Indian Tobacco Research Articles

Interrelations of Level of Urinary Cotinine and Score for Fagerstrom Test for Nicotine Dependence among Beedi Smokers, and Smokeless Tobacco Users in India.

Background:Tobacco related diseases is largely preventable and can stop pre-mature death. According to World Health Organization (WHO), the prevalence rate of smoking is 28.6% (40% among males and 18.2% among females).[1] Beedismoking and tobacco chewing are the commonest forms of tobacco habits in India, and strongly associated with oral cancer in India.[2] There are methods to estimation of severity of tobacco dependency, of them FTND is identified. The score for FTND is used for cigarette smoking, but we do not know the FTND score of ST users and Beedi smokers in India. Therefore, keeping the study in plan, we aim a systemic review with the following objective.Objectives:1. To pursue a review of published researches on interrelations between Beedi smoking and FTND score. 2. To pursue a review of published researches on interrelations between consumption of ST and FTND score.Materials and Methods:A systematic search of published papers were examined from three different electronic databases namely Pubmed, Cochrane library, and ProQuest. The inclusion criteria and exclusion criteria was set based on commonality of the studies which was looked through the objectives. Total of four papers of its category were found, and those met the criteria for inclusion factors.Results:Seventy-one articles were screened initially and forty-three articles were excluded and twenty-eight articles were screened, out of which twenty articles were excluded based on inclusion criteria. The abstracts of remaining eight articles were reviewed and four were removed because of duplication of the data. Finally, four articles were included for review after three stages of screening. Review results revealed that out of four selected reviews, one research study finding was interrelated with FTND score and Beedi and ST users. This study results also revealed that there is not a set of research carried out on FTND score for Beedi smokers and ST users.

Workplace Design Features, Job Satisfaction, and Organization Commitment

Of late, there has been growing awareness among organizations as to the importance of green issues. This article seeks to examine how workplace design features of a green building contribute to the formation of employee organization commitment (OCM) through better job satisfaction (JST) within employees. Based on a comprehensive literature review, a theoretical model was proposed for investigation. Three putative paths linking workspace (WSP) to JST, departmental space (DSP) to JST, and JST to OCM were then tested relying on a survey data of 356 employees collected from three Leadership in Energy and Environmental Design (LEED)-certified companies, namely Indian Tobacco Company (ITC), Suzlon Energy Ltd, and Olympia Technology Park uses structural equation modeling (SEM) methodology as prescribed by Hair et al. Significant evidences were witnessed in support of all three purposed paths. The study drew data only from the green-certified organization. Future research should involve other green organization or larger sample of green building. The size and character of the sample were restricted by organizational constraints.

2016 Winner: Viswanadh Madugula.

We are pleased to announce that the winner of the 2016 JCS prize is Viswanadh Madugula for his paper entitled ‘The ciliary membrane targeting by a ternary complex comprising transportin 1, Rab8 and the ciliary targeting signal’ (Madugula and Lu, 2016).The prize, $1000, is awarded annually to a junior researcher who is the first author of the paper that is judged by the Editors and Editorial Board to be the best eligible paper published in Journal of Cell Science that year. To be considered for the prize, the first author must be a student or a postdoc of no more than five years’ standing.Viswanadh was born in Kakinada of Andhra Pradesh, India. He obtained his Master of Biotechnology from the Jawaharlal Nehru Technological University (Hyderabad, India), under the guidance of Rajkumar Ratinavelu at the Indian Tobacco Company (ITC), R&D center. For his master study, Viswanadh researched the pollen gene flow in Eucalyptus camaldulensis Dennh by using paternity analysis.In 2011, Viswanadh was awarded a research scholarship from the Nanyang Technological University (Singapore) and joined the School of Biological Sciences. He then became fascinated by the subcellular world and decided to start his PhD in the newly set-up lab of Lei Lu, who studies biogenesis and trafficking of cellular organelles by using multidisciplinary approaches. His supervisor encouraged him to explore new research avenues in the field of membrane trafficking. One of the outstanding questions in cell biology then (and now) is how proteins are targeted to the cilium, a tiny protrusion from the plasma membrane that functions as an environment sensor. Around that time, the laboratories of Kristen Verhey and Benjamin Margolis published articles about the role of transportin 1 in ciliary targeting (Dishinger et al., 2010; Hurd et al., 2011). Despite the fact that this meant a new research direction for the Lu lab, Viswanadh decided to embark on a project, in which to test whether importins provide a generic and unified mechanism for ciliary targeting of membrane cargos.For the next five years, Viswanadh was the only one in Lei Lu's lab, who worked on ciliary trafficking. He had to overcome unknown technical hurdles but, through all the challenges, his fascination with this tiny organelle grew. Although ciliary localization was considered to be a trait of ciliary proteins, one of the most difficult tasks for Viswanadh was to find a plasma membrane protein that was not within or on the cilium. CD8a, for example – which had been commonly used as a negative control for ciliary localization – always displayed a significant presence at the cilium. A puzzling observation, until he concluded that the ciliary membrane diffusion barrier must be leaky. Viswanadh realized that ciliary localization was quantitative instead of simply a ‘yes’ or ‘no’. He, therefore, developed an imaging tool, the cilium-to-plasma-membrane-intensity-ratio (CPIR), that allowed him to quantitatively describe the ciliary localization of ciliary membrane proteins. He demonstrated that importin-binding motifs and -binding domains can promote the ciliary localization of reporters.Viswanadh subsequently asked whether bona fide ciliary membrane residents utilize importins for ciliary targeting. He cloned the best-known ciliary membrane proteins or their ciliary targeting signal and tested each one for possible interactions with importin β1 and transportin 1. Several ciliary membrane proteins were found to interact with transportin 1. Interestingly, Gregory Pazour and colleagues found that the ciliary targeting signal of fibrocystin, which displayed positive interaction with transportin 1 in his screen, specifically binds to Rab8-GDP (Follit et al., 2010). Viswanadh, therefore, expanded his scope of interaction study to include Rab8 and found that transportin 1, Rab8 and the ciliary cargo of fibrocystin assemble as a complex to mediate fibrocystin ciliary translocation. Inspired by the better-known nucleocytoplasmic trafficking mechanism, he proposed a new model, whereby the guanine nucleotide exchange of Rab8 within the cilium provides the retention mechanism for ciliary membrane cargos (Madugula et al., 2016).Viswanadh also developed a single-molecule-based imaging tool to quantify the stoichiometry of the nuclear pore complex (Tie et al., 2016). He was recently awarded his PhD and is currently continuing to work in the same lab as a postdoctoral research fellow, pursuing to study the role of importins and Rabs in ciliary targeting.

SC17.03 Lung Cancer in India: Challenges and Perspectives

SC17.03 Lung Cancer in India: Challenges and Perspectives

Increasing the Anti-Addictive Piperidine Alkaloid Production of In Vitro Micropropagated Indian Tobacco by Nitrate Treatments

Background: Lobelia inflata L. (Indian tobacco) is a traditional medicinal plant native to North America. It contains several piperidine alkaloids. Interest in Lobelia alkaloids, and in particular (-)-lobeline, the most active component, has increased in recent years due to their effect on the central nervous system. Thus, lobeline is currently the subject of renewed interest for its anti-addictive activity in the treatment of drug abuse, and neurological disorders. Our studies were aimed at introducing this species into cultivation in Hungary. Results: For direct characterization of di-substituted and mono-substituted piperidine alkaloids in extracts of L. inflata, a tandem mass spectrometric method was developed using electrospray ionization. The compounds (-) lobeline, norlobeline, lobelanidine, norlobelanine and other related structures were identified by HPLC-MS/MS. With the aim of increasing the alkaloid production, we have investigated the effect of changing the ammonium and potassium nitrate levels of the basic Murashige-Skoog medium. The highest dry mass, total alkaloid and lobeline content were measured in the herbs and roots cultured at 570 mg L-1 KNO3 content. Conclusions: The highest values for lobeline derivatives norlobeline and lobelidine were also recorded in the herba and roots of Lobelia inflata cultured on reduced KNO3 containing MS medium. The most sensitive response to media modification was observed in the case of lobelidine. Double-concentration of NH4NO3 had an inhibitory effect on plant growth, total alkaloid and lobeline content.

PUB066 Yoga as a Powerful Tool for Smoking Cessation - Convincing Results of a Community Based Randomised Controlled Trial

Almost 47% smokers in India want to quit(GATS, 2010), if they are able to. Smokers have faced difficulty in quitting due to issues like anxiety, restlessness, insomnia, irritability, depression, anger, lack of concentration and difficulty in resisting craving. Yoga, an ancient science of well-being that developed in India, has long been known to bring peace, vitality and tranquillity on regular practice. Hence, it is expected that practising yoga should help a smoker in quitting. To scientifically evaluate the proposition of yoga as an aid for smoking cessation, a randomized controlled trial has been performed by the authors. A total of 124 ‘current smokers’ who expressed self-intent to quit were recruited into study from the community through resident-welfare organizations in Gurgaon,India. Participants were randomized to one of the 2 intervention arms, 62 each. All participants were offered behavioural counselling at 0, 2, 4, 8 and 12 weeks. In addition to behavioural counselling, 62 participants were linked to a Yoga Ashram (Institute) for twice a week one-hour yoga classes. Yoga group participants were offered dhyaan(meditation), pranayama(breathing exercises) and asanas(physical pose-based exercises) as a holistic wellness approach. Outcome measure included 7 day point-prevalence abstinence (as reported by participants) at end of 4 weeks, 8 weeks and 12 weeks. A total of 106 participants completed the study. Attendance in yoga classes varied from 64% to 100% in the Yoga group. At the end of 4 weeks, participants in the yoga group exhibited increased odds of 7 day point-prevalence abstinence as compared to those in ‘only behavioural counselling’ group [Odds Ratio: 4.2, 95% CI: 1.6 - 7.4]. Participants in the yoga group continued to exhibit higher odds of being abstinent at the end of 8 weeks [Odds Ratio: 3.1, 95% CI: 1.2 – 6.4] and 12 weeks [Odds Ratio: 2.9, 95% CI: 1.2– 6.7]. Results of this study indicate that incorporating yoga as a component of smoking cessation programs has potential to significantly improve the outcome. With the world formally accepting Yoga and UN declaring 22 June as International Yoga Day, time is now even more appropriate for all countries to exploit the benefits offered by Yoga towards smoking cessation. Self-report can potentially introduce reporting bias and subject to availability of resources, saliva cotinine testing will yield more reliable data. More rigorous larger studies are recommended for further robust evaluation. Underlying biological mechanisms responsible for benefit with yoga also need to be investigated and understood.

Reducing tobacco use among low socio-economic status youth in Delhi, India: outcomes from project ACTIVITY, a cluster randomized trial.

To test the efficacy of an intervention to reduce tobacco use among youth (10-19 years old) in slum communities in Delhi, India. This community-based cluster-randomized trial included 14 slums composed of purposely built resettlement colonies and adjacent inhabitant-built Jhuggi Jhopris. Youth in the intervention received a 2 year multiple-component intervention: (a) youth and adult leader training; (b) peer-led interactive activities and outreach; (c) tobacco cessation camps; and (d) enforcement of India's Tobacco Control Law (smoke-free environments and youth access). Overall, no differences between the intervention and control conditions were observed over time; self-reported tobacco use declined in both groups. However, when stratified by type of residence, a significant decrease was observed among youth in the resettlement colonies in the intervention group for overall tobacco use (slope = -0.69) and cigarette and bidi smoking (slope = -0.66), compared to an increase in the control group (slope = 0.24 and 0.12, respectively) (P < 0.001). No differences in smokeless tobacco (SLT) use were observed for either group. Comprehensive community-based interventions that engage youth can be effective in reducing smoking among disadvantaged youth in India. More intensive interventions, like tax increases or large-scale media campaigns, appear warranted for the most marginalized in this context and for SLT products.

‘Mangaldeep’: Spreading Fragrance in India

This case highlights Indian Tobacco Corporation (ITC)’s journey from being a pure leaf tobacco selling company to a reputed conglomerate with popular brands in diversified areas. ITC’s corporate social responsibility (CSR) and sustainability activities taking a turning point with the company taking an immense interest in integrating societal problems in its company’s policies and strategies. These transformations can be seen in almost all the business divisions of ITC. Mangaldeep division, an incense stick division is not an exception to this change. However, the authors are trying to analyze the activities of ITC–Mangaldeep Business unit from different perspectives such as CSR, sustainability and shared value initiatives. Considering the resource constraint and the demand to meet the societal needs, it will be quite interesting to know how both these two challenges are met by a conglomerate like ITC simultaneously in the days to come. The case uses both primary and secondary sources of information to develop this teaching case.

Trends in bidi and cigarette smoking in India from 1998 to 2015, by age, gender and education

ObjectivesSmoking of cigarettes or bidis (small, locally manufactured smoked tobacco) in India has likely changed over the last decade. We sought to document trends in smoking prevalence among Indians aged...

Demographic, ergonomic and psychosocial factors affecting work related musculoskeletal discomforts in tobacco

Work related musculoskeletal disorders have been associated with demographic factors, work stresses and psycho-social stress symptoms. The study aimed to evaluate factors associated with MSDs in different body regions among Indian tobacco processing workers. A group of 450 tobacco processing workers participated in the study. A questionnaire comprising of demographic factors, work related exposures, psycho-social stress and musculoskeletal discomforts was administered. Self-reported prevalence of MSDs, correlation statistics and risk estimates were calculated. Females reported a higher prevalence of discomfort in the upper back, lower back and knees. The ANOVA showed that female workers perceived the work environment and physical activity to be more strenuous compared to their male counterparts. Correlation analyses suggest the influence of different work related aspects on pain in different regions. Physically demanding task situations, high physical activity and poor task clarity were associated with MSDs in both female and male tobacco processing workers. In males, poor job feedback and badly illuminated workspaces, and in females highly specialized job and high skill levels required were associated with MSDs. Psychosocial stress symptoms of workers were found to be associated with pain in different body parts Strategies need to be formulated to improve adverse working conditions to reduce pain related problems and to improve performance in the tobacco processing work.

Analysis of Socio Economic Issues of Women Employee's of Indian Tobacco Industries with reference to Tamilnadu, India.

India is the third largest tobacco producer in the world. The main growing states are Madhya Pradesh, Andhra Pradesh, Gujarat, Karnataka and Uttar Pradesh. More importantly, the bulk (80 per cent) of the tobacco grown there is of the non-cigarette type. It is used to meet domestic demands as bidis, in hookahs, chewing tobacco and snuff. Apart from earning revenue for the state, the tobacco industry generates substantial employment. Around 1.2 million workers are involved in cultivating, curing and processing tobacco, and another 5, 00, 000 workers are occupied in the trade and distribution of different types of tobacco. Estimates of the total number of bidi workers are as high as 5 million approximately. Additionally, many are engaged in collecting tendu leaf. Bidi rolling is one of the major unorganized sector activities in India, which employs large number of women. The Government of India estimates that there are about 4.4 million workers in this industry. Of these, the majority are home-based women workers who live under the poverty line. Thus, there is a need to improve the living and working conditions, about the tendu leaf growers and the workers in unorganized sector. Also helps to understand the problems faced by the women bidi workers in the industry. As well as to promote decent employment and income opportunities for women bidi workers.

How effective is tobacco control enforcement to protect minors: Results from subnational surveys across four districts in India

Context: On analogy with the WHO's Framework Convention on Tobacco Control, Indian tobacco control legislation, namely, Cigarette and Other Tobacco Products Act (COTPA), prohibits the sale of tobacco products to minors and near an educational institution. Aims: The objectives are to measure the compliance to the provisions of COTPA which bans the tobacco sale to and by the minors, prohibits sale within 100 yards distance of an educational institution, and an overall compliance to guidelines of Tobacco-free educational institutions. Methods: Using a pretested observational checklist, a cross-sectional survey was conducted between January and March 2013 across 1227 point-of-sale and 1408 educational institutions in four districts in India in 2013. Requisite ethical and administrative approvals were taken. Results: The study found moderate to low compliance to the provisions of COTPA regarding the ban on sale of tobacco products, to and by the minors, and around educational institutions. Tobacco products were easily accessible to minors in 57.7% of tobacco shops. The mandatory signages under Section-6 (b) of COTPA were not displayed in less than half of the educational institutions. In nearly one-fifth, tobacco products were being sold in and around 100 yards of institute's boundary. More violations pertaining to Section-6 (a) and 6 (b) were reported in district Jhunjhunu (representing Western India) and district Dhar (representing Central India), respectively, as compared to other jurisdictions under study. The tobacco-free institution guidelines were being followed by most educational institutions of Ernakulam district (representing South India). Conclusions: The present study observed a low compliance with enforcement of Indian tobacco control legislation. Thus, monitoring for compliance of policies and advocacy with policymakers is important for ensuring proper enforcement and preventing youth from initiating into tobacco use.

Cause Importance and Cause Familiarity of the “Aashirvaad-Boond Se Sagar Initiative” of ITC in Jammu City

The present study is an investigation of cause related marketing initiative “Aashirvaad-Boond Se Sagar” of Indian Tobacco Company Ltd. The Agri-business companies are increasingly undertaking the CRM initiatives (a type of CSR), wherein these companies have a scope of undertaking social causes along with achievement of their marketing objectives. Therefore, through this study an attempt has been made to understand consumer perception towards such campaigns. For the same, it was undertaken to study the cause familiarity and cause importance of ITC's-“Aashirvaad-Boond Se Sagar” initiative. The second objective undertaken was to analyze the input of cause familiarity and cause importance on attitude towards the brand and further in the third objective the impact of attitude on purchase intentions was studied. The present study was undertaken in the Jammu City and the data was collected from 200 consumers of Aashirvaad brand. Sequential Sampling was used to collect the data through survey method. The data collected was analyzed using Descriptive Statistics and Regression Analysis. The result of the study indicated that the respondents were of the opinion that ITC has promoted an important cause, but the familiarity to the same was somewhat low. There was a clear indication from the analysis that cause familiarity and cause importance have a significant impact on the attitude towards the brand and also the attitude thus formed through CRM initiative further leads to enhanced purchase intentions. Thus signaling the overall effectiveness of the CRM initiative of ITC's Aashirvaad brand.

Patient and Provider Factors Associated With American Indian and Alaska Native Adolescent Tobacco Use Screening.

Tobacco use is the leading behavioral cause of death among adults 25 years or older. American Indian (AI) and Alaska Native (AN) communities confront some of the highest rates of tobacco use and of its sequelae. Primary care-based screening of adolescents is an integral step in the reduction of tobacco use, yet remains virtually unstudied. We examined whether delivery of tobacco screening in primary care visits is associated with patient and provider characteristics among AI/AN adolescents. We used a cross-sectional analysis to examine tobacco screening among 4757 adolescent AI/AN patients served by 56 primary care providers at a large tribally managed health system between October 1, 2011 and May 31, 2014. Screening prevalence was examined in association with categorical patient characteristics (gender, age, clinic visited, insurance coverage) and provider characteristics (gender, age, tenure) using multilevel logistic regressions with individual provider identity as the nesting variable. Thirty-seven percent of eligible patients were screened. Gender of both providers and patients was associated with screening. Male providers delivered screening more often than female providers (odds ratio [OR] 1.6, 95% confidence interval [CI] 0.7-3.9). Male patients had 20% lower odds of screening receipt (OR 0.8, 95% CI 0.7-0.9) than female patients, independent of patient age and provider characteristics. Individual provider identity significantly contributed to variability in the mixed-effects model (variance component 2.2; 95% CI 1.4-3.4), suggesting individual provider effect. Low tobacco screening delivery by female providers and the low receipt of screening among younger, male patients may identify targets for screening interventions.

How Compliant are Tobacco Vendors to India's Tobacco Control Legislation on Ban of Advertisments at Point of Sale? A Three Jurisdictions Review

Section 5 of India's tobacco control legislation "Cigarettes and Other Tobacco Products Act (COTPA), 2003"comprehensively prohibits all kinds of tobacco advertisement, promotion and sponsorship (TAPS), but permits advertisments at the point-of-sale (POS) under certain conditions. This provision has been exploited by the tobacco companies to promote their products. To measure compliance with the provisions of Section 5 of Indian tobacco control legislation (COTPA, 2003) at point of sale. A cross-sectional survey using an observation checklist was conducted in 1860 POS across three jurisdictions (Chennai city, District Vadodara and District Mohali) in India. The most common mode of advertisement of tobacco products was product showcasing (51.1%), followed by dangles (49.6%), stickers (33.8%) and boards (27.1%). More than one fourth of POS were found violating legal provisions for displaying advertisement boards in one or other forms (oversized, extended to full body lenth of POS, displayed brandname/ packshot and promotional messages). Advertisement boards (16.3%) without health warnings were also found and wherever found, more than 90% health warning were not as per the specification in respect to size, font and background color. Point of sale advertising is aggressively used by the tobacco industry to promote their products. There is an urgent need of effective implementation of a comprehensive ban on tobacco product advertisement, promotion and sponsorship at point of sale.

Cytotoxic Effects of Indian Tobacco Rolls (Bidi) Smoke Extract on Macrophages &amp; its Prevention by Alkaloid Vasicine Obtained by Adhatoda vasica

Cytotoxic Effects of Indian Tobacco Rolls (Bidi) Smoke Extract on Macrophages &amp; its Prevention by Alkaloid Vasicine Obtained by Adhatoda vasica

Oklahoma Tobacco Helpline Utilization and Cessation Among American Indians

BackgroundAmerican Indians in Oklahoma have higher rates of tobacco use (29.2%) than any other racial group in the state. The Oklahoma Tobacco Helpline provides free cessation services to all Oklahomans and implements strategies specifically aimed at increasing the utilization and effectiveness of cessation services for American Indians.PurposeTo explore Helpline utilization patterns as well as outcomes, such as participant satisfaction and success in quitting, for American Indians. The utilization patterns and outcomes for American Indians were compared to that of the white population from July 1, 2010, to June 30, 2013, to determine whether the Helpline is equally effective among American Indians compared to whites.MethodsHelpline utilization data from July 1, 2010, to June 30, 2013, were analyzed in the fall of 2013 to identify patterns and compare differences between American Indian and white Helpline registrants. Four- and 7-month follow-up survey data were used to compare outcomes related to satisfaction with services and quit rates.ResultsDuring the 3-year study period, 10.6% of registrants who enrolled in an intervention were American Indian (11,075) and 71.2% were white (74,493). At the 7-month follow-up survey, 31.7% of American Indians reported having used no tobacco in the past 30 days compared to 36.5% of whites, but the differences were not statistically significant between racial groups.ConclusionsThe Oklahoma Tobacco Helpline is equally effective for American Indian and white tobacco users who register for Helpline services.

The Enforcement of India's Tobacco Control Legislation in the State of Haryana: A Case Study

In 2003, the Parliament of India passed the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 (COTPA) to counter the growing societal and health burdens of tobacco in India. The major provisions (Sections 4–7) of COTPA mandate the display of pictorial health warnings on all tobacco product packets and strictly prohibit: smoking in public places, direct and indirect forms of tobacco advertisements, promotion and sponsorship of tobacco products, sale of tobacco products to a minor, and sale within 100 yards of any educational institution. However, India continues to have a high prevalence of tobacco consumption and the provisions of COTPA are routinely flouted. The purpose of the study is to analyze the trends in and the prevalence of COTPA violations in a sample test site (Haryana) to develop informed and practical tobacco control policy recommendations. Violations in five districts of the State of Haryana were observed and recorded. The data overwhelmingly show that the most fundamental provisions (Sections 4–7) of COTPA were frequently violated in each of the five districts. All districts had a high rate of noncompliance, with Sites having at least one violation of Sections 4–7 of COTPA, with rates fluctuating between nearly 70 and 90 percent. Such violations however, were unequally distributed between Sections 4–7 within the five districts with some districts having a higher frequency of Section 4 violations (Panipat and Jhajjar) and other districts with higher violation frequency of Section 5 (Mewat and Kurukshetra). However, all five districts had relatively low numbers of Section 7 violations (i.e., the required display of pictorial health warnings on all tobacco products). The study highlights the challenges of the tobacco control policy in India including: engagement of state and district level enforcement officials for effective enforcement of existing legislation, encouragement for civil society to partner and complement governmental efforts in monitoring progress and reporting violations of COTPA, and the need for supply‐level controls on tobacco (e.g., pictorial health warnings and increased taxation) to reduce tobacco consumption.

Glycogenic Hepatopathy: A Differential Diagnosis of Acute Hepatitis in Diabetes Mellitus

Introduction: Acute hepatitis is always a diagnostic challenge. In the setting of a young adult with type 1 diabetes mellitus (T1DM), the differential diagnosis usually includes viral hepatitis, autoimmune, and metabolic liver diseases such as juvenile hemochromatosis. Liver biopsy (LB) may have a key role in establishing the correct diagnosis. Case Report: A female patient, 29 years old, presented with a 2-month history of asthenia, anorexia, peripheral edema, and epigastric pain, more intense in the last 2 weeks. The patient had poorly controlled T1DM (HbA1c 10.9%, normal range 4-6) diagnosed at the age of 4. She denied the use of drugs, except sporadic alcohol intake and Indian tobacco smoking 6 months before. Physical examination revealed hepatomegaly and peripheral edema without jaundice or altered consciousness. Laboratory analysis revealed acute hepatitis with increased aspartate aminotransferase (991 U/L, normal <31), alanine aminotransferase (461 U/L, normal <31), gamma-glutamyl transferase (219 U/L, normal <31), and alkaline phosphatase (172 U/l, normal <120). Bilirubin levels were normal, the patient had albumin deficiency (28.8 g/L, normal range 38-51) without coagulopathy. The ultrasound confirmed hepatomegaly without nodules or signs of portal hypertension. The etiologic study was negative for viral markers, autoimmunity, iron parameters, and manifestations of Wilson’s disease. LB was performed and the histological examination detected preserved architecture, ballooning, and universal clarification of hepatocytes and cell membrane accentuation with “mosaic” pattern distribution (typically seen in the Mauriac syndrome); glycogenated nuclei were also present. During hospitalization, there was a clinical and analytical improvement associated with glycemic control after adjustment and compliance with nutrition and insulin therapy regimens. At follow-up visit, after 3 months, all hepatic laboratory abnormalities and hepatomegaly had resolved. Discussion: The glycogenic hepatopathy (GH) is a rare cause of elevated aminotransferases in T1DM, being more frequent in patients with poor glycemic control. A similar condition was described by Mauriac, characterized by delayed growth and puberty, hepatomegaly, and cushingoid appearance. The authors intend to raise awareness to the diagnostic challenge of hepatitis in diabetic patients by reporting a case of clinically resolved GH. Disclosure - Helder Cardoso - Advisory committee: Abbvie, Janssen; Speaking and Teaching: BMS, Bayer, Roche.

Timeline trend profile and seasonal variations in nicotine present in ambient PM10 samples: A four year investigation from Delhi region, India

The detection of nicotine, an organic tracer for Environmental Tobacco Smoke (ETS), in the collected PM10 samples from Delhi region's ambient environment, in a appropriately designed investigation was initiated over four years (2006–2009) to: (1) Comprehend seasonal and inter-annual variations in the nicotine present in PM10; (2) Extract regression based linear trend profile manifested by nicotine in PM10; (3) Determine the non-linear trend timeline from the nicotine data, and compare it with the obtained linear trend; (4) Suggest the possible use of the designed experiment and analysis to have a qualitative appraisal of Tobacco Smoking activity in the sampling region. The PM10 samples were collected in a monthly time-series sequence at a known receptor site. Quantitative estimates of nicotine (ng m−3) were made by using a Thermal Desorption Gas Chromatography Mass Spectrometry (TD-GC/MS). The annual average concentrations of nicotine (ng m−3) were 516 ± 302 (2008) > 494 ± 301 (2009) > 438 ± 250 (2007) > 325 ± 149 (2006). The estimated linear trend of 5.4 ng m−3 month−1 corresponded to 16.3% per annum increase in the PM10 associated nicotine. The industrial production of India's tobacco index normalized to Delhi region's consumption, pegged an increase at 10.5% per annum over this period.