Journal of Chemical Health Risks (Islamic Azad University, Iran)
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An In Vitro Comparative Assessment of Dentinal Cracks Progressions Evaluated at Different Root Regions and Thicknesses: A Scanning Electron Microscopy-Based Original Research Study
No full textAim: The study aims to assess dentinal cracks in various root regions and thicknesses using scanning electron microscopy.
Materials and Methods: In this study, we analyzed 90 non-traumatic single-rooted premolars collected over three months. Teeth without carious lesions were cleaned and excluded if infected or previously treated. Roots were embedded in acrylic resin with access cavities created. Using a No. 15 K-file, we measured the working length, keeping it 1 mm short of the apical foramen. Cleaning and shaping were performed with three file systems: Mtwo (Group 1), ProFile GT (Group 2), and TF Adaptive (Group 3), each involving 30 mandibular first premolars. Dentinal cracks were measured in various root sections using Scanning Electron Microscopy (SEM).
Statistical Analysis and Results: Statistical evaluations using SPSS were performed on 90 mandibular first premolars, divided into three groups for biomechanical preparation with different rotary file systems: Group 1 (Mtwo files), Group 2 (Profiles GT files), and Group 3 (T Adaptive files). Dentinal cracks were assessed using Scanning Electron Microscopy (SEM) and analyzed with Pearson Chi-Square tests. Results showed Group 1 had the most cracks, particularly in the coronal and middle regions, with three teeth showing no cracks. Group 2 had 12 teeth without cracks, while Group 3 had the fewest, with 20 teeth exhibiting no cracks. Findings were summarized in Table 5 and analyzed using one-way ANOVA.
Conclusion: The study found that the Mtwo file system causes more dentinal cracks than the Twisted File Adaptive (TFA) system and Profiles GT files. The TFA\u27s hybrid motion reduces stress on tooth structure, lowering the risk of cracks. All file systems risk dentinal damage, but TFA\u27s adaptive motion offers a significant advantage. Crack frequency also depends on tooth anatomy and operator experience
Assessing Dental Students’ Preparedness and Practices in Managing Special Needs Oral Healthcare.
No full textThe provision of oral healthcare for individuals with special needs demands specialized knowledge, skills, and compassionate care. This study aimed to assess the preparedness and practices of dental students in managing patients with special healthcare needs. A cross-sectional questionnaire-based study was conducted among undergraduate dental students. The questionnaire evaluated knowledge, attitudes, and practices related to special needs dentistry. The findings revealed that while most students demonstrated positive attitudes toward treating special needs patients, there were notable gaps in practical experience and confidence levels. The study underscores the importance of incorporating focused training modules and clinical exposure in the undergraduate dental curriculum to enhance competency in providing equitable oral healthcare for all individuals
Nosocomial Infections: Epidemiology, Prevention, Control, Diagnosis and the Role of the Microbiology Laboratory
No full textNosocomial infections, more commonly known as healthcare-associated infections (HAIs), claim numerous lives annually. These infections are contracted by patients during the course of their treatment for other conditions, leading to a significant increase in patient morbidity and mortality. Furthermore, HAIs impose a substantial direct and indirect financial burden, straining already limited healthcare resources. Combating these infections requires a multidisciplinary strategy that integrates the expertise of healthcare professionals, infection control specialists, and microbiology laboratories to implement evidence-based preventive practices. This scripted review aims to highlight beneficial and important diagnostic techniques for identifying various types of HAIs. The findings from this review are intended to be applicable for guiding further appropriate health services, thereby aiding both clinical practice and societal health outcomes
Comparison of Drains Versus No Drains in Abdominal Surgery: Impact on Morbidity and Recovery
No full textBackground: The use of prophylactic drains in abdominal surgery remains controversial. Although drains are traditionally placed to prevent postoperative fluid collection and infection, recent evidence questions their routine benefit. This study aimed to compare postoperative morbidity and recovery between patients undergoing abdominal surgery with and without drains.
Methods: A prospective comparative study was conducted among 200 patients undergoing elective or emergency abdominal surgeries at a tertiary care center. Patients were divided into two groups: Drain group (n=100) and No-drain group (n=100). Postoperative morbidity parameters such as surgical site infection (SSI), seroma, wound dehiscence, and intra-abdominal collections were assessed. Recovery outcomes included postoperative pain, time to mobilization, return of bowel function, and hospital stay. Data were analyzed using Chi-square and Welch’s t tests; p<0.05 was considered statistically significant.
Results: Composite morbidity was comparable between groups (47% vs 38%, p=0.198). However, SSI was significantly higher in the drain group (29% vs 17%, p=0.043). Mean postoperative pain score was greater among drain patients (5.8 ± 1.7 vs 4.9 ± 1.6, p=0.0002). Time to mobilization (18.7 ± 6.3 h vs 14.9 ± 5.8 h, p<0.0001), return of bowel function (33.8 ± 9.7 h vs 29.1 ± 8.9 h, p=0.0004), and hospital stay (6.4 ± 2.3 vs 5.1 ± 1.9 days, p<0.0001) were all significantly prolonged in the drain group.
Conclusion: Routine drain placement after abdominal surgeries does not reduce morbidity and is associated with increased pain, delayed recovery, and higher infection rates. Drains should be used selectively based on intraoperative findings rather than as a standard practice
Study of Role of Serum Lactate Dehydrogenase as a Prognostic Marker in Patients of lymphoma
No full textIntroduction: Lymphomas are malignant neoplasms of the lymphatic system, broadly categorized into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). These entities differ in clinical behavior, histopathology, and prognosis. Serum lactate dehydrogenase (LDH), an intracellular enzyme released during cellular turnover and tissue breakdown, has been proposed as a prognostic biomarker in lymphoproliferative disorders. Elevated LDH levels may reflect tumor burden, disease aggressiveness, and metabolic activity, making it a valuable adjunct in staging and risk stratification. This study investigates the correlation between serum LDH levels and lymphoma subtype and stage, aiming to validate its prognostic utility.
Materials and Methods: A retrospective observational study was conducted on 100 histopathologically confirmed lymphoma cases at a tertiary care center. Demographic details, lymphoma subtype (HL or NHL), clinical stage (Ann Arbor classification), and serum LDH levels were recorded. LDH values were categorized into four ranges: ≤200 U/L, 201–400 U/L, 401–600 U/L, and >600 U/L. Patients with concurrent malignancies, hepatic dysfunction, hemolytic anemia, or incomplete records were excluded. Statistical analysis was performed using SPSS version 25.0. Chi-square tests were applied to assess associations between LDH levels and lymphoma type and stage, with p < 0.05 considered statistically significant.
Observations and Results: Out of 100 patients, 60% were male and 40% female. The majority belonged to the age group ≥41 years. NHL was more prevalent (80%) than HL (20%). HL cases were predominantly in early stages (Stage I and II), while NHL cases spanned all stages. LDH levels were significantly higher in NHL compared to HL (p = 0.003). A strong association was observed between LDH elevation and advanced disease stage (p = 0.00008). Stage IV patients showed the highest LDH levels (>600 U/L), while early-stage cases had predominantly normal or mildly elevated LDH.
Conclusion: Serum LDH levels demonstrated a significant correlation with both lymphoma subtype and disease stage. Elevated LDH was more common in NHL and advanced-stage disease, supporting its role as a surrogate marker of tumor burden and disease progression. LDH estimation is a cost-effective, accessible tool that can aid in prognostic assessment and clinical decision-making, especially in resource-limited settings
Effectiveness of Evidence-Based Nursing Approach in Postoperative Wound Management for Patients with Comorbidities
No full textIntroduction: The effectiveness of evidence-based nursing interventions in postoperative wound management for patients with comorbidities, such as diabetes, hypertension, and obesity, is a critical area of research. This study aimed to evaluate how evidence-based practices can enhance healing outcomes and reduce complications in this patient population.
Objectives: The primary objective of this study was to evaluate the impact of evidence-based nursing practices on postoperative wound healing outcomes for patients with comorbidities. Specifically, the research sought to examine the effectiveness of advanced wound care, nutritional support, and infection control strategies in improving healing rates and reducing complications.
Methods: A qualitative literature review was conducted, synthesizing studies on advanced wound care, nutritional support, and infection control interventions. Data were analyzed thematically to assess the impact of these practices on postoperative wound healing, with a focus on the challenges of implementation in clinical settings.
Results: The findings reveal that advanced wound dressings and personalized nutritional interventions, particularly protein supplementation, significantly improve healing rates and reduce infection risks. However, barriers to implementation, including resource constraints, lack of standardized protocols, and resistance to change among healthcare providers, were identified as significant obstacles.
Conclusions: This research contributes to the growing body of knowledge on postoperative wound management and offers practical recommendations for healthcare providers. It emphasizes the importance of individualized care plans tailored to the specific needs of patients with comorbidities and the need for better integration of evidence-based practices into routine clinical care. Further research is needed to explore long-term outcomes and the effects of interventions in patients with multiple comorbidities
Vitamin D Status and Proteinuria Severity in Children with Steroid-Sensitive and Steroid-Resistant Nephrotic Syndrome
No full textIntroduction: Vitamin D deficiency is a common metabolic abnormality in children with nephrotic syndrome (NS), primarily caused by urinary loss of vitamin D–binding protein (VDBP). The severity of deficiency may differ depending on steroid responsiveness, with steroid-resistant nephrotic syndrome (SRNS) patients showing more prolonged proteinuria compared to steroid-sensitive nephrotic syndrome (SSNS).
Objective: To compare serum vitamin D levels and proteinuria severity between patients with SRNS and SSNS.
Methods: A cross-sectional study was conducted at Dr. Wahidin Sudirohusodo Hospital, Indonesia, from January to March 2025, involving 36 children aged 1–18 years diagnosed with NS (18 SRNS and 18 SSNS). Serum vitamin D levels were measured, and urinary protein was assessed using a semi-quantitative dipstick and protein–creatinine ratio (PCR). Data were analyzed using appropriate statistical tests to compare vitamin D and proteinuria severity between groups.
Results: Serum vitamin D levels were significantly lower in SRNS compared to SSNS (p = 0.033), and all SRNS patients were vitamin D deficient. Almost all SRNS patients (94.4%) had urine PCR ≥ 0.50 g/g, compared to 77.8% in SSNS (p = 0.148). Semi-quantitative analysis showed that heavy proteinuria (4+) was more common in SRNS (61.1%) than in SSNS (38.9%) (p = 0.478). Among SRNS children, those with nephrotic-range proteinuria had markedly lower vitamin D levels than those with non-nephrotic proteinuria (p = 0.005).
Conclusion: Children with SRNS exhibit significantly lower serum vitamin D levels and more severe proteinuria than those with SSNS. Persistent nephrotic-range proteinuria is strongly associated with reduced vitamin D levels. Routine monitoring and appropriate vitamin D supplementation are recommended, particularly for SRNS patients
Effect of Antimicrobial Varnish on Microbial Concentration Around Orthodontic Brackets”– An Invivo Study
No full textIntroduction: Fixed orthodontic appliances limit the ease of naturally occurring salivary cleansing and antimicrobial activity thereby promoting proportionate growth and agglomeration of aciduric bacteria with time, leading to formation of active white spot lesions.
Objectives: Preventing development of WSLs during orthodontic treatment has been attempted through various approaches
Methods: In this study, 4 groups with 10 subjects each were selected, and with split mouth design Chlorhexidine-Thymol antimicrobial varnish (Cervitec® Plus, Ivoclar Vivadent, Lischenstein)premixed with primer is applied on the premolars during bonding and its effect on the microbial composition and concentration around orthodontic brackets, is evaluated through microbial culture at 1st, 2nd, 3rd and 4th months after debonding.
Results: The result shows that within the controls, the microbial counts were found to be gradually increasing from a value of 5.9 ±1.3 (in 104) in group I to 14.9 ± 1.9 (in 104) in group IV while in the experimental sample, the count increase from a value of 1.2 ± 0.6(in 104) in group I to 13.3 ± 2.6 (in 104) in group IV.
Conclusions: It is concluded that the application of chlorhexidine-thymol antimicrobial varnish premixed with primer during orthodontic bonding showed effective reduction in the microbial counts in vivo, for the duration of four months, with proportionate decline in the antimicrobial effect with time
Development And Evaluation of Gastroprotective Mucoadhesive Microspheres for Treatment of Epilepsy
No full textOral drug delivery systems face challenges such as low bioavailability due to the heterogeneity of the gastrointestinal system, pH of the commensally flora, gastric retention time of the dosage form, surface area, and enzymatic activity. Conventional drug delivery systems may not overcome the issues imposed by the gastrointestinal tract (GIT) such as incomplete release of drugs, decrease in dose effectiveness, and frequent dose requirement. Therefore, the failure of conventional drug delivery systems to retain drugs in the stomach may lead to the development of gastro retentive drug delivery systems. The formulation of lamotrigine microsphere, with mucoadhesive properties, was successfully developed by ionic gelation method. Mucoadhesive microspheres were prepared by simple emulsification phase separation technique. Chitosan mucoadhesive microspheres are known to swell in aqueous environments, due to hydration. As a new polymeric structure is formed by introducing bridges between polymeric chains during the cross-linking procedure, Such a structure can be characterized by lower and slower penetration of the solvent through the chain structure of the polymer, suggesting that the swelling ratio and hence the drug release characteristics of the microsphere can be controlled by varying the content of the cross-linking agent used during the manufacturing process.
DOI: https://doi.org/10.52783/jchr.v15.i6.1066
Maxillofacial Rehabilitation with an Immediate Surgical Obturator: Enhancing Oral Function, Speech, and Quality of Life – A Clinical Case Report
No full textThe surgical removal of maxillary tissue for tumor treatment creates major functional and cosmetic problems because it breaks down the natural barrier between the mouth and nose. The surgical obturator serves as an immediate prosthodontic solution which enables patients to regain their speech abilities and eating functions and mastication abilities and provides emotional support throughout their initial healing period. The team creates an immediate obturator before tumor removal which they place right after surgery to seal the defect and maintain facial shape and safeguard the surgical area while blocking postoperative contamination.
The paper explains the complete process of creating and placing an immediate maxillary obturator through a detailed description of laboratory and clinical procedures that require surgical and prosthodontic team collaboration. The prosthesis functions to enhance patient comfort while facilitating early functional recovery and acting as a transitional solution for permanent rehabilitation.