RESUMEN
Introduction The widespread use of tobacco is a major global health threat, causing significant morbidity and mortality. The World Health Organization (WHO) estimates that annually, millions of people die prematurely due to tobacco use, with this number projected to increase significantly in the future. Developing countries, including India, bear a substantial burden of tobacco-related deaths, often beginning during adolescence. This study estimated the prevalence of tobacco use among adolescents in the 13-19 years age group, identified the types of tobacco products used, explored the reasons for initiation, and examined the influence of family, peers, and socio-demographic factors on tobacco use. Methods A community-based cross-sectional study was conducted from August 2022 to June 2024 in a medical college's urban and rural field practice areas in Pune district, Maharashtra. A total of 310 adolescents were surveyed using convenience sampling. Data were collected using a pre-designed, pre-tested questionnaire, and statistical analysis was performed using Jamovi software version 2.3.28. Chi-square and Fisher's exact tests were applied to assess associations between variables. Results Out of 310 participants, 94 (30.32%, 95% CI: 25.25%-35.77%) reported using tobacco. Among these 94 participants, 82 (87.23%) used smokeless tobacco, 19 (20.21%) used the smoked form of tobacco, and seven (7.45%) used both forms. The mean age of initiation was 15.94 years for smoking and 15.59 years for smokeless tobacco. The data indicate a higher percentage of tobacco use among females (50%) compared to males (24.8%). However, in terms of absolute numbers, more males (60) than females (34) reported using tobacco due to the larger number of males in the study sample. The most common reasons for initiation included curiosity (43.74%) and peer pressure (53.99%). Specifically, 49 individuals (42.6%) aged 13-15 were using tobacco, compared to 23 individuals (30.3%) aged 16-17, and only 22 individuals (18.5%) aged 18-19. Participants from urban areas reported higher tobacco use (48%) compared to those from rural areas (46.7%). Among those from joint families, about 24 (31.6%) reported tobacco use, while in nuclear families, it was slightly lower at about 70 (29.9%). Conclusion Factors such as peer pressure and curiosity played significant roles in the initiation of tobacco use, with more than half of the participants citing peer influence as the primary reason for starting. This study revealed differences in tobacco usage patterns across age groups, with younger participants showing higher usage rates. The findings highlight the need for targeted interventions, such as health education and anti-tobacco media campaigns, to reduce tobacco use among adolescents.
RESUMEN
INTRODUCTION: The rising prevalence of obesity has become a global public health crisis. Traditional screening tools like body mass index (BMI) and waist circumference (WC) have limitations, prompting the need for simpler, more effective alternatives. Neck circumference (NC) has emerged as a promising tool due to its simplicity, affordability, and reliability. The study aimed to evaluate neck circumference as a screening tool for obesity among female adults, alongside measuring BMI, waist-to-hip ratio (WHR), WC, and NC, and establishing NC cut-off values using body fat percentage as the gold standard. Additionally, it sought to compare the predictive accuracy of these measures for assessing obesity. METHODS: This cross-sectional study, conducted from March 2023 to October 2023, involved 362 female students from a health sciences university in Western Maharashtra, India. The participants provided informed consent and underwent anthropometric measurements, including height, weight, waist circumference, hip circumference, body fat percentage, and neck circumference. Body fat percentage, measured using a bioimpedance analyzer, served as the reference standard. RESULTS: The study identified a neck circumference (NC) cut-off of 31.3 cm using receiver operating characteristic (ROC) analysis, showing robust sensitivity (71.23%) and specificity (79.02%) for detecting obesity defined by body fat percentage. Waist circumference (WC) showed the highest sensitivity (73.97%) for diagnosing obesity in females, followed by NC (71.23%). CONCLUSION: Neck circumference is a practical, cost-effective, and reliable screening tool for obesity, offering advantages over traditional methods. Its noninvasive nature and ease of measurement make it suitable for large-scale screening, contributing to the early detection and management of obesity-related health risks. This study supports the inclusion of NC in routine clinical assessments and public health initiatives.
RESUMEN
Background Sexually transmitted infections (STIs) and reproductive tract infections (RTIs) pose significant public health challenges globally, particularly in resource-limited settings. This study aimed to investigate the challenges faced by healthcare providers in managing and preventing STIs/RTIs in India. Materials and methods In-depth interviews were conducted with eight healthcare providers, including counselors, gynecologists, and dermatologists, working in government settings. A semi-structured interview guide was used to explore challenges related to patient care and healthcare system resources. Results The study revealed significant gaps in patient knowledge and awareness about STIs/RTIs, with misconceptions affecting treatment-seeking behavior. Social stigma and cultural barriers were identified as major obstacles to open communication and timely care. Gender-specific challenges in healthcare-seeking behavior and partner notification were noted. Healthcare providers reported inconsistent availability of treatment kits and medications, as well as challenges in ensuring patient compliance. The need for improved healthcare infrastructure, including specialized clinics and better interdepartmental coordination, was highlighted. Conclusion Addressing STI/RTI management challenges requires a multifaceted approach, including enhancing public awareness, ensuring consistent medication supply, establishing specialized clinics, and improving interdepartmental coordination. These findings provide valuable insights for developing targeted interventions to improve STI/RTI management and prevention in resource-limited settings.