Narendra Kumar Gupta

Effect of 82% Lactic Acid in Treatment of Melasma.

Melasma is an acquired, chronic, and symmetrical hypermelanosis, characterized by brown patches of variable darkness on sun exposed areas of body. There are numerous modalities of treatment currently in use for this disease, of which the chemical peeling is very commonly used. Therefore, the present work was done to see the effect of 82% lactic acid peel in the treatment of melasma. A total number of 20 patients of either sex attending the OPD of dermatology department with clinically evident melasma were included in the study. 82% Lactic acid peel was applied on the face for 12 weeks in each patient. Patients were evaluated clinically and photographically at various intervals and in follow-up till 24 weeks. Assessment of patient satisfaction and side effects were also noted. All the subjects completed the study. Application of this peel for 12 weeks significantly decreased the melasma area severity index score and also melasma severity scale score. Patient and physician analogue scales also showed the improvement by the treatment. Regarding the adverse effects, burning sensation was the only side effect noted in our study. In conclusion, 82% lactic acid peel is well tolerated and can be used for the treatment of melasma.

Commentary on: Cox M, Malcolm M. Fairgrieve SI. A new digital method for the objective comparison of frontal sinuses for identification. J Forensic Sci 2009;54(4):761–72

Sir, We have gone through the article entitled “A New Digital Method for the Objective Comparison of Frontal Sinuses for Identification,” J Forensic Sci 2009;54(4):761–72, by Cox et al. The authors have proposed the use of frontal sinus for identification purposes. The authors have proposed the use of digital photo editing software Adobe Photoshop CS2 for this purpose. For background, the authors have cited seven references (1–5, 11, and 24) that have relied on the shape of frontal sinus for the identification of suspects. The cited articles generally talk about qualitative assessment, most of the time as an additional approach rather than the only approach, and limit the scope to known suspects, whereas the authors propose a quantitative assessment that can subsequently be applied to population. The methodology described by the authors has the following discrepancies:

Lifestyle and Occupational Stress: A Potential Risk Factor for Obstructive Sleep Apnea in Nonobese Male Subjects: Lifestyle Stress, Airway Inflammation, and OSA

PURPOSE To record the incidence of obstructive sleep apnea (OSA) in nonobese male subjects and investigate the coexistence of lifestyle stress, sleep deprivation, and upper airway inflammation. MATERIALS AND METHODS 552 patients were assessed during a survey of banks, government and corporate offices, recruitment agencies, and schools between January 2012 and January 2016. After applying the inclusion and exclusion criteria designed for this study, the number of patients tapered down to 120 patients who underwent diagnostic tests, viz. polysomnography, chemiluminiscence immunoassay, nephelometry, and upper airway endoscopy. This revealed the presence of OSA coexistent with elevated serum cortisol, C-reactive protein (CRP), and upper airway inflammation. RESULTS Polysomnography showed that 57 of 120 patients suffered from OSA. Objective evaluation of these patients exposed an undercurrent of lifestyle stress in 39 patients. CRP and serum cortisol were found to be significantly high (1.60 ± 0.52 and 7.20 ± 0.76 μg/dL, respectively) in 30 patients. Endoscopy revealed 18 patients with moderate, 7 with severe, and 5 with no upper airway inflammation. CONCLUSION The results of this study demonstrated that OSA was found to be prevalent in the cohort of nonobese male patients studied. Coexistence of lifestyle stress, sleep deprivation, and upper airway inflammation was revealed.

Incidence of Obstructive Sleep Apnea in Elderly Edentulous Patients and the Possible Correlation of Serum Serotonin and Apnea-Hypopnea Index: Incidence of OSA in Edentulous Patients

PURPOSE To estimate the incidence of obstructive sleep apnea (OSA) in elderly edentulous patients (aged 60-65 years) and investigate a correlation of serum serotonin levels with the apnea-hypopnea index (AHI), respiratory effort-related arousal (RERA), and respiratory disturbance index (RDI). MATERIALS AND METHODS 381 elderly completely edentulous patients (307 male, 74 female) aged 60 to 65 years with a history of edentulism of 12 to 15 months, seeking oral rehabilitation at the prosthodontic clinic at Saraswati Dental College & Hospital, Lucknow, India, between January 2014 and January 2016 were enrolled for the present study. After application of the inclusion and exclusion criteria of this study, 183 patients (162 male, 21 female) who were found susceptible, were subjected to the BERLIN questionnaire and Epworth Sleepiness Scale (ESS) to assess sleep disordered breathing (SDB) and then put through all-night polysomnography (PSG). On the basis of AHI, RERA, and RDI scores, 156 patients (143 male, 13 female) who tested positive for OSA were classified according to its intensity. All 156 patients underwent body-mass index (BMI) estimation, cephalometry, and intraoral examination for skeletal and soft tissue profile record. Serum serotonin was estimated from whole blood samples for the 156 OSA and the 27 normal patients. The 156 (147 nonobese, 9 obese) OSA-positive patients were provided with complete dentures and were trained to use the same as a modified mandibular advancement device (MAD) during sleep at night. These patients were kept on a quarterly follow-up for 9 months. Data collected was subjected to statistical analysis, and inferences drawn. RESULTS The incidence of OSA in elderly edentulous subjects was found to be 32.03% in males and 8.91% in females. A mere 9 out of 156 (5.76%) elderly edentulous OSA patients were found to be obese (Class I) on the basis of BMI estimation. Cephalometry of the patients showed that they had a skeletal class I maxillomandibular relationship. AHI scores of nonobese patients revealed that most of the patients had moderate OSA, followed by mild OSA and severe OSA. Serum serotonin levels ranged from 53 to 83 ng/dL. AHI score of the 9 obese patients were in the moderate to severe range, and their serum serotonin levels were 60 to 70 ng/dL. A correlation between severity of OSA and serum serotonin level was validated in this study. CONCLUSION OSA was found to be prevalent in edentulous subjects due to pharyngeal collapse and decreased neuromuscular control. An inverse relationship of serum serotonin levels and AHI scores was established.

Comparative evaluation of pressure generated on a simulated maxillary oral analog by impression materials in custom trays of different spacer designs: An in vitro study.

Introduction: Literature reveals that masticatory load on denture bearing tissues through complete dentures should be maximum on primary stress bearing areas and least on relief area in accordance with the histology of underlying tissues. A study to validate the existing beliefs was planned to compare the pressure on mucosa using selective pressure technique and minimal pressure technique, with the incorporation of two different impression materials utilizing the pressure sensors during secondary impression procedure. Materials and Methods: The study was performed using a maxillary analog. Three pressure sensors were imbedded in the oral analog, one in the mid palatine area and the other two in the right and left ridge crest. Custom trays of two different configurations were fabricated. The two impression materials tested were light body and zinc oxide eugenol. A total of 40 impressions were made. A constant weight of 1 kg was placed, and the pressure was recorded as initial and end pressures. Results: A significant difference in the pressure produced using different impression materials was found (P < 0.001). Light body vinyl polysiloxane produced significantly lesser pressure than zinc oxide eugenol impression materials. The presence of relief did affect the magnitude of pressure at various locations. Conclusion: All impression materials produced pressure during maxillary edentulous impression making. Tray modification is an important factor in changing the amount of pressure produced. The impression materials used also had a significant role to play on the pressures acting on the tissues during impression procedure. Clinical Implication: Light body VPS impression material may be recommended to achieve minimal pressure on the denture bearing tissues in both selective as well as minimal pressure techniques.

Comment on ''Evaluation of Manual and Two-Rotary NiTi Retreatment Systems in Removing Gutta-Percha Obturated with Two Root Canal Sealers''

Proper research design, appropriate evaluation and measurement methods, use of correct statistical tests, interpretation, and inference are the essentials without which any scientific research reporting is incomplete and does not serve its proposed purpose. In this communication, some common flaws in research designing, evaluation, analysis, and inference have been explained using a published article as a reference. The purpose of the paper is to help the scientific community recognize the significance of proper research designing and planning in order to achieve the results which are worthwhile.