Substance use and oral health sensations among substance users residing in rehabilitation centres in an Indian City

Background: The term substance is usually used to address psychoactive/psychotropic drugs which include both licit and illicit drugs. These substances have varied consequences, including long?term and short?term effects, which include sensations post?consumption. Aim: To determine patterns of substance use and short?term oral health effects among substance users. Materials and Methods: A self?administered questionnaire?based study was conducted on the inmates of drug deaddiction and rehabilitation centres in Bhubaneswar city. Results: All the subjects were males and majority (60.6%) were polydrug users. Alcohol (87.3%) was the most commonly used substance, followed by ganja (57%), bhang (35.3%) and brown sugar (33%). A wide range of oral health sensations like dryness of mouth, taste change, numbness in mouth, feeling like chewing something, loose teeth and stammering/difficulty in speaking were found to be significantly associated with substance use. The age of start of substance use (P < 0.0001), socioeconomic status (P = 0.026) and marital status (P < 0.0001) were significantly associated with the pattern of substance use. About 37.6% of inmates felt that they had very good oral health before starting drug use, while only 15.4% described their oral health as very good at present. Having no oral health problem was the most common reason for not visiting a dentist, followed by ignorant attitude towards oral health. Conclusion: A wide range of oral health sensations were found to be caused due to substance use. Understanding of oral health sensations can aid practitioners detect and report cases of substance use in its early phase.

Level of Independence and the Mental Status of the Visually Challenged High School Students in Chennai

Background: The purpose of this study is to measure the number of visually impaired students who are capable of doing and managing their own work and also to evaluate their state of mind due to their impairment. The study is also to bring awareness about the rehabilitation centres and special training on mobility for the children. Objective: To find out the level of independence and the mental status of visually challenged students. Methods: This is a descriptive cross-sectional study. Sixty visually impaired students were included in the study by random sampling method. Male students from class 9th to 12th standard were evaluated. Data relevant to the study are gathered by interview schedule method and questionnaire was designed for the study beforehand. Result: It is evident from the current study that 83.3% of the impaired have not been trained to walk independently. Almost 78.3% of the students are not even aware of the rehabilitation centres. However, about 98.3% of students are independent in grooming and washing & also taking care of their personal work. As per the survey, only 26.6 % of students are feeling isolated, whereas, the balance 73.4% students feel very comfortable while dealing with sighted students. About 96.6% feel very happy and satisfied as they get enough support from their parents.

Short Bowel Syndrome as the Leading Cause of Intestinal Failure in Early Life: Some Insights into the Management / 대한소아소화기영양학회지

Intestinal failure (IF) is the critical reduction of the gut mass or its function below the minimum needed to absorb nutrients and fluids required for adequate growth in children. Severe IF requires parenteral nutrition (PN). Pediatric IF is most commonly due to congenital or neonatal intestinal diseases or malformations divided into 3 groups: 1) reduced intestinal length and consequently reduced absorptive surface, such as in short bowel syndrome (SBS) or extensive aganglionosis; 2) abnormal development of the intestinal mucosa such as congenital diseases of enterocyte development; 3) extensive motility dysfunction such as chronic intestinal pseudo-obstruction syndromes. The leading cause of IF in childhood is the SBS. In clinical practice the degree of IF may be indirectly measured by the level of PN required for normal or catch up growth. Other indicators such as serum citrulline have not proven to be highly reliable prognostic factors in children. The last decades have allowed the development of highly sophisticated nutrient solutions consisting of optimal combinations of macronutrients and micronutrients as well as guidelines, promoting PN as a safe and efficient feeding technique. However, IF that requires long-term PN may be associated with various complications including infections, growth failure, metabolic disorders, and bone disease. IF Associated Liver Disease may be a limiting factor. However, changes in the global management of IF pediatric patients, especially since the setup of intestinal rehabilitation centres did change the prognosis thus limiting “nutritional failure” which is considered as a major indication for intestinal transplantation (ITx) or combined liver-ITx.

Rehabilitation in the Intermediate and Long Term Care (ILTC) Sector

Outside acute hospital rehabilitation units, inpatient rehabilitation is also provided in the ILTC sector. Facilities providing such inpatient rehabilitation include Community Hospitals, Chronic Sick Hospitals, Nursing Homes, Inpatient Hospice Care, Day Rehabilitation Centres and Home Care Services. After the initial acute episode of a disabling disease (e.g. a stroke) has settled, the elderly patient will often than not, require a longer period for inpatient rehabilitation compared to a younger person. Such patients are transferred to a community hospital inpatient rehabilitation unit. The length of stay is about 1 month. However, it can be longer (3 to 6 months) depending on the condition and progress of the patient. The patient is then discharged home or to a nursing home if the family is unable to manage the patient at home. Elderly patients who require continuation of rehabilitation can receive this in various settings in the ILTC sector like the outpatient departments of the community hospital; Day Rehabilitation Centres (DRCs); and Singapore Programme of Integrated Care for the Elderly (SPICE) centers.