Journal of Chemical Health Risks (Islamic Azad University, Iran)
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Locking Plate Vs Intramedullary Nailing in Extra Articular Distal Tibia Fracture a Comparative Study for Union Rates and Complications
No full textBackground: Fractures of the distal tibia, particularly extra-articular patterns, are challenging to manage due to limited soft-tissue coverage and high complication rates. Optimal fixation—either locking plate or intramedullary nailing—remains debated. This study compared union rates, complication profiles, and functional outcomes between the two techniques.
Aim: To compare the outcomes of locking plate fixation and intramedullary nailing in extra-articular distal tibia fractures in terms of union rates and postoperative complications.
Methods: A prospective comparative study was conducted among 120 patients with extra-articular distal tibia fractures treated either with a locking plate (n=60) or intramedullary nail (n=60). Patients were followed for one year. Union time, complications, and functional outcomes were evaluated using clinical and radiological criteria and the American Orthopaedic Foot and Ankle Society (AOFAS) score. Statistical analysis included t-tests, Chi-square tests, and relative risk estimates, with p<0.05 considered significant.
Results: Union by 24 weeks occurred in 90.0% of plated and 93.3% of nailed cases (p=0.51). Mean time to clinical union was shorter with nailing (14.8 ± 3.7 vs. 16.6 ± 4.1 weeks; p=0.007), as was radiological union (18.9 ± 4.5 vs. 20.7 ± 4.9 weeks; p=0.019). Wound complications were higher in the plating group (15.0% vs. 6.7%), while anterior knee pain was more frequent with nailing (13.3% vs. 1.7%; p=0.024). At 6 months, mean AOFAS scores favored nailing (86.7 ± 7.9 vs. 84.1 ± 8.4; p=0.041), but 12-month outcomes were comparable.
Conclusion: Both fixation methods provide reliable outcomes in extra-articular distal tibial fractures. Intramedullary nailing allows faster union and early rehabilitation with fewer wound complications, whereas locking plate fixation offers superior alignment control. Treatment selection should be tailored to fracture characteristics and soft-tissue conditions
Comparative Analysis of Pesticide Versus Pharmaceutical Poisoning Trends and Detection of Synthetic Cannabinoids in Biological Samples: Analytical Challenges
No full textPoisoning continues to be a major public health concern in India, with pesticides and pharmaceutical drugs representing two leading causes of toxic exposure. This prospective observational study, conducted from January 2011 to December 2011 in the Department of Forensic Medicine and Toxicology, School of Medical Sciences and Research, Sharda University, Greater Noida, aimed to compare trends, clinical profiles, and outcomes of pesticide and pharmaceutical poisoning, while also examining the analytical challenges in detecting synthetic cannabinoids in biological specimens. A total of 328 poisoning cases were recorded, of which 192 (58.5%) were pesticide-related and 136 (41.5%) involved pharmaceutical agents. The 21-40-year age group accounted for the majority of cases (61.2%), with a male predominance (63.4%). Suicidal intent was the leading cause (65.9%), followed by accidental ingestion (31.4%). Organophosphorus compounds were the most common pesticides (62.5%), whereas sedative-hypnotics and antidepressants predominated among pharmaceuticals. The mean hospital stay was longer for pesticide cases (4.1 ± 2.6 days) than pharmaceutical cases (2.8 ± 1.9 days), and mortality was significantly higher among pesticide exposures (26.5%) compared to pharmaceuticals (10.3%) (p < 0.05). Toxicological analyses confirmed exposure in 86% of pesticide and 78% of pharmaceutical cases. The review of synthetic cannabinoid detection revealed major analytical limitations with conventional immunoassays, emphasizing the need for advanced techniques such as LC-MS/MS and HRMS for accurate identification. The findings highlight pesticide poisoning as a continuing major health threat in India, and underscore the importance of enhanced laboratory capabilities, stricter regulatory control, and comprehensive toxicovigilance to address both traditional and emerging toxicological challenges
Harnessing Community Power: A Four-Month Nutritional Intervention to Tackle Malnutrition in Under-Five Children in Angul District, Odisha
No full textThis evidence-based study assessed the effectiveness of a four-month community-based nutritional intervention to improve the health and nutritional status of under-five children in Angul district, Odisha. A purposive sample of 300 children (168 boys and 132 girls) was selected. Data were collected through anthropometric measurements—height-for-age, weight-for-age, and weight-for-height—and structured interviews with mothers and caregivers focusing on feeding practices, hygiene, and socio-demographic factors. A range of statistical tools—paired t-tests, one-way ANOVA, logistic regression, and Pearson correlation—were used to assess the intervention\u27s impact and variable associations. The prevalence of stunting declined from 38% to 37.4% (p = 0.048), wasting from 30% to 28.5% (p = 0.039), and underweight from 34% to 31.7% (p = 0.041). Mean Z-scores for all indices—height-for-age (HAZ), weight-for-height (WHZ), and weight-for-age (WAZ)—showed slight positive shifts post-intervention. Key factors such as maternal education, timely complementary feeding, and gender disparities significantly influenced child nutrition.
Introduction: This community-based study was conducted among 300 under-five children in Angul district, Odisha, to evaluate the impact of a four-month nutritional education intervention on child health and growth outcomes. Malnutrition remains a major public health concern in rural India, contributing to poor physical and cognitive development. The baseline assessment revealed a high prevalence of stunting, wasting, and underweight, underscoring the urgent need for community-level strategies focused on maternal awareness and improved feeding practices.
Objectives: The study aimed to assess the effectiveness of a structured nutritional intervention in reducing malnutrition rates and to identify key family determinants—such as maternal education, complementary feeding practices, and hygiene behaviour—affecting child nutritional status.
Methods: A quasi-experimental design was used with a purposive sample of 300 children (0–59 months). Data were collected before and after intervention through anthropometric measurements and structured household interviews. The intervention involved biweekly caregiver workshops and home visits focusing on dietary diversity, complementary feeding, and hygiene. Statistical analysis using paired t-tests, ANOVA, and logistic regression was performed to evaluate changes in Z-scores (HAZ, WHZ, WAZ) and determinant associations at p < 0.05 significance.
Results: At baseline, 38% of children were stunted, 30% wasted, and 34% underweight, with mean Z-scores of -1.85 (HAZ), -1.43 (WHZ), and -1.72 (WAZ). After the four-month intervention, modest yet significant improvements were observed—stunting declined to 37.4%, wasting to 28.5%, and underweight to 31.7%. Children of educated mothers and those introduced to complementary feeding at six months showed significantly better nutritional outcomes (p < 0.001 and p = 0.003, respectively). Boys had slightly poorer mean Z-scores than girls (p = 0.032).
Conclusions: The study demonstrates that maternal education, timely complementary feeding, and behaviour-focused community interventions significantly improve child nutritional outcomes. Integrating nutrition education with community engagement can sustainably reduce undernutrition among children in rural Odisha
Ibudilast-Loaded Ethosomal Nanogel for Transdermal Management of Osteoarthritis: Formulation, Characterization, and Preclinical Evaluation
No full textOsteoarthritis (OA), a common degenerative joint disease characterized by cartilage degradation and inflammation, can be effectively managed with phosphodiesterase (PDE) inhibitors, which provide both anti-inflammatory and chondroprotective benefits. In the present study, ibudilast-loaded ethosomes were formulated using the cold method and subsequently incorporated into a gel based on Carbopol 934 to develop a transdermal nanogel delivery system. The developed ethosome exhibited a mean hydrodynamic diameter of 193.20 ± 0.85 nm with a narrow size distribution (PDI: 0.264 ± 0.002), a negative surface charge indicated by a zeta potential of -28.3 ± 0.32 mV, and an entrapment efficiency of 79.83 ± 0.22%. The nanogel demonstrated suitable pH, viscosity, spreadability, and sustained in vitro release of ibudilast. The topical PDE inhibitor nanogel demonstrated superior therapeutic efficacy compared to the plain ibudilast gel in MIA-induced OA rats, providing strong reassurance of its potential. The Treatment group exhibited a significant reduction in oxidative stress markers (MDA: 5.56 ± 1.05 µmol/L), a reassuring sign of the treatment\u27s effectiveness. Restoration of antioxidant levels (CAT: 49.33 ± 4.05 U/mg, SOD: 20.76 ± 1.99 U/mg, GSH: 40.11 ± 2.73 µmol/mg) and normalization of inflammatory cytokines (TNF-α: 36.16 ± 3.06 pg/mL, IL-1β: 16.65 ± 1.41 pg/mL, IL-10: 27.66 ± 4.58 pg/mL). Histopathological analysis confirmed reduced cartilage erosion, minimal synovial hyperplasia, and improved chondrocyte architecture in the treated group. In conclusion, the study demonstrates that the Ibudilast-loaded nanogel holds significant potential as an effective transdermal therapeutic strategy for managing osteoarthritis
Polysaccharide and Chitosan-Based Colon Drug Delivery System: An Advanced Approach for IBD Therapy
No full textInflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn\u27s disease, is a chronic inflammatory disease of the gastrointestinal system that continues to affect millions of people every day all over the globe. Current therapies (amino salicylates, corticosteroids, immunosuppressing agents, and biologic medications) can provide symptomatic relief; however, they also have systemic side effects and poor bioavailability and are limited in the targeting of the inflamed tissue. Colon-targeted drug delivery systems (CDDS) were created to address these issues with newer drug delivery approaches that deliver the drug directly to the disease site of IBD—this designed targeting mechanism explains better therapeutic outcomes and fewer adverse effects. Chitosan and natural polysaccharides are among some of the most suitable drug carriers for CDDS systems because of a variety of reasons, such as biocompatibility, biodegradability, and their ability to respond to colonic biosystem parameters (pH, microbial enzymes, and oxidative stress). Polysaccharides such as pectin, dextran, alginate, inulin, and guar gum provide selective microbial degradation and therefore release the active pharmaceutical ingredients for controlled drug delivery. Since chitosan derivatives provide improved mucoadhesion and epithelial permeability. The more advanced formulations deliver nanoparticles, hydrogels, microspheres, and prodrug systems. This review summarizes the latest developments in CDDS based on polysaccharides and chitosan, as well as more recent methods such as pH-sensitive, time-controlled, and providing the capacity for colonic time-molecularly controlled drug absorption
Subtle Brutality: Decoding the Psychological Violence & EmotionalAbuse in Relationships through Elif Shafak’s 10 Minutes 38 Seconds inThis Strange World
No full textPsychological violence is a tactic to control, manipulate, or physically harm another person on an emotional or mental side. Freud’s Theory of Personality, talks about a number of different factors that influence personality. The theory talks about the human psyche which is structured into three parts: Id, Ego, and Superego. In the novel, 10 Minutes 38 Seconds in This Strange World by Elif Shafak, the character Leila can be considered the embodiment of elements of Sigmund Freud\u27s Personality Theory, especially the concept of the superego. This study aims to critically analyze Elif Shafak’s novel 10 Minutes 38 Seconds in This Strange World and examine the impact of psychological abuse and self-presentation in relationships. It examines complex relationship themes such as belonging, power dynamics, sarcasm, resilience, and identity through the lens of Sigmund Freud’s psychoanalytic theory. This article explores the main character who is a victim of emotional abuse and the impact this has on her sense of self. It highlights emotional abuse in relationships and its devastating effects. These findings contribute to a deeper understanding of the dynamics of psychological abuse and its effects, while raising awareness and initiating discussions about the importance of healthy and respectful human relationships
Steroid Dependent and Steroid Independent Ocular Manifestations in Children with Nephrotic Syndrome on Long Term Steroid Therapy: A One Year Prospective Cross Sectional Study
No full textIntroduction: Nephrotic syndrome (NS) is a kidney disease seen in children aged 2 to 18 years. Prednisolone acetate is the most commonly used corticosteroid in the management of these children. The disease has a chronic, relapsing course requiring repeated, prolonged course of steroids. Long term steroid therapy is associated with ocular complications like cataract and glaucoma. Nephrotic syndrome may also show a few steroid independent ocular manifestations arising independently from the disease process.
Objectives: To study steroid dependent and steroid independent ocular manifestations in children with nephrotic syndrome on long term steroid therapy.
Methods: A hospital based prospective cross sectional study was conducted from August 2022 to July 2023 in the Departments of Ophthalmology and Paediatric Nephrology at KLES Dr Prabhakar Kore Hospital and Medical Research Centre, Belagavi after obtaining approval from Institutional Ethics Committee. The study was in accordance with the principles and tenets of the Declaration of Helsinki and written informed consent was obtained from all parents of included children. Sixty-one children aged 2-18 years with nephrotic syndrome on corticosteroid therapy were examined. Ocular assessment included visual acuity testing refraction, slit lamp bio microscopy , intraocular pressure measurement and fundus evaluation. The data obtained was statistically analysed.
Results: The mean age of children was 8.27 ± 3.58 years with male predominance (63.93%) . Steroid independent manifestations included eyelid oedema (37.7%) , blepharitis ( 3.28%) and refractive errors (22.95%) , with astigmatic myopia being the most frequent type. Steroid dependent manifestations were observed in 6.56% of children, all of whom presented with posterior subcapsular cataracts . None of the patients developed steroid induced glaucoma or hypertensive retinopathy.
Conclusions: Periorbital oedema and myopia were the most frequent steroid independent ocular findings , while posterior subcapsular cataract was the only steroid dependent manifestation seen in these children . Regular ophthalmologic evaluation is essential for early detection and management of ocular complications in children receiving long term corticosteroids therapy for nephrotic syndrome
Advancing Dental Education with Artificial Intelligence: Opportunities, Challenges, and Future Trends: A Narrative Review
No full textArtificial Intelligence (AI) is reshaping dental education by enhancing diagnostic accuracy, clinical skill acquisition and administrative efficiency, through tools such as machine learning, intelligent tutoring systems, virtual simulations and personalized learning platforms. It also accelerates knowledge acquisition and strengthens clinical decision-making skills, thereby improving educational outcomes. However, successful integration requires addressing challenges such as equitable access, ethical considerations, faculty preparedness and curriculum adaptation to align with modern pedagogical frameworks. This review explores the current applications of AI in dental education, evaluates its impact on student learning, clinical practice and highlights the opportunities and challenges of its effective implementation
Differential Docking of Methotrexate and Metabolite on Renal Transporters and Dihydrofolate Reductase
No full textIntroduction: Methotrexate is widely used for cancer and autoimmune disease therapy, but its use is often limited by nephrotoxicity, particularly during high-dose treatment. This toxicity is linked to its metabolite, 7-hydroxymethotrexate, although the precise molecular mechanisms remain unclear.
Objectives: In this study, we aimed to employ molecular docking methods to compare the binding of methotrexate and 7-hydroxymethotrexate to key renal proteins—OAT1, OAT3, and DHFR.
Material and methods: In this study, we used structures of methotrexate and 7-hydroxymethotrexate to key renal proteins, OAT1, OAT3, and DHFR from AlphaFold, RCSB PDB, and PubChem. AutoDock Vina and PyMOL were used for docking and interaction analysis.
Results: Results showed that 7-hydroxymethotrexate binds more strongly to all targets, especially OAT3 (docking score: -9.7 vs. -8.6 kcal/mol), and forms unique hydrogen bonds with residues Tyr356, Ser442, and Arg469 in OAT3. While both ligands had good affinity for DHFR, differences were more pronounced for the renal transporters.
Conclusions: These findings suggest that enhanced binding of 7-hydroxymethotrexate to OAT3 may contribute to its nephrotoxic risk, supporting the importance of transporter-mediated drug interactions in methotrexate therapy
A Comparative Evaluation of Chitosan Preconditioning Versus Chitosan Incorporated Adhesive on Dentin Bond Strength: An In Vitro Study
No full textIntroduction: The breakdown of the resin-dentin bond over time is still a major challenge in adhesive dentistry. Chitosan, a natural biopolymer with collagen-stabilizing and antimicrobial properties, has been explored to improve bond durability. However, limited data exist comparing chitosan preconditioning and chitosan-modified adhesives.
Objectives: To compare the effect of chitosan preconditioning and chitosan incorporated adhesive on the dentin bond durability of a universal adhesive system.
Methods: A total of 36 extracted human molars were collected and flattened to expose mid-coronal dentin and randomly divided into three groups (n = 12): Group 1 (Control): Selective enamel etching followed by Clearfil S3 Bond Universal and composite restoration. Group 2 (Chitosan incorporated Adhesive): Clearfil S3 Bond Universal modified with 0.5% (w/w) chitosan nanoparticles. Group 3 (Chitosan Preconditioning): Dentin preconditioned with 1% (w/v) chitosan nanoparticles in 1% acetic acid for 60 seconds followed by Clearfil S3 Bond Universal. The samples were filled with resin nanohybrid composite and analyzed for microtensile bond strength (μTBS) on a universal testing equipment. The data was examined with one-way ANOVA and Tukey\u27s post hoc test (p < 0.05).
Results: The mean μTBS values (MPa) were: Control = 39.82 ± 5.29, Chitosan incorporated Adhesive = 41.33 ± 6.39, and Chitosan Preconditioning = 46.46 ± 7.12. Although the chitosan-treated groups exhibited higher mean bond strength than the control, there was no statistically significant difference (p = 0.0658).
Conclusions: In comparison to the control, dentin bond strength was enhanced by both chitosan preconditioning and chitosan incorporated into adhesive. Nevertheless, there was no statistically significant change. The highest mean bond strength was achieved using chitosan preconditioning, which may improve long-term bond durability