Natl Med J India
-
Data are sparse on smokeless tobacco (SLT) use in Bhavnagar. We assessed the prevalence and awareness of and expenditure on SLT use in Bhavnagar. ⋯ Every third person in the urban slum of Bhavnagar was a SLT user. Even though SLT users knew about the harmful effects of tobacco, only a handful were able to quit due to addiction to it. This burden on health services, in addition to the expenditure on purchase of tobacco, requires a comprehensive tobacco cessation programme at the community level.
-
Nuclear receptor subfamily 0, group B, member 1 (NR0B1) gene previously known as DAX1 is a transcription factor that plays a key role in the development of hypothalamo-pituitary-gonadal and adrenal axis. Primary adrenal failure may result from metabolic, infection, autoimmune or developmental causes resulting in a life-threatening condition needing immediate intervention. This study aimed to analyse NR0B1 (DAX1) gene mutation resulting in adrenal hypoplasia congenita (AHC) in three brothers presenting with hypogonadotropic hypogonadism and primary adrenal failure either in infancy or in early childhood. ⋯ Novel mutation in NR0B1 detected by this study explained the cause ofhypogonadotropic hypogonadism with primary adrenal failure in this Indian family. Intrafamilial variability was seen in this family. Early diagnosis by genetic testing, genetic counselling and family screening can help to manage this life-threatening condition.
-
Healthcare systems across the world are dominated by medical care services compared to public health services. Within public health services, individual-oriented interventions dominate compared to population-based interventions perhaps due to the inherent dominance of biomedical approaches within public health. ⋯ The implications are important for developing nations such as India, which have a history of neglect towards ensuring public health due to the domination of policies on medical care. The healthcare system should use a modified typology that asserts its differential commitment to address both public health and medical care needs of its citizens.
-
Interactive case discussion (ICD) is a modified form of clinicopathological conference. ICD is a learning process and with active participation from the audience. The case is selected with specific pre-defined learning points and presented by a person who knows the full details. ⋯ Each MCQ is discussed by the presenter. In the end, the diagnosis and management are briefly discussed. ICD is also used as an activity for continuing medical education.