Background: Passive smoking among children remains a serious public health concern, particularly because children’s ability to avoid household environmental tobacco smoke exposure is limited when parents smoke. In recent years, increasing scholarly attention has been given to oral mucosal pigmentation as a potential clinical sign of long-term passive smoking in children. However, no previous study has synthesized the available evidence on this topic. Aim: This systematic review and meta-analysis aimed to evaluate the association between passive smoking and oral pigmentation in children. Materials and Methods: A systematic search was conducted in international electronic databases, including PubMed, Scopus, Web of Science, and the Cochrane Library, in accordance with PRISMA guidelines. Observational studies assessing the association between passive smoking and oral pigmentation among children aged ≤18 years were included. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT). A random-effects meta-analysis was performed, and pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Between-study heterogeneity was assessed using the I² statistic, and the certainty of evidence was evaluated using the GRADE approach. Results: Seven studies involving a total of 1,582 participants met the inclusion criteria. The meta-analysis demonstrated that passive smoking was significantly associated with an increased risk of oral pigmentation in children, with a pooled OR of 2.58 (95% CI, 1.35-4.95; p=0.004). Compared with children without exposure to passive smoking, those exposed to environmental tobacco smoke had an absolute risk increase of 17% (95% CI, 6.3%-23.9%). Subgroup analysis by assessment method showed a consistent effect among studies using the Gingival Pigmentation Index (GPI) (OR, 2.12; 95% CI, 1.58-2.84), whereas studies using the Dummett Oral Pigmentation Index (DOPI) showed a wider confidence interval (OR, 3.26; 95% CI, 0.68-15.54). According to the MMAT assessment, the included studies demonstrated adequate participant selection in 100% of cases, appropriate outcome measurement in 76.9%, and adequate control of confounding factors in 46.2%. Owing to the observational nature of the included studies, moderate heterogeneity, and the potential risk of confounding by physiological pigmentation, the certainty of evidence was rated as low according to GRADE. Conclusion Children exposed to environmental tobacco smoke had a significantly higher likelihood of oral mucosal pigmentation than unexposed children. These findings suggest that screening for oral mucosal pigmentation during pediatric oral examinations may serve as a non-invasive marker of passive smoking exposure and may provide visible clinical evidence to support counseling parents on smoking cessation and smoke-free household environments.

Goal: To determine main causes of the complication and the death in patients with diabetes, and to identify strategies for preventing from complication and deaths due to diabetes and improving quality of life and prolonging the life of diabetes patients.Objectives:1. To determine the occurrence of diabetes-related complications2. To study the causes diabetes-related complications and deaths3. To study prevention methods for these complicationsMaterials and Methods: From 17953 patient records from the past five years (2005-2009) of the State Clinical Hospital, we have selected 296 records from patients with diabetes. From these records we collected the following information: age, sex, duration of disease, type of work and complications experienced. Also from 2825 death cases, we have selected 48 patient records from the same period. We extracted information on age, sex, type of work and cause of death. Result: Compared to the 1997 data, kidney complications occurred in 68.9% of cases, which has risen from 25.6%. Eye complications occurred in 29.8% (1997) and have fallen to 19.6%. Leg complications rose to 12.8% which may indicate a continued rise in the future. It is evident from the study that type 2 diabetes occurs more often in people from urban areas (75.3%), who have sedentary jobs (87%), with poor health habits, and excess food and alcohol intake.Conclusion: The control of the primary and secondary health organization of the patients with diabetes are poor and preventative medication such as insulin are introduced late. There is poor public knowledge of healthy lifestyle and too much dependence on free drugs and no self-healthmanagement, patients seek medical treatment at late stages, and free drug distribution by order of the Minister of Health is not adequate.