Betel chewing among bus drivers in Jaffna district

Objective: To assess the prevalence, pattern and sociocultural factors associated with betel chewing among bus drivers in Jaffna district. Methodology: Cross-sectional study was conducted among 423 registered drivers using an interviewer administered questionnaire from March to April 2014. Results: All were males. Mean age of the respondents was 41.42 years (SD= ±10.3; range 20-65). The overall prevalence of betel chewing was 70.4%. Of the total 9.4% had chewed betel in the past. Of the current users 61% had chewed betel for more than 5 years. Betel was chewed daily by 89.2%. (of them 60.8% used ≤3 times). Almost all current chewers used areca nut. Fifty five percent of the drivers said they used betel to improve concentration while driving. Seventy five percent of those who used betel in the past said that staining of teeth was the reason for stopping the habit. Private bus drivers were more likely to chew betel while driving than SLTB drivers (p=0.002). Conclusion: The prevalence of betel chewing among bus drivers in Jaffna District was high. Majority had chewed betel for more than five years. Areca nut was a main ingredient of betel quid.

Suprascapular nerve block for postoperative pain relief in arthroscopic shoulder surgery: a new modality?

Arthroscopic shoulder surgery has a 45% incidence of severe postoperative pain. Opiates and interscalene nerve blocks have a high incidence of side effects, and intraarticular local anesthetic has been shown to be ineffective when used for postoperative pain relief. The suprascapular nerve supplies 70% of the sensory nerve supply to the shoulder joint, and local anesthetic block of this nerve is effective in certain shoulder pain disorders. To determine the efficacy of a suprascapular nerve block, subcutaneous saline was compared with a suprascapular nerve block using 10mL of 0.5% bupivacaine with 1:200,000 epinephrine before general anesthesia was induced. In the immediate postoperative period, a 51% reduction in demand and a 31% reduction in consumption of morphine delivered by a patient-controlled analgesic system was demonstrated. There was more than fivefold reduction in the incidence of nausea, as well as reduced visual analog and verbal pain scores for patients who received a suprascapular nerve block. The duration of hospital stay was reduced by 24% in the suprascapular nerve block group. A 24-h phone call interview revealed a 40% reduction in analgesic consumption and a reduction in verbal pain scores at rest and on abduction. There were no complications from the suprascapular nerve block. This study demonstrates that a suprascapular nerve block for pain relief in arthroscopic shoulder surgery is an effective and safe modality of postoperative pain relief.