Association between occupational history of exposure to tobacco dust and risk of carcinoma cervix: A case-control study.

CONTEXT: Cervical cancer is the second most common malignancy among women in India. There is thus a need to identify unexplored risk factors such as occupational exposure to tobacco dust to justify its increasing trend so as to recommend suitable preventive measures. AIMS: The aim was to study the association between occupational exposure to tobacco dust with development of carcinoma cervix. SETTINGS AND DESIGN: Case-control study done in two tertiary care hospitals in Mangalore. METHODOLOGY: 239 histologically confirmed new cases of cervical cancer and the equivalent number of age-matched controls from 2011 to 2012 were interviewed about occupational history of beedi rolling and related factors. STATISTICAL ANALYSIS: Chi-square test, unpaired t-test, logistic regression. RESULTS: Exposure rate to tobacco dust following beedi rolling was 63 (26.4%) among cases and 38 (15.9%) among controls (P = 0.005, odds ratio [OR] =1.893). The latent period from occupational exposure of tobacco dust subsequent to beedi rolling and development of cervical cancer was found to be 26.5 ± 8.5 years. Adjusted OR of beedi rolling with development of cervical cancer was found to be 1.913 (P = 0.005) after controlling the confounding effect of tobacco usage and was 1.618 (P = 0.225) after controlling the effects of all confounders. Three-quarters of beedi rollers were working in conditions of inadequate ventilation and hardy anybody used face mask during work. About a quarter of participants underwent voluntary screening for cervical cancer. CONCLUSION: Occupational exposure to tobacco dust was found to be associated with risk of developing cervical cancer. Measures to promote awareness, timely screening of this disease along with the improvement in working conditions is required for improving the health status of beedi rollers and to minimize the incidence of carcinoma cervix in the community.

Knowledge of first aid skills among students of a medical college in mangalore city of South India.

BACKGROUND: The adequate knowledge required for handling an emergency without hospital setting at the site of the accident or emergency may not be sufficient as most medical schools do not have formal first aid training in the teaching curriculum. AIM: The aim of this study is to assess the level of knowledge of medical students in providing first aid care. SUBJECTS AND METHODS: This cross-sectional study was conducted during May 2011 among 152 medical students. Data was collected using a self-administered questionnaire. Based on the scores obtained in each condition requiring first aid, the overall knowledge was graded as good, moderate and poor. RESULTS: Only 11.2% (17/152) of the total student participants had previous exposure to first aid training. Good knowledge about first aid was observed in 13.8% (21/152), moderate knowledge in 68.4% (104/152) and poor knowledge in 17.8% (27/152) participants. Analysis of knowledge about first aid management in select conditions found that 21% (32/152) had poor knowledge regarding first aid management for shock and for gastro esophageal reflux disease and 20.4% (31/152) for epistaxis and foreign body in eyes. All students felt that first aid skills need to be taught from the school level onwards and all of them were willing to enroll in any formal first aid training sessions. CONCLUSION: The level of knowledge about first aid was not good among majority of the students. The study also identified the key areas in which first aid knowledge was lacking. There is thus a need for formal first aid training to be introduced in the medical curriculum.

Study of home-monitored night blood pressure and its correlation with left ventricular hypertrophy in treatment-naive hypertensive patients.

INTRODUCTION: 24-hour ambulatory blood pressure (BP) monitoring is a well-validated tool that can reveal the patient's nocturnal dipping pattern. However, to the best of our knowledge, the role of home BP monitoring in identifying nocturnal dipping has not been studied. METHODS: We evaluated the nocturnal BP of 30 treatment-naive subjects using a home BP monitoring device. BP measurements were taken once during the daytime and once at night (three hours after sleep) by a blinded observer. Readings were correlated with left ventricular mass index. RESULTS: Night BP measurements were significantly lower in subjects without left ventricular hypertrophy (LVH) as compared to those with LVH, while the daytime readings were not significantly different between the two. The mean dips in nocturnal systolic and diastolic BP were 1.92% ± 6.89% and -0.55% ± 14.31%, respectively, in subjects with LVH. The corresponding values were 12.96% ± 6.16% and 11.36% ± 11.90% in those without LVH. The correlation between left ventricular mass index and night BP readings was statistically significant (systolic r = 0.66, p < 0.001; diastolic r = 0.496, p < 0.005). CONCLUSION: Nocturnal BP measurement using a home BP monitoring device may be a reliable and cost-effective method for detecting early signs of end-organ involvement such as LVH in hypertensives, especially in a resource-limited setting.