Journal of Chemical Health Risks (Islamic Azad University, Iran)
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Observational Study to Assess Safety of Sglt2 Inhibitors in Type 2 Diabetes Mellitus Patients in Clinical Settings
Full text linkIntroduction: Type 2 diabetes mellitus (T2DM) poses a significant global burden. Sodium-glucose co-transporter 2 (SGLT2) inhibitors have emerged as promising agents for glycemic control with additional cardiovascular and renal benefits. However, real-world safety data remain limited.
Objectives: To assess the safety profile of SGLT2 inhibitors in Indian clinical settings through active monitoring of adverse events in patients with T2DM.
Methods: A multicentric, prospective observational study was conducted at four hospitals in Pune, Maharashtra and one hospital at Trichy, Tamilandu in India. A total of 500 patients with T2DM receiving SGLT2 inhibitors alone or in combination with other antidiabetic drugs were enrolled and followed for 26 weeks. Adverse events were actively monitored and evaluated. The baseline and week 26 weeks HbA1c were monitored to check the effectiveness of treatment.
Results: The most frequently reported adverse event was genital mycotic infection (9.4%), followed by urinary tract infection (5.2%). Other AEs included ketoacidosis (2.0%), hypotension (1.8%), hypovolemia (1.4%), dehydration (1.2%), and hypoglycemia (1.0%). There was a significant mean reduction in HbA1c from 8.93% to 7.36% over 26 weeks (Δ = 1.57%).
Conclusions: This real-world study confirms that SGLT2 inhibitors are effective in lowering HbA1c in Indian T2DM patients, with an overall acceptable safety profile. While genital and urinary infections were the most common adverse events, serious events like ketoacidosis and hypotension were rare. These findings support the continued use of SGLT2 inhibitors with appropriate monitoring in routine clinical practice
Comparative Evaluation of Sealing Ability of Mineral Trioxide Aggregate and Biodentine Used for Root Furcation Perforation Repair – A Systematic Review"
Full text linkIntroduction: During endodontic operations, furcation perforations are a serious complication that might jeopardize periodontal health and the affected tooth\u27s long-term prognosis. To stop microbial leaking and encourage periodontal repair, these perforations must be properly sealed. Because of its sealing capabilities and biocompatibility, Mineral Trioxide Aggregate (MTA) has long been regarded as the gold standard for furcation healing. A more recent calcium silicate-based substance called biodentine has gained attention as a possible substitute because of its advantageous physical characteristics and bioactivity.
Objectives: The aim of the present systematic review is to evaluate and compare the sealing ability of Mineral Trioxide Aggregate and Biodentine when used for the repair of root furcation perforations.
Methods: A comprehensive electronic search was carried out across databases such as PubMed, Scopus, and Google Scholar. The included studies compared the sealing capabilities of MTA and Biodentine in the repair of furcation perforations by in vitro or ex vivo experimental investigations. Two reviewers independently carried out the data extraction and quality assessment in accordance with PRISMA criteria.
Results:The majority of the included research evaluated the effectiveness of sealing using spectrophotometric, fluid filtration, dye penetration, or bacterial leakage techniques. Although MTA and Biodentine both showed adequate sealing capabilities, a number of studies found that Biodentine performed better or on par with MTA in terms of marginal adaption and decreased leakage.
Conclusions: Root furcation holes can be successfully repaired using both mineral trioxide aggregate and biodentine. Although MTA is still often used, Biodentine seems to provide a similar sealing capacity combined with benefits like quicker setting time and better handling. To confirm these results and encourage evidence-based material selection in clinical practice, more standardized clinical and in vivo research is advised
CO2 Emissions in Aerobic Wastewater Treatment Process of Potato Processing Industry
Full text linkThis paper is about CO2 emissions (CO2e) in Aerobic biological treatment process for wastewater in potato processing industry which include direct emissions (Scope 1-biogenic activity in aerobic biological treatment process) after primary clarifier and indirect emissions (Scope 2-purchased electricity) used by surface aerators, motors and sludge dewatering equipment and electricity consumption in laboratory of effluent treatment plant (ETP) including the ETP office. The study of scope 3 includes use of chemicals in primary and secondary (aerobic) wastewater treatment process in ETP and waste transportation only. This study indicates that CO2e under scope 1 and 2 both can be minimized by reducing the organic load and total nitrogen (TN) load. The organic load is considered in terms of BOD load in kg. This study indicates that CO2e under scope 1, 2, and 3 increase as the organic load and total nitrogen increase and vice versa. CO2e was found in the lower side for the period of Jan to April and increased from April onwards. The CO2e due to N2O emission is found in range of 2.8% to 3.4% of total CO2e (scope1, 2 and 3) and 11% to 14% of Scope 1 emission which found in increasing order as the TN increased in wastewater. CO2e through BOD removal of wastewater (scope 1) was found in range of 22% to 28% of CO2e. The electricity consumption under scope 2 increased as the organic load increased. CO2e due to electricity consumption was found in range 67.7% to 73.5% of Total CO2e. The CO2e due to electricity consumption is higher in scope 2 as compared to the CO2e in aerobic Biotreatment in scope 1 and chemical consumptions and sludge transportation under scope 3
Assessment of Seasonal Variations in Physico-Chemical Characteristics and Algal Diversity in the Lingti Stream of Kangra District, Himachal Pradesh, India
Full text linkThe present study evaluates seasonal variations in the physico-chemical parameters and algal diversity of the Lingti Stream, Kangra District, Himachal Pradesh, India. Diversity indices across pre-monsoon, post-monsoon, and winter seasons revealed relatively stable algal diversity, with taxa having 21 species consistently and only minor variations in individual abundance (ranging from 827 to 885 individuals). The stability of diversity is high, as shown through the results recorded by Simpson’s Index between 0.908 and 0.8794 and Shannon’s Index between 2.429 and 2.636. According to the Evenness and Equitability indices, the distribution patterns in the community structure are balanced, with the maximum values occurring during the winter season. Analysis of variance showed a total variation of the data as explained by two components of principal axis of Principal Component Analysis (PCA) as PC1 with 89.136 and PC2 with 10.864. The dominant patterns in the data revealed themselves through PC1, where winter results aligned strongly together. The main environmental parameters influencing PC1 were alkalinity, total hardness, and magnesium ion concentration, whereas calcium ions and total dissolved solids (TDS) had the greatest influence on PC2. The values of temperature and pH had limited effects on the composition of both components. The hydrological patterns that change with the seasons, as well as critical water chemistry variables, have a significant impact on the growth of the algal population in the Lingti stream
To Assess the Impact of Antiretroviral Therapy on Renal Function in Hiv-Infected Patients
Full text linkAlthough antiretroviral therapy (ART) has revolutionized the treatment of HIV infection, it can be harmful to renal function, especially when used with some nephrotoxic drugs. HIV-infected patients frequently have chronic kidney disease (CKD), which makes continuous renal health monitoring necessary. With emphasis on the effects of frequently administered antiretroviral medications, this study attempts to evaluate the effect of ART on renal function in people with HIV.
Material & Methods: Prospective cohort study was conducted at Shri Mahant Indiresh Hospital\u27s Outpatient Department in Uttarakhand with 40 HIV-infected patients receiving ART. Patients aged 18 and older who agreed to participate were eligible, while those with contraindications to ART were excluded. Renal function parameters such as serum creatinine, estimated glomerular filtration rate (eGFR), proteinuria, and serum urea were measured monthly. To analyze changes in renal biomarkers, statistical analyses were performed using R Studio, applying the Wilcoxon signed-rank test and the paired t-test.
Results: The study identified significant changes in renal biomarkers after ART initiation. The number of patients with elevated serum creatinine levels (≥1.6 mg/dL) increased from one to five. The eGFR levels showed a concerning trend, with more patients falling into lower eGFR categories after treatment. Proteinuria levels rose from 19 patients (<150 mg/day) to 26 patients (number_1 mg/day). Serum urea levels also increased notably, suggesting possible renal impairment caused by ART.
Conclusion: The findings highlight the nephrotoxic potential of certain antiretroviral drugs, especially Tenofovir disoproxil fumarate, emphasizing the importance of regular renal function monitoring in HIV-infected patients on ART. Early detection of renal impairment is essential for prompt intervention, and healthcare providers should explore alternative ART options for patients showing signs of renal failure. Further research is needed to develop effective strategies to reduce renal toxicity and improve long-term kidney health in this population.
DOI: https://doi.org/10.52783/jchr.v15.4.926
“Association of Low Free T3 Levels with Stroke Pattern, Severity and Outcome in Patients with Acute Ischemic Stroke”
Full text linkBackground: Acute ischemic stroke (AIS) is a major global health burden, leading to significant morbidity and mortality. Recent studies indicate a potential link between free triiodothyronine (fT3) levels and stroke prognosis, with the "low T3 syndrome" emerging as a possible marker of poor outcomes in critically ill patients. However, its specific role in AIS remains underexplored, warranting further investigation into its impact on stroke severity, recovery, and long-term neurological function. This study aimed to investigate the association between low fT3 levels and stroke pattern, severity, and functional outcome in patients with AIS.
Material & Method: A prospective cohort study was conducted at Aarupadai Veedu Medical College & Hospital over 18 months, including 100 patients diagnosed with AIS. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS), and functional outcomes were evaluated using the Modified Rankin Scale (mRS). Free T3 levels were measured within 48 hours of admission. Statistical analysis included correlation and regression models to assess associations between fT3 levels, stroke severity, and outcomes.
Results: The study population had a mean age of 59.66 ± 11.8 years, with a male predominance (59%). Anterior circulation stroke was more prevalent (75%) than posterior stroke (25%). A significant negative correlation was observed between fT3 levels and NIHSS scores (r = -0.317, p < 0.05), as well as fT3 levels and mRS scores (r = -0.314, p < 0.05), indicating that lower fT3 levels were associated with greater stroke severity and poorer functional outcomes. Additionally, NIHSS and mRS scores showed a strong positive correlation (r = 0.878, p < 0.05).
Conclusion: Low fT3 levels were significantly associated with more severe strokes and worse functional outcomes in AIS patients. These findings suggest that fT3 may serve as a prognostic biomarker in stroke management. Further studies are required to explore potential therapeutic interventions targeting thyroid hormone modulation in AIS
Evaluating the Anti Inflammatory Properties of Arrow Root Extract Silver Nanoparticles - An Invitro Study.
Full text linkIntroduction: Silver nanoparticles are recognized for their antimicrobial and anti-inflammatory properties, making them valuable in biomedical applications. Green synthesis methods using plant extracts, such as arrowroot, provide an eco-friendly alternative for nanoparticle production. Arrowroot has traditionally been used for its medicinal benefits, and this study explores its potential in synthesizing silver nanoparticles with anti-inflammatory properties. This study aimed to evaluate the anti-inflammatory effects of silver nanoparticles (AgNPs) synthesized using arrowroot (Maranta arundinacea) extract in an in vitro model.
Materials and Methods: Arrow Root Extract Silver Nanoparticles (AR-AgNPs) were synthesized using arrow root extract and silver nitrate solution. The anti-inflammatory activity was evaluated using the Bovine Serum Albumin (BSA) Denaturation Assay, Egg Albumin Denaturation Assay, and Membrane Stabilization Assay. For BSA and egg albumin assays, protein denaturation was induced by heat (70°C for 10 min), and inhibition was measured spectrophotometrically at 660 nm. In the membrane stabilization assay, human red blood cells were exposed to hypotonic stress, and lysis was measured by recording absorbance at 560 nm. Different concentrations of AR-AgNPs (10-50 μg/mL) were tested in all assays.
Results: The synthesized Arrow Root Extract Silver Nanoparticles (AR-AgNPs) demonstrated significant anti-inflammatory activity in all three assays. In the BSA and egg albumin denaturation assays, AR-AgNPs showed a dose-dependent inhibition of protein denaturation, with the highest inhibition observed at 50 μg/mL. The membrane stabilization assay also showed a notable reduction in hemolysis, confirming the membrane-protective effect of AR-AgNPs. Across all assays, the nanoparticles exhibited a consistent anti-inflammatory response, with inhibition percentages comparable to standard anti-inflammatory drugs.
Conclusion: Arrowroot extract-synthesized silver nanoparticles showed promising anti-inflammatory properties in vitro, suggesting their potential use in treating inflammation-related conditions. Further research is necessary to evaluate their clinical application and ensure their safety for therapeutic use
“Assessment of Protein Energy Malnutrition in Cirrhosis and Comparing Severity of Pem with Prognosis of Cirrhosis”
Full text linkBackground: Cirrhosis is a progressive liver disease linked to substantial morbidity and mortality, with protein-energy malnutrition (PEM) being a common yet often overlooked complication. PEM significantly worsens patient outcomes by increasing susceptibility to complications and negatively impacting prognosis. Despite its high prevalence, the relationship between PEM severity and cirrhosis prognosis remains insufficiently explored, especially within specific local populations. Early identification and nutritional intervention may play a critical role in improving patient outcomes.
Aim: To assess the prevalence of protein-energy malnutrition in patients with cirrhosis and to evaluate the association between the severity of PEM and the prognosis of cirrhosis.
Materials and Methods: This cross-sectional study was conducted at Aarupadai Veedu Medical College and Hospital over 18 months, involving 80 patients diagnosed with cirrhosis. Nutritional status was assessed using Subjective Global Assessment (SGA), and cirrhosis severity was classified using the Child-Turcotte-Pugh (CTP) score. Anthropometric measurements, biochemical parameters, and handgrip strength were evaluated. The association between PEM severity and cirrhosis prognosis was analyzed using chi-square and ANOVA tests, with statistical significance set at p < 0.05.
Results: The study population had a mean age of 49.82 years, with 96.3% male predominance. Alcohol consumption was observed in 92.5% of patients. Based on CTP classification, 50.0% were in Class C, 33.8% in Class B, and 16.3% in Class A. SGA assessment showed 50.0% were well-nourished, 42.5% moderately malnourished, and 7.5% severely malnourished. A significant association was found between CTP classification and SGA scores (Chi-square = 21.62, p = 0.01), demonstrating that worsening liver function correlates with severe malnutrition. The highest mean CTP score (11.5 ± 1.9) was observed in SGA Class C, indicating a strong link between malnutrition and advanced cirrhosis.
Conclusion: The study highlights a significant correlation between worsening liver function and increasing severity of PEM in cirrhosis. These findings emphasize the importance of early nutritional assessment and targeted interventions to improve patient prognosis. A multidisciplinary approach integrating hepatology and nutrition is crucial for optimal disease management. Further research with larger sample sizes and objective nutritional markers is needed to develop standardized nutritional guidelines for cirrhotic patients
A Clinical Evaluation of the Severity of Peri-Implantitis Following Immediate Implant Placement in the Maxillary Anterior Esthetic Zone based on Post-Inflammatory Fluctuating Levels of Biomarkers IL-1β and IL-6 in Peri-Implant Crevicular Fluid (PICF): An
Full text linkAim: This study aims to evaluate the severity of peri-implantitis following immediate implant placement in the maxillary anterior esthetic zone based on post-inflammatory fluctuating levels of biomarkersil-1β and IL-6 in peri-implant crevicular fluid (PICF).
Materials and Methods: This study includes a total of 40 patients. Inclusion criteria included ages 35 to 60, excluding those with mental instability, smoking, or systemic diseases. After informed consent and CBCT assessment, a chlorhexidine rinse was used, and an infra-orbital nerve block was administered for anaesthesia. An immediate implant was placed, and healing abutments were added after two months. Sutures were removed a week later, and patients received oral hygiene instructions. Prosthesis fabrication began in the third month after peri-implant crevicular fluid (PICF) sampling. Samples were collected at four and eight months postoperatively for analysis of IL-1β in Group 1 and IL-6 in Group 2 (20 patients each). Statistical analysis evaluated the relationship between these biomarkers and peri-implantitis severity in the maxillary anterior aesthetic zone.
Statistical Analysis and Results: 40 patients underwent Cone Beam Computed Tomography (CBCT) for implant placement, followed by immediate placement and a two-month healing period. Healing abutments were attached, and prostheses were completed by the third month. Peri-implant crevicular fluid (PICF) samples were collected at four months and analysed for inflammatory biomarkers via ELISA. IL-1β levels averaged 3.64 at four months and rose to 5.12 after eight months, while IL-6 levels were 3.61 at 4 months and 5.105 at 8 months. The study indicated that IL-1β was a stronger inflammatory biomarker than IL-6, which showed significant anti-inflammatory effects, summarized through one-way ANOVA analysis.
Conclusion: This study found that inflammatory biomarkers IL-1β and IL-6 in peri-implant crevicular fluid are linked to inflammation. IL-1β initiates inflammation, while IL-6 amplifies it and has some anti-inflammatory roles. Elevated IL-1β levels in peri-implant fluid are associated with peri-implantitis, which causes inflammation and tissue destruction around dental implants
“Salacia Chinensis Root and Ammania Baccifera Leaf Extract Mediated Green Synthesis of Silver Nanoparticles and Evaluation of Their Antimicrobial Efficacy”
Full text linkExtracting AgNPs (silver nanoparticles) from plant materials through green methods is less harmful for the environment compared to using chemicals. In this study silver nanoparticles were produced using the roots Salacia chinensis and the leaves of Ammania baccifera and performed the green synthesis using these two plant materials. The synthesis was monitored for colour development which was confirmed using UV-visible spectroscopy. Further analysis through FT-IR, XRD, SEM, and TEM confirmed the presence of crystalline, spherical nanoparticles of sizes ranging from 10 to 33 nm. The AgNPs exhibited strong antibacterial and antifungal activities; notable antimicrobial activities against Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Salmonella typhi were observed through standard well-diffusion and MIC/MBC tests. This approach to synthesis is not only inexpensive, but is easily scalable and favourable in temperature, avoiding high temperatures and toxic chemicals, supporting its use for medicinal and industrial purposes. As highlighted in this study, the plant mediated AgNPs demonstrated great potency against infection