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Background: Patients with substance use disorders are common in general medical practice and are a major risk factor for several non-communicable diseases. Appropriate screening is a vital step for providing brief interventions which can provide a good opportunity to tackle this crisis and in achieving target 3.5 of the sustainable development goal which includes strengthening the prevention and treatment of substance abuse. Objectives: To study the magnitude of substance use and factors associated with it among people seeking health care services at primary care settings. Methods: The cross-sectional study recruited people seeking services at primary care settings to screen for substance users (SU) and determine the associated factors. The data was collected using a pretested semi-structured questionnaire including socio-demographic characteristics, health status and the Alcohol, Smoking and Substance Involvement Screening Test tool. Results: The study showed that 43.4% of the participants were SU. The current use of smokeless tobacco was higher compared to tobacco smoking (21.3% and 4.7%). The multivariate logistic regression showed that advancing age (AOR: 2.61 and 95% CI of 1.01–6.79), male gender (AOR: 705 and 95% CI of 4.25–11.70), primary and middle school (AOR: 3.24 and 95% CI of 1.52–6.92) literacy status, unemployed (AOR: 0.49 and 95% CI of 0.25–0.95), religion and other backward caste (AOR: 2.42 and 95% CI of 1.37–4.30) were significant correlates of SU. Conclusion: Substance use was reported by two-fifths of the participants seeking services at primary care centres in our study and stresses the need for incorporating brief interventions to prevent higher degrees of dependence and its complications.

COVID-19 has deeply affected the world in various aspects including the education system worldwide. In this study, we intended to explore the merits and demerits of online clinical learning and its effect on medical education from a student’s perspective. The study also assessed the perception and attitude of final-year medical students towards online clinical modules. This observational study was carried out in the Department of Community Medicine, Kasturba Medical College, Manipal (KMC) in collaboration with King’s College London, UK (KCL). In our study, a total of 42 students were enrolled, with 37 students from KMC and 5 students from KCL. 81% of students reported that they were not willing to continue the online mode of learning. The abrupt switch to e-learning without prior preparedness has exposed some pitfalls that must be attended to. Contrary to other fields, the medical field places high importance on offline clinical teaching which has recently been impacted by online teaching. The survey responses were analyzed for improvisation of online clinical modules as well as to come up with better ideas and outcomes since this mode of learning may have to continue till the spread of the disease is under control.

Abstract Background India is currently facing a rising epidemic of Non-Communicable Diseases (NCDs). Identification of modifiable risk factors is of paramount importance to curb this menace. Fishermen are one of the most vulnerable occupational groups with unique characteristics that make them prone to acquire NCDs, as a significant share of their life is spent at sea. Hence, this study was planned to ascertain the burden of NCDs, determine various risk factors of NCDs, and measure the association between risk factors and NCDs among fishermen of Coastal Karnataka in South India. Methods A cross-sectional study was conducted among 681 fishermen aged 18 years and above as per the semi-structured interview schedule for two years (2017–2019). A convenience sampling strategy was adopted. The data was entered and analyzed using SPSS v.15.0. The results were described in terms of proportions and their 95% confidence intervals. Continuous data were summarized using the mean and standard deviation or median and interquartile range depending on the skewness of data. Chi-square test was used to study the association between NCDs and modifiable risk factors. Multiple logistic regression was used to identify risk factors of NCDs. Results The mean (SD) age of the population was 42.5 (SD 12.5) years. The mean years involved in fishing was 19.8 years (SD 10.9). More than half (59.5%) of the study participants had severe stress and most (80.3%) were ever substance users. Advancing age, not being able to contact family while at sea, poor dietary practice, ever substance use, increasing waist circumference were significant correlates of NCDs. Conclusions The commonly prevalent risk factors of NCDs among fishermen included poor dietary practice, higher stress levels, substance use, increasing waist circumference, and inability to contact with family while at sea. Hypertension and Diabetes were the two common NCDs in the study population. There is a need for immediate attention in managing NCDs’ risk factors by promoting a healthy lifestyle by primary health care providers through a sustainable community awareness program targeting fishermen at a convenient time and location, either at the sea-port or meeting places. Harmful effects of substance use, healthy dietary practices, and the importance of physical activity outside their job need emphasis. In addition, screening programs should be organized with the help of boat owners and fishing associations at-least once a year to pick up NCDs at an early stage.

Introduction. Vitamin D has a significant role in host immune defense against Mycobacterium tuberculosis. It has been suggested that pulmonary tuberculosis may be associated with lower levels of vitamin D. Present study was therefore undertaken to identify the association between vitamin D deficiency and pulmonary tuberculosis. Methods. A case-control study was conducted in a tertiary care hospital from 2014 to 2016, including 50 adult newly diagnosed sputum positive pulmonary tuberculosis patients as cases and 50 age and sex-matched healthy participants as control groups. All participants in the study group had undergone detailed clinical examination and routine laboratory investigations, including vitamin D, calcium, and sputum for AFB. The clinical characteristics, X-ray findings, sputum AFB, and vitamin D levels were analyzed and compared with data obtained from healthy controls. Results. In both groups, the majority were men (88%). BMI was significantly (

Chemotherapeutic agents may rarely cause discoloration and hyperpigmentation of the nails. We present a patient who developed blackish discoloration of nails also referred as melanonychia during six cycles of R-CHOP chemotherapy regimen (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) for the treatment of Non Hodgkin Lymphoma (NHL) follicular type. The patient developed blackish brown discoloration in all the nails. As suggested by previous literature evidence the melanonychia could be associated with cyclophosphamide and doxorubicin. According to the Naranjo causality assessment scale, we established that there was a ‘probable’ association of nail discoloration with the drug.