Removal of gingival melanin pigmentation with the semiconductor diode laser: a case report

OBJECTIVE

This investigation was performed to evaluate the possibility of the removal of canine gingival melanin pigmentation with the semiconductor diode (SCD) laser in vivo.

SUMMARY BACKGROUND DATA

Recently, a semiconductor laser, which can ablate soft tissue, has been developed. It is already used in dentistry as well as in medicine.

METHODS

The SCD laser was irradiated on the pigmented area of canine gingival surface with the irradiation output of 3W. The effect of the SCD laser irradiation was evaluated at the two intervals: immediately after irradiation and at 3 weeks following irradiation. In addition, histological examination was performed before irradiation and at the same intervals from the biopsies (4 microm) of unlased and lased areas.

RESULTS

The SCD laser was effective in removing melanin pigmentation. In histological examination, neither inflammatory cell nor any tissue damage was observed with hematoxylin-eosin staining. At 3 weeks, there was a continuous healing process with the proliferation of squamous epithelial cells.

CONCLUSIONS

SCD laser irradiation can be considered an alternative procedure for removal of melanin pigmentation.

Effectiveness of chemical pleurodesis in spontaneous pneumothorax recurrence prevention: a systematic review

Objectives

Spontaneous pneumothorax is a common pathology. International guidelines suggest pleurodesis for non-resolving air leak or recurrence prevention at second occurrence. This study comprehensively reviews the existing literature regarding chemical pleurodesis efficacy.

Design

We systematically reviewed the literature to identify relevant randomised controlled trials (RCTs), case–control studies and case series. We described the findings of these studies and tabulated relative recurrence rates or ORs (in studies with control groups). Meta-analysis was not performed due to substantial clinical heterogeneity.

Results

Of 560 abstracts identified by our search strategy, 50 were included in our systematic review following screening. Recurrence rates in patients with chest tube drainage only were between 26.1% and 50.1%. Thoracoscopic talc poudrage (four studies (n=249)) provided recurrence rates of between 2.5% and 10.2% with the only RCT suggesting an OR of 0.10 compared with drainage alone. In comparison, talc administration during video-assisted thoracic surgery (VATS) from eight studies (n=2324) recurrence was between 0.0% and 3.2%, but the RCT did not demonstrate a significant difference compared with bleb/bullectomy alone. Minocycline appears similarly effective post-VATS (recurrence rates 0.0–2.9%). Prolonged air leak and recurrence prevention using tetracycline via chest drain (n=726) is likely to provide recurrence rates between 13.0% and 33.3% and autologous blood patch pleurodesis (n=270) between 15.6% and 18.2%.

Conclusions

Chemical pleurodesis postsurgical treatment or via thoracoscopy appears to be most effective. Evidence for definitive success rates of each agent is limited by the small number of randomised trials or other comparative studies.

Histoplasmosis of the small bowel in patients with AIDS

Two cases of jejunal strictures caused by Histoplasma capsulatum in AIDS patients are presented. Both patients were intravenous drug abusers. One patient, who was being treated for Pneumocystis carnii pneumonia, presented with jejunal perforation and the other presented with lower gastrointestinal bleeding and intestinal obstruction. On exploration, both patients were found to have jejunal strictures; one had intestinal perforation, and the other had intestinal obstruction with ulcers and strictures resulting in gastrointestinal bleeding. In areas where it is endemic, histoplasmosis is rarely disseminated. Dissemination is most commonly seen in immunosuppressed patients. Dissemination and extrapulmonary histoplasmosis is now included in the case definition of AIDS.

Incidental MRI lesions suggestive of multiple sclerosis in asymptomatic patients in Karachi, Pakistan

The objective of this study was to identify asymptomatic patients with brain MRI lesions suggestive of multiple sclerosis (MS) in a low-prevalence area of Pakistan. Brain MRIs for 864 patients were reviewed at the Aga Khan University (Karachi, Pakistan) during an 8-month period of 2006 and 2007 to identify patients with lesions suggestive of MS. The lesions were characterised based on modified Barkhof criteria. Six (two females) (0.7%) of 864 patients fulfilled brain MRI criteria suggestive of MS. The mean number of MRI lesions (total lesions on T2) were 9 (range 5-14). Although Pakistan is considered a low-prevalence area for MS, 0.7% of brain MRI scans in patients without clinical MS symptoms showed lesions fulfilling brain MRI criteria of MS.

Impact of Prenatal Exposure to Smoking on Child Health

Prenatal exposure to tobacco smoke remains common, through active smoking and/or passive environmental exposure, and is linked to adverse childhood outcomes. Not only have high-quality studies and meta-analyses demonstrated increased risks of prenatal as well as postnatal complications, but adverse child outcomes are well described. In utero exposure to tobacco smoke has been associated with congenital anomalies, infant and teenager overweight and obesity, and neuropsychiatric sequelae. In addition, certain childhood malignancies have been linked to paternal smoking during pregnancy. In this chapter, adverse childhood outcomes related to intrauterine exposure to electronic cigarettes and marijuana are described.

Depressive Symptoms and Emotional Distress of Transnational Mothers: A Scoping Review

Background: Female led migration is a recent trend that has been gaining momentum, particularly in Latin America. However, little attention has been given to the psychological consequences of mothers who leave their children in their country of origin and migrate to a host country to work. Therefore, it is important to investigate the mental health status of transnational mothers and to further identify issues for intervention and supportive services. Methods: PubMed, PsycINFO, ERIC, CENTRAL, Scopus, and ScienceDirect databases were searched systematically for peer-reviewed articles published from inception through July 2019. The search included the following terms: migrant, immigrant, transnational, transnational mother, AND mood disorders, depressive symptoms, and depression. Initially, 8,375 studies were identified. After exclusionary criteria were applied, 17 studies were identified and included in the review. Results: We found six quantitative studies that investigated depressive symptoms among transnational mothers. Of these studies, three found a positive association between transnational motherhood and depressive symptoms; three of these articles found a null correlation. A total of eight qualitative studies and three mixed-methods studies were found that addressed depressive symptoms and emotional distress among transnational mothers. The eight qualitative studies identified highlighted the significant emotional distress transnational mothers experience. Lastly, the three mixed-methods studies similarly discussed the emotional hardships faced by transnational mothers. Implications: The studies identified suggest that depressive symptoms and emotional distress are prevalent among transnational mothers. Therefore, public health social workers and other mental health providers need to focus on developing strategies to identify and screen transnational mothers for depressive symptoms.

Bacteriological Profile Of Ear Discharge And Their Antibiotic Sensitivity In Chronic Suppurative Otitis Media In Kashmir,India

The objective of the study was to study the microflora and the antibiograms of patients with chronic suppurative otitis media (CSOM) in Kashmir,in order to provide a guidelines for making a protocol for empirical antibiotic therapy. Study design:Prospective study Material and methods: This study was conducted on OPD basis in Department of Ear, Nose and Throat and HNS Government medical college Srinagar kashmir from july 2010 to june 1011 and one hundred twenty five(125) patients with unilateral or bilateral active chronic suppurative otitis media were prospectively studied.They had chronic ear discharge and had not received antibiotics for the previous five days. Swabs were taken from discharging ear's and sent to microbiological section of hospital were culture for bacteria was done Antibiotic sensitivity testing was done with standard antibiotic discs using Kirby-bauer disk diffusion method.4 Results:From the Clinical specimens off the 125 patients microbiological culture was positive in 110 specimens. The most common causal organisms isolated were Staphylococcus aureus (48%) including 8% of methcillin resistant staph aureus and Pseudomonas aeruginosa (16%) followed by coagulase negative.Antibiotic sensitivities of staph aureus (other than MRSA) showed that 72% isolates were sensitivity to gentamicin,55% to ciprofloxacin followed by 36% to cephalosporins (cetazidime,ceftriaxone) .For pseudomonas aeruginosa 72% isolates were sensitive to piperacillin/tazobactum 48% to ciprofloxacin and 32% to ceftazidime/ceftriaxone. Of the three antibiotics commonly available as topical eardrops,ciprofloxacin and gentamicin has the highest susceptibility rate. DOI: http://dx.doi.org/10.3329/bjms.v11i3.11731 Bangladesh Journal of Medical Science Vol. 11 No. 03 July’12

Caffeine and total polyphenol contents of market tea cultivated and processed in Bangladesh

OBJECTIVE

The aim of this study was to determine the contents of caffeine and total polyphenol in six brands of market tea cultivated and processed in Bangladesh.

METHODS

Caffeine and polyphenol contents were determined by solvent extraction (AACC) and the International Organisation for Standardisation Method (ISO) 14502-1 respectively.

RESULTS

Caffeine contents of the different tea samples ranged between 0.99 +/- 0.17% to 2.08 +/- 0.16% (g/100g materials), while that of total polyphenol was from 36.90 +/- 1.39% to 17.29 +/- 2.30% of gallic acid equivalents (GAE). The order of caffeine concentration in tea samples was found as follows: Organic Black Tea > Taaza Tea > Organic Green Tea > Magnolia Tea > Organic Zinger Tea > Organic Tulsi Tea. The polyphenol concentration in the tea samples was highest in Organic Green Tea followed by Taaza Tea and the rest as follows: Magnolia Tea > Organic Black Tea > Organic Zinger Tea > Organic Tulsi Tea. An indicative difference in amounts of caffeine and polyphenols for different tea brand samples is seen in this study.

CONCLUSION

This systematic screening provides information to producers as well as consumers on the quantities of caffeine and polyphenols in commercial tea available in the markets of Bangladesh.

Assessing the Human Health Benefits of Climate Mitigation, Pollution Prevention, and Biodiversity Preservation

Background

Since the Industrial Revolution, humanity has amassed great wealth and achieved unprecedented material prosperity. These advances have come, however, at great cost to the planet. They are guided by an economic model that focuses almost exclusively on short-term gain, while ignoring natural capital and human capital. They have relied on the combustion of vast quantities of fossil fuels, massive consumption of the earth's resources, and production and environmental release of enormous quantities of chemicals, pesticides, fertilizers, and plastics. They have caused climate change, pollution, and biodiversity loss, the "Triple Planetary Crisis". They are responsible for more than 9 million premature deaths per year and for widespread disease - impacts that fall disproportionately upon the poor and the vulnerable.

Goals

To map the human health impacts of climate change, pollution, and biodiversity loss. To outline a framework for assessing the health benefits of interventions against these threats.

Findings

Actions taken by national governments and international agencies to mitigate climate change, pollution, and biodiversity loss can improve health, prevent disease, save lives, and enhance human well-being. Yet assessment of health benefits is largely absent from evaluations of environmental remediation programs. This represents a lost opportunity to quantify the full benefits of environmental remediation and to educate policy makers and the public.

Recommendations

We recommend that national governments and international agencies implementing interventions against climate change, pollution, and biodiversity loss develop metrics and strategies for quantifying the health benefits of these interventions. We recommend that they deploy these tools in parallel with assessments of ecologic and economic benefits. Health metrics developed by the Global Burden of Disease (GBD) study may provide a useful starting point.Incorporation of health metrics into assessments of environmental restoration will require building transdisciplinary collaborations. Environmental scientists and engineers will need to work with health scientists to establish evaluation systems that link environmental and economic data with health data. Such systems will assist international agencies as well as national and local governments in prioritizing environmental interventions.

Laparoscopic accessory splenectomy in recurrent chronic immune thrombocytopenic purpura

Splenectomy is the definitive treatment for most cases of idiopathic thrombocytopenic purpura (ITP). We present the case of a patient who was discovered to have ITP at age 5 and was treated medically for 3 years with decreasing response to medication. At age 8, he underwent splenectomy, after which the platelet count stabilized at approximately 200,000/mm3. Two years later he again had symptoms of thrombocytopenia and was treated medically with moderate success. At age 12, during hospitalization for bleeding, his liver/spleen scan gave negative results. Symptoms persisted, and when the patient was 13 a second scan found two small areas of uptake in the area of the splenic bed suggestive of secondary accessory splenic activity. The platelet count at that time was 6,000/mm3. Laparoscopy was performed, and after careful dissection of the left-upper quadrant, two globular masses, the larger of which was 3 x 2 x 2 cm, were removed without incident. The latest platelet count, 3 months after laparoscopic secondary accessory splenectomy, was 169,000/mm3, and a follow-up scan shows no uptake in the area of the spleen.

Exposomics: a review of methodologies, applications, and future directions in molecular medicine

The exposome is the measure of all the exposures of an individual in a lifetime and how those exposures relate to health. Exposomics is the emerging field of research to measure and study the totality of the exposome. Exposomics can assist with molecular medicine by furthering our understanding of how the exposome influences cellular and molecular processes such as gene expression, epigenetic modifications, metabolic pathways, and immune responses. These molecular alterations can aid as biomarkers for the diagnosis, disease prediction, early detection, and treatment and offering new avenues for personalized medicine. Advances in high throughput omics and other technologies as well as increased computational analytics is enabling comprehensive measurement and sophisticated analysis of the exposome to elucidate their cumulative and combined impacts on health, which can enable individuals, communities, and policymakers to create programs, policies, and protections that promote healthier environments and people. This review provides an overview of the potential role of exposomics in molecular medicine, covering its history, methodologies, current research and applications, and future directions.

Perception of Dentists about Caries-risk Assessment tools in Jaipur, India: A Cross-sectional Study

BACKGROUND

Caries risk assessment (CRA) is an essential element of contemporary clinical care for infants, children, and adolescents. CRA tools aid in the detection as well as documentation of caries risk predictors and let the health care professionals to be more active in identifying and referring high-risk patients for proper treatment and required prevention. The aim of the study was to assess the information-seeking behavior of dental practitioners of Jaipur regarding CRA tools.

MATERIALS AND METHODS

A cross-sectional questionnaire-based survey was conducted among the dental practitioners of Jaipur city. A 17-itemed questionnaire was personally administered to 373 dental practitioners of Jaipur and their knowledge was assessed based on the questions about CRA tools and Cariogram. The data were analyzed using Chi-square test.

RESULTS

Around 80.5% of the practitioners were aware of CRA tools among which only one-fourth were practicing CRA. Significant correlation of qualification, specialty, and years of practice was found with knowledge of CRA tools, practice of CRA and preventive treatment and attitude toward risk assessment.

CONCLUSIONS

A substantial percentage of dentists did not practice CRA, but were interested in receiving more education about CRA and its tools.