Prevalence Of Pigmentation Research Articles

Prevalence of tobacco and areca-nut use among patients attending dental teaching hospital in the central province of Sri Lanka and its association with oral mucosal lesions; a cross sectional study

IntroductionTobacco and areca-nut are risk factors for oral cancer and potentially malignant disorders. Oral cancer is ranked as the commonest among males in Sri Lanka (18.4 %). This research aims to determine the prevalence of tobacco and areca-nut use and its association with oral lesions. MethodIt is a cross-sectional study using 368 patients attending the Dental Diagnostic Clinic. Details of tobacco and areca-nut use were collected and participants were examined for mucosal lesions. ResultsIt revealed that 23.9 % had tobacco use. Out of these, 41.1 %, 22.2 % and 36.7 % had smokeless-tobacco use, smoking and both, respectively. Similarly, 25.3 % had areca-nut/betel-quid use and majority (72.8 %) added tobacco to it. Tobacco (93.2 %) and areca-nut (79.6 %) use was higher among males (p < 0.05). Significant associations of areca-nut use with age (p = 0.001) and education level (p = 0.025) were noted. Oral lesions like de-pigmentation, white patches, ulcers, growths and oral sub-mucous fibrosis (OSF) had prevalences of 2.4 % each. Prevalence of pigmentation, lobulated tongue and erosive lesions was 10.6 %, 4.6 % and 1.4 %, respectively. 32.6 % had abnormalities like linea-alba, periodontal problems, pericoronitis and hairy tongue. The study revealed that >90 % of those who used tobacco and areca-nut had oral lesions (p < 0.05). ConclusionThe prevalence of tobacco and areca-nut use is high among patients attending the Dental Teaching Hospital, and its association with mucosal lesions is significant. Hence regular awareness programs on the adverse effects of tobacco and areca-nut use should be carried out at the Diagnostic clinic as a preventive measure.

Prevalence and Pattern of Leptomeningeal Pigmentation in the Human Brain and Its Role in the Safe Surgical Excision of Extra-Axial Brain Tumors.

Although leptomeningeal melanin pigmentation is well-known, it is not described in the neurosurgical literature. Dark pigmentation native to these transparent membranes might have microsurgical relevance in identifying a plane of dissection. To describe the prevalence of leptomeningeal pigmentation and determine whether its recognition helps during microsurgical excision of extra-axial brain tumors. : This was a prospective cross-sectional observational study in cadavers and neurosurgical patients. Eight adult cadaveric brains were examined for leptomeningeal pigmentation and biopsies taken for histological studies. A total of 126 patients undergoing surgery for cerebellopontine angle and suprasellar lesions were included in the clinical study. The surgeon determined whether the recognition of pigmentation was useful during microneurosurgical arachnoid dissection. Seven of 8 cadavers (87.5%) had leptomeningeal pigmentation on the ventral pons, optic chiasm, lamina terminalis, olfactory tract, and gyrus rectus and infrequently on the cerebral convexities. The prevalence of pigmentation was 76.9% in the clinical study, was seen in all pediatric patients, and was significantly higher in males (P = 0.009), with no significant association with skin color. Immunochemistry identified the pigmentation as melanin. Recognition of this pigmentation was deemed to be useful during tumor excision in 78% of the cases. Leptomeningeal melanin pigmentation has a prevalence of 76% to 87% in the Indian population and is more often seen in younger males. It is most commonly identified overlying the ventral brain stem and optic chiasm. Recognition of its presence is helpful during arachnoid dissection during most cerebellopontine angle and suprasellar tumor resections.

Effect of arsenic safe water on manifestations of arsenicosis

Background: Reports are few in the literature on the long term effect of chronic arsenic toxicity after stoppage of drinking arsenic contaminated water. The object of the study is to ascertain the effect of drinking of arsenic safe water for prolonged period in an arsenic affected population in West Bengal, India.Methods: A longitudinal intervention study was conducted from December 2017 to July 2018. Manifestations of various skin lesions and systemic diseases associated with chronic arsenic exposure were ascertained initially by carrying on baseline study on 200 families having 1200 family members in Madanpur village of Murshidabad district of West Bengal. The study population was taking water from tube wells with arsenic level &gt;50 µg/l. The base line study findings were compared objectively at the end of six months follow up period after installation of a community filter in the village.Results: 2% of the study population was having one or more dermatological and non dermatological manifestations of arsenicosis. There was 4.2% decrease in prevalence of pigmentation but no change in prevalence of keratosis in the follow up survey with 40% decrease in prevalence of non dermatological manifestations after taking arsenic safe water at the end of 6 months of follow up study. Around 60% of population was not aware about adverse health effects of arsenicosis and 70% not taking animal protein regularly.Conclusions: Outcome of arsenical skin lesion following drinking of arsenic safe water depends on initial level and duration of arsenic exposure.

Evaluation of gingival pigmentation in children exposed to and not exposed to environmental tobacco smoking

Background and Aim: The exposure to environmental tobacco smoke (ETS) has been recognized as a strong contributor to respiratory disorders, lung cancer, peripheral vascular function and death. Increased gingival pigmentation in smokers is established. In children exposed to ETS, an increased incidence of caries and pigmentation of gingiva were documented. In a country like India where no stringent smoke-free policies exist and the presence of joint family systems in rural population, children are at a greater health risk when either one of the family member is a smoker. The potential accumulation in melanin-containing tissues of nicotine and tobacco-specific compounds may be a concern for any individual who is chronically exposed to tobacco smoke. Gingival pigmentation is easy to assess and could be of significant importance while educating parents in terms of their child's health. Thus primary objective of our study is to assess the effects of ETS on gingival pigmentation in children with ≥1 smoker parent or close relatives. Materials and Methods: A total of 228 students between the age group of 6-16 years were selected randomly. The cases included children exposed to ETS who were non-smokers and the controls were not exposed to ETS at home. Pigmentation was assessed using Dummet & Co's pigmentation index and smoking was assessed by interview. Results: The prevalence of pigmentation in subjects not exposed to ETS was found to be 132 (80.5%) subjects in comparison to 32 (19.5%) without any gingival pigmentation. It can also be noted that all the 64 (100%) subjects exposed to ETS had pigmented gingiva. Conclusion: Within the limitations of this cross-sectional observational study, we conclude that there may be a correlation between gingival melanin pigmentation of children exposed to ETS.

Cardiovascular and cerebrovascular complications and clinical characteristics in patients with Cushing's syndrome of different aetiologies

Objective To compare the cardiovascular and cerebrovascular complications and clinical characteristics in patients with Cushing's syndrome of various aetiologies.Methods Two hundred and eighty-four consecutive patients with Cushing's syndrome were included and divided into three groups according to aetiologies:Cushing's disease group (CD),adrenal adenoma group (AA),ectopic ACTH syndrome group (EAS).Results (1) Of the 284 patients,the mean age was(37.7 ± 12.3) years(16-76 years),while in EAS group it was(45.1 ±16.4) years (16-68 years,P ＜0.05).Patients in EAS group had shorter duration of illness (1-3 months).Hypokalemia was present in 44.9％,32.3％,100％ of patients in CD group,AA group,and EAS group respectively.(2) Patients in EAS group were more susceptible to alkalosis and edema of lower limbs,and had lower prevalence of striae (P＜0.05) ; AA group had lower prevalence of pigmentation and acne(P＜0.01).(3) Patients in EAS group had significantly higher baseline plasma ACTH,cortisol,and 24 h urine free cortisol levels than those in CD group and AA group.(4) Patients in EAS group and CD group had similar prevalences of overall vascular complications(68.8％ vs 59.2％,P＞0.05),which were significantly higher than that in AA group(43.4％,P＜0.05).Compared with AA group,patients in CD group had higher prevalence of cardiovascular complications (43.8％ vs 31.3％) and cerebrovascular complications (13.1％ vs 6.1％,P＜0.05),manifesting as cardiac arrhythmia(33.7％ vs 22.2％) and cerebral infarction (13.1％ vs 5.1％,P ＜0.05).No significant difference in the prevalence of impaired renal function in three groups was found (P ＞ 0.05).Multivariate logistic regression analysis revealed that the incidence of hypokalemia was positively correlated with vascular complication in group CD,but serum potassium level was negatively correlated with vascular complication.Conclusion Patients in EAS group were older and had shorter duration of illness,and higher levels of hormone,and were more susceptible to hypokalemia,alkalosis edema of lower limbs,and pigmentation.Patients in CD group had higher prevalence of cardiovascular and cerebrovascular complications than that in AA group,especially arrhythmias and cerebral infarction.No significant difference in the incidence of impaired renal function was found among three groups.Hypokalemia might be the independent risk factor of vascular complications in CD group. Key words: Cushing's syndrome; Hypokalemia; Vascular complications; Different aetiologies

Chronic Arsenic Toxicity: Clinical Features, Epidemiology, and Treatment: Experience in West Bengal

Chronic arsenic toxicity due to drinking arsenic-contaminated water has been one of the worst environmental health hazards affecting eight districts of West Bengal since the early eighties. Detailed clinical examination and investigation of 248 such patients revealed protean clinical manifestations of such toxicity. Over and above hyperpigmentation and keratosis, weakness, anaemia, burning sensation of eyes, solid swelling of legs, liver fibrosis, chronic lung disease, gangrene of toes, neuropathy, and skin cancer are some of the other manifestations. A cross-sectional survey involving 7683 participants of all ages was conducted in an arsenic-affected region between 04 1995 and 03 1996. Out of a population of 7683 surveyed, 3467 and 4216 people consumed water containing As below and above 0.05 mg/L, respectively. Except pain abdomen the prevalence of all other clinical manifestations tested (e.g., pigmentation, keratosis, Hepatomegaly, weakness, nausea, lung disease and neuropathy) were found to be significantly higher in As exposed people (water As>0.05 mg/L) compared to control population (water As level<0.05 mg/L). The prevalence of pigmentation and keratosis, hepatomegaly, chronic respiratory disease and weakness rose significantly with increasing arsenic concentrations in drinking water. The respiratory effects were most pronounced in individuals with high arsenic water concentrations who also had skin lesion. Therapy with chelating agent DMSA was not found to be superior to placebo effect. However, therapy with DMPS caused significant improvement of clinical condition of chronic arsenicosis patients as evidenced by significant reduction of total clinical scores from 8.90 ± 2.84 to 3.27 ± 1.73; p<0.0001. Efficacy of specific chelation therapy for patients suffering from chronic As toxicity has further need to be fully substantiated. However, supportive treatment could help in reducing many symptoms of the patients. Treatment in hospital with good nutritious diet has been found to reduce symptom score in a subset of placebo treated patients in West Bengal during the course of DMSA and DMPS trial. People should be advised to stop drinking As contaminated water or exposure to As from any other source. The various clinical manifestations should be treated symptomatically.

Less common oral lesions associated with HIV infection: prevalence and classification.

This paper deals with a number of group II and III lesions, ie lesions definitely but less commonly, and lesions possibly associated with HIV infection, respectively. Salivary gland disease includes dry mouth and/or swelling of major salivary glands, often as a part of CD8-lymphocytosis syndrome. Xerostomia occurs commonly (2-10%) in HIV-infected individuals. Enlargement of the major salivary glands occurs frequently (19%) among HIV-infected children, but rarely among adults (0.8%). The major salivary glands show lymphoepithelial lesions or cysts histopathologically. Hyperpigmentation of the oral mucosa was found in 2.2% of 1710 HIV+ individuals in seven studies. The hyperpigmentation has been ascribed to a number of medicaments, and possibly to HIV. The prevalence of pigmentation is not significantly higher among HIV+ than HIV- individuals. Thrombocytopenia frequently occurs in HIV infection. Oral petechiae were reported in 2% of 1121 HIV+ in five studies. Human papilloma virus (HPV) infection occurred in 1.1% of 989 HIV+ in seven studies. Drug reactions (white lichenoid lesions, ulceration, toxic epidermal necrolysis) have been reported in a number of cases, not allowing prevalence figures. However certain drugs, notably Foscarnet, Interferon and 2,3-dideoxycytidine, may frequently cause oral ulcerations. Oral neurologic manifestations such as peripheral facial paralysis and sensory neuropathy have been reported in a few cases or series only.

Physiologic pigmentation of the oral mucosa in Israeli Jews of different ethnic origin.

The prevalence of oral physiologic pigmentation in three ethnic groups of a total of 2465 Israeli Jews was determined, and the relationship of oral pigmentation to age and sex within the groups was noted. Results showed the presence of oral pigmentation in 63.6% of the Eastern group, 54.8% of the Sephardic group, and 24.9% of the Ashkenazi group. No indication was found of sex predilection, and no significant trend was evident in the prevalence of pigmentation with relation to age. The leading site of pigmentation among the entire sample was the gingiva, and this finding did not vary with ethnicity.

Dose-response relationship between tobacco consumption and melanin pigmentation in the attached gingiva.

The dose response relationship between tobacco consumption and melanin pigmentation in the attached gingiva was examined on two occasions 4 years apart in a group of Japanese lead workers with blood lead concentrations below 2.0 mu mol/kg (40 micrograms/100 g). In the two examinations, 12% and 18% of the total group of workers and 17% and 24% of the smokers had melanin pigmentation. The prevalence of pigmentation was significantly higher in smokers who inhaled more than 10 cigarettes per day (17% and 25%) than in nonsmokers (0% and 2%), and tended to increase significantly with tobacco consumption. Lead absorption was not associated with melanin pigmentation.

Epidemiologic study of excessive oral melanin pigmentation with special reference to the influence of tobacco habits.

The prevalence of oral melanin pigmentation was studied in a population of 30 118 adult individuals in Sweden. Among these, 9.9% showed melanin pigmentation in the oral mucosa. The anterior labial gingiva in the mandible was the most frequently pigmented location. The presence of melanin pigmentation was positively correlated to tobacco smoking. Among tobacco smokers 21.5% were pigmented as compared to 3.0% among individuals not using tobacco. The smoking-related oral pigmentation, smokers' melanosis, could thus be calculated at a prevalence of 18.5% among smokers and the total frequency of smokers' melanosis was calculated at 6.8%. The prevalence of pigmentation was found to increase prominently during the first year of smoking but also to decrease to the level found among non-tobacco users about 3 years after cessation of smoking. Snuff dipping did not significantly elevate the prevalence of oral melanin pigmentation.