Journal of Chemical Health Risks (Islamic Azad University, Iran)
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Patterns of Ossifying Fibromas in the Maxillofacial Skeleton: A Case Series and Literature Review.
No full textOssifying fibroma is a benign fibro-osseous neoplasm of the jaws characterized by the replacement of normal bone with a well-demarcated mass containing fibrous tissue and varying amounts of mineralized material. Although slow-growing, these lesions may attain considerable size and produce facial asymmetry, tooth displacement, or functional impairment if not detected early. This case series highlights the clinical presentation, radiographic features, and surgical management of patients diagnosed with ossifying fibroma of the mandible and maxilla. All cases demonstrated well-defined, unilocular or multilocular radiolucencies with varying radiopaque foci, consistent with the lesion\u27s maturation stage. Surgical enucleation or resection was performed based on lesion size, location, and cortical expansion. Histopathologic examination in all patients confirmed the diagnosis by revealing a fibrous stroma containing trabeculae of woven bone and cementum-like calcifications. Postoperative follow-up showed satisfactory healing without evidence of early recurrence. This series emphasizes the importance of correlating clinical, radiologic, and histologic findings for accurate diagnosis and appropriate treatment planning. Early intervention and complete surgical removal remain essential to minimize recurrence and preserve jaw function. A brief review of current literature is included to contextualize the evolving understanding of this lesion’s behavior and optimal management strategies
The Prevalence and Association between MIH and HSPM in School Going Children of Goa state, India – A Cross-sectional Study
No full textIntroduction: The prevalence of Molar Incisor Hypomineralization (MIH) and Hypomineralized Second Primary Molars (HSPM) varies globally and across different states of India. The aim of the study was to assess the prevalence of MIH and HSPM in 7–9-year-old school children in Goa, India.
Methods: Ethical clearance was obtained from the Institutional Ethics Committee and the study was carried out in primary schools across the talukas of Goa state. Molar Incisor Hypomineralization and HSPM were recorded in 7–9-year-old school children as per the data recording sheets suggested by Ghanim et al. The IBM SPSS version 26 software was used for the statistical analysis.
Results: A total of 503 children were examined, out of which 15.71% had MIH and 8.95% had HSPM. Almost half of the affected children showed the simultaneous occurrence of MIH and HSPM.
Conclusions: The prevalence of MIH and HSPM in Goa were found to be within global prevalence limits. Hypomineralized Second Primary Molars may be a warning sign for the occurrence of MIH.
DOI: https://doi.org/10.52783/jchr.v15.i6.1111
The Dual Threat: Phenotypic Characterization and Virulence Factor Detection of Staphylococci Across Various Clinical Samples
No full textBackground and aim: Coagulase-negative staphylococci (CoNS), apart from Staphylococcus aureus are major causative agents of nosocomial infections, as evident from their increasing incidence in recent years. Aim: To phenotypically characterize staphylococcal isolates from various clinical samples, detect different virulence factors and evaluate their antibiotic resistance pattern.
Materials and Methods: A total of 130 clinical specimens were analysed in a tertiary care hospital. The isolates were identified, speciated using standard methods, biofilm formation as well as antibiotic susceptibility using the Kirby Bauer disc diffusion method were determined in the department of Microbiology. Statistical analysis was done by counts and percentages using MS Excel version 2010.
Results: CoNS constituted the majority (67.5%) of isolates, while S. aureus accounted for 32.4%. A significant proportion of staphylococci (75.6%) were strong biofilm producers, with an additional 16.2% being moderate biofilm producers, highlighting the widespread nature of this virulence factor. High resistance was observed among biofilm-producing strains to conventional antibiotics with methicillin resistance of 91.6% in S. aureus and 84% in CoNS, although all isolates remained sensitive to vancomycin and linezolid. Staphylococcus schleiferi (20%) was the most common CoNS species identified, followed by S. hemolyticus (16%) and S. simulans (16%), a finding that differs from some other regional studies.
Conclusion: The multiple antibiotic resistance and pathogenic potential of biofilm producers emphasize the importance of developing simple, reliable, and inexpensive methods to identify virulence factors, determine the antibiotic sensitivity of CoNS and the critical need for rigorous infection control measures to mitigate the burden of these infections
Evaluation of Knowledge, Attitude and Practice amongst Indian Orthodontists Regarding Directly Printed Aligners– A Questionnaire Study
No full textIntroduction - Clear aligner therapy has gained widespread acceptance for its esthetics, comfort, and convenience, with recent advances in 3D printing leading to the development of directly printed aligners (DPA). Compared to traditional thermoformed aligners, DPA offer improved accuracy, customization, and biomechanical efficiency, while also reducing processing time and material waste. Despite these advantages, evidence on their clinical adoption and effectiveness remains limited.
Aim – To evaluate knowledge, attitude and practice amongst Indian Orthodontists regarding Directly Printed Aligners.
Material and Methods - A validated questionnaire was distributed via WhatsApp to IOS-registered orthodontists using systematic sampling. Based on a calculated sample size of 361, 818 orthodontists were invited, and responses were collected through Google Forms over three weeks. Reliability and validity of the questionnaire were confirmed before distribution, and only consenting participants were included for analysis.
Results - A total of 361 orthodontists participated, with 96.1% aware of the primary material used for directly printed aligners. Most respondents reported better dimensional accuracy (86.7%), faster production (100%), and improved patient comfort (73.3%) with directly printed aligners. Approximately 40% considered them more effective in tooth movement, while 46.7% felt both types were equally effective. Advantages were noted in durability (66.7%), stain resistance (60%), and customizable thickness (66.7%), though 60% found them more technique-sensitive. Despite these benefits, 80% of orthodontists still primarily use indirectly printed aligners but indicated a strong likelihood of recommending and adopting directly printed aligners in the future.
Conclusion - Orthodontists show high awareness and a positive attitude toward directly printed aligners, recognizing advantages in accuracy, production efficiency, customization, durability, and patient comfort. Although indirectly printed aligners remain more commonly used, there is strong interest in adopting directly printed aligners, indicating their potential to become the preferred choice in the future
“Scalpel Versus Electrocautery Dissection: A Comparative Study in Modified Radical Mastectomy”
No full textBackground:
Breast cancer is one of the most common malignancies in women, with many undergoing modified radical mastectomy (MRM) as treatment. Although most procedures are uneventful, complications such as seroma remain common and can cause morbidity, prolonged hospital stay, and delay in adjuvant therapy. This study was conducted to compare the use of scalpel and electrocautery for raising the skin flap and performing axillary dissection in modified radical mastectomy.
Methodology: In this study 82 patients presented with carcinoma of breast and managed by MRM in our were included. Patients undergoing MRM divided into two groups, in one group we used electrocautery for raising the skin flap and axillary dissection while in another group we used scalpel to raise the skin flap along with scissors and suture ligation for axillary dissection. Incidence of seroma formation was compared in both the groups.
Results: In this study, 82 patients were enrolled with a median age of 52 years in Group A and 50 years in Group B, with comparable tumor sizes. Electrocautery significantly reduced operative time but was associated with higher seroma formation, delayed drain removal, and slightly longer hospital stay compared to scalpel dissection.
Conclusion: Electrocautery should be used judiciously in breast surgery. Preferably scalpel should be used to raise the skin flap.
DOI: https://doi.org/10.52783/jchr.v15.i6.1125
Interprofessional Communication and Patient Safety: Strategies for Integrated Healthcare Teams in Hospital Settings
No full textInterprofessional communication represents a critical pillar in contemporary healthcare systems for enhancing patient safety and reducing adverse events. Healthcare facilities worldwide employ diverse professional teams including nursing technicians, operation room technicians, pharmacy technicians, nursing specialists, health education specialists, and medical registrars, each bringing unique perspectives and expertise to patient care. However, communication failures remain the most frequently cited cause of preventable adverse events in hospital settings. This review synthesizes current evidence on interprofessional communication strategies, barriers to effective collaboration, and implementation frameworks for integrated healthcare teams. A comprehensive literature review was conducted using multiple databases including PubMed, SCOPUS, CINAHL, and ProQuest, examining studies published between 2013 and 2024. The findings demonstrate that standardized communication protocols such as SBAR (Situation-Background-Assessment-Recommendation), clearly defined roles and responsibilities, collaborative training programs, and technology-assisted interventions significantly reduce medication errors and adverse events. Furthermore, organizational support, non-punitive safety cultures, and continuous professional development emerge as essential facilitators. This review emphasizes that effective interprofessional communication is not merely an educational requirement but a fundamental prerequisite for patient safety excellence in multi-disciplinary hospital environments. Implementation of these evidence-based strategies can substantially improve patient outcomes, reduce healthcare costs associated with adverse events, and enhance staff satisfaction and retention in healthcare organizations
Comparative Evaluation of Iso Amyl 2 - Cyanoacrylate with Braided Silk Suture After Periodontal Flap Surgery: A Randomized Controlled Trial
No full textBackground: Periodontal diseases induce hard and soft tissue changes necessitating surgical intervention, commonly through flap surgeries. Primary closure of flap margins is critical for establishing a healthy dentogingival unit. Silk sutures, traditionally used for flap closure, are associated with inflammatory responses and secondary infections, highlighting the need for better alternatives. Cyanoacrylates, a group of tissue adhesives, offer potential benefits.
Aim:This clinical study compares the efficacy of Iso Amyl 2-cyanoacrylate with braided silk sutures post-periodontal flap surgery, focusing on wound healing and postoperative pain.
Materials and Methods: A split-mouth, single-blinded study was conducted on twenty sites requiring flap surgery for pocket therapy. Clinical parameters assessed included plaque index, gingival index, wound healing index, and pain using the visual analog scale. Evaluations were performed at baseline and 14 days post-surgery.
Results: Intra and intergroup comparisons were made using paired and unpaired \u27t\u27 tests, respectively, with non-parametric tests applied for pain and HI scores. The intra-group comparison revealed statistically significant improvements in all parameters from baseline to the 14th day. The intergroup comparison showed significant results favoring the test group (P≤ 0.05).
Conclusion: N-Butyl cyanoacrylate is a reliable alternative to conventional sutures. It is easy to apply, reduces operation time, causes less inflammatory response, and decreases postoperative pain while achieving primary closure comparable to traditional silk sutures
Generative AI for OSCE and Workplace-Based Assessment: Mapping Validity, Bias/Fairness, Reliability, and Defensible Governance
No full textBackground: Generative artificial intelligence (GenAI), including large language models (LLMs), is increasingly used in medical education assessment as item writers, rubric-based scorers of constructed responses, and draft generators for narrative feedback. In high-stakes settings (e.g., OSCE pass/fail and programmatic workplace-based assessment [WBA]), GenAI functions as a measurement intervention and therefore requires defensible evidence for validity, fairness, reliability, and governance. [1,2,11]
Methods: We conducted a PRISMA-ScR-aligned scoping review (2020-present) across major medical education and health databases to map empirical and review evidence on GenAI in assessment, prioritizing OSCE/WBA and high-stakes contexts. Evidence was charted using Kane’s argument-based validity framework (scoring, generalization, extrapolation, implications), alongside themes related to bias/fairness, reliability, and governance. [9-11]
Results: Evidence is heterogeneous and concentrated in written assessment (short answers, clinical notes, and post-OSCE documentation) and in automated analysis of narrative WBA feedback. LLM grading can be efficient, but studies show variable agreement with expert human ratings and potential shifts in grade distributions. In early OSCE-related studies, agreement between GenAI outputs and clinician judgments is inconsistent, highlighting threats to the scoring inference and the need for response-process evidence, rater calibration, and drift monitoring. [3,6,16-21]
Conclusion: For clinical skills and high-stakes decisions, GenAI use should be bounded and treated as a regulated assessment intervention. Institutions should require a complete validity argument, explicit fairness audits, program-level reliability evidence, and governance controls (versioning, audit trails, appeals, and change management). We propose a practical DEFEND-VFRG toolkit (Validity, Fairness, Reliability, Governance) for implementation and reporting. [11-15,25
Comparative Evaluation of Low-Level Laser Therapy and Systemic Analgesic in the Management of Temporomandibular Disorders: A Randomized Control Study
No full textBackground: Temporomandibular disorders (TMDs) are a leading cause of orofacial pain, often linked to parafunctional habits, stress, and muscular overactivity. Although NSAIDs and muscle relaxants are commonly prescribed, their long-term use may lead to systemic adverse effects. Low-level laser therapy (LLLT) has recently gained attention as a non-invasive alternative with anti-inflammatory and analgesic benefits.
Objective: To compare the efficacy of LLLT with a systemic analgesic–muscle relaxant combination in managing chronic TMD-associated pain.
Methods: A randomized controlled study was conducted on 40 TMD patients diagnosed using RDC/TMD criteria. Participants were randomly divided into two groups (n=20 each). Group 1 received oral ZERODOL-MR (Aceclofenac 100 mg + Tizanidine 2 mg) twice daily for six days, while Group 2 underwent LLLT (830 nm, 4 J/cm², six sessions over three weeks). Pain was evaluated using the Visual Analogue Scale (VAS) at baseline, one week, one month, and six months. Statistical analysis used Mann-Whitney and Friedman tests (p ≤ 0.05).
Results: Both groups showed significant pain reduction (p<0.001). At one month, LLLT showed complete pain relief (VAS=0) versus residual pain in Group 1 (VAS=0.65, p=0.019). Relief persisted at six months, with no adverse effects in the LLLT group.
Conclusion: LLLT provides safe, sustained pain relief and is an effective alternative to pharmacotherapy for chronic TMD management.
DOI: https://doi.org/10.52783/jchr.v15.i6.1134
“Determine of Colistin Susceptibility in MDR Klebsiella Pneumoniae Isolates from Clinical Samples of CCU Patients in a Tertiary Care Hospital Kanpur”
No full textINTRODUCTION: -Colistin is generally used to treat infections with multidrug-resistant bacteria.Failure of drugs against Klebsiella pneumoniae bacteria has led to the unprecedented increase in the use of colistin (one of the last-resort drugs) and subsequent emergence and dissemination of colistin resistance.
AIM: -To estimate the prevalence of Colistin-Resistance Klebsiella pneumoniae (CRKp) in MDR isolates collected from different Critical care units (CCUs) and to determine the clinical outcomes of the patients.
MATERIALS AND METHODS: This study was conducted at Department of Microbiology and Medicine at RMCH&RC, Kanpur for 18 months between March 2022 to September 2023.Clinical samples from CCU were collected and processed by standard procedures to isolate and identify and to perform AST for Klebsiella pneumoniae spp.MDR Klebsiella pneumoniae species were examined for colistin susceptibility by the Broth Microdilution (BMD)method for the detection of Minimal Inhibitory Concentration (MIC). Data was analysed by comparing susceptibility categories (susceptible or resistant) and minimal inhibitory concentrations (MIC).
RESULT: Out of 240 Klebsiella pneumoniae isolates, 99 (41.3%) isolates were found to be Colistin Resistance by Disc Diffusion (Kirby Baur’s) Method. The prevalence of Colistin Resistance Klebsiella pneumoniae (CRKp) was found by BMD for the detection of MIC-46/240 (19.1%) in the present study. CRKp drug-resistant isolates were commonly 11/46 (23.9%) isolated from samples of respiratory tract infections and the majority 38/46 (82.6%) were from Medicine ICU. The maximum number of CRKp isolates were found from urine cultures 25/46 (54.3%) followed by ET secretion 10/46 (21.7%) and Pus cultures 08/46 (17.3%).
CONCLUSION: Patients in the Medicine ICU were frequently infected and highest isolates were found from urine sample with CRKp strains. Prolonged hospital stay and direct antibiotic pressure in the hospital can lead to the development of CRKp variants