Journal of Chemical Health Risks (Islamic Azad University, Iran)
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Acupressure Vs Cold Application: Impact on Pentavalent Vaccination Pain and Physiological Parameters in Infants
No full textIntroduction:Childhood immunization represents one of the most significant achievements in modern medicine and public health, saving millions of lives each year from vaccine-preventable diseases. However, vaccination procedures often cause pain and distress in infants, which can lead to fear and anxiety during subsequent medical encounters. Pain management, therefore, plays a crucial role not only in reducing immediate discomfort but also in enhancing the overall quality of life.
Objectives: The study aimed to compare the effectiveness of acupressure and cold application on pain and physiological parameters among infants .
Methods: A crossover research design was adopted for the study. Sixty infants were randomly allocated into two groups. Group I received acupressure, while Group II received cold application. After a four-week washout period, the interventions were interchanged. Pain intensity was assessed using the Neonatal Infant Pain Scale (NIPS), and physiological parameters such as heart rate and oxygen saturation were measured using a pulse oximeter.
Results: The mean age of infants in Group I and II was 1.97 ± 0.51 and 1.77 ± 0.45 months. During vaccination, the mean heart rate increased, and oxygen saturation decreased significantly in both groups, indicating a physiological response to pain. No significant crossover effect was observed, suggesting that the order of interventions did not influence the infants’ pain perception or physiological responses.
Conclusions: The findings of the study indicate that both acupressure and cold application are effective in alleviating pain associated with pentavalent vaccination among infants. These interventions are simple, safe, low-cost, and easy to administer, with a rapid onset of action. 
Comparative Evaluation of Patient and Orthodontist Preferences and Attitude in Mandibular Occlusal Photography: Novel Tongue Retractor vs. Conventional Technique
No full textBackground: Intraoral photography is essential in orthodontics for diagnosis, treatment planning, and documentation. Capturing mandibular occlusal photographs is often challenging due to interference from the tongue, gag reflex, and patient discomfort. Conventional techniques require patients to retract the tongue, which may reduce image quality and increase discomfort. A novel 3D-printed tongue retractor has been designed as an adjunct to the occlusal photographic mirror to improve visibility and comfort. This study aimed to evaluate and compare the preferences and attitudes of patients and orthodontists toward intraoral photographic techniques using a novel tongue retractor versus conventional methods.
Materials and Methods: A prospective comparative questionnaire-based study was conducted with 48 participants (24 patients and 24 orthodontists/postgraduate students). Mandibular occlusal photographs were captured using both the conventional method and the novel tongue retractor-assisted method. Visual Analogue Scales (VAS) were used to assess discomfort, acceptability, and stress. Additionally, patients completed a 7-item questionnaire and orthodontists/postgraduate students completed an 8-item questionnaire regarding their preferences. Data were analyzed using descriptive statistics and unpaired t-tests, with p < 0.05 considered statistically significant.
Results: The novel tongue retractor significantly reduced mean scores for discomfort, time needed, nausea, gag reflex, and breathing impairment compared to the conventional method (p < 0.001). No significant difference was noted in TMJ discomfort or discomfort during mouth opening (p > 0.05). Patient preferences strongly favored the tongue retractor-assisted method for comfort, efficiency, and reduced gag reflex, while conventional techniques were preferred for specific photographic views. Orthodontists and postgraduate students reported significantly less discomfort, reduced gag reflex, and improved feasibility with the novel tongue retractor (p < 0.05), though some scenarios still favored conventional methods.
Conclusion: The novel tongue retractor improves patient comfort and operator ease in mandibular occlusal photography, making it a valuable adjunct to conventional techniques. While it cannot completely replace standard methods, its use enhances efficiency, reduces stress, and provides superior patient and operator experiences in routine orthodontic practice
Accessory Anteromedial Portal for Anatomic Femoral Tunnel Placement in ACL Reconstruction: A Technical Short Communication
No full textAnterior cruciate ligament (ACL) reconstruction success is critically dependent on accurate anatomic femoral tunnel placement. Malpositioned femoral tunnels remain a leading cause of residual rotational instability, graft failure, and revision surgery.¹,² The traditional transtibial technique often results in a more vertical femoral tunnel, compromising restoration of native ACL biomechanics.³ The standard anteromedial (AM) portal improves access but may still limit trajectory, particularly in smaller knees or when aiming for the true low–deep native footprint
Efficient Synthesis of Novel Fused Pyrimidine-Thiadiazole Derivatives and their Structure-Dependent Antimicrobial Activities
No full textA new series of fused heterocyclic pyrimidine derivatives incorporating three pharmacologically significant scaffolds e.g. 1,3,4-thiadiazole, 1,2,3,4-tetrahydrocarbazole and substituted phenyl units was synthesized using microwave-assisted protocol. The synthetic methodology provided higher yields, shorter reaction times, and minimized solvent usage compared to conventional heating. The structures of the obtained compounds were confirmed by IR, 1H NMR, 13C NMR and elemental analyses. The antimicrobial potential of the synthesized molecules 4a-f was evaluated in vitro against Gram-positive and Gram-negative bacteria (Bacillus subtilis, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa) and fungasl strains (Candida albicans, Cladosporium oxysporum) using the agar well diffusion method. A structure–activity relationship was observed derivatives bearing electron-withdrawing substituents on the phenyl ring, particularly the para-nitro analogue 4b, exhibited the most significant antifungal activity, with MIC values comparable to fluconazole against C. oxysporum. In contrast, compounds containing electron-releasing groups demonstrated enhanced antibacterial properties, with the 4-hydroxy-3-methoxy derivative 4d showing the highest potency among bacterial targets. Overall, the study highlights microwave-assisted synthesis as an efficient and green approach for constructing biologically active fused heterocycles and identifies promising candidates for further antimicrobial development.
DOI: https://doi.org/10.52783/jchr.v15.i6.1110
Comparative Study of Inhaled Corticosteroid/LABA Combinations on Exacerbation Rates in Moderate Asthma
No full textBackground: Combination therapy with inhaled corticosteroids (ICS) and long-acting beta₂-agonists (LABA) remains the cornerstone for managing moderate asthma. Differences in pharmacodynamic profiles between combinations may influence exacerbation frequency and clinical control. This study aimed to compare the efficacy and safety of two commonly used ICS/LABA combinations-budesonide/formoterol and fluticasone/salmeterol-on exacerbation rates and clinical outcomes in moderate asthma.
Methods: A prospective, comparative, observational study was conducted among 160 patients with moderate persistent asthma attending a tertiary care hospital. Patients were divided equally into two groups: Group A (budesonide/formoterol, n=80) and Group B (fluticasone/salmeterol, n=80). Data on exacerbations, lung function (FEV₁, PEFR), symptom control (ACQ-5), adherence, and adverse effects were collected over six months. Statistical analysis included Student’s t-test, chi-square test, and Poisson regression; a p-value <0.05 was considered significant.
Results: The mean number of exacerbations per patient was significantly lower in Group A (0.46 ± 0.71) compared to Group B (0.73 ± 0.88; p = 0.040). The proportion of patients experiencing ≥1 exacerbation was 28.8% in Group A versus 45.0% in Group B (p = 0.033). Improvement in FEV₁ was greater in Group A (+9.3 ± 6.1 vs +6.8 ± 6.4; p = 0.012), and ACQ-5 scores decreased more substantially (-0.69 ± 0.44 vs -0.51 ± 0.46; p = 0.012). Adverse effects such as oral candidiasis and dysphonia were mild and comparable. Adherence ≥80% was achieved by 83.8% in Group A and 73.8% in Group B (p = 0.122).
Conclusion: Budesonide/formoterol demonstrated superior efficacy in reducing exacerbation rates and improving symptom control compared to fluticasone/salmeterol in moderate asthma, with comparable safety and better adherence. This combination may therefore represent an optimal maintenance option for moderate asthma patients requiring enhanced disease control
A Clinical Study on Prevalence of Apical Root Resorptions During Orthodontic Treatments: An Original Research Study
No full textAim: This study aims to investigate the prevalence of apical root resorptions during orthodontic treatments.
Materials and Methods: This study examined the effects of fixed appliance orthodontic therapy on apical root resorption in 90 patients with various dental issues. Of these, 80 expressed interests in treatment, and only those who completed therapy were included. Participants were selected based on comprehensive dental records, including pre- and post-treatment panoramic X-rays. Exclusion criteria included prior orthognathic surgery, congenital anomalies, poor X-ray quality, systemic health conditions, previous dental trauma, and bruxism. Informed consent was obtained from all. We documented pre-treatment parameters, focusing on tooth extractions, and analysed pre- and post-treatment X-rays of 60 patients. Root lengths of maxillary and mandibular teeth were measured from the root apex to the incisal edge or cusp tip. Apical root resorption was assessed using the Levander and Malmgren classification, ranging from 0 (no changes) to 4 (severe resorption). The cohort was divided into two groups: Group I (40 patients with extractions) and Group II (40 patients without extractions), aiming to compare root resorption metrics and the impact of extractions on root stability.
Statistical Analysis and Results: This study examined the characteristics and treatment outcomes of 80 patients, aged 14 to 33, seeking orthodontic care, with a nearly equal gender distribution of 41 males and 39 females. Participants were divided into two groups: Group I, consisting of 40 patients who underwent tooth extractions, and Group II, comprising 40 patients treated with fixed appliances without extractions. In Group I, the baseline Mean Root Resorption Score (MRRS) for the upper anterior region was 0.37 ± 0.15 before treatment. Post-treatment, this score increased to 0.47 ± 0.24, indicating significant root resorption associated with extractions. In Group II, the pre-treatment MRRS was 0.35 ± 0.14, with a post-treatment score of 0.41 ± 0.17, reflecting less impact on root resorption. Statistical analyses, including the Mann-Whitney U test and Pearson Chi-Square test, were employed to evaluate gender differences and treatment effects, while Table 6 presents a comprehensive summary of root resorption across both groups using one-way ANOVA. Overall, the findings enhance understanding of the effects of extraction versus non-extraction orthodontic treatments on root structure, guiding best practices to balance effective outcomes with dental integrity.
Conclusion: This study concluded that ARR is common and is particularly pronounced in upper central incisors. Key contributing factors include extended treatment durations and specific orthodontic forces, especially during intrusive movements and torque applications. Younger patients are especially vulnerable to severe resorption, highlighting the need for careful treatment planning
A Community Based Study to Assess Out-Of-Pocket Expenditure (OOPE) Among Beneficiary and Non-Beneficiary of Mukhya Mantri Chiranjivi Swasthya Bima Yojna (MMCSBY) In Jaipur (Rajasthan)
No full textBackground: Out of Pocket Expenditure (OOPE) refers to direct payments for healthcare services. In India, high OOPE burdens low income families, often leading to poverty and debt. To address this, Mukhya Mantri Chiranjeevi Swasthya Bima Yojana (MMCSBY) was launch to reduce OOPE, improve access to affordable care and ensuring quality healthcare for all, regardless of income, however impact of this scheme on OOPE between beneficiaries and non-beneficiaries should be assessed. For this purpose study planned to find out OOPE among beneficiary and non-beneficiary of MMCSBY in Jaipur.
Methodology: A community based, cross sectional study was carried out to assess OOPE among beneficiary and non-beneficiary of MMCSBY between November 2023 to August 2024 at Dadiya and Bhated village under field practice area of Rural Health Training Center (RHTC) of Medical Institute, Jaipur, Rajasthan. A semi-structured, validated questionnaire used for data collection. Descriptive statistics and Chi-square test used for analysis (p-value <0.05 Statistically Significant).
Results: A total of 458 households, 257 (56.10%) from Dadiya and 201 (43.90%) from village Bhatad were included. About 190 (41.50%) households were belonged to lower middle socio-economic class III. Majority 399 (87%) were beneficiaries and 59 (13%) were non-beneficiaries of MMCSBY. OOPE were observed in 59 (24%) beneficiary and 34 (57.62%) non-beneficiaries, which was statistically significant (p-value <0.05).
Conclusion: Study revealed that OOPE among beneficiaries was considerably less compared to non-beneficiaries, who incurred more than double expenditure, clearly indicates significant impact on reducing OOPE and highlighting factors which contributing awareness about scheme.
DOI: https://doi.org/10.52783/jchr.v15.i6.1120
A Prospective Observational Study in the Management of Diabetic Ulcer Using Diabetic Ulcer Severity Score
No full textBackground: Diabetic foot ulcers (DFUs) are a common and serious complication of diabetes mellitus, often leading to prolonged hospitalisation, infection, and amputation. Accurate assessment of ulcer severity is essential for guiding management and predicting outcomes. The Diabetic Ulcer Severity Score (DUSS) is a simple clinical tool designed for this purpose.
Objective: To evaluate the ability of DUSS to predict clinical outcomes in patients with diabetic foot ulcers.
Methods: This prospective observational study included 80 patients with DFUs managed at GCS Medical College and Research Centre, Ahmedabad, from January 2023 to January 2025. Patients were assessed using DUSS, and data on demographics, clinical characteristics, comorbidities, glycemic control, microbiological profile, and interventions were collected. Statistical analysis was performed using SPSS version 25, with significance set at p < 0.05.
Results: DUSS scores ranged from 0 to 4, with higher scores correlating with more severe ulcers and increased need for surgical interventions. Poor glycemic control and longer duration of diabetes were associated with higher DUSS scores. Microbiological analysis revealed predominance of Klebsiella and Pseudomonas species, and culture-guided antibiotic therapy was required in most cases. Higher DUSS scores predicted delayed healing, more frequent complications, and a greater likelihood of surgical intervention (p < 0.05).
Conclusion: DUSS is a simple, reliable, and effective tool for assessing DFU severity and predicting clinical outcomes. It can be used in routine clinical practice for early risk stratification, guiding treatment decisions, and improving patient outcomes
Evidence Gaps and Future Directions for Low-Level LASER Therapy in Oral Sub Mucosal Fibrosis: A Scoping Review.
No full textBackground:
Oral submucous fibrosis (OSMF) is a chronic, progressive, potentially sub-cancer disorder characterized by trismus, burning sensation, and mucosal rigidity. Low-level laser therapy (LLLT), also referred to as photobiomodulation, has emerged as a novel adjunctive modality in treating the OSMF. Primary focus of scoping study is mapping the body of evidence about the use of LLLTand to summarize the reported clinical outcomes.
Objective:
To map the existing evidence on the use of LLLT in the management of OSMF, identify research gaps, and suggest future directions for clinical application and research.
Methods:
Scoping review followed the PRISMA-ScR guidelines. Literature was systematically searched across Embase, PubMed, Web of Science, Scopus, Cochrane Library using keywords and Boolean terms regarding “oral submucous fibrosis” and “low-level laser therapy/photobiomodulation”. Eligible studies encompassed observational studies, preclinical studies, randomized controlled trials, case reports, and systematic reviews. Data were charted for study characteristics, LLLT protocols, outcomes (mouth opening, burning sensation, pain, mucosal flexibility, quality of life), and safety. Thematic synthesis was used to map evidence and highlight gaps.
Results:
Evidence suggested LLLT improves mouth opening and burning sensation; yet, available studies are inadequate because of short-term follow-up, heterogeneous protocols, small sample sizes, and lack of standardized outcome measures.
Conclusion:
This review provided a comprehensive overview of the role of LLLT in OSMF, highlighted methodological and evidence gaps, and proposed future research directions, including standardized treatment protocols, long-term trials, and integration of patient-centered outcomes
Parental Knowledge, Attitudes, and Perception on Fluoridated Toothpaste Use in Children: A Cross-Sectional Study from Goa, India
No full textIntroduction: Dental caries remains one of the most prevalent chronic diseases in childhood, and parental knowledge and practices play a crucial role in determining children’s oral health outcomes. Fluoridated toothpaste is a key preventive measure; however, limited data exist regarding parents’ understanding and use of fluoride toothpaste in India. This study assessed parental knowledge, attitudes, and perception related to fluoridated toothpaste and toothbrushing behaviors in children in Goa, India.
Methods: A cross-sectional survey utilizing a pre-validated questionnaire was conducted between August and October 2025 among 250 parents of children aged ≤12 years. Data were analyzed using SPSS version 26. Descriptive statistics summarized categorical and quantitative variables. Chi-square tests evaluated associations between age and brushing practices, and independent t-tests compared knowledge and perception scores between mothers and fathers. Significance was set at p < 0.05.
Results: Only 16.8% of parents selected toothpaste based on fluoride concentration, and 88% were unaware of the fluoride content of their child’s toothpaste. Half of the children used pediatric toothpaste, while 46.8% used adult toothpaste. Toothbrushing frequency was once daily for 50% of children. Recommended toothpaste quantities were followed by 45.5% of parents with children under 3 years and 42.1% of parents of 3–6-year-olds. Parental involvement decreased with increasing child age. Mothers had significantly higher knowledge and perception scores than fathers (p < 0.05).
Conclusions: Parents demonstrated limited awareness regarding fluoridated toothpaste, appropriate dosing, and supervised toothbrushing. Targeted educational interventions are needed to improve parental understanding, promote twice-daily brushing, ensure correct toothpaste amounts, and reduce rinsing practices to maximize fluoride benefits