E-Cigarettes – Are They Safe?
E-cigarettes were first produced in China, and were
marketed as smoke-free cigarettes to quit smoking. E-cigarette
manufacturers are making unsubstantiated claims that they are free of
health hazards. Children and first time users are especially targeted;
these are available in various flavors like chocolate and strawberry.
Now e-cigarettes are becoming ubiquitous and the last 3 years have seen
a mushrooming of online sites which market these products. The 3-billion
dollar industry now has 400 brands in its umbrella in just the past 9
years. The e-cigarette is also sometimes called a PV (personal
vaporizer) or ENDS (electronic nicotine delivery system) and its use is
colloquially called "vaping." It often looks like the traditional
cigarette or a cigar but may also resemble a pen or a USB memory stick.
It consists of a cartridge which contains nicotine, an atomizer where
the liquid nicotine is vaporized, a battery which powers the device and
an LED which mimics the glow of a cigarette.
According to the CDC, more than a quarter million
youth in US who had never smoked a traditional tobacco cigarette used an
e-cigarette last year. The recent US National Youth Tobacco
Survey showed a dramatic increase in young people using e-cigarettes –
from 79 000 in 2011, to 263 000 in 2013. Moreover, accidental or
deliberate ingestion of e-cigarette liquids can lead to acute nicotine
toxicity, and deaths of children have been reported. Besides nicotine,
the users are exposed to solvent and metal residues, and particulate and
organic compounds, albeit apparently less hazardous and at
concentrations lower than those produced by tobacco smoke.
On 26th August 2014, the WHO has recommended that
"indoor use be banned" till we have more data of safety of e-cigarretes.
E-cigarettes "represent an evolving frontier filled with threat and
potential for tobacco control." The WHO has also suggested that
countries may consider other regulatory options including blocking
manufacturers from making health claims about these devices until
scientifically proved, restricting advertising for the products,
subjecting the devices to the same surveillance typical for tobacco
products, restricting sales to minors, and health warnings on the
packaging. However a group of experts on tobacco control have published
a rebuttal in the journal Addiction. They strongly feel that
e-cigarettes have played a great role in the decline in smoking of
traditional cigarettes in the past few years. They consider the WHO
recommendations to be "puritanical" and actually detrimental to public
health. In their opinion, e-cigarettes could have a revolutionary effect
on public health if smokers switch from cigarettes to e-cigarettes.
While the debate rages, we await the truth! (The Lancet 6 September
2014, The Telegraph 10 September 2014, Scientific American 26 August
2014).
New Hope for Amputees
Artificial limbs for amputees have been in use since
700 BC, but with current prosthesis problems abound. The fitting is
imperfect and the skin is often abraded and infected. The ideal
prosthesis would be implanted into the bone which would allow better
sensory perception via the bone called osseoperception. But the critical
problem in this was the poor skin-implant interface which leads to
severe local infections.
To solve this problem, doctors at the University
College of London have developed a new technology called ITAP (Intraosseous
transcutaneous amputation prostheses). They discovered – using scanning
electron microscopy in deer antlers – that large pores at the base of
the antler allowed the skin to grow into it and maintain a perfect seal.
The ITAP is based on this technology and the base of the implant is made
of a porous structure into which the skin can grow. The prosthesis was
first implanted into the bones of animals with amputated limbs.
Following success in animals, it is now being used in humans with
excellent results. Currently it is available as part of a clinical study
in the UK and not freely available for commercial use. (The Gaurdian
26 August 2014)
Teenage Drinking in India
A study from Northern Goa reveals that the proportion of men who
started drinking in their teens rose threefold – from 19.5% for those
born between 1956 and 1960 to 74.3% for those born between1981-85. It
also found that alcohol intake beginning in the teenage years was
associated with a greater likelihood of developing lifetime dependence
on alcohol, hazardous/harmful drinking, alcohol-related injuries, and
psychological distress in adulthood. Teen drinkers were more than twice
as likely to be distressed and alcohol-dependent as those who did not
start drinking early in life. Also, they were three times as likely to
have sustained injuries as a result of their drinking. This was a
population-based study which questioned 1899 men about age of onset of
drinking, drinking patterns and consequences. The trend is disturbing
and merits some thought from pediatricians, parents and public health
activists. (J Epidemiol Community Health. 2014;68: 922-7)