ABSTRACT
Context: Tobacco use is the leading single preventable cause of deaths worldwide. India is the second largest consumer of tobacco in the world. Aims: To study the prevalence of tobacco use among the adult population >15 years age of District Gautam-Budh Nagar and find the association of various socio-demographic factors with the tobacco usage. Settings and Design: Cross-sectional community-based study conducted in urban and rural areas of District Gautam-Budh Nagar, Uttar-Pradesh. Subjects and Methods: The study was conducted among 1461 adults aged 15 years and above in the District Gautam-Budh Nagar. Multistage sampling was used to select the study subjects. The questionnaire used for the interview consisted of questions related to socio-demographic profile, smoking habits and smokeless tobacco use, intention to quit and exposure to second-hand smoke. Statistical Analysis: The data were entered and analyzed in SPSS Software version 20.0. The prevalence of tobacco use was expressed in percentages. The association between various socio-demographic factors and tobacco use was assessed by Chi-square test. P value < 0.05 was taken as significant. Results: Prevalence of tobacco usage in this study was found to be 50.4% (65% among males and 28.8% among females). The prevalence of smoking and smokeless tobacco use in our study was 37.2% and 21.3%, respectively. Increasing age, male gender, and lower educational status were found to be significant risk factors for tobacco use in our study. Conclusions: India needs to gear up the efforts more and can still do more to make the proven tobacco control tools work for its citizens' well-being.
ABSTRACT
BACKGROUND: Chronic aluminum toxicity (CAT) in end stage kidney disease (ESKD) patients is now a rare clinical disorder, unlike in the past, because of improvements in hemodialysis water purification systems and discontinuation of use of aluminum hydroxide as a phosphate binder. The use of aluminum utensils for cooking could be an unrecognised cause of the CAT. OBJECTIVE: To assess the association between aluminum kitchen utensils used for cooking meals and chronic aluminum toxicity (CAT) in patients on maintenance hemodialysis (MHD). MATERIAL AND METHODS: In this case control study, a total of 31 (cases n=10; controls n=21) patients on MHD for more than one year were included. Cases were defined as patients with clinical manifestations (including laboratory parameters) of CAT and high (>200 mcg/L) serum aluminum levels. Control group was chosen from the same hemodialysis facilities. Association between use of aluminum utensils for cooking and occurrence of CAT was assessed. RESULTS: The mean age of patients in the cases and the control group was 52.90 and 52.95 years respectively with on significant difference (p=0.99). There was no difference in mean duration of dialysis (p=0.78), serum calcium level (p=0.06), serum phosphate level (p=0.19), serum albumin level (p=0.06), history of hypertension (p=1.00) and history of diabetes (n=0.12) between two groups. Mean haemoglobin (p<0.05) and mean iPTH (p<0.05) was significantly lower in the cases as compared to control group. Thirteen patients had history of use of aluminum utensils [cases 10 (76.90%) and control 3 (23.10%); p<0.05]. All cases i.e. 10 (100%) had exposure to aluminum utensils whereas three (14.3%) patients in the control group had exposure to aluminum utensils whereas 18 (85.7%) patients had no exposure. The relative risk of having CAT because of use of aluminum utensils compared to not using was 28.46 (1.81 to 445.3) and the odd's ratio estimated was 120 (5.45 to 2642). CONCLUSION: Use of aluminum utensils for cooking meals is associated with CAT. Larger studies are required to confirm these findings.
