Smokeless tobacco (paan and gutkha) consumption, prevalence, and contribution to oral cancer / 한국역학회지

Smokeless tobacco consumption, which is widespread throughout the world, leads to oral submucous fibrosis (OSMF), which is a long-lasting and devastating condition of the oral cavity with the potential for malignancy. In this review, we mainly focus on the consumption of smokeless tobacco, such as paan and gutkha, and the role of these substances in the induction of OSMF and ultimately oral cancer. The list of articles to be examined was established using citation discovery tools provided by PubMed, Scopus, and Google Scholar. The continuous chewing of paan and swallowing of gutkha trigger progressive fibrosis in submucosal tissue. Generally, OSMF occurs due to multiple risk factors, especially smokeless tobacco and its components, such as betel quid, areca nuts, and slaked lime, which are used in paan and gutkha. The incidence of oral cancer is higher in women than in men in South Asian countries. Human oral epithelium cells experience carcinogenic and genotoxic effects from the slaked lime present in the betel quid, with or without areca nut. Products such as 3-(methylnitrosamino)-proprionitrile, nitrosamines, and nicotine initiate the production of reactive oxygen species in smokeless tobacco, eventually leading to fibroblast, DNA, and RNA damage with carcinogenic effects in the mouth of tobacco consumers. The metabolic activation of nitrosamine in tobacco by cytochrome P450 enzymes may lead to the formation of N-nitrosonornicotine, a major carcinogen, and micronuclei, which are an indicator of genotoxicity. These effects lead to further DNA damage and, eventually, oral cancer.

Smokeless tobacco (paan and gutkha) consumption, prevalence, and contribution to oral cancer / 한국역학회지

Smokeless tobacco consumption, which is widespread throughout the world, leads to oral submucous fibrosis (OSMF), which is a long-lasting and devastating condition of the oral cavity with the potential for malignancy. In this review, we mainly focus on the consumption of smokeless tobacco, such as paan and gutkha, and the role of these substances in the induction of OSMF and ultimately oral cancer. The list of articles to be examined was established using citation discovery tools provided by PubMed, Scopus, and Google Scholar. The continuous chewing of paan and swallowing of gutkha trigger progressive fibrosis in submucosal tissue. Generally, OSMF occurs due to multiple risk factors, especially smokeless tobacco and its components, such as betel quid, areca nuts, and slaked lime, which are used in paan and gutkha. The incidence of oral cancer is higher in women than in men in South Asian countries. Human oral epithelium cells experience carcinogenic and genotoxic effects from the slaked lime present in the betel quid, with or without areca nut. Products such as 3-(methylnitrosamino)-proprionitrile, nitrosamines, and nicotine initiate the production of reactive oxygen species in smokeless tobacco, eventually leading to fibroblast, DNA, and RNA damage with carcinogenic effects in the mouth of tobacco consumers. The metabolic activation of nitrosamine in tobacco by cytochrome P450 enzymes may lead to the formation of N-nitrosonornicotine, a major carcinogen, and micronuclei, which are an indicator of genotoxicity. These effects lead to further DNA damage and, eventually, oral cancer.

Evaluation of interleukin-1beta and 8 in gutka chewers with periodontitis among a rural Indian population

PURPOSE: Smokeless tobacco-based oral-use products like gutka are popular in India. Gutka usage leads to increased periodontal destruction and inflammation; however, the relevant mechanism remains unknown. This study aimed to elucidate the role of gutka in periodontitis by examining its effect on the levels of interleukin (IL) 1beta and IL-8 from the gingival crevicular fluid (GCF). METHODS: A total of 45 patients were enrolled in this study. Thirty patients with periodontitis (15 gutka chewers [GCP] and 15 nongutka chewers [NGC]) and 15 periodontally healthy controls (HC) were selected. The full-mouth plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), and recession (RC) were recorded. The IL-1beta and IL-8 levels in the GCF of all subjects were assessed through an enzyme-linked immunosorbent assay (Quantikine). RESULTS: The IL-1beta and IL-8 levels were not significantly higher in the GCP group (IL-1beta, 369.01+/-273.44 microL; IL-8, 205.97+/-196.78 microL) as compared to those in the NGC group (IL-1beta, 195.57+/-96.85 microL; IL-8, 178.61+/-149.35 microL). More gingival RC and loss of attachment was seen among the GCP group (RC: 2.02+/-0.31, P=0.013; CAL: 4.60+/-0.56, P<0.001) than among the NGC group (RC, 1.21+/-1.15; CAL, 3.70+/-0.32); however, PD was deeper among the NGC subjects (P=0.002). PI and GI were significantly higher for the periodontitis group (P<0.001) when compared to the HC, but there was no difference among gutka chewers and non-chewers (P=0.22 and P=0.89). A positive correlation was found between the IL-8 levels and the duration of gutka chewing (r=-0.64, P<0.01). CONCLUSIONS: Gutka chewing leads to increased gingival RC and clinical loss of attachment. There was no effect seen in the proinflammatory cytokine levels in the GCF of gutka users.

Tobacco Use and Oral Health of Inmates in a Nigerian Prison

Objectives: To determine the effect of tobacco use on oral health status of inmates of a federal prison in Enugu, Nigeria.Materials and Methods: The study involved 230 inmates of the Nigerian Prison in Enugu. An interviewer­administered questionnaire was used to collect data on the demographic characteristics of the participants, oral hygiene methods, and smoking habits. An intra­oral examination to determine their oral health status was done using simplified oral hygiene index (OHI­S) for the oral hygiene status, the modified decayed missing and filled teeth (DMFT) index for caries status, and community periodontal index of treatment needs (CPITN) for the periodontal needs. Statistical Package for Social Sciences software, version 15 was used to analyze data.Results: One hundred and twenty participants (52.2%) were current smokers. Mean DMFT of smokers and nonsmokers were 2.38 ± 0.71 and 2.25 ± 0.83 respectively (P = 0.508) while mean Community Periodontal Index (CPI) scores of smokers and nonsmokers were 4.71 ± 1.26 and 2.27 ± 0.86, respectively (P = 0.276). Oral soft tissue lesions such as mucosal burn, oral leukoplakia­like lesions were found mainly in the tobacco users. Conclusion: Tobacco use had a negative effect on the oral health of the participants as smokers had worse oral health profile than non­smokers. They may benefit from counseling programs with the view to educate them on the effect of tobacco use on oral health and by extension, the general health. The full implementation of the Framework Convention on Tobacco Control (FCTC) treaty in Nigeria could help in curtailing these unwanted consequences of tobacco use

Patterns of Tobacco Consumption among Indian Men with Schizophrenia Compared to Their Male Siblings

OBJECTIVE: Tobacco consumption among patients with schizophrenia has been investigated extensively in western countries, but there is a dearth of studies in India, where socio-economic and cultural variables are different. This study aims to investigate the patterns of tobacco consumption among schizophrenia patients compared with their non-psychotic siblings. METHODS: Consenting, successive male outpatients diagnosed with schizophrenia (n=100, DSM-IV criteria), and their non-psychotic brothers (n=100) were compared. Following a structured diagnostic interview, detailed information about tobacco consumption (including smokeless tobacco) was obtained using the Fagerstrom Test for Nicotine Dependence for smoked tobacco, and FTND-smokeless tobacco. The University of Pennsylvania Computerized Neurocognitive battery (CNB) was administered to a sub-group of patients (n=48). RESULTS: Schizophrenia patients initiated tobacco use at a significantly earlier age than their brothers, but there was no significant difference with regard to type, quantity or frequency of tobacco use (smoke or smokeless varieties). Patients who consumed tobacco had significantly higher positive symptom scores compared with non-users (p=0.043). There were no significant differences between nicotine dependent and non-dependent patients with regard to CNB domains except attention. CONCLUSION: Patterns of tobacco consumption were similar among schizophrenia patients and their non-psychotic brothers. Tobacco use was associated with increased positive symptom scores, but there were no significant differences in cognitive measures among nicotine dependent and non-dependent patients.

Improving Physician Referral for Tobacco Cessation Clients of Tobacco Cessation Clinic in South India

The major burden of tobacco related diseases is borne by developing countries. Tobacco cessation is an important step in preventing mortality and morbidity due to tobacco related diseases. The objective of the study was to assess the profile of tobacco users utilizing the services of the district anti tobacco cell in Bangalore. A cross sectional study was carried out in 2009. Total of 122 persons above 18 years old, current tobacco users and who were motivated to quit were interviewed by a trained medical social worker. Information about the socio-demographic profile of the clients, details of tobacco use and nicotine dependence levels using Fagerstrom score was collected. SPSS 16.0 software was used for data analysis. The results have been presented using descriptive statistics and ANOVA tests. The study population was comprised of exclusively males. The mean age was 34.9 years. Seventy four percent (73.8%) were smokers while 26% were users of smokeless tobacco products. Fagerstrom scores showed that majority of tobacco users (54% of smokers and 63% of smokeless tobacco users) had moderate to high nicotine dependence. Most of the clients were self-referred. The average pack years of tobacco use and the mean Fagerstrom score were higher in the physician referred group indicating that physicians have access to tobacco users who could benefit the most from tobacco cessation efforts. Clients attending tobacco cessation clinics tend to have moderate to high tobacco dependence. Health care providers need to put in more efforts to refer tobacco users to tobacco cessation services. Improved physician awareness could help in stepping up tobacco cessation efforts.

Plasma Concentration of Ascorbic Acid and Some Hematological Parameters in Tobacco Snuffers Among the Igbos of Southeastern Nigeria

Tobacco snuffing; like cigarette smoking; is known to be a common habit among the adults of Igbo communities in Nigeria. In view of the various pharmacological actions of nicotine and other additive constituents of tobacco snuff; there is growing concern that ascorbic acid; which is a vital antioxidant; and blood cell production or morphology may be affected. Objective: To investigate the possible effects of prolonged use of tobacco snuff on plasma ascorbic acid concentrations and some hematological parameters. Materials and Methods: Fifty adults of Igbo extraction (35 males and 15 females) residents in and around Enugu metropolis; who have been snuffing tobacco for 6 years and above; were recruited for the study; after they gave informed consent. Also; 50 apparently healthy; age-matched persons (25 males; 25 females); who do not smoke or take tobacco snuff; served as controls. Spectrophotometric method was adopted for ascorbic acid determination while hematological profiles were assessed by Bain method. Results: The results showed no significant difference in the measured parameters relative to the controls AA (P=0.08); Hb (P=0.19); PCV (P=0.10); RC (P=0.06); PC (P=0.20); WBC (P=0.09). Conclusion: The results of the study suggest that tobacco snuff inhalation may not adversely affect plasma ascorbic acid concentration and hematological parameters in adult humans. The study; however; has not concluded that tobacco snuffing is totally wholesome

Smokeless Tobacco Use in Adult Nigerian Population

The study aim was to establish the prevalence and determinants of smokeless tobacco use in Nigerian adults' population. Across-sectional survey of 1776 adults inYola; North-East Nigeria was carried out in June 2007.A modified World Health Organization (WHO) tobacco survey questionnaire was used for interview and data collection. Out of 1776 interviewed respondents; 133 (7.49) were user of smokeless tobacco. Snuffing of tobacco powder was the most common method of using smokeless tobacco (6.8). Fifteen (0.9) chewed tobacco while only 2(0.1) both chewed and snuffed tobacco. Social acceptance (21.8) was the major reason for using smokeless tobacco. Males; 5th and 6th decades of life; poor education; lower socioeconomic class; Margi; Hausa and Fulani tribes were the determinants of smokeless tobacco use.About 89.5of the smokeless tobacco users believed that smokeless tobacco was not harmful to their health. : Although the prevalence of smokeless tobacco use was low among Nigerian adult population in this study. Ignorance of the potential health dangers of smokeless tobacco was rampant therefore; concerted efforts should be made to discourage the use of all forms of tobacco rather than concentrating on cigarette smoking

Reversal effect and mechanism of lobeline on the multidrug-resistance of human breast cancer cells MCF-7/ADM / 中南大学学报(医学版)

OBJECTIVE@#To explore the reversal effect and mechanism of lobeline on the multidrug-resistance (MDR) of human breast cancer cells MCF-7/ADM.@*METHODS@#In human breast cancer cell line MCF-7/ADM, MTT assay was used to determine the cell growth inhibiting ratio of MCF-7/ADM by ADM and Fu. Fluorospectorphotometer was employed to investigate the intracellular concentration of rhodamine123 to reflect the effect of lobeline on the activity of MDR-related protein P-glycoprotein (P-gp). Taking untreated MCF-7/ADM cells as controls, flow cytometry was applied to detect the intracellular concentration of rhodamine123 in MCF-7/ADM cell intervened with lobeline of 20 micromol/L.@*RESULTS@#The sensitivity of MCF-7/ADM to ADM and Fu was significantly increased by lobeline in a dose-dependent manner. The inhibitive concentration 50 (IC(50)) of ADM declined from (44.81+/-0.43) mg/L to (16.72+/-0.75) mg/L with a reversion index of 2.68. The IC(50) of Fu declined from (53.12+/-1.60) mg/L to (38.90+/-1.43) mg/L with a reversion index of 1.37. The fluorescence intensity of lobeline-treated cells was significantly higher than that of the controls, when the concentration of lobeline was more than 10 micromol/L. With fewer side effects, the reversal efficacy of 20 micromol/L lobeline was 71.6% of the classical MDR reversal agent of verapamil at the same concentration.@*CONCLUSION@#Lobeline can reverse the MDR of MCF-7/ADM cells by inhibiting the activity of P-glycoprotein.

Short-Term Effect of High Dose of Vitamin C on Coronary Flow Velocity and Coronary Flow Reserve in Healthy Young Non-Smoker Men

BACKGROUND AND OBJECTIVES: Vitamin C, water-soluble antioxidant, has been reported to restore coronary microcirculatory responsiveness and impaired coronary flow reserve in smokers. However, the effect of high dose of vitamin C on coronary circulation is unclear in nonsmokers. METHODS: We used transthoracic echocardiography to measure the coronary flow reserve, an integrated measure of coronary flow in 20 male healthy nonsmokers (26+/-3 years) before and after administration of the high dose of vitamin C. RESULTS: The coronary peak diastolic velocity was increased by 14.8% after administration of antioxidant vitamin C, whereas the coronary flow reserve did not changed. CONCLUSION: High dose of vitamin C acutely increases the coronary flow velocity without restoration of coronary flow reserve in male healthy nonsmokers.

Pericardiectomy for Constrictive Pericarditis Using the Harmonic Scalpel: A case report / 대한흉부외과학회지

A 68-year-old man with constrictive pericarditis underwent pericardiectomy. The pericardium was dissected with a Harmonic Scalpel (Ethicon Endo-Surgery, Cincinnati, OH). The harmonic scalpel differs from electrocautery in that there is only a minimal transfer of energy and no transfer of electrical energy to the tissues. A significant decrease in intraoperative and possibly even postoperative heart rhythm disorders is to be expected, as there is no conduction of electricity. This new device has many advantages including no muscular stimulation, low heat, a smokeless field and easy hemostasis. We exprienced a patient who underwent pericardiectomy using the Harmonic scalpel, so we report this case with a brief literature.

Nuevas estrategias en el tratamiento farmacológico del tabaquismo / News strategies in the pharmacological treatment of tobac adiction

La adicción a la nicotina es uno de los problemas de salud pública más importantes en todos los países del mundo. Se piensa que el potencial adictivo de la nicotina es similar en intensidad al que genera la cocaína. Las tasas esperadas de muerte relacionadas al uso del tabaco para el 2020 será aproximadamente de 10 millones de personas. Las estrategias farmacológicas actuales para el tratamiento del tabaquismo incluyen la terapia sustitutiva por vías no inhalables, el bloqueo de los receptores nicotínicos y el desarrollo de una vacuna. Se ha demostrado que el bupropión es un antagonista de la nicotina. En los próximos años se tendrá una vacuna para uso clínico (Nic Vax ) que bloquea a la nicotina circulante antes que acceda al sistema nervioso central.

Comparison of respiratory sensations induced by J receptor stimulation with lobeline in left handers & right handers.

We examined the hypothesis that right handers and left handers may differ in sensory perceptions and respiratory responses to J receptor stimulation with intravenous injections of lobeline HCl in incremental doses. The comparison was made between 6 right handers and 9 left handers (all males) for (i) the dose of lobeline required to produce sensory threshold (viz., first appearance of respiratory sensations) and cough threshold (first appearance of cough); and (ii) latency and duration of sensations for sensory and cough threshold. All these comparisons were not found to be significant statistically. The sensation of breathlessness, and feelings of drowsiness, giddiness and headache were perceived in 3 of the 9 left handers, and in none of the right handers, but the difference was not significant. Reflex bradycardia was recorded only in left handers (5 of 9). The time (sec) for cough threshold was negatively correlated to threshold dose of lobeline (r = -0.5, and P < 0.05). The left handers perceived cough at the threshold as more distressing as compared with right handers (VAS P < 0.05). In conclusion, handedness did not influence J receptor responses to i.v. lobeline.

Leukokeratosis nicotinica; tobacco/snuff and tobacco smoking-pre-cancerous and malignant potentials

Leukokeratosis nicotinica is keratosis found in the oral mucosa of chronic chain smokers especially pipe smokers and commonest in the palate. There is no sex predilection so far as the smoking habit is chronic. The lesion is also known as nicotine stomatitis and smoker's keratosis. Though leukokeratosis nicotinica is not ranked mainly as precancerous lesion; it may have some degrees of dyplastic changes indicative of premalignancy and in some cases carcinoma in situ

A Clinical and Histopathological Study of Tattoos: I. A Clinical Study / 대한피부과학회지

128 individuals with tattoos, who were seen during physical examination for conscription from February to May, 1985, were taken for a clinical study of tattoos. The results were as follows: 1. The color of the tattoos were blue-black or light blue. The materials most commonly employed were Chinese ink stick and others were Chinese ink, black ink, blue ink, and smokeless coal powder. 2. The tattoos were made by tattooed themselves or by their friends and sewing needles were punctured to introduce particles of pigment into the skin in all cases. 3. As to the sites of tattoos, left forearm was the favorite(42.4%) and others were left upper arm(28. l%), right forearm(5. 5%), right upper arm(5 1%) etc. 4. Among 271 tattoos of 100 kinds, a rose was most frequently seen(5. 9%) and others were a symbol of love(4. 8%), a butterfly(4.l%), - I (one mind) (3.7%), patience (3. 7%) etc. 5. The complications of tattooing were found in 8. 6p, of the tattooed and they were pyoderma, hypertrophic scar, keloid, lymphadenopathy, post-inflammatory ]yper-and hypopigmentation, and scar formation about tattoos. 6. The removd of tatoos were tried all by tattooed themselves. The most frequent method used was scratching up with a knife and others were cigarette burn, attatchment of bean-curd, rubbing with salt, and chemical burns with hydrochloric acid. etc.