The Clinical Significance of the Impact of Vaping on Plasma Clozapine Levels | Chapter 4 | Disease and Health Research: New Insights Vol. 4

Background: Clozapine is an antipsychotic medication essential for treating treatment-resistant schizophrenia. Heinz Baumann and his team at Wander AG, a Swiss pharmaceutical company, first synthesized Clozapine in 1958. Its plasma levels are influenced by cytochrome P450 (CYP450) enzymes, particularly CYP1A2. Vaping and traditional smoking may impact clozapine metabolism.

 

Objective: This study aims to explore how vaping affects the plasma levels of clozapine, focusing on the pharmacokinetic interactions between clozapine and vaping constituents, and the implications for clinical practice.

 

Methods: A literature review was conducted to examine the interactions between nicotine smoking, CYP450 enzymes, and clozapine metabolism. Additionally, case reports were analyzed to understand the clinical implications for patients on clozapine who switch from smoking to vaping.

 

Results: Unlike traditional smoking, vaping often lacks combustion products like polycyclic aromatic hydrocarbons (PAHs), leading to reduced CYP1A2 induction. Case reports showed that switching from smoking to vaping often results in elevated plasma clozapine levels due to decreased CYP1A2 activity, causing adverse effects from toxicity. However, some vape products containing combustible products like aldehydes and carbonyls can induce CYP450 enzymes, leading to subtherapeutic plasma clozapine levels.

 

Conclusion: Switching from smoking to vaping may affect clozapine metabolism primarily through reduced activity of the CYP1A2 enzyme. This can lead to higher serum clozapine levels, hence increased risk of toxicity and deleterious adverse effects. But vaping can also lead to the induction of CYP450 enzymes thereby causing decreased plasma clozapine levels. So, the effect of vaping on plasma clozapine levels can be dependent on its constituent ingredients. Therefore, health professionals should carefully monitor plasma clozapine levels in patients who switch from smoking to vaping and adjust dosages as needed to maintain therapeutic efficacy and minimize adverse effects.

 

Author (s) Details

Nkechinyere Mary Harry
Vinnytsia National Pirogov Medical University, Vinnytsia Oblast, Ukraine.

 

Ibrahim L. Folorunsho
Badr Al Janoub Hospital, Najran, Saudi Arabia. 

 

Kenechukwu Anona
University of Ibadan, Ibadan, Nigeria.

 

Nnenna Okafor
College of Medicine, All Saints University, St Vincent and the Grenadines, Caribbean

 

Gibson O. Anugwom
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrni/v4/1759

Nicotine Replacement Therapy: A Clinical Approach | Chapter 13 | New Visions in Medicine and Medical Science Vol. 6

 

India's diverse geography affects leading causes of death like TB, pulmonary, vascular, and neoplastic disorders. Smoking, a global issue, exacerbates poverty by diverting funds from essentials, while second-hand smoke poses health risks indoors. Second-hand smoke causes serious cardiovascular and respiratory diseases, including coronary heart disease and lung cancer, and kills around 1.3 million people prematurely every year.

China, Brazil and India are the largest tobacco leaf growers, with China accounting for 3.2 million metric tons . The main tobacco farming practices in LMICs (low and middle-income countries) that are responsible for environmental degradation are the use of agrochemicals and deforestation to clear land for tobacco growing and for fuel wood used in the flue-curing of tobacco. These practices lead to two major environmental consequences: ecosystem disruptions and soil degradation, which consequently lead to the loss of land resources, biodiversity and food insecurity . Studies have shown that tobacco absorbs more nitrogen, phosphorus and potassium than other major food and cash crops, and therefore, tobacco growing decreases soil fertility more rapidly than other crops.

The addiction to tobacco and related products poses a great challenge to healthcare providers. Various forms of Nicotine replacement are available in the market. Each form is associated with a specific dosage, methods of usage and pros and cons. The selection of the modality for nicotine replacement depends upon multiple factors like type, duration and severity of addiction, affordability of the patient and availability of the product in the market. They can be used as a single modality or in combination with other products. The current chapter discusses various nicotine replacement therapies and their intricacies.

Author(s) Details:

Dr. Anagha Shete
Department of Oral Medicine and Radiology, D Y Patil Dental School, Lohegaon, Pune, India.

Dr. Mrinal Shete
Department of Oral Pathology and Microbiology, D Y Patil Dental School, Lohegaon, Pune, India.

Dr. Vaishnavi Lolage
D Y Patil Dental School, Lohegaon, Pune, India.

 

Please see the link here: https://stm.bookpi.org/NVMMS-V6/article/view/14304

Insights into Oral Lesions Epidemiology and Risk Factors in North India: Findings from a Comprehensive Hospital-Based Investigation | Chapter 3 | New Visions in Medicine and Medical Science Vol. 3

 Aim: The present study was conducted to understand the clinical profile of individuals with oral precancerous lesions or oral cancer, estimate the relative prevalence of these disorders, and test the hypothesis that chewing tobacco/pan masala is a risk factor for them.

 

Background:  One of the most prevalent and deadly illnesses is oral cancer throughout the world. There are various obstacles that developing nations must overcome in order to locate and eliminate possible danger factors. Oral cancer and precancerous lesions are thought to be most strongly associated with tobacco chewing/pan masala.

 

Methodology: A hospital-based study was conducted and 471 subjects were recruited in the study. The subjects comprised patients with squamous cell carcinoma (n = 85), oral submucous fibrosis (n = 240), leukoplakia (n = 32), lichen planus (n = 15), and controls (n = 99). Statistical analysis of the data was done using Chi-square and regression analysis.

 

Results: A strong correlation was observed between the presence of the chewing habit in all the oral precancerous lesions and oral cancer. Duration of the habit and intensity of habit were also strongly correlated with the risk of oral precancerous lesions and oral cancer. Other factors such as alcohol and smoking were found to be less important in concern with oral cancer and precancerous lesions.

 

Conclusion: The Indian subcontinent bears one-third of the global burden. Annually, about 800,000 deaths in India result directly from tobacco-related cancers. Cancers of the oral cavity hold a critical position in healthcare systems due to the potential for early detection, which is both theoretically feasible and highly beneficial in practice. Early detection typically correlates with a significant reduction in the risk of disfigurement, recurrence, and mortality.

Author(s) Details:

Sharon John,
Department of Oral Pathology and Microbiology, King Georges Medical University, India.

Priya Devi,
Department of Oral Pathology and Microbiology, King Georges Medical University, India.

Shalini Gupta,
Department of Oral Pathology and Microbiology, King Georges Medical University, India.

Please see the link here: https://stm.bookpi.org/NVMMS-V3/article/view/13950

Betel Quid Habit Linked to Emerging Health Risks of Diabetes and Other Insulin Resistance Diseases in Poor Young South Asian Populations | Chapter 9 | Recent Updates in Disease and Health Research Vol. 3

Betel quid is traditionally prepared with areca nut, betel leaf, and slaked lime. The habit of betel quid chewing has existed for millennia and until recently, has been largely centered around cultural, medicinal, and ceremonial activities, particularly in South Asian countries. However, discovery of its psychoactive, euphoric, and aphrodisiac properties contributed to the global spread and abuse of betel quid, which now is widely consumed as a social lubricant and source of financial profit. Unfortunately, victims of the profit motive include young girls and boys who get addicted due to high rates of habitual consumption. Furthermore, the alarming practice of incorporating tobacco in quid preparations has grown and is particularly problematic for pregnant women. Long-term serious health concerns linked to habitual quid chewing include increased rates of malignancy, oral pathology, and cardiovascular, hepatic, fertility, metabolic, and neuropsychiatric disorders. Metabolic disorders and insulin resistance disease states such as type 2 diabetes, obesity, and metabolic syndrome have significant adverse effects due to their contributions to cognitive impairment and neurodegeneration. Mechanistically, the areca nut/betel quid constituents are metabolized to N-nitroso compounds, i.e., nitrosamines, which at high doses are carcinogenic, but at chronic lower levels, they cause insulin resistance diseases. Epidemiological data have highlighted rising tides of obesity, diabetes, and dementias, each of which has been linked to insulin resistance states that now disproportionately burden poor countries. Public health measures are needed to impose socially and ethically responsible barriers that curb commercialization strategies to enhance betel quid access and thereby reinforce practices that contribute to global health disparities.

Author(s) Details:

Suzanne M. de la Monte,
Department of Pathology and Laboratory Medicine, Providence VA Medical Center, Providence, RI 02808, USA, Women & Infants Hospital of Rhode Island, Providence, RI 02808, USA, Alpert Medical School, Brown University, Providence, RI 02808, USA, Departments of Medicine, Rhode Island Hospital, Providence, RI 02808, USA and Department of Neurology, Neurosurgery and Neuropathology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI 02903, USA.

Natalia Moriel,
Department of Molecular Pharmacology and Physiology, Brown University, Providence, RI 02912, USA.

Amy Lin,
Department of Molecular Pharmacology and Physiology, Brown University, Providence, RI 02912, USA.

Nada Abdullah Tanoukhy,
Department of Molecular Pharmacology and Physiology, Brown University, Providence, RI 02912, USA.

Camille Homans,
Department of Neuroscience, Brown University, Providence, RI 02912, USA.

Gina Gallucci,
Departments of Medicine, Rhode Island Hospital, Providence, RI 02808, USA.

Ming Tong,
Departments of Medicine, Rhode Island Hospital, Providence, RI 02808, USA.

Ayumi Saito,
Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02912, USA.

Please see the link here: https://stm.bookpi.org/RUDHR-V3/article/view/13711

Tip of an ICEBERG: The Growing Cancer Burden in India and How to Manage it | Chapter 8 | Socio-Scientific Interaction in Diabetes and Cancer and Its Management

 India has indisputably transitioned from the era of communicable diseases to the era of non-communicable diseases. It has a substantial impact on public health at multiple levels. These repercussions of cancer are only expected to increase in future due to our increasing elderly population. The major takeaways of the GLOBOCAN 2020 report include the rising global burden of cancer, global disparity in cancer incidence and mortality in different geographic regions, and the impact of the human development index (HDI) on cancer incidence and projected global cancer burden by 2040. Among the top five cancers in females, breast cancer was found to be the highest, followed by three female genital organs cervix, ovary and corpus uteri. Among males, three sites; lung, mouth and tongue, were limited with tobacco-related cancers. The new statistics should serve as a ‘wake-up call’ for the governments and policy makers. we need to develop region-specific solutions considering our resources and the kind of cancer burden present in every area. Developing effective policies and their execution will result in decrease in cancer morbidity and mortality, which will lead to huge economic benefits for the country. 

Author(s) Details:

Naveen Kumar,
Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India.

Shivani Kapila,
Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India

Please see the link here: https://stm.bookpi.org/SSIDCIM/article/view/12726

A Comparative Study on Smoking Index and Auditory Reaction Time | Chapter 3 | Recent Developments in Medicine and Medical Research Vol. 6

 Tobacco smoking is one of the most commonly overused medications by people of all ages. Cigarettes are a factor that affects reaction time due to the stimulant characteristics of their active element nicotine. The smoking index is a technique that can be used to determine how much people smoke. By multiplying the average number of cigarettes/bidis smoked per day by the tobacco smoking duration, the smoking index [SI] is derived (in years).

The following are the study objectives: The purpose of this study was to assess and compare auditory reaction time in smokers with various smoking indices. To see if the smoking index is linked to changes in auditory reaction time.

Methods: After receiving approval from the institutional ethical committee, this study was carried out at MR Medical College in Kalaburgi. The study included 50 seemingly healthy male smokers between the ages of 40 and 60. A Reaction Timer was used to record the auditory reaction time after obtaining a detailed smoking history. Three readings were taken, with the average of the three readings used for analysis, and the student's t test was used. A P value of less than 0.05 was used to determine statistical significance.

In contrast to many prior research that concluded smoking caused a decrease in reaction time, we revealed that reaction time to high and low pitch noises is increased in smokers with higher smoking indexes compared to smokers with lower smoking indexes. Conclusion: We infer that the smoking index has an effect on the central nervous system, but that this may have resulted in an increase in auditory reaction time because the bulk of our study individuals are elderly (aged 51-60 years).

Author(S) Details

Madiha Mehvish
Department of Physiology, PCMSRC, Bhopal, India.

Veeresh. B. Salgar
Department of Medicine, GIMS, Kalaburgi, India.

View Book:- https://stm.bookpi.org/RDMMR-V6/article/view/4509

Scientific Investigation for Determining the Sustainability Index of Tobacco Planted in Various Types of Land Typology in Pamekasan, Madura | Chapter 10 | New Perspectives in Agriculture and Crop Science Vol. 2

Economic importance of tobacco plantation has long been undeniable for East Java. In this province, especially in Madura, Pamekasan constitutes one of the greatest tobacco producers, cultivated in many types of farm typology such as sawah, tegal and gunung. This current study aimed at investigating sustainability index of tobacco planted in various land typologies in Pamekasan. Data were collected using in-depth interview and focus group discussion. The study was conducted in Pamekasan, Madura, between April 2016 and March 2016. Data obtained were evaluated using RapTobacco (derived from Rap-Fish) commonly known as Multi-Dimensional Scaling (MDS), covering ecological, social economy, institutional and policy and technological aspects. The results demonstrated that the highest sustainability index was observed at technological dimension, reaching up to 66.99 (sawah), 55.97 (tegal) and 58.13 (gunung). Although tobacco farming was sustainable in terms of technological dimension, more advanced technological supports might help it to reach a meaningful improvement, such as the use of information system for generating accurate climate data, as well as production and better distribution of proper tobacco seeds. Statistically, stress value was found <0.25%, while R2 value ranged from 92% to 94%. In short, we could conclude that the present model successfully fitted the testing data and could satisfactorily calculate sustainability index.

Author(s) Details

Raden Faridz
Department of Agroindustrial Technology, Faculty of Agriculture, University of Trunojoyo Madura, Bangkalan, East Java, Indonesia.

Ariffin
Department of Agricultural Science, Faculty of Agriculture, Brawijaya University, Malang, East Java, Indonesia.

Soemarno
Department of Agricultural Science, Faculty of Agriculture, Brawijaya University, Malang, East Java, Indonesia.

Henny Pramoedyo
Department of Agricultural Science, Faculty of Agriculture, Brawijaya University, Malang, East Java, Indonesia.

View Book :- http://bp.bookpi.org/index.php/bpi/catalog/book/172