Smokeless tobacco is one of the major causes of cancer

Health Care, Heart Care Foundation of India, Medicine Comments Off

It can also lead to heart diseases and other associated health issues over time

New Delhi, 28 January 2018: According to the recent Global Adult Tobacco Survey India Report, 2017, one in every five Indian is hooked to smokeless tobacco (SLT). Among men, two most commonly used tobacco products are SLT, that is, khaini (8.5 crore) and gutka (5.1 crore). Amongst women, the three most commonly used are SLT, that is, betel quid (2 crore), oral application (2 crore), and khaini (1.9 crore).

Use of SLT can cause oral precancerous lesions such as oral submucous fibrosis, which can put the user at risk of developing oral cancer. Apart from this it can predispose the user to other infections in the mouth and also heart disease. In India, the use of SLT remains the dominant cause of tobacco-attributable diseases, including cancer of the oral cavity (mouth), esophagus (food pipe) and pancreas. SLT not only causes adverse health effects but also accounts for a huge economic burden.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, President Heart Care Foundation of India (HCFI) and Immediate Past National President Indian Medical Association (IMA), said “Any form of tobacco like snuff, chewing, and dipping varieties which are not burnt can be termed as smokeless. Sheesha is a form of fruit-flavored tobacco, which is roasted in a foil along with charcoal and passed into a small chamber of water through a glass-bottomed pipe. It is then inhaled slowly. Of late, there has been a drastic increase in the number of teenage sheesha users with the majority of them using it mainly as a form of recreation in groups. It is a common misconception that sheesha is less damaging to the body as compared to cigarettes and hookahs since it is flavored and passed through water. However, the substance inhaled still contains nicotine and other carcinogens which can cause a lot of damage.”

SLT also contains sugar. Therefore, prolonged chewing of tobacco and inhalation of sheesha can adversely affect control of blood sugar levels in patients with diabetes.

Adding further, Dr Aggarwal, who is also the Vice President of Confederation of Medical Associations in Asia and Oceania, said, “Use of SLT mixed with areca nut is a common practice in India and as stated in the beginning, betel quid and gutka, the two most commonly used forms of SLT have areca nut as a common ingredient. Areca nut itself is classified as a class one carcinogenic i.e. having cancer-causing properties, besides other adverse health effects.”

Here are some ways in which one can quit this habit.

  • Try short-acting nicotine replacement therapies such as nicotine gum, lozenges, nasal sprays, or inhalers. These can help overcome intense cravings.
  • Identify the trigger situation, which makes you smoke. Have a plan in place to avoid these or get through them alternatively.
  • Chew on sugarless gum or hard candy, or munch raw carrots, celery, nuts or sunflower seeds instead of tobacco.
  • Get physically active. Short bursts of physical activity such as running up and down the stairs a few times can make a tobacco craving go away.

ECRI Institutes 2018 Top 10 Hospital C-suite Watch List (Part 1)

Health Care Comments Off

Mobile medical app to help treat substance use disorders

The first mobile medical application to help treat substance use disorders, which was approved by the US Food and Drug Administration (FDA) in September 2017 tops the list. The reSET App can be used as adjunct outpatient treatment of alcohol, cocaine, marijuana, and stimulant substance use disorders in patients who are not currently on opioid replacement therapy, who do not abuse alcohol solely, or whose primary substance of abuse is not opioids. It delivers cognitive behavioral therapy to patients to teach the user skills that help them to increase abstinence from substance abuse as well as compliance to treatment program.

This device is an example of upcoming field of ‘digital therapeutics’ i.e. use of digital technology to improve the health of a person, without the side effects of medications and without the added costs. It also helps the doctor to deliver more effective care to these patients.

Direct-to-consumer genetic testing

Direct-to-consumer genetic testing has made its way into the market and it is a growing trend. The test facilitates information about ‘genetic’ health risks i.e. helps people to know what disease-associated genes they might be carrying, without the involvement of a doctor. The test results are delivered directly to the patient (or the customer). Direct-to-consumer genetic testing is not yet available in India.

Direct-to-consumer tests mean more people have access to diagnostic tests and at a reduced cost.

The home pregnancy kit, blood glucose sticks are examples of direct-to-consumer test. Another example is the OraQuick In-Home HIV test, which is a rapid home-use HIV screening test kit that does not require sending a sample to a lab for analysis. The result is obtained in 20-40 minutes, and the test can be done in the privacy of home, while maintaining confidentiality of the result. The Govt. of India is also contemplating the option of introducing direct-to-consumer test HIV test in the country to improve identification of those infected with HIV.

Acuity-adaptable care delivery models

The acuity-adaptable care delivery model has recently become the focus of attention. In this, the patient remains in the same room during their hospitalization, right from admission to discharge, regardless of level of acuity (intensity of care required) and the required appropriate level of care is brought to them. This concept has been applied in pregnancy, where the woman stays in the same room for labor, delivery, recovery and postpartum care.

In the current standard of care, the patient is shifted/transferred for instance to the ICU/OT, depending on the acuity needs of that patient. There may be wait time or the bed may/may not be available. This concept is however not without its challenges in the form of staffing (cross-trained nurses), team work, infrastructure, work flow.

(To be contd)