Profile of women substance users seeking treatment at tertiary care treatment center in India: A retrospective chart review study

Introduction: Among substance users, women represent a small, unique subpopulation. Studying their socio-demographic and substance-use profile helps us understand their concerns and formulate management strategies. Materials and Methods: In this retrospective chart review, all the available records of outpatient treatment seekers at National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences (AIIMS), Ghaziabad, from 1 January 2011 to 31 December 2015 were screened. Data from the women substance users were entered into a specially designed MS Excel format and analyzed. Results: In these 5 years, 217 women (mean age 36.75 ± 11.84 years) sought treatment. Majority were married (75.6%), housewife (53.5%), educated (59.4%), from an urban background (70.0%). Most common primary substance used was opioid (61.3%), including heroin (30.0%) and pentazocine (16.1%). About 20.3% reported injectable opioid use. The mean duration of opioid use was 5.44 ± 4.68 years. History of prior treatment seeking was reported by 4.6% and no prior significant abstinence attempts by 77.4%. Discussion and Conclusion: Majority of female treatment seekers, are young, married urban women and seek treatment for opioid use, particularly heroin (as opposed to pentazocine, suggested by previous studies). Prior treatment seeking and abstinence rates are low. Data indicates the need of specialized services for this population.     

Highlights from the scientific and educational abstracts presented at the ASER 2016 annual scientific meeting and postgraduate course

The annual meeting of the American Society of Radiology (ASER) took place in San Francisco, California on September 14 through September 17, 2016. Attendees represented the USA as well as international emergency radiology communities, including those from academic, private practice, and teleradiology settings. There were several “members in training” in attendance as well. The meeting again featured the “Trauma Head to Toe” 2-day didactic course, highlighting various important topics on imaging of traumatic injuries. Scattered throughout the 4 days were several poster and case of the day presentations, scientific sessions, and self-assessment modules. The following is a summary of the educational posters and scientific papers.     

High proportion of pentazocine dependence among treatment-seeking female injecting drug users (FIDUs) in India: A distinct population?

Background. Adverse consequences of injecting are greater among female injecting drug users (FIDUs), yet treatment-seeking is low because of stigma, poor social support, and unavailability of gender-specific services. FIDUs, despite being a distinct subpopulation of women substance users, are sparsely studied.

Aims. We aimed to study the sociodemographic and clinical profile of treatment-seeking FIDUs at a tertiary drug treatment center in North India.

Methods. In this retrospective study, we reviewed medical records of all the FIDUs who sought outpatient treatment from January 1, 2011, to December 31, 2015.

Results. Out of a total of 217 records of female patients, 44 were current IDUs (20.27%), with mean age 35.48 ± 10.13 years. Majority were Hindu (84.1%), married (81.8%), homemakers (52.3%) educated up to 12 years (65.9%). Primary drug of dependence was injection pentazocine for 33 patients (75.0%) and injection smack (street heroin) for 8 (18.2%). Commonest reason for initiation of drug use was iatrogenic (n = 25; 56.8%). Major physical complications were reported by 29 (65.9%), while 12 (22.8%) reported psychiatric comorbidity.

Conclusion. A typical treatment-seeking FIDU is middle-aged, educated, homemaker using injecting pentazocine. High rate of injecting with iatrogenic onset highlights the need for women-specific services as well as awareness-building among physicians.     

A starter's guide to preclinical teeth arrangement: simplified clinometer

Arrangement of artificial teeth in a bilaterally symmetrical fashion with proper inclinations of teeth had been a challenging task for beginners. A variety of tools and guiding equipment have been developed to help students to learn teeth arrangement. Unfortunately, those tools were either costly or unsuitable for use with mean value articulators. This article attempts to introduce a simplified clinometer which can be attached to mean value articulator and can be used as a guide to arrange teeth in a bilaterally symmetrical manner by the undergraduates in both clinical and preclinical set-up. CLINICAL SIGNIFICANCE: Training of the future dentists in sound esthetic principles in a preclinical environment, using this device, will increase the final clinical efficacy of their work. AIM: The aim of this article is to provide a simple but effective device to undergraduate students to help them learn teeth arrangement easily and systematically.     

Behavior shaping of complete denture patient: a theoretical approach

The psychological status of a geriatric patient undergoing complete denture treatment is one of the key determinants of the success of prosthesis. Hence, the understanding and behavior management of such patients is of paramount importance for any clinician aspiring to be a successful in practice. Even though several attempts have been made to understand the effects of psychology of patients undergoing this particular treatment on the final outcome of treatment, no single theory or classification has been proposed so far as to be able to completely understand the thought process of geriatric patients. The aim of this paper is to propose a theoretical approach, a step by step guide to clinicians to better understand the thoughts, aspirations and expectations of complete denture patients and their effects and consequences in different patients, when not met with.     

Morphological Differences between Ruptured and Unruptured Basilar Bifurcation Aneurysms

Background Aspect ratio (AP), daughter artery ratio (DA), and lateral angle ratio (LA) have been reported in middle cerebral artery bifurcation aneurysms to correlate with rupture status.Objective To study the differences in AP, DA, LA, and aneurysm orientation between ruptured and unruptured basilar bifurcation aneurysms.Methods Three-dimensional (3D) angiograms of patients with basilar bifurcation aneurysms were analyzed for AP, DA, and LA. Aneurysm projection was classified as type A if the long axis of aneurysm was along basilar artery and type-B if otherwise.Results Thirty-one ruptured and 17 unruptured aneurysms were analyzed. The APs were significantly different (p = 0.008), 2.63 ± 1.1 for ruptured aneurysms and 1.7 ± 0.55 for unruptured aneurysms. AP ≥ 1.9 correlated with rupture status with 68% sensitivity and 70% specificity. Type-A configuration was significantly associated with ruptured aneurysms with an odds ratio (OR) of 5.9. LAs were 0.9 ± 0.4 and 1.4 ± 0.8 for ruptured and unruptured aneurysms, respectively, and the difference tended to be significant (p = 0.56). DAs were 1.25 ± 0.22 and 1.21 ± 0.19 for ruptured and unruptured aneurysms without any statistical difference.Conclusion AP > 1.9, type-A configuration, and lower LA is associated with ruptured basilar bifurcation aneurysms. DA did not differ between ruptured and unruptured aneurysms