Background: Electronic cigarette (e-cigarette) is an emerging class of electronic nicotine-delivery system claimed by the industries as a quitting aid. Laboratory testing of some refill liquids for ...e-cigarettes(e-liquids) contain impurities and toxic substances, or are not filled true to label. The additional impurities in the liquids or vapour (e.g., polyaromatic hydrocarbons (PAHs), Tobacco specific nitrosamines (TSNAs), aldehydes and acrolein), unexpected toxins and/or unreliable nicotine in different glycols mixed with concentrated flavours, warrants a thorough evaluation of the chemical constituents of these E-liquids. Previous research in the evaluation of these constituents involved gas or liquid chromatography (GC, LC) combined with mass spectrometric (MS) detection for the analysis in combination with 1H- Nuclear Magnetic Resonance (NMR) analysis. This study aimed to evaluate the chemical composition of e-liquid refills using 1H- NMR, 13C-NMR along with DEFT, GCMS and IR spectroscopic analysis. Methods: A total of 6 samples marketed and sold highly in India through online, claimed to have 0,3,6,12 and 18 milligrams of nicotine and one sample claiming no nicotine/no tar were identified and purchased. The presence of Tobacco Specific Nitrosamines (TSNAs), tobacco alkaloids, Polycyclic Aromatic Hydrocarbons (PAHs), Volatile Organic Compound (VOCs) were analysed using 1H- NMR, 13C-NMR along with DEPT, Gas Chromatography Mass Spectroscopy (GCMS) and IR spectroscopy. Results: Significant levels of VOCs were noted which included glycerin, propylene and ethylene glycol. Acrolein and PAH were not detected in the samples. However, presence of additional organic compounds including nitrosamines, and nicotine were detected by13C- NMR, DEPT and IR spectroscopy. Conclusions: NMR spectroscopy is a useful and rapid method to simultaneously detect several ingredients in e-liquids, and GCMS, IR and DEFT also provided additional information on the constituents of e-liquid products. Systematic evaluation of chemical constituents of the e-cigarette may hence throw light on its possible short term and long term health effects.
Background: India is the world's third largest consumer of tobacco. There are twice as many users of smokeless tobacco products (STPs) as cigarette smokers. The Government of Tamil Nadu has banned ...the sale of gutkha and pan masala in 2013. Our aim was to identify the varieties of illegal STP available in Chennai, India. Methods: In systematically chosen zones and regions of Chennai city, we randomly identified three kinds of kiosks (n = 18) and asked for "gutkha" and "pan masala," one of each product available. Details of each product were reviewed based on the information printed on the sachets. Results: Totally 65 STPs were collected; 26 distinct products and 23 brands. All products were claimed to be "tobacco" by the shop keepers. Sixty-five percent of the products informed to contain tobacco and 15.4% to contain pan masala. Five sachets did not inform about the content; 30.8% did not have a pictorial warning; a text warning was printed on 80.8%, but only two products had the messages in Tamil; 70% had promotional messages printed, and 57% had their registration numbers printed. Conclusion: The ban on STP is being systematically violated in Chennai. STP are cheap and easily available and due to promotional laudatory messages and lacking information about the content and warning of health damage, the consumers are left with the perception that they buy more or less harmless product. The Indian Government must introduce policies to control production, import, and sale of illicit STP but we also call for a coordinated international solution.
Background: A large state-wide tobacco survey was conducted using modified version of pretested, globally validated Global Adult Tobacco Survey (GATS) questionnaire in 2015-22016 in Tamil Nadu, ...India. Due to resource constrains, data collection was carrid out using paper-based questionnaires (unlike the GATS-India, 2009-2010, which used hand-held computer devices) while data entry was done using open access tools. The objective of this paper is to describe the process of data entry and assess its quality assurance and efficiency.
Methods: In EpiData language, a variable is referred to as 'field' and a questionnaire (set of fields) as 'record'. EpiData software was used for double data entry with adequate checks followed by validation. Teamviewer was used for remote training and trouble shooting. The EpiData databases (one each for each district and each zone in Chennai city) were housed in shared Dropbox folders, which enabled secure sharing of files and automatic back-up. Each database for a district/zone had separate file for data entry of household level and individual level questionnaire.
Results: Of 32,945 households, there were 111,363 individuals aged ≥15 years. The average proportion of records with data entry errors for a district/zone in household level and individual level file was 4% and 24%, respectively. These are the errors that would have gone unnoticed if single entry was used. The median (inter-quartile range) time taken for double data entry for a single household level and individual level questionnaire was 30 (24, 40) s and 86 (64, 126) s, respectively.
Conclusion: Efficient and quality-assured near-real-time data entry in a large sub-national tobacco survey was performed using innovative, resource-efficient use of open access tools.
Background : The incidence of breast cancer in young patients less than 35 years is less than 1%. The physical and psychosocial morbidity may affect their ability to successfully function in their ...social roles. Hence we studied the quality of life (QOL) issues in this subset. Materials and Methods :Younger women with age less than 35 years, diagnosed with non-metastatic breast cancer at our Institute, from 1995 to 2005, were included in the study. Quality of life issues were studied during the follow-up using EORTC QOL C30 and BR23. Descriptive and inferential statistics were used in order to analyze the data. Results : A total of 51 patients were included for the study. The mean age at diagnosis was 30 years. The effect of breast cancer on the occupation and marital status was minimal. The global health status and the functional scores were high, while the overall sexual function was lower. The global health status was higher in the mastectomy group. The arm symptoms ( P = 0.027) and pain were higher in the Breast conservation surgery (BCS) group. The sexual symptoms appeared to be higher in the ovary ablated group when compared to the ovary preserved group. The sexual functional scores (P = 0.02) and sexual enjoyment scores (P = 0.003) were better in the mastectomy group. Conclusion : The overall QOL in younger patients with breast cancer appeared to be good. The QOL and sexual function were marginally worse in the breast conservation group when compared to mastectomy group.
The Quality of Life (QOL) questionnaire version I consisted of 38 items that were validated using 392 patients. The experiences gained through the interaction with the patients during the ...administration of the questionnaire provided a lot of inputs for the improvization of the tool.
The current study is aimed at certain modifications of the QOL questionnaire version I and standardization of the same.
The modifications of version I QOL scale included the change of verbatim, splitting, deleting, and adding of new items. Finally, version II included 42 items. It was administered to 183 cancer patients irrespective of their demographic details for further standardization.
The principal component method with varimax rotation was used. Spearman's product moment correlation and Cronbach's alpha coefficient were used for reliability analysis.
The data were subjected to factor analysis to explore the factors. Eleven factors emerged with the eigenvalue ranging from 8.03 to 1.10 and accounted for 66.7% variance. The first factor contributed maximally, 19.5%, and the remaining 10 factors contributed a total of 46.2% variance on QOL. They are general well-being, physical well-being, psychological well-being, familial relationship, sexual and personal ability, cognitive well-being, optimism and belief, economical well-being, information support, patient-physician relationship, and body image. The Cronbach alpha of 0.90 and split-half reliability of 0.80 indicated a high reliability of the tool.
The factor structure showed that QOL is a multidimensional concept having different aspects. The Cancer Institute QOL Questionnaire version II for cancer patients is found to be a valid and reliable tool and feasible to administer at the clinical settings.
Background: Cancer is a major health-related stress and demands
adequate coping. Patients with head and neck carcinoma (HNC) often face
exhaustive and debilitating treatment as well as physical and
...functional residual effects such as disfigurement, compromised speech,
dry mouth and difficulty in swallowing. Understanding how patients cope
with these challenges is important in comprehensive care of patients
with HNC. Objective: To assess and evaluate the coping preferences of
head and neck cancer patients. Materials and Methods:Towards this
goal, a prospective study was conducted at the Cancer Institute (WIA),
Chennai. 176 HNC patients participated in the study. The age group
ranged from 19 to 87 years. The questionnaire used for assessing coping
preferences was Jalowiec coping preference scale containing 40 items,
with responses ranging on a 5-point scale. The variables chosen were
treatment, site, education, survival, age and gender. Statistical
analysis used: SPSS 9.0 version was used for both descriptive and
multivariate analysis. Results: No significant difference was
observed in the preference of Emotion-Oriented Coping (EOC) in relation
to age, treatment, site, education and survival. Treatment, site,
education and gender showed significant differences in the preference
of Problem-Oriented Coping (POC). There was, however, no difference in
the preference of POC among the patients with different survival
periods and age. Conclusion:In conclusion, HNC patients adapt both EOC
and POC during the course of the illness. Literates, males and patients
subjected to different modalities of treatment preferred more of POC
compared to other groups.
Gutkha ban in Chennai, India: is there any impact? K., Deepak; M., Angeline; E., Vidhubala ...
International Journal Of Community Medicine And Public Health,
11/2017, Letnik:
4, Številka:
12
Journal Article
Odprti dostop
Background: Gutkha is banned under Food Safety Act, India, effective from May, 2013 in Tamil Nadu. The current study is to find out the impact of Gutka ban on sale and consumption in Chennai city. ...Methods: Shop keepers (n=90) selling Gutkha and tobacco users (90) were chosen using stratified simple random sampling method from 15 zones of Chennai. Three different types of shops (platform/permanent/petty) were identified and a structured questionnaire was used. The questions included for shopkeepers were awareness about Gutkha ban, supply mode, sale and price difference and questions for users included motivation to quit, reduction in use, availability and price difference. Results: No shop had open display of Gutkha and all the shopkeepers and users were aware of the ban. Shopkeepers either bought Gutkha from the whole sale market (58.9%) or the agent (41.1%). Raid was conducted at 81% of the shops. There was a significant reduction in the sale after the ban (p<0.05). Users did not find it difficult to procure as it was easily available; however, price has increased up to 300%. Users felt guilty (18.9%) and fearful (23.3%) when using banned products. Users were motivated to quit (22.4%), made attempts to quit (58.9%) and felt the need for professional support to quit (38.9%). Significant difference was observed in the number of sachets used before and after ban (p<0.05) by the users. Conclusions: The ban did not have any impact on the availability of Gutkha, however it had a little impact on users. Stringent enforcement is crucial to achieve the purpose.
Background: Resource allocation for tobacco surveillance in low-income settings like India is a challenge. The current study describes an efficient method to conduct a large population-based tobacco ...survey in an Indian state. Methods: Tamil Nadu Tobacco Survey (TNTS) was conducted in Tamil Nadu, the sixth most populous state in India, between March and November, 2015. About 100,000 subjects aged 15 years and above, representing both urban and rural populations within 32 districts, were included. The Global Adult Tobacco Survey (GATS) questionnaire was modified and translated into the local language (Tamil) to develop the survey questionnaire, which was pre-tested in 1,690 participants in three districts in November 2014. The survey was conducted through research collaboration between 31 educational institutions and three NGOs. Once collected, data were double-entered using an open access tool (Epidata). Results: The quality and the accuracy of the data was ensured at every level and the data was double entered to minimise the entry error. Among a total number of 32,945 participating households, 111,363 eligible individuals were identified, of which 99,825 individuals completed the survey. The overall Household Response Rate (HRR) was 91.23% (range within districts: 72-99%). The overall Individual Response Rate was 89.24% (range within districts: 73-99%). The unweighted population almost equally represented the weighted population in the selected demographic variables such as age, gender, and type of residence. Conclusions: TNTS was conducted in an efficient manner utilizing local resources, without compromising on quality. This method can be replicated in any setting with the low or limited resource.
Quality of Life (QOL) is an important health outcome measure in oncology. Given the underlying pressure of individual geo-political entities, a universal solution may not be applicable and hence ...there is a need to develop a regional tool and standardize the same to address the linguistic and socio-cultural factors.
To standardize a tool to assess the QOL of patients with cancer to suit the Indian scenario.
The samples were collected from the Cancer Institute (WIA), Chennai. Samples comprise of 400 patients with all sites and stages of cancer.
January 2001 to January 2002. Patients were in the age range of 41-60 years. Thirty-eight items were pooled from existing tools, reviews, and the field trial, by which face and factorial validity were established. Reliability of the tool was also tested. Correlation analysis was done to find out the relation between the domains of QOL. STATISTICS USED: Principal component method with varimax rotation was used. Spearmen product moment correlation and Cronbach alpha coefficient were used for reliability analysis.
Ten factors emerged with Eigen values ranging from 8.55 to 1.10 and accounted for 62.6% of variance. The first factor contributed maximally, 22% of variance. The remaining nine factors contributed totally to 40% of the variance on QOL. The ten factors that emerged were psychological well being, self-adequacy, physical well being, confidence in self-ability, external support, pain, mobility, optimism and belief, interpersonal relationship and self-sufficiency and independence. The internal consistency using Cronbach alpha test was 0.90 and split-half reliability was 0.74.
The tool was found to be highly reliable and valid. It was feasible to administer it at clinical settings.
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