![]() Blood urea, glucose, and electrolytes were normal. The laboratory tests showed a peak in the troponin-T level, of 5.056 ng / ml (normal < 0.1 ng / ml), and creatine kinase MB of 350.6 u / l (normal < 24 u / l). Angioplasty was performed and followed by a bare metal stent implantation for the culprit lesion in the LAD. Even though the patient was on continuous intravenous nitrate, further intra-coronary nitrate failed to relieve a presumed coronary spasm. Apart from short runs of nun-sustained VT, he remained asymptomatic until the third hospital day, when the chest pain reappeared and a coronary angiogram was performed which revealed a 70% proximal left anterior descending artery (LAD) lesion, 40% left circumflex artery (LCX) lesion, and a normal right coronary artery. The chest pain subsided and ST elevation was markedly reduced after 30 minutes. The patient responded successfully to fibrinolyitic therapy. Oral aspirin, clopidogrel, metoprolol, and statin were also instituted. (b) Patient's electrocardiogram after successful fibrinolyitic therapyįibrinolyitic therapy was given at presentation as well as intravenous nitrate and heparin. (a) A 12-lead electrocardiogram shows ST elevation in leads V2 – V5, I, and AVL, with reciprocal ST-segment depression in leads II, III, and AVF. The effects and consequences of ST are discussed. A thorough review of the risk factors profile revealed heavy ST use for one year. We report the case of a young man who presented with acute myocardial infarction. Other reasons are that it is presumed to be a less harmful alternative for those having difficulty quitting smoking and its easy affordability. Proliferation of restrictions on the smoking area is the main reason behind many people using ST, especially for the young, below 18 years of age. Many factors contribute to the popularity of ST consumption. There are no precise figures available on the exact prevalence of ST usage in the gulf region, but most observers agree that is widely used by workers coming from Asia, and it has been recently noticed that these products have gained popularity among adult and adolescent citizens. ![]() In Sweden, around 20% of the adults used ST. In the United States, 5.2% of young adults, between the ages of 18 and 25, and 3.2% adults over the age of 26, used ST in 2006. The prevalence of ST use in India is 20%, and significantly higher in males. It carries different names: ‘Snus’ or ‘Snuff’ is a well-known name in Sweden, ‘Niswar’ (Naswar) or ‘Tombaco’ is used in Pakistan, Afghanistan, and India, ‘toombak’ in Sudan, and ‘Sweka’ or ‘Niswar’ in the Gulf Region. The ST is primarily used in Central Asia, Iran, Afghanistan, Pakistan, Tajikistan, India, and in Europe, like Sweden. The dip rests on the inside lining of the mouth usually for a period depending on the user's preference, between few minutes to an hour. Dipping tobacco, also known as moist snuff or spit tobacco, is held in the mouth between the cheeks and gums instead of being smoked. Smokeless tobacco forms are chewing, dipping, and snuff tobacco. Tobacco is consumed in two forms: the smoked tobacco products, like cigarettes and shisha (water pipe) and the smokeless tobacco (ST). The consumption of tobacco is a major source of mortality and morbidity worldwide.
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