Predictors of Nicotine Dependence Among Adult Male Midwakh and Cigarette Smokers.

Objectives: Midwakh is a popular form of smoking in the Middle East. This study aimed to assess the predictors of nicotine dependence among cigarette or midwakh smokers in the United Arab Emirates (UAE). Methods: This cross-sectional study was conducted from September to December 2015 in Ajman, UAE. A convenience sampling strategy was implemented to recruit adult male smokers aged ≥18 years who exclusively smoked either cigarettes or midwakh. A validated self-administered questionnaire was used to collect data from the participants, with nicotine dependence assessed using the Modified Fagerström Test for Nicotine Dependence. In addition, the levels of salivary cotinine and exhaled breath carbon monoxide (CO) were measured. Results: Of the 88 adult male smokers included in the study, 40 (45.5%) were cigarette smokers and 48 (54.5%) smoked midwakh. The majority of participants were 26-35 years of age (48.9%), followed by 18-25 years (30.7%) and >35 years (20.5%). Midwakh use was associated with more than a three-fold increase in the risk of moderate-to-high nicotine dependence compared to cigarette smoking. Moreover, for each unit increase in CO level, there was a 10% increase in the risk of nicotine dependency. There was also a significant association between nicotine dependence level and depth of inhalation (P = 0.023). Conclusion: Type of smoking and CO level were found to be significant predictors of nicotine dependence among adult male smokers. In particular, greater dependency was observed among midwakh smokers than cigarette smokers.

Strategy to sensitize private practitioners on RNTCP through medico-social workers in urban field practice area of a Medical College in Bengaluru, Karnataka.

BACKGROUND: India accounts for 25% of global TB burden and majority of TB patients seek care from private practitioners. It becomes imperative to involve private practitioners with newer strategies to strengthen the Revised National Tuberculosis Control Program (RNTCP). A study was conducted to assess the knowledge, attitude and practices among private practitioners with regards to tuberculosis case detection and referral and to demonstrate the feasibility of utilizing existing medico-social worker of a medical college in sensitizing the private practitioners. METHODS: An intervention study was conducted during 2017. In an urban field practice area of a medical college, 34 allopathic private practitioners (PP) from six slums formed the study population. The RNTCP trained Medico social workers (MSW) of medical college provided repeated sensitization to private practitioners on case referrals. The data of KAP among private practitioners was collected. The output of repeated sensitization was measured by comparing the number of cases referred by Private Practitioners to DMC during the pre and post intervention period. RESULTS: Only 1 in 2 practitioners were aware about the duration of cough in presumptive TB cases. Nearly 44% of them were not aware about the first investigation of choice under RNTCP; 53% of the doctors did not know about the total number of sputum samples to be collected. After the sensitization of PPs by MSWs the number of presumptive pulmonary cases was increased by more than two folds. CONCLUSION: The strategy of utilizing the services of medico-social workers employed in a medical college to sensitize the private practitioners is feasible and has demonstrated the increase in number of presumptive TB case referrals to DMCs.

Evolution of technology in teaching: Blackboard and beyond in Medical Education.

TEACHING AND LEARNING: the passing of knowledge from one generation to another - has been in existence from the earliest times of human civilization. It began in 1801, with a large piece of slate hung on the wall in a school in Scotland to provide information to a large audience at one time. In the US by mid-19th century, every class room had a blackboard to teach students. The modern version of the blackboard is either green or brown board. This was introduced in late 1960s. The whiteboards came into use during the late 1980s. Projected aids have been used since 1420. The various devices used are the epidiascope, slide projector, overhead projector for transparencies and the micro projector. An instrument to project images from a horizontal surface onto a vertical screen was invented in the 1870s. By the 1960s, transparencies were in use in classrooms. The 'Hyalotype', a transparent image of a photograph using actual black and white photographs on a glass slide that could be projected was invented in 1851. By 1916, the German company Agfa started producing colored lantern slides. The first version of PowerPoint was released by Microsoft in the year 1990. Cell phones, palmtops, and handheld computers; tablets, laptops, and media players are included under mobile learning devices. With the evolution of technology, students achieved competence and interested in interactive learning. The education industry has moved from distance learning to e-learning and finally to m-learning as knowledge expanded exponentially and the demand escalated. While using teaching aids with advanced technology, we must not forget the lessons from the past, striking a balance between embracing new methods of teaching and learning while upholding the timeless principles of education. The newer educational technology can be part of a comprehensive system for lifelong education. CONCLUSION: Use of technology in education has come a long way since the earliest times of human civilization. While embarking on aids with advanced technology, we need to take full cognizance of the lessons from the past, striking a balance between embracing new methods of teaching and learning while holding on to the timeless principles of education. Thus, the newer educational technology can be effective tools of teaching and learning in this rapidly changing technological world and be part of a comprehensive system for lifelong education. ACKNOWLEDGEMENTS: The authors wish to acknowledge Prof. Raja Bandaranayake for his valuable suggestions and editing this manuscript.

Assessment of Breast Cancer Awareness among Female University Students in Ajman, United Arab Emirates.

OBJECTIVES: The aim of this study was to assess female university students' knowledge of breast cancer and its preventative measures and to identify their main misconceptions regarding breast cancer. METHODS: This cross-sectional study was conducted between April 2011 and June 2012 and included female students from three large universities in Ajman, United Arab Emirates (UAE). A stratified random sampling procedure was used. Data were collected through a validated, pilot-tested, self-administered questionnaire. The questionnaire included 35 questions testing knowledge of risk factors, warning signs and methods for the early detection of breast cancer. Participants' opinions regarding breast cancer misconceptions were also sought. RESULTS: The participants (n = 392) were most frequently between 18 and 22 years old (63.5%), non-Emirati (90.1%) and never married (89%). A family history of breast cancer was reported by 36 (9.2%) of the students. The percentage of participants who had low/below average knowledge scores regarding risk factors, warning signs and methods for early detection of breast cancer was 40.6%, 45.9% and 86.5%, respectively. Significantly higher knowledge scores on risk factors were noticed among participants with a family history of breast cancer (P = 0.03). The misconception most frequently identified was that "treatment for breast cancer affects a woman's femininity" (62.5%). CONCLUSION: A profound lack of knowledge about breast cancer was noted among female university students in the three UAE universities studied. The most prominent gaps in knowledge identified were those concerning breast cancer screening methods.

Acute effects of dokha smoking on the cardiovascular and respiratory systems among UAE male university students.

BACKGROUND: In the United Arab Emirates (UAE) tobacco use is rampant. A less reported, yet widely used form of smoking native to UAE is midwakh or dhokha. The aim of the study is to assess the acute effects of smoking dokha (Arabian pipe) on the cardiovascular and respiratory systems among male university students in the UAE. METHOD: A quasi-experimental study was conducted among 97 male volunteers aged more than 17 years. Blood pressure, heart rate and respiratory rate of each participant, were measured before and immediately after smoking. A self administered questionnaire was used to collect personal details and data about smoking pattern. RESULTS: Mean increases in systolic blood pressures (12±1 mmHg), heart rates (20±2 bpm) and respiratory rates (4±1 breaths/min) were observed (p<0.001). A mean decrease in diastolic blood pressures (1±1 mmHg) was observed (p=0.483). CONCLUSION: Smoking dokha has a significant acute effect on systolic blood pressure, heart rate and respiratory rate. Anti smoking campaigns must address the ill effects of this form of smoking. Results from the study warrant further research into this method of smoking which is becoming more popular.

Smokers and marriage: attitude of youth in the United Arab Emirates.

INTRODUCTION: In order to control the tobacco scourge, an array of measures is required. Among them is focusing on adolescent relationships as it has been shown that being in a close relationship with a smoker or a non smoker will in the long run be a major factor in deciding whether the individual adopts smoking for initial non-smokers or ceases the habit for initial smokers. OBJECTIVES: To assess the attitude of youth towards other smokers and towards marrying a smoker. MATERIALS AND METHODS: A cross-sectional study was carried out among 415 students from five universities in the United Arab Emirates (UAE). Self-administered structured questionnaires were used for data collection. The Chi square test was used to detect significant differences between frequencies. RESULTS: Of the 415 participants who provided their gender information, 99 (24%) were males and 314 (76%) were females. Of all the participants, 83.5% were not willing to marry smokers, while 16.5% were willing. Of those whose parents smoked (106) 68% did not like it when their parents smoked, 13.6% had no opinion, 17.5% did not mind, while the other 1% had other thoughts. Of those whose close friends smoked, 43.4% did not like it, 16.2% did not have any opinion, 36.9% did not mind while 3.5% had other thoughts. CONCLUSION: Most participants, both males and females are not willing to marry smokers and prefer to have non-smokers as spouses. Also, smokers are seen as less attractive by both genders in contrast to what appears as popular beliefs amongst youngsters and what is depicted in tobacco advertisements. Tobacco control activities can be undertaken in the community and colleges by incorporating students as facilitators.

Intrinsic component of resilience among entry level medical students in the United Arab Emirates.

BACKGROUND: Resilience is the capacity to recover and to cope successfully with everyday challenges. Resilience has intrinsic and extrinsic components and an effort has been made to study the intrinsic component and its association with sociodemographic factors, among the entry level students of the Integrated Bachelor of Medicine and Bachelor of Surgery (MBBS) course. METHOD: The present study was conducted in Gulf Medical University, using a self-administered questionnaire, comprising of two parts, distributed to all the students who consented to participate. The first part contained questions on socio-demographic details while the second part contained questions on the intrinsic and extrinsic components of resilience of the students. The data collected was analysed using Predictive Analytic Software (PASW) 18.0 using frequency, mean, SD and median. RESULTS: Among the 58 students who participated 24 (41.4%) were males and 34 (58.6%) females, of which 70.7% were < 20 years and 29.3% ≥ 20years. The mean score for the intrinsic component of resilience was 48.9 (SD, 5 and range 35-60). The median scores showed no significant variation (p<0.05) with age, gender, religion, nationality, family structure, highest education among parents, the person they share their feelings with or the number of friends. However, minimally higher scores were noted in the median scores of students from nuclear families, with Western nationality and those whose parents had a university level education, who shared their feelings with people of their own generation or outside their family and who have 5-9 friends. CONCLUSION: The intrinsic component of resilience was found to be almost uniform for the study group and the level is high. A study has to further look into its effect on coping with the stresses encountered during the academic year.

Knowledge regarding risk factors of hypertension among entry year students of a medical university.

CONTEXT: Hypertension in youth is increasing, but there is a dearth of data about the knowledge of risk factors in this age group. AIMS: To assess the knowledge of risk factors of hypertension among university students and associate it with the blood pressure, physical activity, family history of cardiovascular disease (CVD), and sociodemographic variables. MATERIALS AND METHODS: A cross-sectional survey among students enrolled in the first year, in the four academic programs, with the use of a validated, self-administered questionnaire on physical activity in the past 30 days and knowledge of risk factors of hypertension. A score of 6 on 11 was considered as good knowledge for modifiable risk factors. Blood pressure was also measured. The data was analyzed using PASW-17, Chi square test, and binary logistic regression analysis was done. RESULTS: Of the 110 participants, 69.2% were < 20 years of age, 76.4% were females, and 40% were Arabs. Stress, high cholesterol, obesity, and smoking were identified as risk factors by 75.5, 73.6, 77.6, and 71.8%, respectively; 69.1% considered high salt intake and 62.7% considered high calorie diet as risk factors. Energy drink was considered as a risk factor by 64.5%, coffee consumption 35.5%, physical inactivity 47%, and oral contraceptives 13.6%. Half the group did not consider a family history of CVD as a risk factor, 60% did not consider older age as a risk factor, and 88% did not think male gender was a risk factor. Knowledge of modifiable risk factors was better than that of non-modifiable risk factors. Although nationality, course of study, raised blood pressure, and history of diabetes showed significant association with good knowledge, their net effect was not significant by the Adjusted Odd's Ratio. CONCLUSIONS: The study identified some gaps in knowledge regarding both modifiable and non-modifiable risk factors of hypertension among students. A larger study would enable health promotion activities tailored to the needs of this age group.

A Comparison of the Nutritional Status of Adolescents from Selected Schools of South India and UAE: A Cross-sectional Study.

OBJECTIVE: To assess the nutritional status of adolescents of Indian origin living in India and the United Arab Emirates to see how variable the prevalence is of stunting and wasting among adolescents of the same ethnic background living in different socio-economic and demographic environments. MATERIALS AND METHODS: A cross-sectional survey. SETTING: Schools in South India and the United Arab Emirates. PARTICIPANTS: A total of 2459 adolescent boys and girls between the ages of 10 and 16 years old. RESULTS AND DISCUSSION: Anthropometric measurements from 2459 adolescents between the ages of 10-16 years old, 1200 from India and 1259 from UAE, were collected. The subjects were divided into six age groups with 1-year intervals. Adolescents falling below the age and gender-specific 5(th) percentile and 3(rd) percentile of the WHO recommended standards were defined as having thinness and stunting accordingly. Regardless of gender, the rate of stunting was higher in Indian adolescents from India (25.5-51%) when compared with Indian adolescents in UAE (3.1-21%). Thinness was also more in those in India (42-75.4%). When compared with adolescents living in the UAE (4.5-14.4%). The study was done in two groups having a common ethnicity but living in different socio-economic environments. With the results of this study, we can say that improved economic conditions favor better expression of genetic potential for physical growth.