Journal of Chemical Health Risks (Islamic Azad University, Iran)
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Diagnostic Accuracy of the AHEAD Developmental Module Compared to the Trivandrum Developmental Screening Chart (TDSC) in Children Aged 1 Month to 5 Years
Full text linkBackground: Early identification of developmental delays is critical for timely intervention. In India, the Trivandrum Developmental Screening Chart (TDSC) is a widely accepted tool but is limited in scalability and digital adaptability. The AHEAD Developmental Module is a novel digital screening tool designed to overcome such limitations.
Aim: To assess the diagnostic accuracy of the AHEAD Developmental Module compared to the TDSC in detecting developmental delays in children aged 1 month to 5 years.
Methods:
A cross-sectional validation study was conducted involving 800 children. Both the AHEAD Developmental Module and TDSC were administered to each participant, and results were compared against a gold-standard developmental paediatrician assessment. Diagnostic parameters such as sensitivity, specificity, predictive values, likelihood ratios, and kappa agreement were computed.
Results: The AHEAD module demonstrated a sensitivity of 64.1% (95% CI: 56.7–70.1%) and specificity of 94.5% (95% CI: 92.3–96.0%). The positive predictive value was 81.7%, and negative predictive value was 87.2%. The likelihood ratios (LR⁺ = 11.56, LR⁻ = 0.38) indicated high discriminative ability. Cohen’s Kappa was 0.627 (p < .001), suggesting substantial agreement with the TDSC, and PABAK was 0.72.
Conclusion: The AHEAD Developmental Module demonstrates substantial diagnostic accuracy and can serve as a viable, scalable, and culturally contextual alternative to conventional tools like the TDSC in community and clinical settings
Protein Expression Dynamics in Xylotrechus quadripes Larvae Reared on Artificial Diets Treated with Simarouba amara Bark Extract: A Model for Controlling Infestation on Coffea arabica
Full text linkThe Coffee White Stem Borer (Xylotrechus quadripes), a destructive pest of Coffea arabica, causes extensive damage to coffee plantations and threatens sustainable production. Conventional chemical pesticides offer limited long-term control and pose environmental risks, prompting the search for eco-friendly alternatives. This study investigates the insecticidal efficacy of Simarouba amara bark extract (SABE) when incorporated into artificial diets fed to X. quadripes larvae. The effects of SABE on larval growth, survival, and proteomic response were evaluated. Larvae reared on SABE-treated and control diets were subjected to protein extraction and analysis using Orbitrap High-Resolution Liquid Chromatography–Tandem Mass Spectrometry (OHRLC-MS/MS). Subsequent bioinformatics analysis was performed to identify differentially expressed proteins (DEPs) and their associated biological functions and metabolic pathways. SABE treatment significantly reduced larval survival compared to the untreated control. Proteomic analysis revealed the expression of 15 unique proteins in SABE-fed larvae versus 22 in the control group. Functional enrichment analysis of DEPs indicated the activation of detoxification-related proteins, including cytochrome P450s and glutathione-S-transferases, along with proteins involved in stress response and metabolic regulation. These changes suggest that SABE induces physiological stress and disrupts key metabolic processes, ultimately leading to larval mortality. The findings highlight the potential of S. amara bark extract as a botanical insecticide targeting X. quadripes. By interfering with essential molecular pathways, SABE offers a promising, biodegradable alternative to conventional chemical pesticides. This study provides a molecular foundation for the development of sustainable pest management strategies in coffee cultivation, contributing to the reduction of pesticide use and environmental impact
Comparative Study of Indian Medical Devices Regulations with Selected Countries: A Systematic Review
Full text linkThe global medical device industry has seen significant growth in recent years, highlighting the need for coherent and harmonized regulatory frameworks. India, recognizing this demand, introduced the Medical Devices Rules (MDR), 2017 under the Drugs and Cosmetics Act, 1940 to enhance safety, effectiveness, and quality of medical devices. This paper compares India\u27s evolving regulatory system with six established regimes: those of the USA, UK, EU, Canada, Australia, and Japan. Key aspects examined include device classification, approval pathways, Quality Management Systems (QMS), clinical evidence requirements, labeling, unique device identification (UDI) implementation, regulation of software as medical devices (SaMD), and post-market surveillance. While India’s framework exhibits strengths—such as adopting a risk-based classification system and initiating regulatory capacity-building—challenges remain in areas like innovation, facilitation and technical infrastructure. The study concludes with policy suggestions to strengthen India\u27s regulatory ecosystem and support its ambitions to become a global hub for medical devices
Targeting Cancer Stem Cells Using Nanoparticles: A Review of Emerging Diagnostic and Therapeutic Strategies
Full text linkCancer stem cells (CSCs) constitute a small but pivotal subset of tumor cells implicated in cancer initiation, progression, therapeutic resistance, and relapse. These cells possess distinctive properties such as self-renewal, multilineage differentiation, and elevated expression of drug efflux transporters, which collectively contribute to their resistance against conventional therapies. Advances in stem cell biology including research on dental mesenchymal stem cells have elucidated the regulatory roles of key signaling pathways such as Wnt/β-catenin, Notch, and Hedgehog in maintaining CSC stemness and plasticity. In parallel, nanotechnology has emerged as a powerful tool for addressing CSC-associated challenges. Engineered nanoparticles offer targeted delivery through CSC-specific surface marker recognition, pathway inhibition, and induction of differentiation. Moreover, their ability to enhance imaging and combine therapeutic and diagnostic functions within a single platform (theranostics) has opened new avenues for personalized cancer care. This review critically examines the molecular characteristics of CSCs, outlines therapeutic vulnerabilities, and highlights recent advancements in nanoparticle-based strategies aimed at improving the diagnosis and eradication of CSCs particularly in oral and head and neck cancers
A Comparative Evaluation of Conventional Osteosynthesis with Posterior Border Osteosynthesis for Open Reduction and Internal Fixation of Condylar Fracture of Mandible
Full text linkIntroduction: Mandibular condylar fractures (MCF) constitute a significant proportion of facial trauma cases, often requiring surgical intervention for functional and anatomical restoration. Open reduction and internal fixation (ORIF) with miniplates is a standard approach. However, the optimal number of plates for stable fixation remains debatable. The study aimed to compare two plating systems for ORIF of MCF - one using two non- compression miniplates (conventional osteosynthesis) and the other with single non-compression miniplate (posterior border osteosynthesis).
Objectives: To assess and compare the duration of operation. To achieve adequate and painless mouth opening, functional and stable temporomandibular joint and pre-injury occlusion. To assess and compare the post operative complications.
Methods: Twenty-six patients requiring ORIF of MCF were selected for the study and divided into two groups of thirteen. Group 1 received single mini plate fixation. Group 2 received two miniplate fixation. The patients were assessed for intraoperative time, anatomic reduction, articular function, facial nerve injury in both the groups.
Results: Both groups achieved satisfactory healing and functional outcomes. Group 1 demonstrated significantly reduced operative time, facial nerve injury compared to Group 2. No significant differences were observed in anatomic reduction and articular function between the groups.
Conclusions: Single miniplate fixation is a reliable and less invasive option for ORIF of MCF. It provides adequate stability and favourable functional outcomes, with reduced surgical morbidity and operative time when compared to two miniplate fixation. Hence, single miniplate fixation may be preferred for ORIF of MCF
Characterization of Potential Eluxadoline Impurities: Identification and Synthetic Approach
Full text linkEluxadoline is a novel active pharmaceutical ingredient (API) used in the treatment of diarrhea and abdominal pain associated with diarrhea-predominant irritable bowel syndrome (IBS-D). During its synthesis, five unknown impurities were identified, synthesized, and comprehensively characterized using various analytical techniques such as 1H NMR, 13C NMR, mass spectrometry, and IR spectroscopy. These five process/degradation impurities are Eluxadoline diacid impurity (EDA impurity), Eluxadoline desmethyl impurity (EDM impurity), Eluxadoline desmethyldiacid impurity (EDMDA impurity), Eluxadoline amino methyl ester impurity (EAME impurity), and Eluxadoline Alcohol impurity (EA impurity). These impurities are crucial as reference standards for the development and quality control, regulatory compliance of the active pharmaceutical ingredient manufacturers and researc
An Overview on Skin Cancer and Emerging Treatment Approaches
Full text linkIn the next 20 years, skin cancer is predicted to rise significantly if it is not detected early. It is a worldwide threat to the healthcare system that is influenced by both genetic and environmental causes. The purpose of this manuscript is to examine current developments in skin cancer prevention and therapy, with an emphasis on the incorporation of plant-based medicines and developing technology. The greatest environmental risk factor for skin cancer is exposure to ultraviolet light which can cause melanoma as well as non-melanoma skin cancer (NMSC), which includes basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Plant-based chemicals are becoming more popular in the field of therapeutics because of their anti-cancer capabilities. Natural substances with UV-protective and anti-carcinogenic properties, such as flavonoids and polyphenols, show promise as supplements to conventional therapies. Additionally, novel approaches to treatment, like as immunotherapy and drug delivery systems based on artificial tools, are being investigated to maximise the effectiveness of conventional chemotherapies while reducing their adverse effects. The types, classifications, and advanced treatment methods for skin cancer are all thoroughly reviewed in this article. It also explores the promise of plant-based treatments and the growing significance of more recent therapeutic approaches in the treatment of skin cancer. The manuscript provides a forward-looking perspective on improving treatment outcomes and lowering the worldwide burden of skin cancer by analysing these innovative treatments. These revelations may open the door to the incorporation of cutting-edge treatments and technological advancements into clinical practice, enabling more efficient treatment of skin cancer
Management of Premature Infants (Understanding, Quality of Service, and Expectations of Nurses) on the Growth and Development of Young Infants
Full text linkIntroduction: Neonatal emergency treatment plays a crucial role in addressing children’s growth and development disorders.
Objectives: This study aimed to determine the relationship between premature infant management (understanding, service quality, and nurse expectations) to the growth and development of young infants in the perinatology room.
Methods: Using both quantitative and qualitative approaches, data were collected from 36 nurses and 20 premature infants in perinatology, Data analysis was carried out qualitatively using the discourses analysis technique.
Results: Results indicated that 75% of nurses had good knowledge of premature infant care, though 14% provided only adequate services. Enhance support is needed for high-risk infant management.
Conclusions: Fluid intake in infants improved from 71ml to 95ml over 5 days, though some infants faced challenges due to metabolic immaturity. The study recommends advanced training for nurses and better equipment to improve the quality of care for premature infants and support healthy growth and development. 
A Queuing-Based Supply Chain Model With Fuzzy Theory For Multiproduct Items Under Steady-State Probability Distribution
Full text linkWe proposed a sustainable queuing-based supply chain model with a steady-state probability distribution for multiproduct items in wetland area under a fuzzy environment. In this proposed model, the manufacturer produces multiproduct items as demanded by several retailers, and after completing the production process, different items are placed in other warehouses. The rent of warehouses varies occasionally and is temporary. Some warehouses are built with advanced facilities and have a low steady-state probability distribution. Due to varying holding costs, we considered the holding cost imprecise and treated it as a triangular fuzzy number. The total fuzzy cost is defuzzified with the help of the centroid method. Each product has a different backorder cost due to needing more items. We created a linear fuzzy cost function by adding the costs associated with the shipment, back ordering, and fuzzy holding. The theory of the proposed model is managed with FCFS, GI/G/1 queue because, during manufacturing, the manufacturer sets a setup time for each product, and multiple products do not overlap during the production of items and switch to the output of another. Finally, we develop the proposed model to analyse the logistic process to a three-echelon inventory model and compare the total fuzzy cost with the total cost without a fuzzy environment, termed a crisp model. Lastly, we have taken a numerical example to justify the proposed model. We aim to know about the effect of fuzzy on the total fuzzy cost as per assumptions, and we included the sensitivity analysis part
Introduction: Our proposed model solves some problems during manufacturing and production under fuzzy environment for multi-product where backorders are allowed. Some problems are;
What is the minimum inventory cost during production and manufacturing for multi-product? Where the holding cost varies according to variation of demand. Present study tried to nullify imprecise nature of the holding cost by using centroid method.
When the rate of demand of products increases or decreases the companies of production or manufacturing for the multi-product may be loss or profit and in this situation, our proposed model is very helpful to control the variations of costs by using Steady-state probability distribution.
Almost, queuing-based supply chain model for multi-product are considered fixed holding cost and calculated inventory cost but our proposed model calculated fuzzy minimum total inventory cost when the holding cost is taken as fuzzy holding cost.
Objectives: The highlights of this proposed model are : (i) Impact of inventory inputs on the total inventory cost and the decision variables. (ii)Impact of fuzzy inputs on the decision variables and total inventory cost for the supply chain. (iii) Comparison of total inventory cost with and without a fuzzy environment. (iv) Our proposed model is more applicable and usable and is presented using mathematical effects. (v) The conclusion section is also presented, in which more results are explained, and future work is presented to improve.
Methods: The task of the proposed work is presented in Figure 1. The rest part of this manuscript is structured in section/subsections. Subsection 1.2 covers the research gap and contributions of the proposed study. Section 2 presents the basic definitions for the development of the proposed study. Section 3 explains the formulation of proposed model and numerical examples with discussion. Section 4 reveals that about the sensitivity analysis and results discussion. Section 5 shows the managerial application and social implication. Further, Section 6 explains the conclusions and future scope of the proposed study.
Results: we analysed that when applying fuzzy concepts to the holding cost of the inventory in such cases, the total cost is affected, and we get the best-optimised values through fuzzy concepts compared to crisp modelling concepts. From the above discussion, it is clear that the total cost calculated using fuzzy holding cost is better than the cost calculated without fuzzy holding.
Conclusions: we concluded that we get the optimum results when we take the holding cost as imprecise, treat it as a fuzzy triangular number, and then find the total fuzzy cost. In the proposed model, we obtained the warehouses\u27 lead time, fill rate, and stock-out probability performance
Comparison of Post Operative Analgesic Efficacy Between Dexmedetomidine with Levobupivacaine Versus Dexmedetomidine with Ropivacaine in Ultrasound Guided Transversus Abdominal Block for Total Abdominal Hysterectomy Surgeries in a Tertiary Care Hospital in
Full text linkBackground: Effective postoperative pain control is essential for enhanced recovery following total abdominal hysterectomy. The Transverse Abdominis Plane (TAP) block, guided by ultrasound, offers targeted analgesia for lower abdominal surgeries. This study compares the postoperative analgesic efficacy of Dexmedetomidine combined with ropivacaine versus Dexmedetomidine combined with Levobupivacaine in TAP blocks.
Materials And Methods: In a randomized, double blinded study, female patients undergoing total abdominal hysterectomy were divided into two groups. Group LD received Dexmedetomidine with levobupivacaine, while group RD received Dexmedetomidine with Ropivacaine for ultrasound guided TAP blocks after surgery.
Results: Both combinations provided effective postoperative analgesia. However Group L showed significantly longer duration of analgesia and reduced need for rescue analgesics compared to group R(p<0.05).
Conclusion: Dexmedetomidine with levobupivacaine provides superior postoperative analgesic efficacy compared to Dexmedetomidine with Ropivacaine in Ultrasound guided TAP blocks for total abdominal hysterectomy, with prolonged analgesia and reduced need for additional analgesics