Knowledge, attitude, and practice among tobacco and alcohol addicts before and after psychological intervention in a de-addiction center at Madhya Pradesh, India.

CONTEXT: Tobacco and alcohol addiction has emerged as a major public health issue in most of the regions of the world. It has resulted in enormous disability, disease, and death and acquired the dimension of an epidemic. It is estimated that five million preventable deaths occur every year globally, attributable to tobacco use. The number is expected to double by 2020 if death due to tobacco continues to occur at the same rate. Alcohol, on the other hand, contributes to 25% of all deaths in the age group of 20-39 years. The interventions such as supportive pharmacotherapy, nicotine replacement therapy, counseling, behavioral intervention, psychotherapy, and detoxification therapy are being commonly employed in the management of patients with addiction to tobacco and alcohol. AIM: The aim of this study is to compare the knowledge, attitude, and practice (KAP) among tobacco and alcohol addicts before and after psychological intervention in a de-addiction center. SETTINGS AND DESIGN: This study was a randomized control trial, focusing on psychological interventions practiced in a de-addiction center, Indore, Madhya Pradesh, India. MATERIALS AND METHODS: The information on KAP related to tobacco and alcohol was collected at baseline from 83 participants. This was compared with the information collected in the postintervention follow-ups from each participant. STATISTICAL ANALYSIS USED: Statistical tests for parametric analysis were done using one-way ANOVA with Scheffe's post hoc test, RMANOVA with Mauchly's test for sphericity assumption, and Bonferroni test for comparing the main effects. Nonparametric tests included Pearson's Chi-square test, McNemar's Chi-square test, Spearman's rho, and Kruskal-Wallis test. The statistical significance was fixed at 0.05. RESULTS: The mean KAP score for the study population was highest at the first follow-up followed by the second follow-up for both tobacco and alcohol addiction. The least KAP score was observed at the baseline. CONCLUSIONS: Although a significant improvement in the mean KAP score was observed at the first follow-up, subsequent follow-up revealed a reduction in the overall KAP score in the present study. This could be attributed to the fact that following their discharge from the de-addiction center, most of the participants reverted back to their deleterious habits.

Effectiveness of two psychological intervention techniques for de-addiction among patients with addiction to tobacco and alcohol - A double-blind randomized control trial.

OBJECTIVE: The objective of this study was to evaluate effectiveness of two psychological intervention techniques (reading - writing therapy vs. games - narrative therapy) using motivational intervention alone as a control among tobacco addicts. MATERIALS AND METHOD: This randomized control trial was conducted over a period of 6 months from April to September 2013 at a de-addiction center in Madhya Pradesh, India. Patients with moderate-to-high levels of dependence as determined by Fagerstrom Test for Nicotine Dependence (FTND) admitted for treatment in a de-addiction center were recruited. A cluster randomization technique was used for allocation of participants to three different groups. Group allocation was concealed from investigator and done by coordinator. Three interventions were group A - motivational intervention alone, group B - games and story therapy along with motivational intervention, and group C - reading and writing therapy along with motivational intervention. Interventions were applied for 1 month. Two postintervention follow-ups (one at the time of discharge and one after 1 month following discharge) were done to assess level of dependence using FTND besides undertaking urine cotinine analysis among three randomly selected participants in each group. RESULTS: A total of 82 participants (28 in group A, 27 each in groups B and C) completed the study. Eighty-one (98.8%) participants had complete abstinence at the end of 1 month with no significant difference in the success rate between different categories (P = 0.357). At the end of 1 month following discharge from center, only 7 participants (8.5%) had complete abstinence and 51 participants (62.2%) had partial reduction and remaining 24 participants (29.3%) were considered failures with no difference between three groups (P = 0.768). CONCLUSION: Although overall abstinence was low (8.5%), all intervention techniques were equally effective in at least reducing level of dependence with no significant difference in their efficacy.

Assessment of periodontal status among eunuchs residing in Bhopal city, Madhya Pradesh, India: a cross-sectional study.

AIM: To assess the periodontal status among eunuchs residing in Bhopal city, Madhya Pradesh, India. MATERIALS AND METHODS: Based on convenient non-probability snow ball sampling technique, all the self-identifi ed eunuchs residing in the city of Bhopal along with a matched control consisting of cross section of the general population residing in the same locality where these eunuchs live was examined to assess the periodontal status of the population by using WHO oral health assessment proforma 1997. All the obtained data was entered into a personal computer on Microsoft excel sheet and analyzed by using a software; SPSS version 20. Data comparison was done by applying chi square test, ANOVA and multiple logistic regression analysis. RESULTS: A total of 639 subjects comprised of 207 eunuchs, 218 males and 214 females. The overall gingival and periodontal disease prevalence was 87.3% with calculus and shallow pocket contributing a major part i.e., 67%. Among study participants, 56.9% males were having highest prevalence for calculus. Whereas, eunuchs were having highest prevalence for bleeding (17.4%), shallow pocket (22.7%) and deep pocket (9.7%). However, highest of 19.7% males and 10.1% eunuchs were having attachment loss of 4-5 mm and 6-8 mm respectively. However, 6.3% eunuchs were having attachment loss of 12 mm or more. CONCLUSION: The results of the current study showed poor periodontal status among eunuch population with most of the population requiring simple therapy. This indicates that comprehensive oral hygiene instruction and dental prophylaxis need to be initiated.