Areca Nut Products Research Articles

Oral lesions of 500 habitual psychoactive substance users in Chennai, India

The aim of this study was to ascertain the prevalence of oral lesions among 500 psychoactive substance users in a hospital-based population. The study group consisted of 500 consecutive patients attending TTK Hospital, a non-governmental organisation involved in rehabilitation of substance users. Patient history was recorded in a pre-determined format and clinical findings were recorded by a trained physician and dental surgeons. Psychoactive substances used by the patients were alcohol (97%), tobacco (72%), arecanut (57.2%), narcotics (6.8%), cannabis (3.2%) and benzodiazipines (1.8%). Ninety-one percent of patients had one or more oral lesions: dental caries (39%), gingivitis (37.6%), extrinsic stains (24%), oral submucous fibrosis (OSF) (8%), periodontitis (7.4%), leukoplakia (6.6%), melanosis (5.2%), nicotina palatini (2.2%) and erythroplakia (0.6%). For OSF, those using arecanut and alcohol had an odds ratio (OR) of 2.4 [95% confidence intervals (CI) 1.23-4.69, P=0.009], smokers using arecanut products and alcohol had an OR of 3.07 (95% CI 1.59-5.91, P=0.000), and smokers who chewed arecanut products and used drugs had an OR of 23.1 (95% CI 2.05-260, P=0.001) compared with the general population. Those who smoked and used alcohol, arecanut and drugs had a 20.67-fold higher risk of developing leukoplakia compared with those who did not engage in these habits. In conclusion, 91% of patients had one or more oral lesions that needed dental treatment, and most patients were not aware of their oral lesions. The high prevalence of OSF and leukoplakia in substance abusers compared with the general population emphasises the need for regular dental assessments in these patients.

Epidemiological and etiological study of oral submucous fibrosis among gutkha chewers of Patna, Bihar, India

An etiological and epidemiological study of oral submucous fibrosis (OSMF) has been done in Patna, Bihar. Total 157 cases of OSMF and 135 control subjects were selected for study in the period of 2002-2004. It was observed that Male:Female ratio was 2.7:1. The youngest case of OSMF was 11 year old and the oldest one was 54 years of age. Maximum number of cases were belonging to 21-40 years of age and they were belonging to low or middle socioeconomic class. Most of the OSMF cases used heavy spices and chillies, where as control mild spices and chillies. Gutkha was the most commonly used by the OSMF cases only 3 per cent did not use any gutkha or other areca nut product where as 80 per cent control did not have any chewing habit. The OSMF cases used gutkha and other products 2-10 pouches per day and kept in the mouth for 2-10 minutes and they were using since 2-4 years. Most of the OSMF cases kept gutkha in the buccal vestibule or they chewed and swallowed it, only a small number of patients chewed and spitted it out. It was also observed that OSMF developed on one side of the buccal vestibule where they kept the chew and other side was normal.

Isolation, Identification and Screening of Potential Antagonistic Microorganism for the Biocontrol of Phytophthora meadii McRae Causing Fruit Rot of Arecanut (Areca catechu L.)

Fruit rot of arecanut caused by Phytophthora meadii McRae is a major constraint in arecanut production causing substantial loss in yield. Use of biocontrol agents is effective, ecofriendly and nonhazardous possibility for fruit rot management. The present investigation focuses on the screening of potential biocontrol agents against the fruit rot pathogen . Phytophthora meadii on arecanut. Among the 14 isolates screened on dual culture method and bioassav experiments, Trichoderma viride (04), Bacillus cereus , B. polymyxa and B. licheniformis were emerged as potential biocontrol agents.

Increased copper level in oral mucosal tissue of patients with submucous fibrosis and who chew areca nut products

Increased copper level in oral mucosal tissue of patients with submucous fibrosis and who chew areca nut products

Palm‐nut problem: Asian chewing habit linked to oral cancer

quid consisting of nut pieces from an Areca catechu palm mixed with powdered lime (calcium hydroxide) and wrapped in the leaf of the pepper plant Piper betle. Betel used primarily as a stimulant. Areca nuts contain alkaloids that induce euphoria and raise a person's heart rate and skin temperature. Some chewers say a cheekful of betel aids digestion. Over the past decade, avarietyof evidence has linked betel chewing to several types of oral cancer. Although the custom falling out offashion in several countries, such as Thailand and Cambodia, it's growing in popularity in other areas. Especially troubling that many new betel users are adolescents and children, say Asian health officials. Some governments in Asia are taking steps to reduce betel use. Oral cancer relatively rare in Western countries. In some south Asian countries, however, it ranks first among malignancies. According to the World Health Organization (WHO), a disproportionate number of the world's cases of oral cancer in men occurs in regions of Asia where betel chewing common. Once diagnosed mainly in adults, such cancers are now on the rise in young people. Saman Warnakulasuriya, an oral pathologist at the Guy's, King's, and St. Thomas' Dental Institute in London, says that greater commercialization of areca-nut products extendingbetel use. What used to be homegrown and sold by farmers now a big industry in most parts of Asia, he says. Packaged betel mixtures, known by several names, are now widely available in Asian countries and some regions of the world with large populations of Asian immigrants. Many of these products contain tobacco, spices, sweeteners, and other additives to make them more flavorful, potent, and addictive. Aggressive advertising, targeted at the middle class and adolescents since the early 1980s, has largely enhanced the sales, notes Beatrice Secretan, a health researcher who contributed to the 300-page Monograph on Betel-quid andAreca-nut Chewing published in October 2004 by WHO's International Agency for Research on Cancer, based in Lyon, France. The situation, she says, is similarto the real start ofthe tobacco epidemic, with industrially manufactured cigarettes, at the beginning of the 20th century.

Oral submucous fibrosis: a case-control study in Chennai, South India.

Oral submucous fibrosis (OSF) is a pre-cancerous condition caused by the use of areca nut in various forms. There are very few published reports on areca nut use and OSF from Chennai, South India. A hospital-based case-control study on habits and OSF was performed in Chennai over a 3-year period. A total of 185 consecutive patients with OSF were matched with age- and sex-matched controls. History was recorded in a pre-determined format by qualified dental surgeons. The male to female ratio of OSF cases was 9.9 : 1. All areca nut products were associated with OSF, with the risk being greatest for pan masala. The duration of the habit was more significant than the frequency of the chewing habit. The present study confirms the strong association between areca nut use and OSF and the increasing use of pan masala.

Smokeless tobacco and health in India and South Asia.

South Asia is a major producer and net exporter of tobacco. Over one-third of tobacco consumed regionally is smokeless. Traditional forms like betel quid, tobacco with lime and tobacco tooth powder are commonly used and the use of new products is increasing, not only among men but also among children, teenagers, women of reproductive age, medical and dental students and in the South Asian diaspora. Smokeless tobacco users studied prospectively in India had age-adjusted relative risks for premature mortality of 1.2-1.96 (men) and 1.3 (women). Current male chewers of betel quid with tobacco in case-control studies in India had relative risks of oral cancer varying between 1.8-5.8 and relative risks for oesophageal cancer of 2.1-3.2. Oral submucous fibrosis is increasing due to the use of processed areca nut products, many containing tobacco. Pregnant women in India who used smokeless tobacco have a threefold increased risk of stillbirth and a two- to threefold increased risk of having a low birthweight infant. In recent years, several states in India have banned the sale, manufacture and storage of gutka, a smokeless tobacco product containing areca nut. In May 2003 in India, the Tobacco Products Bill 2001 was enacted to regulate the promotion and sale of all tobacco products. In two large-scale educational interventions in India, sizable proportions of tobacco users quit during 5-10 years of follow-up and incidence rates of oral leukoplakia measured in one study fell in the intervention cohort. Tobacco education must be imparted through schools, existing government health programmes and hospital outreach programmes.

Effects of areca nut extracts on the functions of human neutrophils in vitro.

Aqueous extracts of ripe areca nut without husk (ripe ANE) and fresh and tender areca nut with husk (tender ANE) were examined for their effects on the defensive functions of human neutrophils. Exposure of peripheral blood neutrophils to ripe ANE and tender ANE inhibited their bactericidal activity against oral pathogens, including Actinobacillus actinomycetemcomitans and Streptococcus mutans, in a dose-dependent manner. At the concentrations tested, ripe and tender ANEs did not significantly affect the viability of neutrophils as verified by their ability to exclude trypan blue dye. However, both ANEs inhibited the production of bactericidal superoxide anion by neutrophils as measured by cytochrome c reduction. Moreover, the ripe ANE inhibited neutrophils more effectively than did tender ANE. Arecoline, a major alkaloid of areca nut, only exhibited an inhibitory effect on the functions of neutrophils when high concentrations were used. Therefore, arecoline could not be used to explain the inhibitory effects observed for ANEs. In conclusion, our results demonstrated that ripe and tender ANEs reduced the antibacterial activity and the superoxide anion production of neutrophils. This effect may contribute to a less efficient elimination of bacteria from the periodontal environment. Inhibition of the antimicrobial functions of neutrophils may alter the microbial ecology of the oral cavity, and this may be one possible mechanism by which areca nut compromises the oral health of users of areca nut products.

A dependency syndrome related to areca nut use: some medical and psychological aspects among areca nut users in the Gujarat community in the UK

Use of betel nut (areca nut) and its products is widespread, particularly in the Indo-Chinese continents, being the fourth most widely used substance after tobacco, alcohol and caffeine, affecting approximately 20% of the world's population. Betel nut, with or without admixed tobacco, is widely used among UK Indo-Asian immigrants, particularly Gujurate speakers. To date most research has concentrated on oral submucous fibrosis and malignancy. This paper reports detailed socio-demographic, clinical, laboratory and psychological studies in 11 current and former heavy betel nut users, referred by an Oral Medicine Unit in NW London. The patients, nine males, two females, had a high incidence of cardiovascular disease and truncal obesity. Laboratory investigations showed a high incidence of reduced serum B12 levels (4/9) and raised urinary cotinine levels (6/11), although none were current cigarette smokers. These findings are consistent with heavy usage of tobacco-areca combinations by this group. Routine biochemical and haematological investigations and clinical examination revealed no consistent abnormalities. Subjects had used areca for an average of 35 years with the mean age of first use being 13 years. Most subjects reported beneficial psychosocial effects. Ten subjects reported cessation withdrawal effects with the mean Severity of Dependence Score of 7.3. These findings are consistent with the existence of a dependency syndrome among those who use areca nut products. Further research is required to delineate the relative contributions of areca nut and tobacco to this clinical picture. Use of the areca nut, especially with tobacco, represents an area of health prevention among the UK minority populations that has, to date, been overlooked.

Private Property Rights and Forest Preservation in Karnataka Western Ghats, India

AbstractAreca nut orchard owners have been mulching their orchards with foliage from surrounding government‐owned deciduous forests at an average rate that may well deplete foliage within a decade, thereby endangering the long‐term viability of the region's most profitable agricultural enterprise. A bioeconomic model of areca nut production is formulated to determine the circumstances under which privatization of forest resources in the hands of orchard owners will stem this rapid depletion. An empirical application suggests that foliage is not currently sufficiently abundant to survive privatization; however, the prospects for preservation can be increased with the imposition of a preprivatization period of regulated use.