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Background Indian Premier League (IPL) cricket tournament - a shorter version of the sport which is played between assorted company-owned or individual owner teams - has grown immensely popular over the last decade. There is long history of tobacco advertisement, promotion and sponsorship (TAPS) in cricket. While direct and indirect TAPS is completely prohibited under the Cigarettes and Other Tobacco Products Act (COTPA), 2003 the nexus between tobacco industry and cricket in India continues. We monitored any tobacco product and allied brand or surrogate advertisement, promotion, sponsorship (TAPS) or placement during every match played in the IPL-13 season in the year 2020. Methods Using an investigative approach, 60 match highlights during IPL-13 (during September 19 to November 10, 2020) were monitored for TAPS (both on-site i.e. sportswear and/or in stadia) shown on the official website ( www.iplt20.com ). All sponsors and advertisers were validated using brand names or logos from their respective official website. Results Two IPL teams (Rajasthan Royals and Royal Challengers Bangalore) were sponsored by major tobacco industry owned brands. Violations by a major smokeless tobacco company promoting their brand extension product i.e. Vimal Elaichi, on the official telecast websites ( www.espncricinfo.com and www.cricbuzz.com ) and television channels ( www.Zeenews.india.com/Gujarati ) was observed. Tobacco companies i.e. Kamla Pasand and ITC Limited were also listed as associate sponsors for the 2020 championship. Conclusion Despite comprehensive ban under India's tobacco control law (COTPA, 2003), sponsorship by tobacco industry was found widespread in IPL-13. Advertisement and logos of tobacco companies are persistent during the telecast and promotion of the IPL events, in clear violation of India's tobacco control legislation and Article 13 of WHO's Framework Convention on Tobacco Control (WHO-FCTC) and its guidelines. Given that India and South Asia comprise the largest audience for televised cricket, strong exclusion criteria is needed by the international cricket authority and national cricket associations to ensure compliance with the national law and global good practice, making the cricketing world truly tobacco free.

Background Globally, policies to counter targeting of young people by the tobacco industry have proven to be effective and a key determinant of reducing the magnitude of tobacco epidemic. This paper presents a case for increasing the minimum legal age to access tobacco to 21 years in India. Method We analysed the two rounds of nationally representative Global Adult Tobacco Survey (GATS) data: GATS-1 (2009–10) and GATS-2 (2016–17). We segregated data for two categories of tobacco consumption (smokers and smokeless tobacco users) at the age of initiation ( 21 years) and analysed for their consumption patterns found during the time of the survey (current daily, current less than daily, former and ever users) from GATS-2 (2016–17). Further, we compared the projections from the sub-national level analysis for youth initiating tobacco use before 21 years and change in the prevalence of overall underage tobacco users between the two survey rounds. Result Nearly 77% of smokers and 75% smokeless tobacco users in India initiate tobacco use before or until the age of 21 years. Many large, most populous and high tobacco prevalence states had higher than national mean (14.1%) of youth initiating into tobacco use before 21 years. Overall, as compared to GATS-1, there is a perceptible increase in the prevalence of underage tobacco use in most states. Conclusion Global best practices and the significant number of young tobacco users in India call for increasing the age of access to tobacco from the current 18 years to 21 years. This will help in reducing the overall adult tobacco use prevalence in the longer run in India.

A novel e-waste-degrading strain, PE08T, was isolated from contaminated soil collected from a paper mill yard in Lalkuan, Uttarakhand, India. Strain PE08T was Gram-stain-negative, rod-shaped, aerobic, oxidase-positive and catalase-positive. Optimum growth was observed at 30 °C (range, 5–40 °C), with 1–2 % NaCl (range, 0–3 %) and at pH 7 (range 6–11). The phylogeny based on 16S rRNA gene sequences delineated strain PE08T to the genus Pseudomonas and showed highest sequence similarity to Pseudomonas furukawaii KF707T (98.70 %), followed by Pseudomonas aeruginosa DSM 50071T (98.62 %) and Pseudomonas resinovorans DSM 21078T (97.93 %). The genome of strain PE08T was sequenced and had one scaffold of 6056953 bp, 99.84 % completeness and 182× coverage were obtained. The G+C content in the genome was 64.24 mol%. The DNA–DNA hybridization and average nucleotide identity values between strain PE08T and its closely related type strain, P. resinovorans DSM 21078T were below 34.8 % and 87.96 %, respectively. The phylogenetic analysis based on whole-genome sequence and concatenated GyrB and RpoB proteins revealed that strain PE08T forms a district clade in the family Pseudomonadaceae . The predominant fatty acids were summed feature 8 (C18 : 1ω7c and/or C18 :1 ω6c), summed feature 3 (C16 : 1ω7c and/or C16 : 1ω6c), C16 : 0 and C12 : 0. The major polar lipids were diphosphatidylglycerol, phosphatidylglycerol and phosphatidylethanolamine. The phenotypic, chemotaxonomic and genetic analysis, including overall genome relatedness index values, indicated that strain PE08T represents a novel species of the genus Pseudomonas , for which the name Pseudomonas lalkuanensis sp. nov. is proposed. The type strain is PE08T (=MCC 3792=KCTC 72454=CCUG 73691).

Cancers of the oral cavity are one of the most common malignancies encountered among cancer patients in India.1 There are different histological variants of oral cavity cancers, and squamous cell carcinoma (SCC) is most common among them. The main etiological factors implicated for development of oral cavity cancers are tobacco chewing and alcohol use.2 In India, carcinoma of buccal mucosa has the highest incidence among all the oral cavity cancers.3 The mean age of presentation is 50 years.4 Incidence among males is three times that of females.5 Most of the patients present in advanced stage (Stage III & IV) with majority in stage IV.6 Metastasis from oral cavity cancer takes place by detachment, invasion, proliferation and evasion through lymphatic system and blood vessels. It is regulated at various levels in the body.7 Most common sites of distant metastasis from oral cavity cancers are lungs and liver. Sometimes vertebral bone metastasis is also seen among patients. Metastasis to omentum and intra peritoneal organs other than liver is very rare.

Immunity has become an important aspect of concern, as the spread of corona virus, is on the rise. The strategies to boost and modulate the immunity have therefore become need of the hour. The present study was carried out to evaluate the effect of Charak immunity Tablets (CIT) on innate and adaptive immune response in healthy individuals. It was a single-blind, randomized, placebo-controlled, exploratory study. After obtaining Ethics Committee permission, 36 healthy individuals of either sex aged 18-35 years with prior consent were recruited in the study. They were randomly divided into 2 groups to receive either CIT or Placebo in 2:1 ratio. Both the interventions were given in a dose of 1 tab (500 mg) twice daily. The assessment variables were vitals [temperature, pulse, and blood pressure], respiratory health [respiratory rate, oxygen saturation and peak expiratory flow rate], questionnaire based assessment of immune status, perceived stress and quality of life along with objective assessment of immunity [CD4+, CD8+ counts, Interferon gamma (IFN γ), Tumor necrosis factor alpha (TNF-α) and Interleukin 10 (IL-10)] as well as oxidative stress; [Malondialdehyde (MDA) and Glutathione peroxidase], which were assessed at fixed time points. Of 36 recruited participants, only 18 participants completed the study. CIT treated individuals showed a statistically significant improvement in respiratory health, quality of life, perceived stress and subjective immune status. There was a decrease in the levels of serum IFN γ on day 60 compared to baseline. TNF-α and IL-10, both estimated from supernatant of Peripheral Blood Mononuclear Cells (PBMCs) stimulated with lipopolysaccharide (LPS), showed a decrease and a significant increase respectively on day 60 compared to baseline in CIT group. Further, CIT significantly decreased MDA levels.The present study indicates that CIT is an effective and safe drug to boost immunity. However, our findings need to be confirmed in larger sample size using more specific immune parameters.

The WHO Framework Convention on Tobacco Control (WHO FCTC) has accomplished much in advancing tobacco control. Non-governmental organisations (NGOs) were critical to the development of the Convention, who aided in mobilising stakeholders and advocated for core provisions of the treaty. NGOs and intergovernmental organisation are well recognised within the Convention and deemed essential to its continued implementation and evolution. Further, the treaty has been understood to be multidisciplinary in its aspiration to improve public health, and the role of both health sector and non-health sector stakeholders is an important component for describing the reach and potential for the Convention. In 15 years, however, non-state actors' participation in the WHO FCTC Conference of the Parties (COP) - where Parties to the treaty engage in discussions that shape the treaty's implementation and evolution - has been underrepresented in terms of sectoral diversity. We reviewed COP documents and assessed non-state actors' participation in the COPs since the Convention's entry into force. We conclude that greater inclusion in COPs from health and non-health sector NGOs, intergovernmental organisations and UN Special Agencies would strengthen the global reach and full implementation of the WHO FCTC.

ObjectiveAreca nut is one of the most widely consumed substances globally, after nicotine, ethanol and caffeine and classified as carcinogenic to humans. This study examines the disparity and determinants of areca nut consumption with and without tobacco in India.DesignNationally representative cross-sectional study.ParticipantsWe used the nationally representative Global Adult Tobacco Survey 2016–2017. The analytical sample size was 74 037 individual’s aged 15 years and above with a response rate of 92.9%.MeasuresCurrent consumption of areca nut without tobacco and with tobacco.MethodWe examined determinants of areca nut consumption (without tobacco and with tobacco) using multinomial logistic regression, accounting for the survey design.ResultsAbout 23.9% (95% CI 23.1 to 24.8) of the adult population consume areca nut, that is, approximately 223.79 million people in India; majority of users (14.2%–95% CI 13.5 to 14.9) consumed areca nut with tobacco. When compared with women, men were more likely to consume areca nut (with tobacco relative risk (RR)=2.02; 95% CI 1.85 to 2.21 and without tobacco RR=1.13; 95% CI 1.07 to 1.20). Age, marital status, education, occupation, caste, religion and region were significantly associated with areca nut consumption. However, the direction and magnitude of association differ with respect to the areca nut consumption with and without tobacco.ConclusionThe ongoing tobacco control efforts would not address the majority of areca nut users until greater attention to areca nut consumption with and without tobacco is reflected in health policies in India.

Background: Tobacco use among young and adolescents is the biggest threat to public health globally. In Bangladesh, every one in 14 youth (13-15 years) uses tobacco in some form. While this problem is growing in the country, we estimate the underage initiation of tobacco use and present evidence that policy measures like increasing the age of purchase and use from the current 18 years to 21 years in the country backed with current tobacco control efforts and adopting vendor licensing will significantly reduce future tobacco burden. Method: We analysed the two rounds of nationally representative Global Adult Tobacco Survey (GATS) data: GATS-1 (2009-10) and GATS-2 (2016-17) and segregated the data for two categories of tobacco consumption (smokers and smokeless tobacco users) based on the age of initiation (21 years). Consumption patterns were also analyaed by using the GATS-2 data. Projections from sub-national level analysis for youth initiating tobacco use before 21 years and change in the prevalence of overall underage tobacco users were calculated based on weighted value. Result: According to GATS-2, around 89% of current tobacco users initiated tobacco use into daily use before the age of 18 years in Bangladesh. Whereas, striking differences were observed (statistically significant) for the average age of initiation of smoking among smokers aged 20-34 increased from 17.4 in 2009 to 19.3 years; and 20.1 to 22 years for SLT. Moreover, more than 24% of them initiated into regular smoking before the age of 15 years. Conclusion: There is an increasing trends of tobacco initiation among the underage youth of Bangladesh. By increasing the age of access, sale, purchase, and use of tobacco from current 18 years to 21 years will significantly reduce youth initiation and taper down the overall adult tobacco use prevalence over the long run in Bangladesh. publishedVersion

We examined the magnitude of smokeless tobacco (SLT) use in India and identified policy gaps to ascertain the priorities for SLT control in India and other high SLT burden countries in the Southeast Asia region. We reviewed and analysed the legal and policy framework to identify policy gaps, options and priority areas to address the SLT burden in India and lessons thereof. In India, 21.4% adults, including 29.6% of men, 12.8% of women, use SLT while more than 0.35 million Indians die every year due to SLT use. SLT use remains a huge public health concern for other countries in the region as well. Priority areas for SLT control should include: constant monitoring, increasing taxes and price of SLT products, strengthening and strict enforcement of existing laws, integration of SLT cessation with all health and development programmes, banning of advertisement and promotion of SLT, increasing age of access to tobacco up to 21 years, introducing licensing for the sale of SLT, standardising of SLT packaging and preventing SLT industry interference in the implementation of SLT control policies besides a committed multistakeholder approach for effective policy formulation and enforcement. SLT control in India and the other high SLT burden countries, especially in the Southeast Asia region, should focus on strengthening and implementing the above policy priorities.

OBJECTIVE: Ultrasonography in patients with juvenile idiopathic arthritis (JIA) could potentially be useful for evaluation of enthesitis. The aim of this study was to evaluate enthesitis in patients with JIA quantitatively by power color and spectral Doppler ultrasonography by determining color fraction (CF) and resistive index (RI). METHODS: A cross-sectional single-center study was performed in 15 (61 entheseal sites) patients with JIA with clinical enthesitis. A total of 9 age and sex matched healthy controls (53 entheseal sites) were also examined and compared. Entheseal sites (quadriceps tendon, patellar tendon, tendo-Achilles, medial and lateral epicondyles of humerus) were examined on USG B mode for tendon thickening, hypo- and hyper-echogenicity, enthesophytes, and cortical erosions/irregularities by power Doppler ultrasound for the presence of Doppler signal and by power color Doppler and spectral Doppler ultrasonography to derive CF and RI respectively. RESULTS: The mean thickness of entheseal site in patients and controls were 3.55±0.82 mm and 2.8±0.37 mm, respectively (p

Background: National estimates of tobacco and alcohol use are insufficient to guide policy at sub-national and district level. This study examines sub-national and district-level prevalence and tobacco and alcohol use and its variations in India. Methods: Data on smoking tobacco, smokeless tobacco (SLT) and alcohol use in adults aged 15-49 was analysed from the National Family Health Survey. Sex-stratified prevalence of each types of tobacco and alcohol use at sub-national administrative units was estimated. We fitted multilevel logistic regressions to quantify the variation at the district and community level in tobacco and alcohol use. Findings: Overall, men used any form of tobacco or alcohol (53%, 52.5–53.4) more than women (7.4%, 95% CI 7.3–7.5). 23.4% (95% CI 23.1-23.9) smoked tobacco, with higher use of any SLT (29%, 28.6-29.4) and alcohol (29.2% 28.7-29.6). Women mostly used SLT (5.6%). Cigarette (13.6%, 13.3–14.0) and bidi (13.2%, 12.9–13.5) were most commonly and almost equally used types of smoking tobacco among men. Gutkha/paan masala with tobacco was the most consumed SLT product among both men (15.3%, 15.0–15.6) and women (2.2%, 2.1–2.3), followed by khaini. Beer was the most commonly used alcohol among men, followed by hard liquor. We found that considerable unexplained variation in tobacco and alcohol use attributed to between-population differences at districts (3.5% in smoking, 4% in alcohol and 6% in SLT) and community level (14.9% in smoking, 19.7% in alcohol and 21.5% in SLT) among males. Among females, between-population differences were even larger at districts (16.6% in smoking, 18% in SLT and 29.9% in alcohol) and community level (35.4% in smoking, 32.8% in SLT and 44% in alcohol). Interpretation: Regular assessment of sub-national tobacco and alcohol consumption across different population groups along with development of local cessation interventions must be integrated with health policy to reduce disease burden and preventable deaths. Funding Statement: No specific funding received for this study Declaration of Interests: All the authors declare that they have no conflict of interest. Ethics Approval Statement: The study was reviewed by the National Institute of Cancer Prevention and Research Institutional Ethics Committee and was exempted from full review as the study was based on an anonymous public use dataset with no identifiable information on the study participants.

INTRODUCTION- COVID 19 pandemic is creating havoc in medical infrastructure. Further misery is created by the fact that there is no proven treatment of COVID 19 infection. Most of the drugs given currently in COVID 19 is for symptomatic management of infection. Updated protocols released on time to time basis have drugs which are based more on clinical observations rather than experimental ones. These drugs consists mainly repositioned drugs already approved by FDA for other disease treatment. METHOD- In our study, we have used Piroxicam polyhedral crystals sublingually for control of fever in COVID 19 pneumonia which was not controlled by Paracetamol and steroids combination. It was advised in patients progressing to severe disease category or developing pneumonia. RESULT- Our case series with limited data shows that cases have responded well to Piroxicam in control of fever. They became normothermic after single dose of drug. Further, patients' blood oxygen levels have also improved with therapy; however, with limited data, a cause-effect relationship could not be determined. CONCLUSION- At present, Piroxicam can be advised in COVID 19 infection under medical supervision for control of persistent high fever. In future, randomised studies are needed to further consolidate above claim that Piroxicam is helpful in controlling fever as well as improving blood oxygen saturation of cases

Background: Hypospadias is a common congenital anomaly in which the anterior urethra is incompletely developed and does not extend to the tip of the glans penis. The present study was aimed to study the clinical prole of hypospadias. Settings and Design:This was a prospective, observational study. Methods: This prospective study was conducted at Department of General Surgery, LLR & Associated Hospitals, GSVM Medical College, Kanpur, India, from January 2019 to October 2020, on 72 patients of hypospadias, after taking clearance from the Institutional Ethical Committee, and taking proper informed consent for participation. Data collected for each patient included age, sex, demography, symptoms with duration, and relevant past and treatment history. Results: The most common age of presentation was between 1-5years of age (48.61%, n=35). Distal hypospadias (DH) was the most common site. (47.22%, n=34). 4.16% (n=3) patients presented with urethrocutaneous stula. Chordee was more commonly seen in patients with mid & proximal penile hypospadias (64.70%, n=33). In the present study, 4.1% (n=3) had associated undescended testis, 4.1% (n=3) had an associated bid scrotum and 1.3% (n=1) had an associated congenital hernia. Conclusions: Most cases of hypospadias present before 10 years of age. Distal hypospadias is the most common type. Chordee is associated most commonly with proximal penile and mid penile hypospadias. It may also be associated with other congenital anomalies like, undescended testis, bid scrotum or congenital hernias

Aim The aim is to compare the extent of irrigant penetration into root canals up to the working length and in simulated lateral canals after passive ultrasonic irrigation (PUI) and manual dynamic agitation (MDA). Materials and methods Root canals of 36 single-rooted extracted teeth were shaped using rotary files. Irrigation was done with 5.25% sodium hypochlorite and 17% ethylenediaminetetraaceticacid. Teeth were decalcified in 5% nitric acid. Lateral canals were created by inserting 10 K-files and then, the teeth were cleared using methyl salicylate. Samples were randomly divided into three groups of 12 teeth each: Group I — Control, group II — PUI, and group III — MDA. A contrast solution was delivered to the root canals during final irrigation and activation. Specimens were photographed using dental operating microscope, and the mean length of dye penetration was measured. Results Data were analyzed using analysis of variance (ANOVA), Tukey test, and repeated measures ANOVA. Passive ultrasonic irrigation group showed the highest penetration of the irrigant upto the working length followed by MDA. Manual dynamic agitation and PUI groups had equivocal results in lateral canal irrigation. Conclusion Passive ultrasonic irrigation technique is the most effective in delivering the irrigants up to the working length. The effectiveness of PUI and MDA is equivocal in lateral canal irrigation, and hence, MDA can be considered an alternative to PUI, in the case of nonavailability of PUI. Clinical significance The clinician can consider the use of MDA technique for irrigant agitation in root canals as an alternative to PUI, based on the extent of irrigant penetration. How to cite this article Khare M, Suprabha BS, Yadav A, Shenoy R, Boaz K, Rao A. Effectiveness of Ultrasonic and Manual Dynamic Agitation Techniques in Irrigant Penetration: An in vitro Study. World J Dent 2017;8(3):207-212.

Smokeless tobacco is consumed by 356 million people globally and is a leading cause of head and neck cancers. However, global efforts to control smokeless tobacco use trail behind the progress made in curbing cigarette consumption. In this Policy Review, we describe the extent of the policy implementation gap in smokeless tobacco control, discuss key reasons on why it exists, and make recommendations on how to bridge this gap. Although 180 countries have agreed that the WHO Framework Convention on Tobacco Control is the best approach to control the demand and supply of smokeless tobacco, only 138 (77%) Parties define smokeless tobacco in their statutes. Only 34 (19%) Parties tax or report taxing smokeless tobacco products, six (3%) measure content and emissions of smokeless tobacco products, and 41 (23%) mandate pictorial health warnings on these products. Although awareness of the harms related to smokeless tobacco is growing in many parts of the world, few Parties collect or present data on smokeless tobacco use under global or national surveillance mechanisms (eg, Global Tobacco Surveillance System and WHO STEPwise). Only 16 (9%) Parties have implemented a comprehensive ban on smokeless tobacco advertisement, promotion, and sponsorships. Globally, a smaller proportion of smokeless tobacco users are advised to quit the use of smokeless tobacco products compared to tobacco users. Use of smokeless tobacco is becoming a global cause of concern, requiring a greater commitment on the full implementation of the WHO Framework Convention on Tobacco Control measures.

National estimates on tobacco and alcohol consumption are insufficient to guide policy at the sub-national level. This study assessed the sex-stratified prevalence of different types of smoking and smokeless tobacco and alcohol consumption among adults aged 15-49 using the National Family Health Survey (2015-16) at sub-national administrative units. Three-level logistic regression models were applied to quantify the variation at district- and community-level in smoking and consumption of smokeless tobacco and alcohol. A higher prevalence of smoking, smokeless tobacco and alcohol consumption was observed among men. The study found that the considerable unexplained variations in two different forms of tobacco and alcohol consumption among men attributed to between-population differences at district-level and community-level. The between-population differences were even larger at the district- and community-level in tobacco and alcohol consumption among women. Continious assessment of tobacco and alcohol consumption at lower administrative units and the development of evidence-based localised cessation interventions must be integrated with health policy to reduce disease burden and preventable deaths.

Present study done during kharif 2013–14 and 2014–15 at the Agricultural Research Farm, Banaras Hindu University, Varanasi evaluates the egg and larval population of Helicoverpa armigera in pigeonpea, as influenced by selected IPM modules. The least egg population was observed with the module M2 (pheromone traps @ 20 + bird perches @ 20 + Bacillus thuringiensis subsp. kurstaki @ 1.0 kg + spinosad 45SC @ 73 g/ha. As regards larval population, the module M4 (pheromone traps @ 20 + bird perches @ 20 + indoxacarb 14.5 SC @ 60 g a.i. + imidacloprid 17.8 SL @ 20 g a.i. + indoxacarb 14.5 SC @ 60 g a.i./ha) was the one with least numbers. The relationship between egg and larval counts was positive and highly significant in all modules during both the years.

Background & objectives: Over the past decade, the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) has served as a powerful tool to initiate and advance global tobacco control efforts. However, the control strategies have mainly targeted demand-side measures. The goal of a tobacco-free world by 2040 cannot be achieved if the supply-side measures are not addressed. This analysis was undertaken to examine the tobacco control legislations of various Parties ratifying WHO FCTC with an objective to ascertain the status of prohibition of importation, sale and manufacturing of smokeless tobacco products. Methods: All 180 Parties to WHO FCTC were included for the study. A comprehensive database of all the parties to FCTC was created and tobacco control legislations and regulations of all parties were studied in detail. Results: Overall, the sale of smokeless tobacco (SLT) products was prohibited in 45 Parties. Eleven Parties prohibited manufacturing of SLT products and six Parties imposed a ban on importation of SLT products. Australia, Bhutan, Singapore and Sri Lanka banned all three. Interpretation & conclusions: Comprehensive tobacco control strategy with effective tobacco cessation programme should complement strong legal actions such as prohibition on trade in SLT products to meet the public health objective of such laws and regulations. In addition, multisectoral efforts are needed for effective implementation of such restrictions imposed by the governments.

Background Article 16 of WHO FCTC focuses upon limiting the supply and exposure of tobacco products to Minors. Implementation of Article 16 has been researched by few local and regional studies, primarily focusing on Cigarettes. This paper evaluates global progress in the area of access of SLT products to minors and compares with cigarettes. Methods A cross-sectional database of notified policies in FCTC ratified countries (n = 179) was prepared for SLT and CIG. Indicators studied were: Ban on Sale to minors; Treaty requirements (under the Ban on Sale to Minor); ban on sale by minor, prohibition on distribution of free tobacco products and prohibition on sale of loose/individual tobacco products. Countries were categorized according to World Bank Income groups and WHO regions. Data was analyzed using SPSSv17.0. Results Unequal implementation of provisions under Article 16 has been implemented for CIG and SLT products (nearly 79% Parties for CIG and 67% for SLT). Most countries have a partial (or none) policy in place (only 12% Parties have notified all provisions under Article 16(1) for CIG, and 10% for SLT). Implementation has been evaluated for CIG through indicators in GYTS, but not for SLT. Conclusions A comprehensive policy formulation on banning sale of tobacco to minors and its proper enforcement is required to prevent access and availability of tobacco including SLT to minors.

Background Until 1990, spitting was an offence in United Kingdom carrying a £5 fine. Spitting was also banned in other developed countries especially in Europe early in the 20 th Century as a preventive measure against tuberculosis and later to maintain cleanliness. Several health experts consider spitting a public health concern and smokeless tobacco in all its forms induces spitting, thereby causing risk for communicable diseases like tuberculosis. Methods A comprehensive review of existing literature on prohibition of spitting in public places was undertaken. Legislative and policy publications were reviewed for the reasons of such prohibition and punishments thereon. Results Spitting has been considered a public inconvenience and a nuisance. Spitting of chewing and other smokeless tobacco stains and defaces public vehicles, buildings and other public property and is a public nuisance. In a scientific study done in India the most frequent cited reason for quitting tobacco use was spitting and ash dropping which was embarrassing in-front of others. Several states in India have banned spitting by law. Nepal has banned use of any kind of tobacco products in public places. Bhutan prohibits smearing lime and spitting doma in public area. Hangzhou- a province in China has banned spitting in public places. Countries like Singapore, Myanmar and Australia also have imposed ban on spiting in public and impose hefty fine for violation of the provisions. Conclusions Several countries and cities have promulgated norms against spitting in public places, including spitting after SLT use. There is a need to undertake further research to study impact of spitting ban on SLT use.

Contemporary techniques, as well as the availability of bioactive and adhesive materials in endodontics, have helped revivifying teeth that were deemed hopeless. These newer materials and techniques would enable the clinician: (a) to predictably stop microbial activity (b) to achieve a total corono-apical fluid tight seal and (c) to strengthen mutilated teeth by obtaining intra-radicular reinforcement through mono-block effect. This case report demonstrates the successful treatment of a mutilated anterior tooth with the use of bioactive and adhesive materials to obtain a total seal and mono-block effect. This article also shows the use of a simple method in the placement of root filling cement into the root canal.

Nitrogen (N) deficiency and low temperature conditions are the prominent facet of Western Himalayan agro-ecosystems. A slight change in the environment alters the protein expression of the microorganisms. Therefore, proteomes of the two psychrotrophs Dyadobacter psychrophilus B2 and Pseudomonas jessenii MP1 were analyzed using two dimensional electrophoresis and MALDI-TOF-MS, to determine the physiological response of altitudinally different but indigenous microorganisms in response to cold stress under N depleting conditions. Functional assessment of 150 differentially expressed proteins from both the psychrotrophs revealed several mechanisms might be involved in cold stress adaptation, protein synthesis/modifications, energy metabolism, cell growth/maintenance, etc. In both the proteomes, abundance of the proteins related to energy production and stress were significantly increased while, proteins related to biosynthesis and energy consuming processes decreased. ATP synthase subunit alpha, beta, ATP-dependent Clp protease, Enolase, groL HtpG and N(2)-fixation sustaining protein CowN proteins were found to be expressed in both B2 and MP1, similarly to previously studied diazotrophs under low temperature N2 fixing conditions and therefore, can be considered as a biomarker for monitoring the nitrogen fixation in cold niches. Nevertheless, in both the diazotrophs, a good fraction of the proteins were related to hypothetical proteins which are still uncharacterized, thereby, suggesting the need for in-depth studies on cold adapted diazotrophs and their adaptive mechanisms.

Altitude is the major factor affecting both biodiversity and soil physiochemical properties of soil ecosystems. In order to understand the effect of altitude on soil physiochemical properties and bacterial diversity across the Himalayan cold desert, high altitude Gangotri soil ecosystem was studied and compared with the moderate altitude Kandakhal soil. Soil physiochemical analysis showed that altitude was positively correlated with soil pH, organic matter and total nitrogen content. However soil mineral nutrients and soil phosphorus were negatively correlated to the altitude. RT-PCR based analysis revealed the decreased bacterial and diazotrophic abundance at high altitude. Metagenomic study showed that Proteobacteria, Acidobacteria and Actinobacteria were dominant bacteria phyla at high altitude soil while Bacteroidetes and Fermicutes were found dominant at low altitude. High ratio of Gram-negative to Gram positive bacteria at Gangotri suggests the selective proliferation of Gram negative bacteria at high altitude with decrease in Gram positive bacteria. Moreover, Alphaproteobacteria was found more abundant at high altitude while the opposite was true for Betaproteobacteria. Abundance of Cytophaga, Flavobacterium and Bacteroides (CFB) were also found comparatively high at high altitude. Presence of many taxonomically unclassified sequences in Gangotri soil indicates the presence of novel bacterial diversity at high altitude. Further, isolation of bacteria through indigenously designed diffusion chamber revealed the existence of bacteria which has been documented in unculturable study of WIH (Western Indian Himalaya) but never been cultivated from WIH. Nevertheless, diverse functional free-living psychrotrophic diazotrophs were isolated only from the high altitude Gangotri soil. Molecular characterization revealed them as Arthrobacter humicola, Brevibacillus invocatus, Pseudomonas mandelii and Pseudomonas helmanticensis. Thus, this study documented the bacterial and psychrophilic diazotrophic diversity at high altitude and is an effort for exploration of low temperature bacteria in agricultural productivity with the target for sustainable hill agriculture.

Tamarind is an economically important tree species; its fruit pulp is widely used in kitchen in India. A symptomatic tamarind tree with yellow leaf symptoms found in the western part of India was assayed for phytoplasma presence. The 16S rDNA sequence of the detected phytoplasma (TM01) was found clustering with sequences in the elm yellows (16SrV) phytoplasma group. The virtual RFLP analysis of obtained 16S rDNA sequence TM01 revealed that it could be tentatively classified into a novel phytoplasma subgroup, 16SrV-L since its AluI, HaeIII and MseI restriction profiles of R16F2n/R16R2 sequenced amplicons generated were unique as compared to the earlier reported profiles of this phytoplasma subgroup. This is the first phytoplasma report in Tamarindus indica.

The search for new biosurfactant producing strains from uncommon or extreme microbial habitats has become increasingly important due to their biotechnological and environmental significance. In view of this, fourteen bacterial strains were isolated from eight different sea water samples obtained from various locations of Antarctica. All of them were screened for biosurfactant production and only the isolate BRI 10 was found to be positive in all the tests. It was identified as Oceanobacillus sp. BRI 10 based on 16S rRNA sequencing and phylogenetic analysis. The production of biosurfactant was found to be maximum (E24 = 55%) in the medium containing glucose (3%) and ammonium chloride (0.48%) at 30 °C, pH 8.0 at the end of 48 h. The biosurfactant was stable at higher temperature and at alkaline pH. TLC and FTIR analysis revealed that biosurfactant is a glycolipoprotein. It exhibited antimicrobial activity against Escherichia coli and no cytotoxicity against normal cell line. It is found to emulsify lubricant oil, crude oil, diesel and kerosene in the order kerosene > lubricant oil > diesel > crude oil. The emulsification activity (D610) of biosurfactant was 0.64 as compared to 0.31 with SDS. Crude oil biodegradation experiments resulted in 56 and 90% degradation on 9th and 27th day respectively. These results suggested its applicability against diverse hydrocarbon pollution.

The influence of dried cell powder and culture filtrates of endophytic fungi on production of inophyllum in cell suspension cultures of leaf- and stem-derived callus of Calophyllum inophyllum was investigated. Two fungi, Nigrospora sphaerica and Phoma spp., endophytic to C. inophyllum, were isolated from leaf tissues, and were identified by both 18S rRNA gene amplification and sequencing. Elicitation of suspension cultures of both callus types of C. inophyllum with dried cell powder and culture filtrates of both fungi consistently elicited production of inophyllum A, B, C, and P. In comparison to stem-derived callus, suspension cultures of leaf-derived callus enhanced production of most inophyllum. Of the four inophyllum studied, the highest production of inophyllum A, C, and P was achieved in elicited suspension cultures of leaf-derived callus. Suspension cultures of stem-derived callus enhanced production only of inophyllum B. When suspension cultures of leaf-derived callus were elicited with 40 mg dried cell powder of Phoma spp., a level of 751-fold (6.84 mg/100 g elicited biomass) of inophyllum A was produced, compared to control. Whereas, a level of 414-fold (6.22 mg/100 g elicited biomass) of inophyllum B was produced when suspension cultures of stem-derived callus were elicited with 20 mg dried cell powder of N. sphaerica. When compared to control, a 10% culture filtrate of N. sphaerica in suspension cultures of leaf-derived callus elicited inophyllum C and P production by 928-fold (7.43 mg/100 g elicited biomass) and 750-fold (1.5 mg/100 g elicited biomass), respectively.

A typical muscle variation of latissimus dorsi - the axillary arch is represented by the muscular or fibromuscular slip detached from the anteroinferior border of the musculus latissimus dorsi passing over the axilla under the axillary fascia crossing the medial side of the brachial plexus to continue as a septum intermusculare mediale brachii distally to the medial epicondyle of humerus. The full extent of the muscle is rarely present. Slips of muscle extend from the latissimus dorsi at the inferior angle of scapula to insert into pectoralis major (Langer), coracobrachilis, biceps or coracoid process forming what is described as a common variant - the muscular axillary arch. We report three cases of variants of latissimus dorsi, one of which has not been reported in the literature before.

Background: Cancer is among leading cause of death (8.8 million) worldwide. Around 14.2 million new cases were recorded in 2012 and increasing each year. On the other hand there are about 2.8 billion users of different social media platforms (i.e., 37% of the world population). This tremendous power of social media can be used for disseminating effective information and communication on cancer prevention more efficiently (i.e., in less time to more people) to create awareness against the disease. Tobacco, alcohol and food industry have been using social media for aggressive advertising and marketing of their products. There is an urgent need to maximally use this medium of communication for advancing cancer prevention globally. Aim: To assess the role of social media in implementing effective health promotion strategies to advance cancer prevention. Methods: Extensive Web search has been done on the way social media (e.g., Facebook) is used for advancing public health communication and how it has been leveraged in the field of cancer prevention. Several Facebook pages and groups, YouTube channels were analyzed thoroughly. Various reports and articles on social media have been reviewed and analyzed. Results: Social media has been found very effective in terms of engaging greater number of population globally. Many Facebook pages and groups are available that provide information regarding specific cancer or provide support for cancer survivors. Several informative videos related to cancer prevention and survivors' stories are broadcast on various YouTube channels run by individuals, government, and nongovernment organizations. There have been many Instagram accounts on cancer but many of them don't provide relevant information on cancer prevention. However, genuine and relevant information are available through several Twitter handles. These social media platforms have very high penetration power. Facebook, YouTube, Instagram and Twitter have monthly reach to more than 1871, 1000, 500 and 263 million users respectively. This large number of user base can become a great source of spreading information on various aspects of cancer prevention through a comprehensive social media campaign. Conclusion: Social media platforms improve outreach and can also help carrying the relevant preventive health messages on cancer prevention, not only for the cancer patient but the public at large. Social media will help in amplifying the messages to the global mass while motivating prevention and health promotion to achieve public health objectives.

Background: Smokeless tobacco (SLT) is available in many forms in India and is widely used by all social groups. SLT market in India is the world largest market. Over the last 2 decades, the SLT industry in India has grown immensely, mostly in cottage industry sector and unorganized sector. Several SLT products are self-made or mixed by users themselves. This presents a great challenge for regulation of such unbranded and loose products. Cancer of the oral cavity and the pharynx are a major public health problem in India. At least 90% of these cancers are caused by SLT products use. Aim: To study the challenges for unbranded SLT products in implementing the mandated regulatory compliances under the Indian Tobacco Control Law that applies to all tobacco products. Methods: The information on unbranded/loose SLT products was collected through literature search, field trips, discussions with SLT product vendors and with community members of different age group. Results: Several types of unbranded SLT products are sold both in urban and rural India. These unbranded products vary from state to state. In some cases they vary from 1 place to another within a state. Most of the unbranded products do not comply with the legal mandates of the Indian tobacco control (COTPA) and food safety (FSSA) laws that regulate sale of tobacco products. The biggest fall-out of unbranded sale is that there is no pictorial health warnings to warn the users about the ill effects of these SLT products as required under section 7 of COTPA. In addition these products also do not mention the minimum requirement of the packaging and labeling under the legal metrology law. In absence of the pictorial health warnings these SLT products become more accessible and affordable to minors. The FSSA prohibits use of tobacco and nicotine as ingredient in any food item, however, most of the unbranded SLT products are sold with added flavorings, condiments and spices which are classified as food. Conclusion: Strict implementation of the mandated regulatory provisions is needed to check the unrestricted sale of unbranded products. Noncompliant unbranded/loose SLT products should be confiscated as per the prescriptions of the existing tobacco control and food safety laws. Findings from this paper calls for development of policies that will prevent sale of unbranded/loose SLT products in India to protect the unsuspecting youth and other vulnerable group of population from these cancer traps.

Recourse to litigation and positive judicial interventions is one of the most effective tools to meet public health objectives. The present review envisions compiling litigation and judicial measures in Southeast Asia Region (SEAR) while assessing their role in advancing smokeless tobacco (SLT) control, and equally highlighting, how tobacco industry has used litigation to undermine tobacco control efforts in the Region. The litigation, especially from the SEAR, up to 2017, that have facilitated SLT control or have been used by the tobacco industry to challenge an SLT control policy decision were reviewed. Most of the litigation related to SLT control from the Region are on pictorial health warnings. Bhutan has imposed a complete prohibition on sale, manufacture and import of all kinds of tobacco products and the litigation there relates to the prosecution of offenders for violating the ban. Judiciary in the Region is well informed about the ill-effects of tobacco use and remains positive to tobacco control initiatives in the interest of public health. In India, several SLT-specific litigation helped in better regulation of SLT products in the country. Litigation has compelled governments for effective enforcement of the domestic tobacco control laws and the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC). Parties to the WHO FCTC must now use Treaty Article 19 to strengthen their legal procedures and make the tobacco industry liable, for both criminal and civil wrongs.

Introduction: Evidence from high-income countries has shown tobacco control mass media campaigns to be cost-effective in reducing tobacco consumption, but similar evidence from low-income countries is rarely reported. An evaluation of the Government of India’s 2009 smokeless tobacco campaign, titled Surgeon, which ran nationally on television and radio for 5 weeks, provided an opportunity to test its cost-effectiveness. Objectives: To determine the cost-effectiveness of mass media campaigns in low and middle-income countries, using a national anti-smokeless tobacco mass media campaign from India as an example. The cost-benefit of the Indian campaign and the health savings accrued from the campaign were calculated. Methods: Standard methods of cost-benefit analysis using a societal perspective were employed. Primary data for the analysis was obtained from a nationally representative household survey of 2,898 smokeless tobacco users that was designed to test the Surgeon campaign’s impact. Campaign costs were estimated to be US$ 1,005,000. Based on the estimated additional quit attempt among smokeless users due to the national campaign compared to status quo, the burdens of smokeless population such as health expenditure, disabled adjusted life-years (DALYs). Results: The Surgeon campaign was found to be highly cost-effective: It resulted in an estimated additional 869,436 successful smokeless quitters after 1 year with a cost per net quit at US$1.16. It was further estimated that the campaign resulted in 20,106 Disability Adjusted Life Years gained and savings from direct medical costs worth US$ 4.9 million. The savings from the total medical costs (considering caregiver cost and labor loss) was worth US$ 21.9 million. The Incremental Cost-Effectiveness Ratio (ICER) of the campaign was US$ 50 per disabled-adjusted life year, which is significantly lower than India’s 2010 GDP/Capita of US$ 1400, the World Health Report recommended benchmark for identifying cost-effective interventions. Conclusion: These findings replicate evidence from high-income countries and suggest that anti-tobacco mass media campaigns can be highly cost-effective, with significant returns on investment, in low-income countries. They are recommended even in resourcelimited settings to combat tobacco related morbidity and mortality. Disclosure of Interest: None Declared