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Head and Neck
Published in Adnan Darr, Karan Jolly, Jameel Muzaffar, ENT Vivas, 2023
Hannah Nieto, Theofano Tikka, Adnan Darr, Karan Jolly, Paul Pracy, Vinidh Paleri
History: Onset, periodicity, increase in sizeRed flags: Dysphagia, dysphonia, dyspnoea, odynophagiaPMH: History of salivary calculi/sialadenitisPrevious salivary gland surgeryTrauma, dental workSH: SmokingDrinkingBetel nut chewing
Essential Pharmacology of Abused Drugs
Published in Frank Lynn Iber, Alcohol and Drug Abuse as Encountered in Office Practice, 2020
Many drugs are bases that ionize under acidic conditions and cannot be absorbed by diffusion. Betel nut is such a drug, so it is chewed with alkaline lime to enhance its absorption. Basic drugs ionize in the stomach and will not be absorbed until they reach the alkaline milieu of the small intestine. These drugs include opiates, amphetamines, barbiturates, and some individual members of other drug classes. The pH of the gastrointestinal tract influences the amount and rate of drug absorption.
Adherence in Ethnic Minorities : The Case of South Asians in Britain
Published in Lynn B. Myers, Kenny Midence, Adherence to Treatment in Medical Conditions, 2020
The literature on health attitudes and behaviour among South Asians in Britain is full of contradictory imagery. The community is depicted as knowing little of the concept of screening, and yet on the Indian subcontinent, the determination of foetal gender by amniocentesis is well-known to the point of abuse (Pandya, 1988). The culture is characterised as retrograde with respect to the seclusion of women and yet the support of the extended family system is seen to be beneficial. Overcrowding is used as an indicator of poverty and thereby implicated in poor health, but it has also been noted that the cultural practice of parental-infant bed sharing may limit the occurrence of sudden infant death syndrome (Farooqi, 1994). Subgroups of the community are described in terms of “good” and “bad” health practices. For example, alcohol and cigarette consumption is low in Pakistani and Indian females (Ahmad, Kemohan and Baker, 1988) but the habit of betel nut chewing has been implicated in the excess cases of oral cancer found amongst South Asians (Donaldson and Clayton, 1984). Any attempts to generalise about health in general or adherence are further complicated by the confounding of ethnicity with class (Navarro, 1990; LaVeist, 1996). Poor adherence may be as much, if not more, related to structural than to attitude barriers.
Changing pattern of tobacco consumption and quitting behavior in Northeast India
Published in Journal of Substance Use, 2021
Boishali Saikia, Strong P. Marbaniang, Pradeep Kumar, Preeti Dhillon
The prevalence of use of SLT in Northeast India is estimated to range from 39.3% to 86.7% among males, and 23.6% to 87.2% in females. In their study, Singh and Singh mention that betel quid (synonymous with chewing pan or paan) and gutka are known causes of lip cancer, cancer of the esophageal, mouth cancer, and pharyngeal cancer. In Northeast India ‘betel nut’ or ‘betel quid’ is the most widely consumed form of SLT (Singh & Singh, 2016). Its chewing is part of local tradition (Ladusingh & Singh, 2015; Wary & Sharan, 1988). Betel nut is usually chewed with betel leaf and slaked lime. To the Khasis in Meghalaya and the Assamese in Assam, offering a betel leaf with betel nut before serving water or tea is a sign of welcoming a guest (Hauzel, 2017). The Khasis consider betel nut, locally known as kwai, to be a great social leveler. Since even the poor can afford it, it is believed to remove the disparity between the poor and the rich.
Retail Availability and Characteristics of Addictive Areca Nut Products in a US Metropolis
Published in Journal of Psychoactive Drugs, 2021
The purpose for including menthol in the betel products is likely to enhance the cooling, tingling sensation mitigated by betel nut alkaloids (cholinomimetic chemicals), and to temporarily freshen breath. However, menthol may contribute to betel nut toxicities. Although generally considered a safe substance, chronic ingestion of menthol elicits abnormal cutaneous, gastrointestinal, neurological and oral manifestations, all of which have been documented in betel nut users (Farco and Grundmann 2013). A serious adverse effect of AN chewing is hepatotoxicity, and interestingly menthol is hepatotoxic to rodents (Brewer and Chen 2017). This is significant since it is common for consumers to ingest betel products throughout the day, potentially leading to over accumulation of menthol in the body. The presence of menthol in these products is also significant since menthol bans in tobacco cigarettes is rapidly occurring in a growing number of US states (Schroth et al. 2019).
A Discourse Analysis on Betel Nut Chewing in Hunan Province, China
Published in Journal of Psychoactive Drugs, 2021
Betel nuts are widely chewed in South and Southeast Asian countries and the Asia Pacific tropical regions. As a recreational substance, the betel nut is linked with the cultural and social traditions and customs, and shared at family meetings and social occasions. It has been estimated that 600 to 1200 million people (10% to 20% of the world’s population) chew betel nuts (Binns, Wah, and Katie 2011 with 50 million betel nut users in China (China Industry and Economy News, January 27, 2016). Yang, Fu, and Tang (2019) summarized the prevalence of betel nut chewing in some countries as shown in Table 1.