Background: Conventional methods for assessing exposure to environmental tobacco smoke rely mainly on questionnaires and biomarkers with short half-lives, such as urinary cotinine. In contrast, oral mucosal pigmentation may represent a visible, non-invasive biomarker of chronic exposure. However, its clinical and policy relevance, as well as its validity for screening purposes, remain insufficiently established. Aim: To summarize the evidence on the association between exposure to environmental tobacco smoke and oral mucosal pigmentation and to assess some confounding factors. Materials and Methods: We synthesized findings from observational studies that examined the association between environmental tobacco smoke exposure and oral mucosal pigmentation across all age groups. International electronic databases, including PubMed, Embase, Web of Science, and Scopus, were searched. Data were extracted on exposure–response relationships, measurement instruments, anatomical distribution of pigmentation, confounding by physiological pigmentation, and biochemical validation. The quality of included studies was assessed using the Mixed Methods Appraisal Tool (MMAT). A narrative synthesis was conducted, focusing on the biological plausibility of the biomarker, standardization of measurement, and its potential implications for screening and tobacco control policy. Results: Thirteen observational studies from seven countries, involving a total of 3,284 participants, met the inclusion criteria. Four studies reported a statistically significant association between duration of exposure and severity of pigmentation, while one cohort study showed that urinary cotinine levels increased with age among children. The Gingival Pigmentation Index and the Dummett Oral Pigmentation Index were the most commonly used assessment tools; however, methodological heterogeneity limited direct comparability across studies. The anterior gingiva was the most frequently affected anatomical site. Only a limited number of studies adequately controlled for physiological pigmentation, and skin color was identified as an important confounding factor. The pooled odds ratio was 2.35; however, the certainty of evidence was low due to the observational nature of the included studies. Conclusion Oral mucosal pigmentation may serve as a potential biomarker of long-term exposure to environmental tobacco smoke. Nevertheless, standardized assessment protocols, adequate control for physiological pigmentation, and validation against “gold-standard” biomarkers are required. If validated, this marker could be used for rapid identification of high-risk groups and incorporated into tobacco control policies.

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.

AbstractIntroduction: Effects of medicine have many influential pharmaceutical and non-pharmaceutical factors. Term, “factors of medicine had been out because clinical research had proven that effect of medicine and reaction depends on medicine preparation technology, type of medicine, method to apply medicine. Prior to that, it was considered that quality of medicine depends on physical and chemistry conditions of medical ingredients, amount of active ingredients, etc. Bio digestion of medicine is an important criteria to take correct treatment, to reduce side effects in order to providing medical safety, to improve medicine quality, and to increase treatment impact. This study is about to prove that medical effect depends on medical factor particularly type of medicinePurpose: Aim is to study drug medical dissimilarity action in vivo enviromentMaterials and Methods: diuretics pharmacology tests 18-24gr 40 pieces weighting Balb /cshugamyn conducted on mice. Test "Monos" pharmacological sector in cooperation with the Institute for Research on drugs. Statistics by SPSS-20 software implementation and results of student criteria (p<0.05) was recognized and confirmed by one way ANOVA.Research is completedthe diuretics in the following the next sequence (Tryeindlinburg, 1980) 1. The research was conducted prior to the start of the test animals 0,3ml / 20gr doses of saline solution (NaCl 0.9%) treated with oral fluid pressure generated2. The research groups of injecting drug predicted doses experimental animals to drink5.3. Drinking the drug preparations 2.5 hours after the 30-minute intervals during the test animals urine test groups amount of urine of animals (p <0.05) compares.Result: Experimental animals, urine collected during the 30-minute interval of 2.5 hours, urine volume between the groups was compared with the control group.Administered medications, a comparative study of the Russian Federation " X1" acting industry furosemid make urinate "X2" Company "X3" LLC furosemid (p <0.05) compared to the control groups entails strong drugs furosemide make urinate consistent.Table form of furosemide drugs that acts comparative study of the Russian Federation "X1" acting industry furosemide make urinate "X4" Pharm Co Ltd furosemide (p <0.05) entails experimental groups with the control group furosemide make urinate strong comparison function (p <0.05)Conclusion:Medical activity that was different shows drug medical dissimilarity action, when comparing between types of pyroselid drug in various industries.Key words: Tablet form, active treatment, furosemide, injection, tablet, drug therapy acts as