European Journal of Cardiovascular Medicine

Addiction involves continuous use of a substance with neglect of other things in life. It essentially incorporatesconceptslikeCraving, Tolerance, Withdrawal, Abuse etc., developing a sense of Dependence in the person. With the increasing civilization and modernization, abuse of various substances has been rampant across all age groupsspecially youth. Recent National Crime Record Bureau (NCRB) dataindicates that maximum crime against society conducted by Youth were under drug or substance influence. With an overall increase in understanding, towards managingpersons with substance abuse, various treatment modalities were in place. However, review of existing literature indicates that, use ofbehavioraland/or pharmacologicaltreatment modalities, though targeting Craving issues are,at best yielding mixed outcomes.Relapses are commonly seen in person with addiction problems as the sense of Craving- meaning the urge to take a substance, is not well tolerated by the addict. Further, it also poses challengeseven with use of cognitive therapeutic techniques to induce a sense of comfort in the substance/drug addiction,for, craving is not for the intake of substance/drug, but for the pleasure(pleasurable sensations) that the person gets after intake of a particular substance/drug. So here Vipassana Meditation can be effective, for, it helps the person to understand the impermanence nature of all (bodily) sensations, be it unpleasurable or pleasurable ones. Thereby with practice of Vipassana, the person gradually develops a sense of perfect Equanimity of mind, so there will be no aversion for unpleasurable sensations and no Craving for pleasurable sensations. Thus, with practice of Vipassana the addict can come out of his addiction, permanently.

Background: The internet, mobile phones, and other similar tools are indispensable for the current functioning of both private life and business. In these two years of Covid 19 pandemic (2019 2021), internet use, especially for different games as well as social networking, were indispensable for the global population, allowing engagement and interaction among many people online in a virtual world. The term ‘Internet Addiction Disorder’ was first coined and described by Dr. Kimberly Young. There are various models for diagnostic criteria which contain some commonalities

Background: The number of adolescents in India are 250 million and are a significant proportion to the Indian population. Increase in the addictions, both in terms of behavioral and non-behavioral addictions leading to lot of changes in the attitudes of the adolescents resulting in aggressive and some times violent behaviour which is detrimental to the future of the individual and also to the societies as a whole. Methodology: It is an institution-based study in southern part of India, conducted among 500 adolescents in the schools and colleges of Rajahmundry city, East Godavari district, Andhra Pradesh. The Aggression scale and socio demographic details and other factors are obtained from the adolescents Results: 26 (5.2%) members showed aggression and factors like gender, type of school or college, residential status and Socio-economic status were significantly associated with Aggressive behaviour

Background: Cardiovascular disease (CVD) has become a major public health problem and leading cause of mortality in developing countries. Cardiovascular risk assessment approach is feasible and cost-effective tool, which helps to identify those at high risk for developing CVDs. so that immediate preventive measures or action can be taken to reduce the risk. Aim: The present study was conducted to assess the CVD (myocardial infarction or stroke) risk by utilizing the WHO/ISH risk charts (non-cholesterol based/ noninvasive chart) in a tribal population of Nasik, India. Methods: This was a cross-sectional community-based study conducted in the rural health training center of the tertiary Healthcare Institute Nashik on 110 participants. The WHO/ISH risk prediction chart for South-East Asia Region D (SEAR D) was used for calculating the 10-year cardiovascular risk. Results: Among total 110 study participants, 83 (75.5%) were in the mild-risk (<10%) category. The 10-year risk of myocardial infarction and stroke is comparable among both sexes (Male- 24.4%, female – 25%), type of occupation (Farmer 24.4%, Non-farmer group – 24.6%), and educational status (Up to secondary level – 25%, above secondary education – 23.3%). Risk factors such as advancing age, three generation family, Tobacco addiction, Family History of Diabetes, Stress, high blood pressure (Both SBP & DBP) and raised random blood sugar level were found to be significantly associated with increased risk of the major cardiovascular event. Conclusion: WHO/ISH chart is a best useful tool in identifying CVD risk. This can further help in planning and implementing targeted interventions amongst identified high risk population in tribal population.

Background: Cannabis is the generic word for all psychoactive preparations of the Cannabis sativa plant. Delta-9 tetrahydrocannabinol (THC) is the main psychoactive component in cannabis. Cannabis is one of the most often used illegal substances in the world. Cannabis is the fourth most prevalent psychoactive substance in the world, behind coffee, nicotine, and alcohol, with an estimated 200 to 300 million regular users. Objectives: 1. To evaluate sociodemographic profile among persons abusing cannabis. 2. To evaluate problematic domains among persons abusing cannabis. 3. To evaluate withdrawal symptoms among persons who abstain from cannabis. 4. To estimate the distribution of psychiatric comorbidity among persons abusing cannabis. 5. To estimate sociodemographic variables and psychosocial attributes between adolescent and adult-onset of cannabis use. Material & Methods:Study Design:  Hospital based prospective cross-sectional study. Study area:Manasa Psychiatry Hospital, Secunderbad, Telangana. Study Period: August 2022 – August 2023. Study population:  Participants were patients diagnosed with cannabis use disorders who came to the Psychiatry Department. Sample size: Study consisted a total of 40 subjects.  Sampling Technique: Convenience sampling. Study tools and Data collection procedure: After obtaining the written consent from the participants as required by the international ethics committee the following questionnaire was given to all subjects 1. Semi-structured proforma 2. Marijuana problem scale 3. The Cannabis withdrawal scale 4. MINI PLUS structured clinical interview. Results: In our study, those who seek cannabis-related problems were predominantly male i.e. 100%. No females registered for cannabis-related problems during our study period. 75% of people were below 10th standard. 80% of individuals with CUDs were unmarried. 30% were unemployed among persons who presented with CUDs. 92.5% of patients belong to low socioeconomic status. 90% of patients belong to Hinduism. 72.5% of patients belong to urban areas. In our study statistically significant difference in marital status and religion i.e., most of the adolescent-onset cannabis users were unmarried and Hindus. But occupation, place, SES there was no significant difference between these 2 groups. Conclusion: Psychiatric comorbidity is widespread in people who are addicted to cannabis, especially those who seek treatment. Cannabis withdrawal symptoms worsen as the length of cannabis addiction grows. The most common associations with cannabis abusers are comorbid other substance use and a family history of substance use. Adolescents who start using cannabis have lower levels of psychosocial characteristics such as impulsivity, drug-using peer relationships, drug availability in the neighbourhood, and skipping school or job than those who start using cannabis in early adulthood.

Introduction: Psoriasis is a chronic skin ailment which can be connected with an increased occurrence of other illnesses, including the metabolic syndrome. Materials and Methods: A Cross-Sectional Study of a total of 100 patients visiting the Outpatient Department of Dermatology and Venereology of at Nalanda Medical College and Hospital in Patna, for psoriasis was done. The parameters included were age at onset of disease, current age, sex, type of disease, and distribution of lesions. Data and statistical analysis were done. Results: most common age of presentation between 18-43 years, there was a predominance of males, with a male-to-female ratio of 2.41:1, service class affected most followed by business people and house wifes respectively. addiction present in 80% cases and family history positive in 28% subjects. Majority cases were of moderate to severe PASI in our study. Metabolic syndrome was diagnosed in 21 out of 100 cases and 20 out of 100 controls (p-value: 1.000). We did not find any association of psoriasis with metabolic syndrome in our study. Conclusion: Our study refuted any association of psoriasis with metabolic syndrome at the onset of disease activity in Indian patients. The plenty of reports from west approving such an association can be explained by increased risk factors like smoking, alcohol consumption, obesity and stress levels. Further, most such studies have been conducted with patients on treatment, while ours is the study on newly diagnosed patients prior to the initiation of any therapy.

Metabolic syndrome (MetS) is a condition characterized by insulin resistance, diabetes mellitus, and impaired glucose intolerance, often associated with obesity, hypertension, dyslipidaemia, or microalbuminuria. The global health pattern is shifting towards chronic diseases like cardiovascular and diabetes mellitus, with a higher burden of non-communicable diseases. In India, the Epidemiological Transition Level (ETL) is <1, indicating a predominance of degenerative, non-communicable diseases and injuries. A community-based cross-sectional study was conducted to estimate the prevalence of Metabolic Syndrome (MET) and associated risk factors among the adult population in the urban field practice area of CIMS Bilaspur, Chhattisgarh. The study involved 540 systematic random samples and analyzed the dietary habits and substance abuse of 540 participants, ranging from 20 to 80 years old. The majority were from class-III socioeconomic status, with low education, bad diet, and obesity being key contributing variables. Recommendations include engaging in regular physical activity to reduce weight, abdominal obesity, and BMI, improving diet by reducing sugar, salt, and fat consumption, regular health check-ups, taking medication regularly, and quitting alcohol, smoking, and other addictions. Large-scale studies are necessary to discover all population risk variables

Background:   Smartphones are the new generation of mobile phones that provide integrated communication and entertainment services. With a rapid rise in its use, a new kind of health disorder called “smartphone addiction (SA)/abuse/misuse” has now emerged as a challenging public health problem among adolescents. Aim: To study on Physical activity and lipid profiles to understand the impact of smartphone usage on adolescents in Malawa region, Indoor MP. Methods: This cross-sectional study was conducted in the Department of Physiology, Index Medical College, Hospital and Research Centre Indore MP, India. The study participants from primary, higher secondary, and intermediate schools located in rural and urban areas of Madhya Pradesh; of either sex adolescents (10 to 19 years) of age group were enrolled in this study. Anthropometric parameters (age, height, weight, and BMI), physical inactivity, and lipid profile screening (such as total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, and very low-density lipoprotein) were recorded. Results: The mean age of the study participants, was 15.9±2.5years, with a minimum of 10 to maximum 19 years. The mean weight, height, and BMI of the study participants were 57.1±10.8 kg, 158.0±7.7 cm, and 22.9±4.9 kg/m2 respectively. All participants were eating chips, Kurkure, magi, burgers, pizza, sweets, and using cold drinks. Our study also noted that 73.0% of children were using the smartphone while eating. 64% of participants reported using a smartphone for more than 2 hours each day. When we compared indoor physical activity with lipid profile, then we noted that indoor physical activity everyday duration of was insignificant associated with lipid profile (p>0.05). Lower total cholesterol levels and higher HDL levels were significantly associated with outdoor physical activity greater than 60 minutes (<0.05). Outdoor physical activity and total cholesterol level were positively significantly associated (p<0.05). Lipid profile (total cholesterol, triglycerides, and LDL) was positive and HDL was negative and significantly associated with the use of a smartphone every day (p<0.001). Conclusions: Children with smartphone addiction were less likely to walk for each day. Namely, smartphone addiction may negatively influence physical health by reducing the amount of physical activity, such as walking, and increasing lipid profile (fat mass).

Background: Nomophobia (NO-Mobile Phone-PHOBIA) is the fear of being without a mobile phone, a growing concern in the digital era. With increasing smartphone usage, nomophobia has become a significant psychological and behavioral issue, particularly among younger individuals. Objective: This study aimed to assess the prevalence of nomophobia among smartphone users attending the Urban Health Training Centre, Dharwad, and its association with sociodemographic factors. Methods: A cross-sectional study was conducted over two months (May–June 2018) among 188 smartphone users aged 15–55 years. Data were collected using a semi-structured questionnaire, including the Nomophobia Questionnaire (NMP-Q). Statistical analysis was performed using SPSS version 22.0, with the Chi-square test applied to assess associations. Results: The prevalence of nomophobia was high, with 47.87% of participants experiencing mild nomophobia, 46.28% moderate nomophobia, and 2.66% severe nomophobia. A significant association was observed between nomophobia and education level (p<0.01), occupation (p<0.01), socioeconomic status (p<0.01), type of family (p<0.01), hours of smartphone use per day (p<0.01), and social networking usage (p<0.01). However, no significant association was found between gender (p=0.612) and total expenditure on smartphone services (p=0.06). Conclusion: Nomophobia is highly prevalent among smartphone users, with a significant impact on daily life. Younger individuals, those with higher education, and those from higher socioeconomic backgrounds are more susceptible. Awareness programs and behavioral interventions are needed to mitigate the negative effects of excessive smartphone use.

Introduction. Alcohol causes around 4.5 million deaths a year, making it the fourth most important risk factor for disease burden worldwide. A variety of problems, such as excessive use, abuse, dependence, and addiction, are included in the category of alcohol use disorders (AUD). Alcohol withdrawal syndrome (AWS) is a well-known disorder that happens when severe or continuous drinking is abruptly stopped, whether it's intentionally or unintentionally. Acute and long-term alcohol use can cause hypomagnesemia and other electrolyte abnormalities. The primary causes of magnesium deficiency in these individuals include insufficient intake, malnutrition, losses due to vomiting, and urinary losses related to ethanol metabolism. Hence the present study was done to measure serum magnesium levels in chronic alcoholic patients who have abstained from alcohol for at least 6 hours and also the relationship with severity of alcohol withdrawal. Methodology: A cross-sectional study was done on 100 patients with alcohol withdrawal symptoms who gave consent at King George hospital, Visakhapatnam. Alcohol withdrawal symptoms severity was measured with the help of the CIWA-Ar (Clinical Institute Withdrawal Assessment for Alcohol, revised) scale and serum magnesium levels were measured. Details like age, hypertension, diabetes and smoking were also studied. Results: The Mean age of the study participants is 40.86 ±11.28 years. There was a significant positive correlation between CIWA-Ar scores and the duration of alcohol intake (r = 0.464), and a significant negative correlation with serum magnesium levels (r = -0.802). Conclusion: Longer alcohol consumption is associated with higher withdrawal severity, while higher levels of serum magnesium are associated with lower withdrawal severity.

Background: Cerebral venous thrombosis have wide spectrum of symptoms and signs with headache is the most common presenting symptom, in 70–90% of cases. Neuroimaging is the corner stone in the diagnosis of cerebral venous thrombosis. In the present study we are going to investigate the clinical profile, radiological findings and risk factors of cerebral venous thrombosis. Material and Methods: Present study was single-center, prospective, observational study, conducted in patients age group 18 years and above irrespective of genders admitted to the hospital with a radiological evidence of cerebral venous thrombosis. Results: Most of the patients were in the age group of 18-40 years contributing to 65%. Mean age of patients was found to be 36.23 years. Males to females ratio (sex ratio) found to be 1:1.2. Most common risk factor in male patients is addiction (alcohol and smoking) found in 55% of total male patients. Most common risk factors in female patients was use of OC pills and HRT accounting for 30.3% of total female patients and pregnancy related (ANC and PNC) found in 30.3% patients out of which 21.21% females belongs to puerperium period. The most common presenting symptom was Headache (60%) followed by convulsions (41%), focal deficits (15%) and altered sensorium was present in 13.33% patients. Most common neurological sign was papilledema (23.33) followed by Hemiparesis (15%). Most common radiological finding was cerebral edema seen in 28.33% followed by hemorrhagic infarction seen in 23.34% of cases. 3.33% patients had sub arachnoid hemorrhage. In this study multiple (more than one) sinus involvement. Conclusion: CVST is mostly seen in third decade. Addiction, drugs, underlying procoagulant state like pregnancy, puerperium, coagulation disorders, infections are major risk factors for CVST.

Background: In 2017, a joint tuberculosis-tobacco collaboration was launched to decrease the habit of addiction to the tobacco use in subjects that have TB (tuberculosis). Aim: The present study was aimed to assess the predictors and prevalence of smokeless tobacco use and its awareness in  subjects having pulmonary tuberculosis.  Methods: The present study assessed 516 subjects that had drug-sensitive pulmonary TB and were selected randomly within the defined study period. The data were gathered from all the subjects using the Global Adult Tobacco Survey questionnaire. Predictors for smokeless tobacco were assessed using multivariate logistic regression analysis. Results: In 516 study subjects assessed, there were 27% females and 73% males, 46% had literacy, 62% were from nuclear family, travelling was part of occupation in 40% subjects, and 66% study subjects were married. Smokeless tobacco use history was positive in 52% of study subjects 8% using tobacco occasionally and 44% used it daily. The significant predictors of TB identified in study subjects were monthly income of 3-6 thousand, 9-12 thousand, and >12000, occupation that required travelling, and male gender. In 98% subjects, they were aware of the harmful effects of smokeless tobacco on the health. Conclusion: The present study concludes that smokeless tobacco is used by more than half subjects with pulmonary tuberculosis. The collaborative framework of TB and tobacco needs to be further strengthen using brief counselling sessions in subjects with tuberculosis that use smokeless tobacco for collateral benefit attainment to control tuberculosis in India

Introduction: Cardiovascular diseases, particularly coronary artery disease (CAD), are the leading cause of death globally. Smoking is a major modifiable risk factor for both the development and progression of CAD, contributing to plaque formation and instability. In India, tobacco use remains widespread, particularly in rural areas, exacerbating the CAD burden. This prospective observational study aims to assess smoking patterns, addiction levels, demographic correlations and angiographic features among CAD patients, comparing outcomes in smokers versus non-smokers. The findings will guide targeted interventions and improve rehabilitation efforts. Methods: A prospective observational study was conducted on 240 patients with angiographically confirmed obstructive CAD (≥70% stenosis in major epicardial arteries or ≥50% in the left main artery) which were recruited from inpatient departments. Patients were classified as current, past, or never smokers. Detailed demographic, clinical, angiographic, and smoking histories were collected, alongside nicotine dependence assessment using the Fagerström Test. A follow-up over 12 months evaluated smoking behaviour and cardiovascular outcomes including new onset angina, acute coronary syndrome/ STEMI, stent thrombosis, repeat revascularisation and mortality. Statistical analyses included multivariate logistic regression and Cox proportional-hazard modelling. The aim of this study is to investigate the impact of smoking on coronary artery disease (CAD) severity, coronary angiographic characteristics, to compare rate of mortality, MI and repeat revascularization between smoker and nonsmokers in 1 year follow up along with smoking behaviour on follow up. Results: The study findings reveal marked intergroup differences. Current smokers exhibited the highest nicotine dependence (Fagerstrom score 7.95 ± 1.45) and longest smoking duration (21.62 ± 4.71 years), compared to past smokers (4.8 ± 0.79; 15.31 ± 5.48 years) and never smokers (0; 0 years). Risk factor analysis showed significant associations, with hypertension (p=0.004) and dyslipidaemia (p<0.01) more prevalent in current smokers, while diabetes (p<0.01) was greatest in past smokers and family history of CAD (p<0.01) in never smokers. Smoking behavior re-evaluation also showed highly significant group differences (χ²=435.78, p<0.01), with persistent smoking in current smokers and notable relapse among past smokers. Conclusion: The study concluded that smoking as a significant risk factor for coronary artery disease (CAD), with current smokers experiencing more severe disease and higher rates of adverse outcomes.