Surendra Kumar

Tobacco Use and Oral Leukoplakia: Cross-sectional Study among the Gond Tribe in Madhya Pradesh

BACKGROUND Leukoplakia is an asymptomatic and potentially malignant change in the oral mucosa and high frequencies have been reported among smokers. The present study concerned the prevalence of tobacco use and leukoplakia and also associations between the two. STUDY DESIGN This cross sectional survey was conducted amongst the Gond tribal population of Kundam Block, Jabalpur district, Madhya Pradesh state, Central India during 2007 to 2009. Screening for leukoplakia was conducted by a medical officer with two mouth mirrors. It is only based on visual inspection and oral pathology was not performed. A semi-structured questionnaire was used to collect information on socio-demographic and smoking habits. Prevalence of leukoplakia among users and non-users of tobacco was calculated in terms of percentages. RESULTS Of 1,552 individuals aged more than 12 years of age who were screened, 144 (9.3%) were found to have oral leukoplakia. The prevalence of leukoplakia was significantly elevated among tobacco users as compared to non-users (11% vs 2.5%; p<0.001). The percentage of leukoplakia was almost similar in both tobacco smokers and chewers (9% vs 11%; p=0.304). However, the percentage of leukoplakia was especially high among those chewers who also smoked tobacco (21.9%). CONCLUSIONS The findings of the present study showed a positive effect of tobacco use and prevalence of leukoplakia. Also the prevalence was very high among Gond tribe, a marginalized population living in central India. There is a need for effective screening and treatment of leukoplakia in this area.

Poverty Does Not Limit Tobacco Consumption among Tribal Populations: Evidence from Central India

Globally, the prevalence of adult smoking is more than 1.1 billion; among them 82% residing in low and middle income countries (Jha et al., 2002). Tobacco use is a cause for many diseases like cancer, tuberculosis, heart disease, and it continues to be the leading cause of preventable deaths (International Union Against Tuberculosis and Lung Disease, 2012). It kills nearly 6 million people and causes hundreds of billions of dollars of economic damage worldwide. If current trend continues, by 2030 tobacco will kill >8 million people worldwide each year, with 80% of these premature deaths among people living in low and middle income countries (World Health Organisation, 2011). It is reported that 1/5 male deaths and 1/20 female deaths over the age of 30 years is due to tobacco use (Jha et al., 2002). About half of them are in reproductive and economically active segment of the population. The Regional Medical Research Centre for Tribals, Jabalpur, Madhya Pradesh (MP) has undertaken a series of studies to estimate the magnitude of tribal health problems and to suggest control measures to improve health condition of tribal population health. Part of our tribal health research activities we performed this study to estimate the prevalence of tobacco use among the tribal population of Kundam Block and the salient findings have been seen, including: Living standards: Of 1021 households were interviewed, 96% (981) lived in kachha houses made of mud, thatched or other low quality materials. Among them 33% were living in single room, 23% did not have separate kitchen, 12% did not have electric power in there house, 78% reported main source of water as hand pump and 96% used open defication as a toilet facility. Socio-economic profile: Among females only one percent were house wives, others were engaged in agriculture either as a farmer, agriculture labour or as other labour works. The level of education shows that 41% were illiterates and only one percent was graduated. Prevalence of tobacco use: It was observed that 2970 (65%) consumed some form of tobacco and prevalence of tobacco use in different socio-economic group was given in Figure-1. Around 47% (men 34%, women 59%; p<0.05) chewed tobacco/pan masala; 15% (men 28%, women 2%; p<0.05) smoked tobacco and 3% (men 6%, <1% women) both smoked and chewed tobacco. The prevalence of chewing tobacco was significantly higher in all age groups as against smoking. It was also observed that children in the age of 6-9 years started using tobacco LETTER to the EDITOR

Clinical Profile and Prognostic Indicators in Adults Hospitalized with Severe Malaria Caused by Different Plasmodium Species

Introduction Severe malaria remains a major cause of death and morbidity among adults in the Asiatic tropics. This study was planned to evaluate clinical profile and prognostic indicators of severe malaria in adults so as to improve insight into this highly prevalent disease. Materials and Methods This prospective observational study was conducted on 60 confirmed cases of malaria. Cases were divided into two groups: (a) study group: suffering from severe malaria and (b) control group: no severe manifestations. All cases were thoroughly studied for clinical features, laboratory evaluation, and outcome. Prognostic evaluation was also done by different score systems. Results In all, 40 cases suffer from severe malaria (study group), while 20 cases belong to the control group. The majority of our cases were males of age 21–40 years. The most common species of malaria in the study group was vivax (52.5%), followed by falciparum (25%) and mixed malaria species (22.5%). The clinical predictors for severe malaria were rural habitat, longer duration of fever, marked chills, tiredness, giddiness, nausea, vomiting, decreased urine output, jaundice, and altered sensorium. Extreme weakness (80%), jaundice (55%), renal failure (50%), and severe anemia (27.5%) were the most common presenting features in severe malaria. Two patients died of severe mixed malaria. The mortality rate was significantly associated with lower hemoglobin level (P = 0.002); higher total leukocyte count (P = 0.006), blood urea (P < 0.001), serum creatinine (P < 0.001), SGOT (P = 0.001), SGPT (P < 0.007), serum bilirubin (P = 0.003), and parasite density (P = 0.033); lower platelet count (P = 0.043); and those who had more APACHE II score (P = 0.003), SOFA score (P = 0.04), and Multiple Organ Dysfunction Score (P < 0.001) and lower Glasgow Coma Scale (P < 0.001). Conclusions Manifestations of severe malaria is becoming increasingly more prevalent specifically in vivax and mixed malaria cases. Our study proposes that there are certain clinical predictors and prognostic indicators that should be kept in mind for better management of severe malaria.

Develop Attitude Scale and Measure the Attitude of Farmers towards Recommended Soybean Cultivation Practices

Soybean [Glycine max (L.) Marril] belongs to family leguminoceae, sub family papilionaceae and genus glycine. It is mainly grown in kharif season. Soybean is reported to have originated in eastern Asia or China and has been to man over 5000 years. It was introduced in USA in the year 1804 and has since revolutionized the agriculture of that country. In India efforts have been made since 1969 to popularize its cultivation and consumption. Soybean has been known by various names in India such as Bhat, Bhatman, Ramkuithi etc. It is called the miracle crop of the twentieth century and is popularly known as “queen of pulses,” wonder crop, farmer’s friend and agriculture’s Cinderella.

Effect of Plant Geometry, Seed Priming and Nutrient Management on Growth, Yield and Economics of Summer Greengram [Vigna radiata (L.) Wilczek]

Mungbean is an important short duration grain legume which can be grown in varying environmental conditions, during all three crop seasons viz., kharif, rabi and summer in different parts of the country. Mungbean is grown throughout Asia, Australia, West Indies, South and North America, Tropical and Subtropical Africa. However, India alone accounts for 65% of the world acreage and 54% of the total world production. During 2014-15, 1.51 million tonnes of mungbean was produced from 2.71 million hectare area distributed over different seasons Anonymous, (2014). Greengram is consumed in several ways by making dal, curries, soup, sweets and snacks.

Vitamins: An Elixir of Life and Importance

Vitamins, very important known name need in very minute quantity and group of complex organic compounds present in natural food stuffs, play a key role in normal metabolism and lack of which in the diet causes deficiency several critical diseases. Vitamins are differentiated from the trace elements, also present in the diet in small quantities for health, growth, reproduction and other important metabolism. Vitamin are not formed in the body and need to take from natural source but some vitamin like A and K (Fat soluble vitamin) store in the body. Water soluble vitamin B complex and C (Water soluble vitamin) not store in the body and excess amount may easily pass out. In absent of single vitamin from the diet of a species that requires it will produce deficiency signs and symptoms. Deficiency and excesses of vitamin may cause harmful effect on the body and cause causes many symptoms.

A Prospective analysis of the efficacy of JESS (Joshi's External Stabilizing System) fixator in management of complex tibial plateau fractures.

Objective: Complex tibial plateau fractures are caused by variety of mechanisms and have different fracture patterns, may be associated with soft tissue injuries, compartment syndrome, blistrations. Restoration of joint congruity, limb alignment, early range of motion, with a stable knee is difficult at times. We studied efficacy of JESS (Joshi’s External Stabilizing System) with or without limited fixations in these complex tibial plateau fractures. Material and Methods: 32 patients of complex tibial plateau fractures (Schatzker type V and VI) associated with severe soft tissue injury, crushing , compartment syndrome were studied. All cases were treated by Joshi’s External Stabilizing System with or without limited fixation by cannulated cancellous screws. Progress and complaints of the patients were recorded in accordance with Rick/Delamertier and Meason Hohl scoring system. Follow up of patients was at regular interval of 4 weeks for 6 months and thereafter 6 monthly. Results: Out of 32 patients of complex tibial plateau fractures ( 23 Schatzker Type VI and 9 Type V) with mean age 37.47 (range 20-68) years had right knee injury (n=20) more than left knee (n=12). Mean interval period between injury and the surgery was 6.44 (range 3-16) days. Mean duration of hospital stay was 9.03 (range 525) days. Mean range of flexion was 112.19 0 (range 75 0 -130 0 ), Extensor lag of 5 0 -10 0 seen in 4 cases. 26 patients have no limitation in activity. Post operative complications like superficial / Pin tract infection in 7, deep infection in 1 and non-union in 1 case were observed. Excellent in 26, good in 4 and satisfactory results in 2 patients were observed in this study. Conclusion: JESS (Joshi’s External Stabilizing System) combined with limited fixation is a good alternative technique in management of complex tibial plateau fractures. This technique works on the principle of ligamentotaxis. JESS construct helps to take care of wound and dressings and permits early physiotherapy and