfil) in comparison to the commercially available nanocomposite and micro-hybrid composite has comparable microleakage when bonded using self-etching and total-etched adhesive systems.

Self-reported adherence among individuals at high risk of metabolic syndrome: effect of knowledge and attitude

Objective: This study aimed to evaluate factors that affect adherence in individuals at high risk of metabolic syndrome, with a focus on knowledge and attitude effect

Subjects and Methods: A sample of 900 high-risk individuals with metabolic syndrome was recruited in this cross-sectional study. During the study period, all participants filled in validated structured questionnaires to evaluate the adherence to different management options of metabolic syndrome, knowledge about the syndrome, and health-related attitude. Simple linear regression followed by multiple linear regression analysis were used to evaluate the effect of knowledge, attitude, and other factors on participants' adherence to both medications and lifestyle changes

Results: Of the 900 participants, 436 [48.4%] were nonadherent to medications and 813 [90.3%] were nonadherent to lifestyle changes. Increasing age [r = 0.140, p = 0.000], the presence of hypertension [r = 0.075, p = 0.036], and a more positive attitude toward health [r = 0.230, p = 0.000] were significantly associated with increasing adherence to medications. Higher educational level [r = 0.085, p = 0.023], higher knowledge score [r = 0.135, p = 0.001], and more positive attitude toward health [r= 0.183, p = 0.000] were found to significantly increase the adherence to lifestyle changes, while central obesity [r = ?0.106, p = 0.003] was found to significantly decrease the adherence to lifestyle changes

Conclusion: Patients' knowledge about metabolic syndrome and attitude to health affected adherence rates in patients at high risk of metabolic syndrome. Hence, we suggest the need to incorporate patients' educational programs into current management of metabolic syndrome

case of urticaria pigmentosa

Urticaria pigmentosa is the most common variant of cutaneous mastocytosis. A three and a half-month-old female child presented with generalized eruption of multiple brownish macular and papular lesions on the trunk, limbs, face and neck of two months duration. On stroking the individual lesion, there was formation of wheal and erythema [Darier's sign positive]. Histopathological examination of lesional skin and staining with Giemsa stain and hematoxylin eosin showed infiltration of numerous spindle shaped mast cells in perivascular and periappendageal location in the upper dermis. These findings were suggestive of mastocytosis. There was no systemic involvement. We present a typical case of urticaria pigmentosa

Chediak Higashi Syndrome with Recurrent Upper Respiratory Tract Infection.

A four-year old child presented with history of recurrent infections since birth, mostly upper respiratory tract infections or sino-pulmonary involvement and moderate grade fever with symptomatic relief on antibiotics and antipyretic medications. We present this case which was diagnosed as respiratory tract infection with neutropenia consistent with Chediak-Higashi syndrome(CHS), with a brief review of this rare genetic clinical entity.

The significance of microbiopsies in cytological smears.

Background: The role of fi ne needle aspiration cytology (FNAC) in the diagnosis of malignant lesions is well documented. Conventionally obtained fi ne needle aspiration (FNA) smears frequently contain well preserved viable intact tissue fragments (microbiopsies). Aims: The present study was aimed at evaluating the microbiopsies and carrying out further cyto-histopathologic correlation in order to assess what additional information they could provide. Materials and Methods: A total of 116 FNA smears from clinically suspected malignant lesions were examined, of which 81 smears (70.0%) contained representative tissue fragments of the tumors. Histopathological details were available in 75 cases. Immunocytochemistry (ICC) was applied in selected smears as and when required. Results: Tumors in which microbiopsies aided in diagnosis chiefl y included soft tissue malignancies (12 cases), typed into malignant peripheral nerve sheath tumor, fi brosarcoma, spindle cell sarcoma and malignant melanoma; lung tumors (14 cases) classifi ed as small cell carcinoma, large cell carcinoma, squamous carcinoma and adenocarcinoma; breast tumors (08 cases), typed into ductal, medullary and lobular carcinoma; and lymph node metastasis (19 cases) from primaries in lung, larynx and thyroid. The cyto-histopathologic concordance was raised from 81.2% in the absence of microbiopsies to 93.2% in their presence. Conclusions: FNA smears containing microbiopsies are of ample help in establishing fi rm diagnosis, tumor typing, and predicting possible primary sites in metastatic tumors which were not possible by cytology alone. Hence, this technique can be utilized to enhance the diagnostic accuracy of FNAC, if put into practice in evaluation of routine cytology smears, without increasing any fi nancial burden on patients.

Osteosarcoma of the Clavicle in an Adolescent Child.

Clavicle is an unusual site for any primary bone tumour, including osteogenic sarcoma. Although a rare site of affection, most clavicular tumours tend to be malignant. We present a case report of osteosarcoma of the clavicle in a twelve-year-old male child who presented with a huge swelling of the left clavicle for the last six months.

Perforation of axillary vein by a branch of the axillary artery: an anatomical study / Perforación de la vena axilar por una rama de la arteria axilar: un estudio anatómico

Anatomical variations in the region of axilla and pectoral region are very common. These variations need attention to avoid complications arising during surgeries and diagnostic and interventional invasive procedures in this region such as surgeries for breast carcinoma, venous access during central venous line, pacemaker and cardiac defibrillator implantation etc. During routine cadaveric dissection we had noticed a rare variation of axillary vein and artery. In this case axillary vein, just deep to the inferior border of pectoralis minor was pierced by the lateral thoracic artery, a branch of axillary artery. Perforation of the axillary vein by a branch of the axillary artery is extremely rare variation encountered till now. We report a variation wherein the lateral thoracic artery a branch of the second part of axillary artery was unusually long and perforated the axillary vein, just posterior to the inferior border of pectoralis minor muscle before supplying the structures in the anterolateral chest wall. Histological findings revealed duplication of lumen at the site of perforation through which the lateral thoracic artery was passing and the surrounding area was sealed by the connective tissue. Sound knowledge of anatomy of axillary and pectoral region may help in reducing complications while doing surgical and diagnostic procedure in these regions.

Las variaciones anatómicas en las regiones axilar y pectoral son muy comunes. Estas variaciones necesitan atención para evitar las complicaciones que surgen durante las cirugías y los procedimientos invasivos de diagnóstico e intervención en esta región, tales como cirugía de cáncer mamario, acceso venoso para una vía venosa central, implantación de marcapasos y desfibrilador, etc. Durante una disección de rutina se evidenció una variación poco frecuente de la vena axilar y arteria axilar. Se presenta una variación en que la arteria torácica lateral, rama de la segunda parte de la arteria axilar, inusualmente larga, perforaba la vena axilar, justo por detrás del margen inferior del músculo pectoral menor, antes de irrigar a las estructuras de la pared torácica anterolateral. La histológía reveló la duplicación del lumen en el sitio de perforación a través del cual pasa la arteria torácica lateral, que periféricamente fue sellada por tejido conectivo. La perforación de la vena axilar por una rama de la arteria axilar es una variación que raramente se observa, por eso un buen nivel de conocimientos de la anatomía de las regiones axilar y pectoral puede ayudar a reducir las complicaciones cuando se realizan procedimientos quirúrgicos y de diagnóstico en estas regiones.

Pindborg Tumor in an Adolescent- An Atypical Presentation.

Calcifying epithelial odontogenic tumor (Pindborg tumor), is a rare benign odontogenic neoplasm representing about 0.4-3% of all odontogenic tumors. This tumor more frequently affects adults in an age range of 20- 60 years, with a peak incidence in the 5th decade of life. Calcifying epithelial odontogenic tumour has a much lower recurrence rate than ameloblastoma and malignant transformation with metastasis is rare.

Effect of some abiotic factors on population buildup of Idioscopus clypealis (Lethierry) in western Uttar Pradesh.

Idioscopus clypealis (Lethierry) is commonly known as mango leaf hopper. The hopper reduces mongo production by causing non setting of flower and dropping of immature fruits. The first appearance of hoppers (0.12 and 0.16) on the branches of mango trees was recorded in February which is correlated with increase in maximum (23.89 degrees C and 24.29 degrees C) and minimum temperature (11.46 degrees C and 11.88 degrees C) and decrease in relative humidity (88.15% and 86.85%). Peak hopper population (5.88 and 6.46) was recoded in May on temperature range of(40.34 degrees C and 40.88 degrees C) and (27.22 degrees C and 27.62 degrees C) as maximum and minimum, which was very high, whereas, relative humidity was very low (55.80% and 55.09%). With the increase in maximum and minimum temperature and decrease in relative humidity hopper population raised. Thus, maximum and minimum temperature positively affected the hopper population, whereas, relative humidity had negative effect, but rainfall showed no significant effect, as it was fluctuating.

Giant Cell Tumor along with Secondary Aneurysmal Bone Cyst of Scapula: a rare Presentation

Giant cell tumor (GCT) is a distinctive lesion characterized by the proliferation of multinucleate giant cells in a stroma of mononuclear cells; it is generally seen in skeletally mature individuals. GCT of bone is usually found in the long bones around the knee or in the distal radius of young adults and is unusual in the flat bones. We report a case of GCT of the acromion of the scapula; with a secondary aneurysmal bone cyst; in a 30-year-old female. Based on our review of the eng language medical literature; it appears that the occurrence of a GCT along with a secondary aneurysmal bone cyst in flat bones (e.g.. the scapula) is very rare

Modelo de asignación de recursos en atención primaria / A model for resource allocation in primary health care

Resource allocation in primary health care is a worldwide issue. In Chile, the state allocates resources to city halls using a mechanism called "per capita". However, each city hall distributes these resources according to the historical expenses of each health center. None of these methods considers the epidemiological and demographic differences in demand. This article proposes a model that allocates resources to health centers in an equitable, efficient and transparent fashion. The model incorporates two types of activities; those that are programmable, whose demand is generated by medical teams and those associated to morbidity, generated by patients. In the first case the health promotion, prevention and control activities are programmed according to the goals proposed by health authorities. In the second case, the utilization rates are calculated for different sociodemographic groups. This model was applied in one of the most populated communities of Metropolitan Santiago and proved to increase efficiency and transparency in resource allocation.

Ischemic stroke following mild head injury is it the cause.

Recognition of childhood stroke is difficult. Newer diagnostic modalities like magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) have made this task much easier. Head trauma usually causes hemorrhage. We are presenting seven cases of mild head injury presenting as ischamic stroke. Neuroimaging suggested infarct involving left basal ganglia and internal capsule in five and bilateral involvement in two cases. MRA done in three was normal.

Effect of cybil on reproductive success of wild Drosophila melanogaster.

Cybil (a synthetic pyrethroid) was used to assess its impact on the reproductive success in F1 and F2 generations of wild Drosophila melanogaster. The LC50 has been estimated as 0.0267 microl/100 ml food. Reproductive success has been found to be affected in addition to fecundity and pupation following toxicity of cybil.

Rational use of EEG in childhood epilepsy.

Electroencephalogram (EEG) helps in diagnosing seizures and various childhood epileptic syndromes that have significant treatment implications. It represents the electric activity of the brain. Activating procedures can further increase the diagnostic yield. Besides diagnosing, it has a role in discontinuation of treatment and drug monitoring. EEG has its own limitations--it can be normal in an epileptic child and abnormal in a normal one. Electrical activity of the brain varies with age and physiological states like sleep. In neonates the background activity is much more important than epileptiform discharges unless these are repetitive and focal. Pseudo-epileptiform patterns like fourteen and six Hz activity can be confusing. Common typical epileptiform patterns seen in childhood are hypsarrhythmia in infantile spasm, burst suppression in early infantile epileptic encephalopathy, generalised 3 Hz spike wave discharges in absence seizures and periodic complexes in SSPE. EEG patterns like low voltage, electro-cerebral inactivity, multifocal spikes and excessive slow background are associated with poor outcome in neonates. Newer approaches have increased the yield and made localisation more precise. Epilepsy is a clinical diagnosis but EEG has significant role in substantiating the clinical suspicion, classification and management.

Radioprotection of chick thymus by vitamin E.

One day and 7 days old male white leghorn chicks were administered vitamin E prior to their exposure to sublethal dose (2.25 Gy) of gamma radiation from 60C source. The results show that vitamin E helps in faster recovery of damage in chick thymus caused by irradiation.

Effect of radiation on some haematological parameters and its modification by vitamin E in chicks.

White leghorn male chicks of 1 and 7 day age groups were studied for acute (2.25 Gy) gamma radiation (with or without vit. E pretreatment) induced haematological changes in the peripheral blood at days 1, 3, 5, 7, 14 and 28 postirradiation. A continuous decrease in the erythrocyte numbers was observed in the animals irradiated without vit. E treatment. The changes in haematocrit, haemoglobin, MCV, MCH and MCHC values were in line with the erythrocytic changes reflecting radiation induced damage to the erythroid elements. Animals pretreated with vit. E show lesser depression in the erythrocytic component at all the stages indicating its radio-protective influence. The significant increase in the immature RBC's in the peripheral blood in vit. E treated animals after irradiation, implies enhanced erythropoiesis.