Prevalence and causalities of tobacco consumption (TC) among adolescents: a cross sectional study at Pune.

BACKGROUND AND OBJECTIVES: Health risks associated with tobacco consumption (TC) are well known. The aim of this study was to assess the prevalence and causality of tobacco consumption among adolescents. METHODS: A cross-sectional study was conducted with 6577 participants aged 12 to 20 years from 21 schools and colleges in Pune during year 2005/6. Data on socio demographic profile, family members' tobacco habits and respondents' tobacco consumption habits were collected by self-administered questionnaire. Convenience sampling method was used for data collection. RESULTS: Complete information on age, gender and participants' consumption of tobacco was available for 6119 students. This data was used for analysis. Average age of the students was 16.9 +/- 1.79 years. 51% were boys. 9% lived in the hostels. Prevalence of TC was 4.2% (256). Prevalence increased from 2.1% at < 14 years to 9.8% at 18 to 20 years of age. Respondents aged < 14 years spent about Rs. 110 per month on tobacco while those over 18 years of age spent about Rs.142 per month (P < 0.05). Significantly (p < 0.0001) more boys (85.2%) consumed tobacco compared to girls (14.8%). Hostel residents consumed tobacco more than those not living in hostel (13% Vs 8.6%). Significantly more (p < 0.0001) number of fathers and brothers of TCs consumed tobacco than non TCs. (Fathers: 53.1% Vs 29.7%), (Brothers: 5.7% Vs 1.1%). CONCLUSION: Tobacco consumption among adolescents in Pune is low. However to reduce it further, intervention should start prior to teenage before they form their opinion and start consuming tobacco.

Characterization of an in vitro transcription system from rinderpest virus.

An in vitro transcription system for rinderpest virus (RPV) is described. Ribonucleoprotein complexes isolated from RPV-infected Vero cells, human lung carcinoma cells, or detergent-disrupted purified virions synthesized authentic RPV mRNAs for the N, P, M. F and H genes as identified by dot blot hybridization analysis with individual cDNA clones. The relative abundance of the mRNAs synthesized in vitro decreased from the 3' end of the genome to the 5' end, very similar to that observed with measles virus transcription in vitro. The transcription by purified virions was stimulated three-fold by the addition of infected human lung carcinoma cell lysate, demonstrating the involvement of host factor(s) in mRNA synthesis.

Effect of ingestion of glucose on fibrinolytic activity and prothrombin time in diabetic and non-diabetic persons.

Effect of ingestion of 50 g of glucose on euglobulin clot lysis time and prothrombin time was studied in 14 diabetic and 12 non-diabetic persons. There was no significant change in euglobulin clot lysis time and prothrombin time after ingestion of glucose in the non-diabetic group. In the diabetic group, ingestion of glucose resulted in significant increase in euglobulin clot lysis time at the end of one hr which returned to initial level at the end of two hours even though blood glucose level at two hrs was still higher than fasting level. Increase in clot lysis time has no correlation to the blood glucose level. There was no significant change in prothrombin time after glucose ingestion.

Effect of fermented (butter milk) food on fibrinolytic activity.

Effect of one day fermented milk (butter milk) was studied in 18 medical students between 18 to 20 years of age. Results showed that there is a significant decrease in fibrinolytic activity two hours after giving butter milk and the effect persists even at the end of six hours.

Effect of intra amniotic saline and prostaglandin on fibrinolytic activity, prothrombin time and serum electrolytes -- a comparative study.

Effects of intra-amniotic instillation of hypertonic saline and prostaglandin F2 alpha for medical termination of pregnancy were studied. Fibrinolytic activity significantly increased at 4 hr and 24 hr after hypertonic saline but only at 24 hrs after prostaglandin. There was no significant change in prothrombin time after hypertonic saline but significant increase was observed after prostaglandin. In both the cases serum sodium level did not show any significant change. Serum potassium level significantly decreased at 24 hrs after hypertonic saline but no change was observed after prostaglandin.

Effect of ascorbic acid on total and high density lipoprotein cholesterol of plasma in normal human subjects.

Ascorbic acid, 30 mg/kg/day, fed for 20 days did not significantly change either total cholesterol or high density lipoprotein cholesterol of plasma of 27 male medical college students of age varying between 17 and 20 years.

Effect of short term 'Pranayam' practice on breathing rate and ventilatory functions of lung.

Thirty three normal male and forty two normal female subjects, of average age of 18.5 years, underwent six weeks course in 'Pranayam' and their ventilatory lung functions were studied before and after this practice. They had improved ventilatory functions in the form of lowered respiratory rate (RR), and increases in the forced vital capacity (FVC), forced expiratory volume at the end of 1st second (FEV1%), maximum voluntary ventilation (MVV), peak expiratory flow rate (PEFR-lit/sec), and prolongation of breath holding time.

Health insurance in Singapore: who's not included and why?

INTRODUCTION: Health insurance and the consequent risk pooling are believed to be essential components of a sustainable healthcare financing system. We sought to determine the profile of Singaporeans who had not procured health insurance over and above MediShield, the national government-spearheaded health insurance program and the factors associated with insurance procurement. METHODS: A total of 1,783 respondents were interviewed via telephone and asked to rank their agreement with statements pertaining to healthcare cost, quality and financing on a fivepoint Likert scale. RESULTS: Respondents were representative of the general population in terms of ethnicity and housing type, but lower income households were over-represented. Respondents also had a higher education level compared to the general population. Data on 1,510 respondents, with full information on household (HH) income, education and insurance status, was analysed. HH income below S$1,500 per month (odds ratio [OR] is 5.66, 95 percent confidence interval [CI] is 3.9-8.3, p is less than 0.0001) and a secondary education and below (OR is 2.05, 95 percent CI is 1.5-2.8, p is less than 0.0001) were associated with not procuring insurance over and above MediShield coverage. Respondents with insurance were less likely to agree that healthcare was affordable and that the "3M" framework was sufficient to meet healthcare needs. CONCLUSION: Singaporeans with a lower HH income and a lower education level were less likely to possess health insurance. This may be related to a stronger belief that healthcare is affordable even without insurance. Educational efforts to encourage the more widespread use of health insurance should be targeted toward lower income groups with less formal education and should be complemented by other interventions to address other aspects of insurance procurement considerations.

Public perceptions of the factors that constitute a good healthcare system.

INTRODUCTION: In Singapore, few studies have been done on the factors that the general public considers to be most important in the healthcare system. We conducted this pilot study to determine the factor structure, reliability and validity of statements in a healthcare survey questionnaire as predictors of public perception of a good healthcare system. METHODS: Data on public perceptions of healthcare from a national survey of 1,434 adult Singaporeans was analysed using a principal component analysis and regression, to obtain the factors and predictors. The survey employed 31 statements on healthcare quality, cost, access and the role of the individual vis-à-vis society, which participants ranked on a five-point Likert scale. RESULTS: The exploratory factor analysis identified six critical factors (F): National healthcare financing framework (F1), Service at public institutions (F2), Service at private institutions (F3), Individual responsibility for health (F4), Affordability at public institutions (F5), and Affordability at private institutions (F6). These factors explained 54 percent of variance, and Cronbach's alpha ranged from 0.5 to 0.72, except for F1. Regression analysis showed an association of public perception of good healthcare in Singapore with the following factors: F2 (odds ratio [OR] 1.79, 95 percent confidence interval [CI] 1.48-2.16, p-value is less than 0.0001); F3 (OR 1.29, 95 percent CI 1.10-1.52, p-value is less than 0.0001); F5 (OR 1.52, 95 percent CI 1.27-1.83, p-value is less than 0.0001); F1 (OR 1.31, 95 percent CI 1.08-1.59, p-value is 0.01); F4 (OR 1.33, 95 percent CI 1.16-1.54, p-value is less than 0.0001); but not with F6. CONCLUSION: This pilot study provides a practical, reliable and valid first perception second level matrix to assess the Singapore healthcare system. Further snapshot surveys to assess perceptions of the healthcare system should be conducted with questionnaires abridged to include only these five identified critical factors.

Effect of forced breathing on ventilatory functions of the lung.

Ventilatory functions were studied in 36 male and 35 female subjects (mean age 18.5 years), who underwent six weeks course in forced breathing. Ventilatory functions were studied in the form of Forced Vital Capacity (FVC), Forced Expiratory Volume at the end of one second as % of FVC (FEV1%), Maximum Voluntary Ventilation (MVV), Peak expiratory flow rate (PEFR) and Breath Holding Time. Some of these ventilatory functions were found to be increased after a course of forced breathing.

Effect of ingestion of raw garlic on serum cholesterol level, clotting time and fibrinolytic activity in normal subjects.

The effect of raw garlic on serum cholesterol, fibrinolytic activity and clotting time was studied in 50 medical students of the age group of 17 to 22 years before and after feeding raw garlic. All pre-experimental values ranged within normal limits. The volunteers were then divided into experimental and control groups. The subjects of the experimental group were given 10 gm of raw garlic daily after breakfast for two months. Fasting blood samples of all the subjects were investigated after two months. In the control group, there was no significant change in any of the above parameters. In the experimental group, there was a significant decrease in serum cholesterol and an increase in clotting time and fibrinolytic activity. Hence, garlic may be an useful agent in prevention of thromboembolic phenomenon.

Production of gluconic acid using Micrococcus sp.: optimisation of carbon and nitrogen sources.

A process for production of gluconic acid from glucose by a Micrococcus sp. is described. More than 400 bacterial cultures isolated from local soil were tested for gluconic acid production. Three isolates, were selected on basis of their ability to produce gluconic acid and high titrable acidity. These were identified as Micrococcus sp. and were named M 27, M 54 and M 81. Nutritional and other parameters for maximum production of gluconic acid by the selected isolates were optimised. It was found that Micrococcus sp. isolate M 27 gave highest yield of 8.19 g gluconic acid from 9 g glucose utilised giving 91% conversion effeciency.

Circle cystostomy: technical considerations.

Our experience of 30 selected cases in whom circle cystostomy was used for postoperative drainage of the urinary bladder is described. Technical details and considerations used in the preferential selection of this method of urinary drainage over the standard balloon catheter (Foley) drainage are discussed.

Effect of ingestion of glucose on fibrinolytic activity and prothrombin time in diabetic and non-diabetic persons.

Effect of ingestion of 50 g of glucose on euglobulin clot lysis time and prothrombin time was studied in 14 diabetic and 12 non-diabetic persons. There was no significant change in euglobulin clot lysis time and prothrombin time after ingestion of glucose in the non-diabetic group. In the diabetic group, ingestion of glucose resulted in significant increase in euglobulin clot lysis time at the end of one hr which returned to initial level at the end of two hours even though blood glucose level at two hrs was still higher than fasting level. Increase in clot lysis time has no correlation to the blood glucose level. There was no significant change in prothrombin time after glucose ingestion.

Effect of forced breathing on ventilatory functions of the lung.

Ventilatory functions were studied in 36 male and 35 female subjects (mean age 18.5 years), who underwent six weeks course in forced breathing. Ventilatory functions were studied in the form of Forced Vital Capacity (FVC), Forced Expiratory Volume at the end of one second as % of FVC (FEV1%), Maximum Voluntary Ventilation (MVV), Peak expiratory flow rate (PEFR) and Breath Holding Time. Some of these ventilatory functions were found to be increased after a course of forced breathing.

Effect of ingestion of raw garlic on serum cholesterol level, clotting time and fibrinolytic activity in normal subjects.

The effect of raw garlic on serum cholesterol, fibrinolytic activity and clotting time was studied in 50 medical students of the age group of 17 to 22 years before and after feeding raw garlic. All pre-experimental values ranged within normal limits. The volunteers were then divided into experimental and control groups. The subjects of the experimental group were given 10 gm of raw garlic daily after breakfast for two months. Fasting blood samples of all the subjects were investigated after two months. In the control group, there was no significant change in any of the above parameters. In the experimental group, there was a significant decrease in serum cholesterol and an increase in clotting time and fibrinolytic activity. Hence, garlic may be an useful agent in prevention of thromboembolic phenomenon.

Effect of fermented (butter milk) food on fibrinolytic activity.

Effect of one day fermented milk (butter milk) was studied in 18 medical students between 18 to 20 years of age. Results showed that there is a significant decrease in fibrinolytic activity two hours after giving butter milk and the effect persists even at the end of six hours.

Production of gluconic acid using Micrococcus sp.: optimisation of carbon and nitrogen sources.

A process for production of gluconic acid from glucose by a Micrococcus sp. is described. More than 400 bacterial cultures isolated from local soil were tested for gluconic acid production. Three isolates, were selected on basis of their ability to produce gluconic acid and high titrable acidity. These were identified as Micrococcus sp. and were named M 27, M 54 and M 81. Nutritional and other parameters for maximum production of gluconic acid by the selected isolates were optimised. It was found that Micrococcus sp. isolate M 27 gave highest yield of 8.19 g gluconic acid from 9 g glucose utilised giving 91% conversion effeciency.

Effect of intra amniotic saline and prostaglandin on fibrinolytic activity, prothrombin time and serum electrolytes -- a comparative study.

Effects of intra-amniotic instillation of hypertonic saline and prostaglandin F2 alpha for medical termination of pregnancy were studied. Fibrinolytic activity significantly increased at 4 hr and 24 hr after hypertonic saline but only at 24 hrs after prostaglandin. There was no significant change in prothrombin time after hypertonic saline but significant increase was observed after prostaglandin. In both the cases serum sodium level did not show any significant change. Serum potassium level significantly decreased at 24 hrs after hypertonic saline but no change was observed after prostaglandin.

Effect of ascorbic acid on total and high density lipoprotein cholesterol of plasma in normal human subjects.

Ascorbic acid, 30 mg/kg/day, fed for 20 days did not significantly change either total cholesterol or high density lipoprotein cholesterol of plasma of 27 male medical college students of age varying between 17 and 20 years.