Tobacco Chewing Research Articles

Demographic profile and risk factors of head-and-neck squamous cell carcinoma in west Tamil Nadu: A cross-sectional observational study

ABSTRACT JOURNAL/crsat/04.03/02201859-202306020-00007/figure1/v/2023-08-03T140821Z/r/image-tiff JOURNAL/crsat/04.03/02201859-202306020-00007/figure2/v/2023-08-03T140821Z/r/image-tiff Background: Head-and-neck squamous cell carcinomas (HNSCC) comprise 30% of all cancer cases in India. The risk factors for HNSCC include tobacco and alcohol consumption. Objectives: Our primary objective was to evaluate the epidemiological profile of patients with HNSCC in the western Tamil Nadu population. Our secondary objective was to assess the association of the epidemiological profile with different anatomical sites and risk factors. Materials and Methods: This was a cross-sectional study of data compiled from the clinical records of Sri Ramakrishna Institute of Oncology and Research Department, Sri Ramakrishna Hospital, Coimbatore (Tamil Nadu, India) from January 2018 to December 2021. Clinicodemographic data like age, sex, primary tumor site, clinical staging, family history, and exposure to risk factors (smoking, tobacco chewing, alcohol) were collected from patients with histologically confirmed HNSCC using a specially designed questionnaire. Human papillomavirus (HPV) status was determined by p16 immunohistochemistry and validated using polymerase chain reaction (PCR) by employing consensus primers for HPV deoxyribonucleic acid (DNA). Results: We enrolled 150 patients. The male-to-female ratio was 3:1. The mean age was 54.4 ± 10.2 years; majority of patients (59 [39.3%]) were aged between 51 and 60 years. The most frequently affected site was the oral cavity (58 [38.7%]). Tobacco chewing was the most common and the only risk factor observed among female patients (23 [62.2%]), while smoking along with alcohol consumption was commonly observed among male patients (24 [21.2%]). Smoking in combination with other risk factors (44 [29.3%]) was more common than smoking alone (9 [8%]). Tobacco chewing was a predominant risk factor for nasopharyngeal (4 [63.6%]) and oral cavity cancer (19 [32.8%]), while smoking was a predominant risk factor for laryngeal cancer (3 [30%]). Smoking with alcohol consumption was largely seen in oropharyngeal cancer (5 [33.3%]), while all three risk factors were observed in hypopharyngeal cancer (4 [14.3%]). Out of 38 samples tested, only four were positive for HPV (10.5%). Conclusions: The most affected demographic group with regard to HNSCC is middle-aged men (51–60 years), and the oral cavity is the most commonly affected site. Tobacco chewing is the most prevalent risk factor among women while smoking and alcohol consumption are the most common risk factors among men. Spreading awareness about the risk factors of HNSCC and their prevention is crucial to optimizing disease control.

Predictive Risk Factor Analysis of Oral Submucous Fibrosis among Gond Tribes of Central India: A Cross-Sectional Study

ABSTRACT Introduction: Oral submucous fibrosis (OSMF) is a potentially malignant disorder characterized by fibrotic changes in the oral mucosa. It is a significant public health concern, particularly among certain ethnic populations. The Gond tribes of Central India represent one such population, and the prevalence and risk factors associated with OSMF among them remain largely unexplored. This study aims to conduct a predictive risk factor analysis to identify the factors associated with OSMF among the Gond tribes and provide insights into the etiology and pathogenesis of the disease within this specific population. Materials and Methods: A cross-sectional study was conducted among the Gond tribal population of Central India. A total of 800 participants were included in the study. Oral examinations were conducted by trained researchers to assess the presence of OSMF and other oral health conditions. Demographic and socioeconomic data were collected, including age, gender, education level, occupation, and household income. Lifestyle factors such as tobacco and betel nut chewing, alcohol consumption, and oral hygiene practices were assessed through structured questionnaires. Dietary patterns and nutritional status were evaluated, and oral health-related factors such as dental caries, periodontal health, and other oral lesions were examined. Multivariate analysis was performed to identify independent risk factors associated with OSMF among the Gond tribes. Results: The prevalence of OSMF among the Gond tribes was 12.5%. Demographic analysis revealed a balanced representation of genders, with a range of age groups included. Lifestyle factors such as tobacco and betel nut chewing were prevalent among the Gond tribes, with a significant proportion of participants reporting regular use of these substances. Poor oral hygiene practices and undernutrition were also identified as risk factors. Dietary patterns showed a high consumption of carbohydrate-rich foods and a relatively low intake of fruits and vegetables in addition to OSMF. Conclusion: This study provides valuable insights into the prevalence and risk factors associated with OSMF among the Gond tribes of Central India. The findings highlight the need for targeted interventions addressing tobacco and betel nut chewing, poor oral hygiene practices, advanced age, low education level, and undernutrition within this population. Comprehensive oral health promotion programs, including tobacco cessation initiatives, oral hygiene education, nutritional interventions, and improved access to dental care, are crucial for reducing the prevalence of OSMF and improving oral health outcomes among the Gond tribes. Future research should focus on longitudinal studies to further elucidate the causal relationships and long-term impact of these risk factors on the development and progression of OSMF within the Gond tribal population.

Prevalence and Risk Factors of Periodontal Disease among Rural and Urban Residents of a South Indian City: A Cross-Sectional Study.

The prevalence of oral diseases has been increasing alarmingly in the state of Kerala. Screening for periodontal disease (PD) is crucial due to its negative impact on oral and overall health. Since the occurrence and severity of PD depend on its risk factors, a structured survey in randomly selected districts in the state can be a valuable tool for policymakers to envisage strategies to enhance oral health care and control shared systemic illnesses. Data on the prevalence and risk factors of PD among the residents of the Thiruvananthapuram district of Kerala is not currently available in the public domain. This data could also be representative of the other 13 districts with more or less similar topographical, cultural, and lifestyle characteristics. To study the prevalence of PD and its risk factors among the residents of the Thiruvananthapuram district of Kerala and to compare the urban-rural differences. In this community-based cross-sectional study, a multistage cluster random sampling method was used to select the participants. Among the 1285 participants, 560 were from urban areas, and 725 were from rural areas. A modification of the Ramfjord PD index was used to assess periodontal health. The epidemiological risk factors were evaluated using sociodemographic data, personal histories, and physical and biochemical parameters. Multivariate logistic regression was used to determine the relationship of PD with independent variables. Mediation analysis was performed to examine the mediating effects of independent factors. The rural population (61.4%) had a higher frequency of PD than the urban (35.5%) and an overall prevalence of 50%. Aging, poor oral hygiene, and low educational level (EL) were significant risk factors for PD in urban and rural settings, with hypertension only being significant in the latter. A higher odds ratio (9.07-29.68) with a confidence interval of (5.45-48.94) for poor oral hygiene was noted. Poor oral hygiene and tobacco use had mediating effects between low EL and PD. In this study, the overall prevalence of PD was 50%, with the rural population being more afflicted. Poor oral hygiene has been identified as a modifiable risk factor for PD in urban and rural populations. Poor oral hygiene and tobacco use have been demonstrated to be mediators of the strong link between low EL and PD. Therefore, this study reiterates the need for better oral health awareness and treatment facilities to minimize the impact of the above risk factors on the periodontium. A shared risk relationship between PD and hypertension in the rural population emphasizes the need for an integrated approach to public health by including oral health as part of noncommunicable disease prevention and intervention programs.

Comparison of two hypofractionated palliative radiation therapy schedules head and neck cancers in terms of their clinical outcomes

More than 70% of patients with locally advanced head and neck malignancies (LAHNC), poor performance status, and eligibility for palliative radiation (RT) for symptom relief present in India. In this prospective trial, patients with LAHNC at a local cancer centre in north-west India will be treated with two distinct short-course hypo-fractionated RT regimens. There were 7 females and 33 males in this study. The bulk of our study group consisted of smokers and tobacco chewers, and the majority had this habit for 20–30 years, according to the results. In our study population, there was an overall improvement in quality of life, along with improvements in pain, speech, and overall health. In conclusion, patients' quality of life significantly improved in both groups, and there was no statistically significant difference between the two. The Christie regime may be similarly helpful in treating some patients to obtain a complete response.

Effect of chewing tobacco on reaction time – A comparative study

Background: The smoked and smokeless forms of tobacco consist of about 4000 chemical constituents having carcinogenic potential and nicotine is the major among these. A considerable amount of evidence states that long-term administration of nicotine can change the fundamental properties of cholinergic neurotransmission, leading to changes in synaptic efficacy and resulting in modified behaviors. The effects of nicotine on cognition have been interesting, but knowledge regarding it seems to be inconsistent. As there are very few studies in India to the influence of nicotine on reaction time, especially in the case of smokeless tobacco users, this study was undertaken with an attempt to find out whether “smokeless tobacco” effects cognition by assessing the reaction time. Aims and Objectives: To estimate and compare the auditory reaction time (ART) and visual reaction time (VRT) of tobacco users with non-tobacco users. Materials and Methods: This study is conducted on 70 male participants with 35 healthy male tobacco chewers in the age group of 18–55 years and an equal number of healthy age-matched male controls (non-tobacco chewers). ART and VRT were recorded in both groups using a reaction time apparatus with an inbuilt chronoscope. Results: Both ART and VRTs are faster in tobacco chewers compared to non-tobacco chewers, and the difference is statistically highly significant. Conclusion: This study, hence, demonstrates that nicotine shortens reaction times, thereby temporarily improving cognition, which can be attributed to the stimulatory effect of nicotine that may be due to an accelerated response to the various stimuli caused by the effect of nicotine. This can be due to catecholamine release in the brain that affects the central nervous system of chronic tobacco users to have significant consequences in the near future.

XRCC3 and NBS1 gene polymorphisms modulate the risk of pre-oral cancer and oral cancer in the North Indian population.

Oral cancer is alarming disease in the developing countries like India. DNA repair capacity may affect by genetic polymorphisms in DNA repair genes and thus may cause to cancer. XRCC3 involves in homologous recombination repair pathway and repair DNA damage and crosslinks while, NBS1 participate in repair of double strand DNA break and starts the cell-cycle checkpoint signaling. This study was to conducted to find the association of XRCC3, NBS1 polymorphisms with oral disease. TT genotype of XRCC3 was associated with high risk of precancerous lesions and oral cancerous lesions (P value=0.0001, OR=9.68, 95% CI=2.82-33.21; and P value=0.0001, OR=13.10, 95% CI=3.38-50.73 respectively). We did not observe any interactions of XRCC3 polymorphism with demographic parameters in influencing the risk of oral diseases. Variant allele genotypes (CG, GG) of NBS1 (C>G) polymorphism showed protective association with Oral submucous fibrosis (OSMF), lichen planus as well as oral cancer (OR=0.31, OR=0.01; OR=0.39, OR=0.03; OR=0.43, OR=0.31 respectively). Particularly, tobacco chewer with CG & GG genotypes were at decrease risk of oral diseases (P value=0.02, OR=0.32, 95% CI=0.12-0.80). Compared to CC/CC combined genotype CG/CC, CG/CT, GG/CC and CG/CT genotypes decreased the risk of oral disease (OR=0.05, 0.47, 0.26 & 0.14 respectively). This study concludes that SNP in XRCC3, NBS1 affects susceptibility to oral disease.

Prevalence of Oral Cancer in Western Population of Maharashtra for 3 Years: A Prospective Study.

In developing countries, oral cancer (OC) is estimated to be the third most common malignancy after cancer of the cervix and stomach. The aim of this study was to report the prevalence of OC for 3 years and its association with age, gender, type, and duration of habits along with the site of OC. This study was conducted in the Department of Oral Medicine and Radiology from January 2019 to December 2021. All the patients were examined after recording their demographic data using a mouth mirror and probe. The diagnosis of OC was arrived based on the clinical features of the lesions. The type and duration of habits and site were recorded in clinical pro forma. The Statistical Package for the Social Sciences (SPSS) software version 21.0 was used for the statistical analysis, the Chi-square test was applied, and the significance level was set at P < 0.05. The prevalence of OC was 0.22% in our study. Of 317 cases, the majority of the patients were males (n = 204), and females (n = 113) accounted for a male: female ratio of 2:1. The most common age affected was 51-70 years with a history of tobacco chewing, followed by patients with multiple habits (smokers, tobacco chewers, and alcoholic). The buccal mucosa was the most common site followed by malignancies of multiple sites. Regular camps regarding tobacco cessation and counseling should be taken care of by dentists. Male patients aged above 40 years are routinely recommended for dental visits.

Salivary oxidative stress level among tobacco chewers and smokers- A comparative Study

Salivary oxidative stress level among tobacco chewers and smokers- A comparative Study

Smokeless tobacco: a ticking time bomb for Pakistan

Oral cancers are one of the most prevalent cancers worldwide with almost 300,000 cases reported annually1. In Pakistan, it is the leading type of cancer in men and women after breast cancer. Each year around 16,000 new cases of oral cancers are documented with 5500 cases resulting in death2. There are multiple etiological factors for oral cancers among which the use of smokeless tobacco (SLT) is at the top of the list. SLT is available in different consumable forms such as chewable tobacco, betel leaf, snuff (naswar), Betelnut, etc., which contain a number of carcinogenic substances3. Studies have revealed that naswar is the most common etiological factor of oral cancers among the Pakistani population as compared to the other forms of SLT3. The basic constituents of naswar are slaked lime, powdered tobacco, and indigo which contain more potent carcinogens such as unionized nicotine and tobacco-specific N-nitrosamines, that are specifically harmful to the oral cavity4. It can be used through different routes either inhaled nasally or by placing inside the mouth under the tongue. The nicotine is absorbed into the oral mucosa which is further aided by the increased pH of the mouth by slaked lime5. It has been observed historically that the use of SLT products is very commonly acceptable in Pakistani culture3. The sale and production of naswar are not well regulated and it is being sold by different vendors at cheaper prices and in different package sizes with no such instructions and health warnings written on it1,2. Moreover, some scientific data implicates it as replacement therapy for tobacco smoke cessation as it is a cheaper nicotine substitute1. In 2005, Pakistan formalized the WHO “Framework Convention on Tobacco Control (FCTC),” which addresses the details of the regulation and control of tobacco and SLT products by regulating its price, taxation, packaging, labeling, advertisement, promotion, and sponsorship5. In the last few years, Pakistan has made significant progress in smoking cessation policies but regulation of STL production and taxing is still lagging5,6. A case-control study, conducted in Khyber Pakhtunkhwa, Pakistan, revealed that 68% (men) and 38% (women) of oral cancer patients in Pakistan are due to naswar use. It was also shown that those who used naswar ever in their lifetime have 20 times more risk to develop oral cancers compared with the nonusers of naswar1. Thus, the increasing incidence of oral cancers with the relative use of naswar sets a ground basis for the implementation of strict policies regarding the manufacture and sales of SLT. Studies have provided shreds of evidence that there is a marked decrease in tobacco product use among young people by applying a ban on their promotion and advertisement. Health warnings and relevant constituents written on packages can also be an important tool for minimizing SLT use6. Sticking firmly to the FCTC protocols of smokeless tobacco use is the dire need of time. Furthermore, awareness regarding the harmful effects of STL use should prevail on urban and rural levels as there is a great lack of knowledge among the local population. Ethical approval None. Sources of funding None. Author contribution S.F., O.A.S., G.S., and A.K.: wrote the manuscript. O.A.S. and S.A.: review editing, formatting, and referencing. Conflict of interest disclosure The authors declare that they have no financial conflict of interest with regard to the content of this report. Research registration unique identifying number (UIN) N/A. Guarantor Omer Ahmed Shaikh. Financial Disclosure The author(s) received no financial support for the research, authorship, and/or publication of this article.

Abstract C128: Prevalence of tobacco use, potentially malignant lesions and oral cancer among Irula tribes, Nilgiri hills, Tamilnadu, India

Abstract Background: Despite remarkable world-wide progress in the field of diagnostic, curative and preventive medicine, still there are large populations of people living in isolation in natural and unpolluted surroundings far away from civilisation, maintaining their traditional values, customs, beliefs and myths. They are commonly known as tribes and are considered to be the indigenous people of the land. The Imperial Gazetteer of India, 1911, defines a tribe as a “collection of families bearing a common name, speaking a common dialect, occupying or professing to occupy a common territory and is not usually endogamous though originally it might have been so”. India has the second largest tribal population of the world next to the African countries. About half of the world’s autochthonous people live in India, thus making India home to many tribes which have an interesting and varied history of origins, customs and social practices. In spite of the tremendous advancement in the field of preventive and curative medicine, the health care delivery system in these primitive tribal people are still poor and need to be strengthened. Hence this study was contemplated with an aim to assess the prevalence of tobacco use, potentially malignant lesions and oral cancer among Irula tribes, Nilgiri hills, Tamilnadu, India. Methodology: A cross-sectional descriptive study was conducted to assess the tobacco use potentially malignant lesions and oral cancer among Irula tribes. Data was collected using a pretested Questionnaire, which included Demographic data, tobacco habits, its frequency and form. Oral examination was done by a single examiner. The data collected was analysed using SPSS version15. Results: Results showed that among 240 study population, showed 57% had no formal education, 34.5% had not visited dentist before. 64.5% had indigenous brushing habits. 52% of oral mucosal lesions and 6% malignant oral tumors were observed. A very high prevalence of periodontal disease, tobacco chewing, deep rooted beliefs and customs regarding dentition and dental treatment was observed in this community. Prevalence of oral mucosal lesions in the study population was due to tobacco usage and lack of awareness regarding the deleterious effects of the products used. Conclusion: The dangers from smoking and chewing tobacco are well documented within the literature but the public’s lack of knowledge of the risks is a concern. Health professionals are encouraged to ensure that the public is made aware of these risks, especially those within high-risk groups. Citation Format: Delfin Lovelina Francis. Prevalence of tobacco use, potentially malignant lesions and oral cancer among Irula tribes, Nilgiri hills, Tamilnadu, India [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C128.

Assessment of knowledge and awareness among North Indian populations about oral precancerous lesions (OPL): A cross-sectional survey study.

A precancerous lesion is a morphologically altered tissue in which oral cancer is more likely to occur than its apparently normal counterpart. They are quite common in the Indian population due to the habitual habit of chewing tobacco. The aim of this study was to evaluate the awareness of oral precancerous lesions by a questionnaire-based survey among the study subjects having been diagnosed with it. In this descriptive study, a structured questionnaire having 11 survey questions has been used to record the response from study subjects who have been diagnosed and reported for treatment for oral premalignant lesions in the Department of Oral Medicine and Radiology. A total of 1013 study subjects were assessed for awareness about OPL and its consequences. 44.3% of the study population was addicted to smoking tobacco (cigarettes) while 57.9% of study subjects were addicted to non-smoking tobacco (Pan masala). The reason behind their addiction was reported to be stress (54.9%) and workload (25.3%). Most of the study subjects were diagnosed with oral sub-mucous fibrosis (53.4%). 78.6% of study subjects diagnosed with OPL were not aware of it and 94% were willing to quit the addiction. The awareness about OPL among patients was found to be low. Although many wanted to quit their addiction to smoking and chewing tobacco but were unable to do so. So it is a need for time to develop a national policy on tobacco use and related diseases. This policy will definitely reduce the burden of oral premalignant lesions and oral cancer in Indian population.

Psychological wellbeing of college going Adolescent: Study of dual earner family in metropolitan cities

WHO reported that almost twenty percent of adolescent around the world suffers from psychological issue. The reported prevalence of mental issues ranges from 1-to-25 percent across different states. Due to changes in lifestyle, both parents have to work to fulfill the needs of the children growing in metropolitan cities. This study attempts to understand mental issues among the adolescents of the dual-earners. A self-administered questionnaire was developed to assess the lifestyle, and psychological wellbeing of the adolescents aged 15-19 years studying in the colleges of Delhi and Mumbai University. GHQ-12 was used to analyses the Psychological issues among the students. Total of 447 adolescent fulfilling the selection criteria, completed the questionnaire. The Results show that 22% in Mumbai and 27% in Delhi are suffering from Anxiety and Depression while almost one-fourth have Social Dysfunction in both cities. Adolescent with lower socio-economic status is suffering from multiple forms of mental health issues. Odds of psychological-wellbeing are less among adolescents who are studying in either Arts or Commerce field as compare to science students. Adolescents who have ever smoked, chew tobacco and drink alcohol have shown the significant higher symptoms of Anxiety and Depression. Anxiety &amp; Depression and Loss of confidence is higher among the adolescent who spend less than two hours with their father either on weekdays or weekends and whose father drinks alcohol or smokes. The Permissive and authoritative/flexible parents have positive impact over their children psychological wellbeing. The study reflects the growing mental-health issues among adolescents due to varying factors and points the need of psychological counsellor for parent-child duo.

Tobacco Chewing and Oral Cancer in a Renal Transplant Recipient

Tobacco Chewing and Oral Cancer in a Renal Transplant Recipient

Oral Squamous Cell Carcinoma Metastasising to Unusual Sites: A Case Series of Four Cases

Oral cancer ranks as the sixth most common malignancy worldwide, with Squamous Cell Carcinoma (SCC) being the predominant type observed in the head and neck region. Incidence and mortality rates of SCC have significantly increased over the past few decades. Smoking and tobacco chewing are the most common aetiological factors, predominantly affecting elderly males. Distant metastasis at the time of diagnosis is a rare occurrence, typically disseminating through blood vessels or lymphatics. The lungs are the most frequent site for distant metastasis, followed by bone, mediastinal nodes, and occasionally the liver. However, in our cases, we observed metastasis to uncommon sites, excluding the liver. Accurate diagnosis necessitates the correlation with clinical history, radiological, histopathological, and immunohistochemical findings. Despite employing various surgical and radiotherapeutic modalities, distant metastasis diminishes the chances of survival, successful treatment, and worsens the prognosis. This article presents four cases of oral SCC that exhibited metastasis to unusual sites. Two cases had a primary tumour in the left lateral border of the tongue, with distant metastasis to the breast and skin (chest wall), while the other two cases had a primary tumour in the left buccal mucosa and left mandibular region, with distant metastasis to the kidney and liver.

Sociodemographic profile, work practices, and disease awareness among stone mine workers having silicosis from Central Rajasthan.

Silicosis continues to pose an important health hazard among workers having occupational exposure to stone dust. Several studies have addressed clinical presentation, radiographic and pulmonary function abnormalities in workers with silicosis. This study was planned to analyze sociodemographic profile and awareness about several aspects of silicosis among the stone mine workers visiting our centre. A questionnaire was administered in a convenient sample of eligible subjects over six years period. The questionnaire was aimed to collect sociodemographic variables, like age, gender, educational status, residential background, smoking status etc., apart from information on work-related profile including protective measures taken. Also knowledge and attitude regarding silicosis was assessed. Silicosis awareness index was also calculated as per the response received. Majority of the study subjects were male (96.6%) with rural background (98.5%). 54.1% subjects were in the age group of 30 to 50 years. 81.9% mine workers were illiterate. The common addictions observed among them included smoking (60%), tobacco chewing (34%), alcohol (20%) etc., Varying duration of work exposure was observed with more than 10 years in 63.4% and more than 20 years in 32.2% workers. The commonest work exposing them to stone dust was breaking stones by chisel and hammer (51%) followed by separation of stone slab (20%) and stone drilling (15%). 80.9% subjects were not aware of the term silicosis, more than 80% were not aware of the symptoms and causes of silicosis. Only one fifth subjects were having awareness of using protection against the disease. Overall awareness about silicosis was better among literate and youngers participants. Stone mining industry reflects male dominance, poor literacy, long working hours for many years, financial compulsion to start and continue the job and very poor awareness regarding the disease silicosis and importance of personal protection at workplace.

A Cross-Sectional Study of Hypertension among 20-40 Years Old Residing in an Urban Area of Bagalkot City, North Karnataka.

Hypertension is the commonest cardiovascular disorder and one of the major risk factors for cardiovascular mortality which accounts for 20-50% of all deaths. Although most studies describe hypertension in older adults and the elderly, there is a paucity of data on young adults as they are deemed to be at a lower risk of developing the disease. To study the prevalence of hypertension and study the risk factors and strength of association between factors and hypertension among 20-40 years old. A cross-sectional study was conducted among 20-40 years old residing in the urban field practice area to find the prevalence of hypertension and its association with socio-demographic factors. After obtaining informed consent, data were collected with the help of an interview method by systematic random sampling using predesigned and pretested semi-structured questionnaires. Three readings of blood pressure were recorded using a sphygmomanometer, and the average reading was considered. Data analysis was done using Microsoft Excel, Open Epi software, and SPSS software. Out of 420 subjects, the prevalence of hypertension was found to be 17.9% and pre-hypertension was 52%. Factors significantly associated with hypertension were age, marital status, type of family, family history of hypertension, tobacco chewing, stress, and body mass index (BMI). The present study reveals a high prevalence of hypertension (17.9%) in the 20-40 years old age group, which can lead to increased cardiovascular disease burden in the population.

Chemokine Receptor Gene (CCR5) Polymorphism in Acute Coronary Syndrome: A Cross-sectional Study

Introduction: Acute coronary syndrome is a multifactorial disease with a complex pathogenesis, mainly resulting from the interplay of genetic and environmental risk factors. Chemokines and their receptors play crucial roles in the initiation and progression of atherosclerosis. Chemokine Receptor 5 (CCR5) is an important mediator of leukocyte recruitment and leukopedesis. Most studies conducted on the relationship between CCR5 gene polymorphism and coronary artery disease in different regions and populations worldwide show conflicting results. Aim: To investigate the genetic polymorphism of CCR5 genes associated with patients with acute coronary syndrome in the Vijayapura population. Materials and Methods: A cross-sectional study was conducted at BLDE (Deemed to be University) Shri B.M. Patil Medical College Hospital and Research Centre, Vijayapura, Karnataka, India, involving patients admitted for acute coronary syndrome. A total of 100 patients were admitted with acute coronary syndrome. Nineteen patients with diabetes mellitus were excluded from the study based on the exclusion criteria. Clinical history, examination, electrocardiographic assessments, laboratory profiles, and blood samples were taken for the analysis of CCR5 gene polymorphism as part of the work-up. Patients were classified into two groups: one with the presence of CCR5 polymorphism as Group A (n=6), and the other without polymorphism as Group B (n=75). Parameters such as age, sex, occupation, lipid profile, renal function tests, and CCR5 polymorphism were studied between the groups. The data were statistically analysed. Categorical variables between the two groups were compared using the Chi-square test. Normally distributed continuous variables were compared using independent t-test, and non normally distributed variables were compared using the Mann-Whitney U test. Results: In the present study, the most common age group was 50-70 years with a male predominance of 60.7%. Most of the patients in the study group were farmers (34.7%), followed by housewives (32%) and businessmen (14.7%). The most common risk factors observed in both study groups were smoking and tobacco chewing. Gene sequencing revealed CCR5 gene polymorphism in six out of 81 patients who were labelled as Group A, indicating an incidence of 7.5% (p&lt;0.001). Out of the six positive patients in Group A, three were males and three were females. One patient was 45 years old, while the remaining five were above 60 years old. Conclusion: The present study demonstrates a positive association between CCR5 polymorphism and acute coronary syndrome, indicating that the study population is genetically susceptible to the disease. By screening for high-risk individuals, better and more effective early interventions can be planned, thereby reducing the social burden, morbidity, and mortality associated with the disease.

An account of areca nut uses and oral health damages from an Indian perspective

There is a perception in India that packaged paan masala and betel quid (BQ) with areca nut loosely called paan supari both being devoid of tobacco are not carcinogenic. This article intends to be an awareness initiative against this notion. It focuses on the use of areca nuts in various forms. An understanding is necessary for the identification of components of gutka, various forms of BQ, and paan masala wherein areca nut is used. Areca nut consumption damages oral health and leads to the development of oral submucous fibrosis (OSF). OSF is used as an umbrella term for depicting all potentially malignant lesions. Gutka is a product popular in India that uses areca nuts and a form of flavored tobacco (zarda) as the main component. Although oral tobacco is implicated as a grade I carcinogen, areca nuts and BQ-containing areca nuts belong to the same grade. Areca nuts are the fourth largest addictive substance in the world. Deleterious effects of areca nuts in various forms are a grossly underreported area of research. Initiatives against areca nut uses are required.

Genetic and epigenetic instability induced by betel quid associated chemicals.

Over the years, betel quid chewing and tobacco use have attracted considerable interest as they are implicated as the most likely causative risk factors of oral and esophageal cancers. Although areca nut use and betel quid chewing may lead to apoptosis, chronic exposure to areca nut and slaked lime may promote pre-malignant and malignant transformation of oral cells. The putative mutagenic and carcinogenic mechanisms may involve endogenous nitrosation of areca and tobacco alkaloids as well as the presence of direct alkylating agents in betel quid and smokeless tobacco. Metabolic activation of carcinogenic N-nitrosamines by phase-I enzymes is required not only to elicit the genotoxicity via the reactive intermediates but also to potentiate the mutagenicity with the sporadic alkylations of nucleotide bases, resulting in the formation of diverse DNA adducts. Persistent DNA adducts provides the impetus for genetic and epigenetic lesions. The genetic and epigenetic factors cumulatively influence the development and progression of disorders such as cancer. Accumulation of numerous genetic and epigenetic aberrations due to long-term betel quid (with or without tobacco) chewing and tobacco use culminates into the development of head and neck cancers. We review recent evidence that supports putative mechanisms for mutagenicity and carcinogenicity of betel quid chewing along with tobacco (smoking and smokeless) use. The detailed molecular mechanisms of the extent of accumulation and patterns of genetic alterations, indicative of the prior exposure to carcinogens and alkylating agents because of BQ chewing and tobacco use, have not yet been elucidated.

Tobacco and betel quid chewing is associated with glial cell line-derived neurotrophic factor (GDNF) gene variants in three Indian populations

Tobacco and betel quid chewing is associated with glial cell line-derived neurotrophic factor (GDNF) gene variants in three Indian populations