Journal of Chemical Health Risks (Islamic Azad University, Iran)
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“Large Uterus, Small Ports: How Should Specimens Be Retrieved in Total Laparoscopic Hysterectomy?”
Get PDFIntroduction: : Total laparoscopic hysterectomy (TLH) offers significant benefits over laparotomy, but specimen retrieval in cases of large uteri remains challenging. Multiple techniques have been described to preserve minimally invasive advantages while minimizing oncologic risks.
Objectives: To review the literature on specimen retrieval strategies for large uteri during TLH, highlighting efficacy, safety, and limitations of each approach.
Methods: A narrative review was conducted by searching PubMed and Google Scholar for studies published between 2011 and 2025 that reported specimen retrieval techniques in total laparoscopic hysterectomy (TLH). The review focused on case series and clinical reports describing methods used for uteri larger than 280–300 g or exceeding 12 weeks’ gestational size.
Results: Methods included vaginal morcellation, extracorporeal morcellation via mini-laparotomy, contained in-bag morcellation, wedge resection, and innovative approaches such as Colpo-V incision, zigzag umbilical incision, and Bakri balloon–assisted dilation. Vaginal morcellation remains widely practiced (Sinha et al.), while uncontained power morcellation has declined due to oncologic concerns. Contained morcellation and extracorporeal strategies reduce tissue dissemination but prolong operative times.
Conclusion: No single technique is universally superior. Selection should be individualized, balancing uterine size, patient anatomy, and oncologic safety. Further multicenter prospective studies are required to establish evidence-based guidelines
Marginal Adaptation of Eggshell Powder Coalesced Calcium Hydroxide Sealer Using SEM; An In-Vitro Study
Get PDFIntroduction: The synthesis and use of nanoparticles in dentistry has paved way for nanoscience in advanced dentistry. Eggshells are rich sources of calcium carbonate (94%) which can be used in synthesis of hydroxyapatite (HAp). Clinical studies have employed eggshell powder (ESP) either independently or in conjunction with other substances as agents for mineralizing teeth.
Objectives: This research sought to evaluate the marginal adaptability, interfacial layer of eggshell incorporated calcium hydroxide based sealer under scanning electron microscope (SEM).
Methods: Eggshell powder was produced through a calcination process, resulting in pure calcium oxide powder, free from pathogens. Egg shells were cleaned in sterile distilled water, boiled and dried to make a fine powder. This ESP was placed in furnace and obtained mass was observed under SEM. Thirty extracted permanent single rooted teeth were decoronated and instrumented by NeoEndo Flex (Neoendo Flex File, Orikam, Haryana, India) rotary file system. Derived ESP was then mixed with calcium hydroxide based sealer (Sybron Endo Kerr, USA). The modified sealer was used to obturate the teeth. The teeth were sectioned and examined under SEM for the marginal adaptability. An independent t-test and one-way analysis of variance were conducted, with subsequent Tukey’s post hoc analysis applied.
Results: The results of this study state that the group B obturated with eggshell hydroxyapatite (ESH) modified sealer has lesser micro-gaps than group A. The control group A showed micro-gaps of larger dimensions than group B. The micro-gaps found in group B were greater in coronal section followed by middle and least in apical level contributing to lesser apical micro-leakage. The least derived particle size of novel ESH was 899 nm/0.899µm. the p value was less than 0.05 which is statistically significant for both the evaluated groups.
Conclusions: ESP, a naturally occurring and commonly accessible byproduct of the food industry, functions as an efficient source of calcium for dental applications. ESH sealer has shown better marginal adaptability to root dentin, which restores its potential to be used in evolving nano-dentistry. 
Sub-ablative Laser Energy in Caries Prevention: Recent Advancement in Pediatric Dentistry: A Review
Get PDFAim: The aim of the study was to assess the effects of Laser with Sub-ablative energy for prophylactic intervention to reduce the caries incidence in Pediatric population and comparing Lasers with other traditional interventions (TPI\u27s) when used alone or together with TPI such as Fluoride varnish etc.
Methods: For a Systematic Review articles were selected using the Medline, Web of Science, Embase and Cochrane Data bases. The main terms used for search were : "Laser & Caries", "Lasers & Caries Prevention", "Lasers & Acid resistance and Enamel", Laser & Fluoride" and "Laser & Demineralization".
Eligibility Criteria: Abstracts of the Articles identified by the search and all Articles that appeared to meet the Inclusion Criteria were selected and actual Articles were collected. Inclusion Criteria: 1. Study that relates use of Laser for Caries prevention, 2. Studies related with application of Topical Fluoride, 3. Study was published in a refereed professional or scientific journal. Exclusion Criteria: Case reports and single case studies, Studies on dentin and root surface.
Result: Laser irradiation under specific conditions can change the crystallographic properties of apatite crystals increasing the acid resistance of Lased enamel. CO2 Lasers were most effective device in preventing acid demineralization. The combination of Lasers with TPI was more effective than Laser or Fluoride used alone.
Conclusion: The available data after reviewing Articles suggests that Lasers combined with fluoride is a promising treatment in caries prevention. Despite some positive indications an inadequate level of evidence was found concerning Lasers effectiveness in preventing caries
Comparison of Oral Diclofenac & Transdermal Diclofenac Patch as a Post-Operative Analgesia in Orthodontic Patients Having Multiple Premolar Extractions: A Clinical Trial
Get PDFBackground: Aims: This study was conducted to evaluate and compare the analgesic efficacy of transdermal Diclofenac patches and oral Diclofenac tablets following orthodontic premolar extractions, and to assess any associated adverse effects.
Methods: A total of fifty young pre-orthodontic patients requiring bilateral extraction of maxillary and mandibular first premolars were enrolled in the study. Extractions were performed in two separate appointments. During the first visit, the right maxillary and mandibular first premolars were extracted, and patients were prescribed 50 mg oral Diclofenac sodium tablets to be taken three times daily for three consecutive days. At the second appointment, the contralateral (left side) premolars were extracted, and a 100 mg transdermal Diclofenac patch was applied once daily for the following three days. Pain intensity and pain relief were assessed on each of the three postoperative days using standardized 5-point Verbal Pain Intensity, Pain Relief Score Charts, Visual analogue scale (VAS) and Verbal response scale (VRS) three times in three consecutive days after 2 hours, 6 hours and 12 hours.
Results: Statistical analysis demonstrated a consistent increase in pain relief scores and a corresponding decrease in pain intensity scores, VAS scores and VRS over the three-day postoperative period for both oral Diclofenac tablets and the transdermal Diclofenac patch. Although both formulations provided effective analgesia, a greater number of patients expressed a preference for the transdermal patch, citing the convenience of once-daily application, better analgesia and a lower frequency of systemic side effects.
Conclusion: These findings suggest that the transdermal Diclofenac patch offers analgesic efficacy better than that of oral Diclofenac tablets. Additionally, the improved patient compliance associated with the patch indicates its potential utility as a routine option for managing postoperative pain following dental extractions
In Vivo Assessment of Clinical Performances of Commercially Available Synthetic Osteoconductive Grafts B-OSTIN HA Nano™ and OSferion™ During Direct Sinus Lift Surgical Procedures for Managing Inadequate Implant Bone Heights in Middle-Aged Patients: A Hosp
Get PDFAim: This study aims to assess the clinical performance of commercially available, specific, synthetic, Osteoconductive and Biocompatible Grafts B-OSTIN HA Nano™ and OSferion™ during the Direct Sinus Lift procedure for managing inadequate Implant Bone heights in middle-aged patients
Materials and Methods: This study includes a total of 30 patients with a missing Maxillary Right Molar. Inclusion criteria required ages 35-60 and excluded those with systemic diseases, mental instability, or smokers. Significant bone resorption was noted on Cone Beam Computed Tomography (CBCT), necessitating a maxillary sinus lift. During surgery, a flap exposed the sinus\u27s anterior wall, and graft material was packed into the sinus using the "Postage Stamp Technique." Three months later, implants were placed, with healing abutments and implant-supported prostheses installed. Patients were divided into two groups: Group 1 received Hydroxyapatite (B-OSTIN HA Nano™) grafts and Group 2 received Tricalcium Phosphate (OSferion™) grafts. Clinical parameters, including bone height increase and graft stability, were evaluated with CBCT, assessing implant stability as satisfactory, non-satisfactory, questionable, or hopeless. This study aims to evaluate the clinical performance of the grafts during sinus lift procedures for inadequate implant bone heights.
Statistical Analysis and Results: This study involved 30 patients aged 35 to 60 years, missing the maxillary right first molar and seeking implant placement. Cone-Beam Computed Tomography (CBCT) scans indicated reduced bone height, necessitating a maxillary sinus lift and alloplastic bone grafts. Implants were placed three months after the lift, with prosthesis fitting three months later. Patients were divided into two groups: Group 1 received Hydroxyapatite (B-OSTIN HA Nano™) grafts, while Group 2 received Tricalcium Phosphate (OSferion™) grafts. CBCT evaluations showed that Group 1 had 9 patients with satisfactory bone height increases, 8 with satisfactory scaffold responses, and 7 with satisfactory implant stability. In Group 2, 8 had satisfactory increases in bone height, 7 had scaffold responses, and 6 had implant stability. Group 1 outperformed Group 2 overall, as detailed in statistical analyses using one-way ANOVA.
Conclusion: This study concluded that Hydroxyapatite (B-OSTIN HA Nano™) significantly improves bone height compared to Tricalcium Phosphate (OSferion™), which is essential for successful implant placement. Hydroxyapatite serves as an effective scaffold for new bone tissue growth and is praised for its biocompatibility, while Tricalcium Phosphate is favoured for its biodegradability and rapid regeneration. Further research is needed to compare the efficacy of these materials
Understanding Hypothyroidism: A Clear Look at Current Research and Treatment
Get PDFIntroduction: This narrative review aims to provide a comprehensive overview of current research trends and treatment strategies in hypothyroidism.
Objectives: To provide a comprehensive narrative review of the recent advances in diagnosis and management of hypothyroidism by synthesizing current research evidence.
Methods: A systematic literature search was performed across databases including PubMed, Google Scholar, and Cochrane, using relevant keywords related to hypothyroidism, research trends, and therapeutic strategies. A total of 267 records were identified. After removing 21 duplicates, 246 articles were screened for relevance. Of these, 114 were excluded based on titles and abstracts. Sixty-three full-text articles were sought, with 4 unavailable for retrieval. Fifty-nine reports were assessed for eligibility, and 5 were excluded (3 focusing on thyroid cancer, 2 lacking sufficient information). Finally, 54 studies published up to June 2023 were included in this review.
Results: From 267 records, 54 studies were included. Research trends highlight genetic variants identified through GWAS, advancing precision medicine and early detection. Environmental factors, particularly endocrine disruptors, influence thyroid dysfunction. Novel biomarkers like reverse T3 and deiodinase enzymes improve diagnostics. Besides levothyroxine, therapies under study include combinations of T4 and T3, controlled-release T3, TSH analogs and stem cell therapy. Lifestyle strategies—diet, exercise, stress management and complementary medicine—support care, while systemic effects span cardiology, neurocognition, fertility and mental health.
Conclusions: Thyroid hormone replacement remains central to hypothyroidism management, yet challenges including persistent symptoms, variable response, and diagnostic limitations endure. Advances in genetics, biomarkers, and novel formulations are paving the way for personalized and precise care. Lifestyle and nutritional interventions may complement standard therapy to improve outcomes. Future directions include immunotherapies, stem cell–based approaches, and precision medicine strategies. Collectively, evidence supports a multidimensional framework integrating optimized pharmacological treatment with complementary and emerging therapies to enhance long-term patient quality of life
Use of Progesterone Supplement Therapy for Prevention of Preterm Birth - Review of Literatures
Get PDFPreterm birth (PTB) is one of the most common complications during pregnancy and it primarily accounts for neonatal mortality and numerous morbidities including long-term sequelae including cerebral palsy and developmental disability. The most effective treatment of PTB is prediction and prevention of its risks. Risk factors of PTB include history of PTB, short cervical length (CL), multiple pregnancies, ethnicity, smoking, uterine anomaly and history of curettage or cervical conization. Among these risk factors, history of PTB, and short CL are the most important predictive factors. Progesterone supplement therapy is one of the few proven effective methods to prevent PTB in women with history of spontaneous PTB and in women with short CL. There are 2 types of progesterone therapy currently used for prevention of PTB: weekly intramuscular injection of 17-alpha hydroxyprogesterone caproate and daily administration of natural micronized progesterone vaginal gel, vaginal suppository, or oral capsule. However, the efficacy of progesterone therapy to prevent PTB may vary depending on the administration route, form, dose of progesterone and indications for the treatment. This review aims to summarize the efficacy and safety of progesterone supplement therapy on prevention of PTB according to different indication, type, route, and dose of progesterone, based on the results of recent randomized trials and meta-analysis
Comparing Effectiveness of Dinoprostone Gel and Single Foley’s Catheter for Medical Termination of Pregnancy with Previous Caesarean Scar
Get PDFWomen who have had a previous caesarean scar and are undergoing medical termination of pregnancy (MTP) have shown encouraging results from both chemical induction with Dinoprostone gel and mechanical induction of labour with Foley\u27s catheter. T o assess and contrast the efficacy of a single Foley\u27s catheter and Dionoprostone gel for medical termination of pregnancy (MTP) in patients who have had a prior caesarean section. The Department of Fetomaternal Medicine at BMU, Dhaka, carried out this quasi-experimental study from December 2023 to November 2024. The study population consisted of all patients with a history of caesarean scarring during the study period who were listed for medical termination of pregnancy within 14–28 weeks of gestation. A purposive sampling method was used to select 60 participants, who were assigned to Group A (single Foley’s catheter = 30) and Group B (Dinoprostone gel = 30). The collected data was evaluated for accuracy, consistency, and completeness prior to analysis. To analyse the data, SPSS version 23.0 was used. Among 60 participants, baseline demographics were comparable between Group A (Dinoprostone, n=30) and Group B (Foley’s, n=30): age 18–34 years in 27 (90.0%) each (p=0.715), SSC–HSC education in 12 (40.0%) each (p=0.199). Comorbidities like DM [Group A: 10 (33.3%), Group B: 9 (30.0%)], and HTN [9 (30.0%) vs 6 (20.0%)] were similar. Induction success was higher in Group A: 28 (93.3%) vs 19 (63.3%) (p=0.004). Time to labor and delivery was shorter in Group A: 16.1 ± 6.6 hrs vs 23.3 ± 8.6 (p=0.001); 24.8 ± 7.1 hrs vs 31.2 ± 9.3 (p=0.004). Hospital stays <3 days: 18 (60.0%) vs 9 (30.0%) (p=0.019). Dinoprostone gel was more effective and time-efficient than a single Foley’s catheter for pregnancy termination in women with cesarean scars, with higher success rates and shorter hospital stays, without increasing maternal complications.
DOI: https://doi.org/10.52783/jchr.v15.i5.10068
Hptlc Fingerprint Profiling of Hydroalcoholic Extracts from Ficus Carica and Morus Alba: A Comparative Phytochemical Analysis
Get PDFIntroduction: High-performance thin-layer chromatography (HPTLC) is a robust analytical technique for phytochemical fingerprinting and standardization of herbal extracts. However, comparative fingerprint profiling of Ficus carica (fig) and Morus alba (white mulberry) hydroalcoholic extracts has not yet been explored
Objectives: This study aims to develop and validate HPTLC methods to generate and compare chemical fingerprints of hydroalcoholic extracts of F. carica and M. alba.
Methods: Leaves and bark of authenticated F. carica and M. alba were shade-dried, powdered, and extracted with 10% ethanol and 1% water via Soxhlet. Preliminary phytochemical screening was performed to detect major metabolite classes. HPTLC separation used silica gel 60 F₂₅₄ plates with an optimized mobile phase Toluene: Ethyl acetate: Formic Acid (6: 4: 0.2). Samples were applied as 6 mm bands, developed to 8 cm in a saturated chamber, then visualized under UV 254/366 nm and post-derivatized with anisaldehyde‑sulfuric acid. Densitometric scanning was conducted at 366 nm.
Results: Both extracts exhibited rich phytochemical profiles including flavonoids, phenolic acids, tannins, and alkaloids with different Rf valve.
Conclusions: At 254 nm, many conjugated phytochemicals—especially alkaloids, phenolics, flavonoids—absorb strongly, making their spots appear as dark bands on plates coated with F₂₅₄ silica gel.in the HPTLC analysis of sample there was many unknow compound found in the sampl
Serum Magnesium Useful for Early Detection and Progression of Type 2 Diabetes Mellitus and Nephropathy
Get PDFIntroduction: : Magnesium, Insulin, urinary ACR, eGFR, play various roles in the pathophysiology of type 2 diabetes mellitus and nephropathy. This study aimed at determining whether serum magnesium, insulin, urinary ACR and eGFR are significantly altered during normo albuminuria of type 2 diabetes patients that subsequently develop micro and macro albuminuria and whether such changes are useful in predicting the disease early.
Objectives: To estimate serum magnesium and corelate with clinical markers of nephropathy in patients with type 2 diabetes mellitus. Additionally, the serum magnesium can serve has a early diagnostic and prognostic marker for nephropathy.
Methods: This was a cross sectional study which compared biochemical, clinical parameters in 40 type 2 diabetes mellitus with normo albuminuria, 40 type 2 diabetes mellitus with micro albuminuria, 40 type 2 diabetes mellitus with macro albuminuria and 40 age, gender and BMI matched healthy controls. Blood sugars, glycated haemoglobin, renal function tests, serum insulin, magnesium, eGFR and urinary ACR were analysed.
Results: There were significant differences in serum magnesium, insulin, urinary ACR, and eGFR among different stages of type 2 diabetes mellitus patients when compared to controls. Additionally, the serum magnesium negatively correlated with BMI, blood sugars, glycated haemoglobin, urea, creatinine, insulin, urinary ACR and positively correlated with eGFR (P=0.001**). Furthermore, the receiver operating characteristic curve analysis area uncer the curve for serum magnesium, urinary ACR and eGFR were; 0.989, 0.573 and 0.565 respectively. Decreased serum magnesium (specificity: 100; sensitivity; 95; CI=0.935 to 1.000; p=0.0001) were associated with T2DM and nephropathy.
Conclusions: Hypomagnesemia precede type 2 diabetes mellitus and can serve as early predictive and prognostic indices for type 2 diabetic nephropathy