Technology-based Tobacco Cessation Training in Indian Context

In tobacco use disorders (TUDs), technology-based training of health-care professionals can reduce the treatment gap and bring attitudinal change. The study aimed to assess the practices and determine the change in knowledge and attitude among health-care professionals following an online training program (OTP). Half-day OTP on tobacco cessation using prepost quasi-experimental study design with a structured questionnaire?based assessment was conducted. Among 293 completed surveys, knowledge post?OTP was higher but insignificant (P = 1.2). Post?OTP, participants felt less angry and disappointed toward tobacco users(mean of difference (MOD) =0.21, P = 0.0007); more sympathetic and concerned (MOD = ?0.22, P = 0.0005); and acknowledged tobacco users deserve the same medical care as nonusers (MOD = ?0.177, P = 0.001). Post?OTP scores in attitudes did not change significantly for the responsibility domain (P < 0.05). In practice, relatively greater number of health-care professionals asked about tobacco use and advised cessation, however lesser assessed, assisted, and referred. To conclude, technology-based training program can result in attitudinal changes toward tobacco users.

Quantifying the mobile phone usage and gauging the perception about its harmful effects among the Otorhinolaryngologists in India- A questionnaire-based pan India survey

Background-There is a definitive risk to human health because of mobile phones. The awareness towards mobile phones emitted electromagnetic radiation is of paramount importance to prevent health risks and possible negative health disorders. Aim and objectives-The aim of the survey is to assess the awareness of mobile phone radiation and its harmful effects on the body and the mobile phone usage trend among Otorhinolaryngologists from India. Methodology-The present survey aimed to obtain baseline data on cell phone usage and radiation awareness among a relatively homogenous cohort of Otorhinolaryngologists from India. This is a cross-sectional online survey assessing awareness of Mobile Phone radiation through a custom-made questionnaire devised by the authors which consisted of four parts: 1. Demographic details, 2. Mobile phone usage trend, 3. Knowledge of mobile phone radiation 4. Awareness of health hazards produced by mobile phone radiation. Results- The total number (n) of otorhinolaryngologists to whom the questionnaire was sent was 6336 of which 259 of them responded which formed the sample size of our study. Thus, the response rate of the survey was 4%. A total of 259 Otorhinolaryngologists participated in the study. The mean age of the population involved in the survey is 41.7810.32 years. The male-female ratio of the survey is 161:98 respectively. There were 172 private and 87 government ENT practitioners in the survey. MS otorhinolaryngology was the most common qualification of the study with 223 doctors having the degree, 20 having DNB, and 7 of them having completed DLO. The mean years of medical practice after postgraduation of the Otorhinolaryngologists participating in the questionnaire are 13.537.38 years. The major contributors to the survey were private ENT consultants with a count of 110, followed by Senior Residents 58, Assistant Professor 39, Professor 29, Associate professor 10, and Additional professor 13. It was evident from the questionnaire that 242 of the respondents were right-handed and 204 of the study population used their right ear for talking over the phone, it was also cross-checked by giving a miss call to them in close vicinity. The mean years of exposure to mobile phone usage by Otorhinolaryngologists are 15.01 5.75. A maximum of 153 surgeons were using mobile phones for 11-20 yrs. The average hours of daily mobile phone usage were 373 minutes. A highest of 101 Otorhinolaryngologists using mobile phones for >4 Hrs. Surprisingly through the questionnaire we came to know that a total of 60 doctors among the 250 use the phone daily for an average of more than 10 Hrs, which is 24% of the study population surveyed. Questions 15-24 were purposed to bring the awareness knowledge of the respondents towards electromagnetic radiation of the cellular phones, and it can be arbitrarily said that a score of 5 or more means that the person is aware. The average of the correct responses to each of the 10 questions given by the ENT practitioners is 5.97±1.66. Similarly, questions 25 to 35 assess the awareness of health hazards produced by mobile phone radiation. The mean correct response of the Otorhinolaryngologists is 6.30±1.87.

Choking – A Public Health Problem- Are We Prepared?

Choking or acute airway obstruction is the emergency condition which is usually first dealt by general public and only then by health professionals. It has been documented in literature that educating the public about choking hazards and its management can positively affect the incidence of choking events and mortality. (1) In the developed countries, Basic Life Support (BLS) courses and First Aid courses are routinely done by public and are aggressively pursued by government and health care givers but in India there is no such uniform program. Indian Society of Anesthesiologists (ISA) has developed indigenous CPR guidelines and they are also organizing affordable nationwide CPR training modules, at present their program does not deal with the choking, but hopefully as their program will gain more acceptance, they will also incorporate choking modules. (2)

Specific Absorption Rate (SAR) value of mobile phones: An awareness study among mobile users

Mobile phone is an inevitable part of ones life. Once been luxury has now become necessity. It’s been used by all age group people for different application apart from calling and texting. The advance in mobile technology has brought many new applications using mobile. But while using cell phone for talking or being connected to someone the user gets exposed to harmful Electro Magnetic Radiations. The exposure rate to these radiations vary from handset to handset. When cell phones are used in close proximity to human body, the radiations emitted from cell phones penetrate deep inside the human skin. Penetrated radiations produce induced electric field inside the body, resulting in absorption of power, which can be analyzed using a parameter called specific absorption rate (SAR). But still one question arises in mind that are people really aware of Safety standard especially SAR value. What does SAR value mean? It’s the specific absorption ratio measure of amount of radio frequency intensity or energy absorbed by body while connected on cellular network. It is defined as the power absorbed per mass of tissue and has units of watts per kilogram (W/kg) and in a way defines safety range of mobile handset .This study aims to measure the knowledge and awareness of SAR value of handset and the factors that influence awareness of SAR value. This is the largest sample study about mobile usage and awareness of SAR amongst mobile users .

Breast feeding practices in infants of rural Western Uttar Pradesh region of India.

Background: Breastfeeding is one of the most effective ways to ensure child health and survival. But globally only less than 40% of infants under six months of age are exclusively breastfed. Adequate breastfeeding counselling and psychological support are essential for mothers and families to initiate and maintain optimal breastfeeding practices Objective: The study was done to know the prevalence of exclusively breast feeding, early initiation of breast feeding and practices of pre-lacteal feed in rural Uttar Pradesh and their relation with maternal age. Material and Methods: This observational analytic cross sectional study was conducted on 355 mothers of infants aged one and half to 12 months who came in OPD or Indoor of Department of Pediatrics UPRIMS and R, Saifai for immunization or some problem. A semi-structured, pre-tested Performa was used to interview the mothers. Results: Only 48.5 % of subjects were practising Exclusive breast feeding , inadequate milk secretion was major cause of non exclusive breast feeding Early initiation of breast feeding was done in 41.5% of mothers. Pre-lacteal feed was given in 46.8 % of responders. Relation of early initiation of feeding and use of pre-lacteal feed with age of mother was found significant. Conclusions: Despite of so many efforts by Government and NGOs, most of the mothers in Rural Uttar Pradesh are still unaware regarding healthy feeding practices. We need to improve our counselling and motivation regarding exclusive breast feeding.

Facial Necrotizing Fasciitis: A Rare Complication of Maxillary Sinusitis.

Necrotizing fasciitis is an uncommon infection of the fascia and subcutaneous tissue, which is extremely rare in head and neck region because of high vascularity. Necrotizing fasciitis arising as a complication of maxillary sinusitis is exceptionally rare. We present the case of a 50-year-old female patient who was immunocompetent and developed facial necrotizing fasciitis as a sequel of maxillary sinusitis. She was effectively managed by surgical debridement and antibiotics. To the best of our knowledge, this is the second case report in English literature presenting as necrotizing fasciitis secondary to maxillary sinus infection.

Prevalence of hepatitis C virus genotypes and impact of T helper cytokines in achieving sustained virological response during combination therapy: A study from Central India.

Characterisation of host immune response to hepatitis C virus (HCV) genotypes may have an important prognostic and therapeutic implication. Genotype-3 was more prevalent in the examined cohort and demonstrated a significantly higher response to combination therapy than genotype-1. Sustained virological response (SVR) was 94.74% in genotype-3 and 45.45% in genotype-1. The patients who achieved SVR reported higher levels of circulating T helper 1 cytokines in comparison to subjects with no SVR in both the studied groups. Besides providing local prevalence, our study might also assist in understanding the host immune mechanisms involved to achieve SVR during combination therapy in chronic HCV patients.

Rosai Dorfman syndrome with extranodal manifestation.

Rosai Dorfman Syndrome (RDS) is a benign condition and a rare cause of cervical lymphadenopathy. It usually occurs in the first decade of life and manifest as massive enlargement of cervical lymph nodes. The disease has a benign course and involvement of the nasal cavity as an extranodal site is exceptional. A 22-year-old male presented as progressive massive bilateral cervical lymphadenopathy accompanied with nasal obstruction and occasional episodes of epistaxis. A FNAC from cervical lymph node and biopsy from nasal mass was compatible with RDS.

Benign esophageal stricture following aluminium phosphide poisoning.

Aluminium phosphide is often implicated in accidental and suicidal poisoning in India. Ingestion of even half a fresh tablet invariably results in death, whereas exposed tablets are usually considered harmless. We report two cases of short-segment esophageal strictures that occurred following ingestion of exposed tablet of aluminium phosphide. Both cases could be successfully managed by endoscopic dilatation.

Neuroendocrine tumors of the pancreas.

Neuroendocrine tumors of the pancreas (NETP) are rare. We report our surgical experience of 11 patients with NETP. These included 5 patients with benign insulinomas. Raised serum insulin and C-peptide levels with hypoglycemia were always diagnostic. Ultrasonography, CT, visceral angiography, arterial stimulation and venous sampling, and intraoperative ultrasound localized the tumor in 0/5, 1/5, 3/4, 2/2, 3/3 cases, respectively. The 6 other malignant NETP (one gastrinoma, 2 carcinoids, 3 non-functioning) were managed by pancreatic resection (Whipple's operation = 3, distal pancreatectomy with total gastrectomy = 1, total pancreatectomy = 1, distal pancreatectomy with left nephrectomy and proximal gastrectomy = 1). Two patients died postoperatively. We had 5 major and 2 minor postoperative complications, with 2 deaths. During follow up from 1 to 7 years, one patient with malignant carcinoid tumor died at two and half years, of local recurrence. The other 8 patients are disease-free with good quality of life.

Spontaneous splenic rupture secondary to metastatic gastric carcinoma.

Spontaneous rupture of the spleen secondary to metastatic carcinoma is rare. We report the second such case. Rupture is usually diagnosed at laparotomy. However ultrasound and computerized tomography can play a role in diagnosis.

Small bowel leiomyoma: an unusual presentation.

Dual pathology having similar symptomatology is uncommon. We present a patient whose symptoms, although not absolutely typical of inguinal hernia, were attributed to bilateral irreducible inguinal hernias and were treated surgically. He remained symptomatic and later, was found to have an intraluminal leiomyoma of the jejunum, which was then removed. We suggest that the presence of any unusual clinical features should prompt further investigation to detect an alternative causative pathology.

Richter's hernia: a rare presentation of abdominal tuberculosis.

Intestinal obstruction due to Richter's hernia has not been reported in abdominal tuberculosis. This 21-year-old man with abdominal tuberculosis presented with small gut obstruction due to Richter's hernia associated with ascites and patent right processus vaginalis (PV). He underwent laparotomy with reduction of Richter's hernia and closure of the PV at the right deep inguinal ring.