Therapeutic Evaluation of 5% Topical Amlexanox Paste and 2% Curcumin Oral Gel in the Management of Recurrent Aphthous Stomatitis‑ A Randomized Clinical Trial
THE EFFECTS OF PERIODONTAL TREATMENT ON DIABETIC PATIENTS: THE DIAPERIO RANDO...sDJKFhjh
While many systemic diseases have been considered to be associated with periodontitis, the link between diabetes and periodontitis has been the subject of the most intensive research over the past decades.
Both periodontitis and diabetes are highly prevalent in modern societies and have a negative impact on quality of life.
Periodontal therapy might help to reduce local inflammation, and consequently, the putative systemic entry of bacterial by- products (e.g., lipopolysaccharides from Gram - negative bacterial walls) and pro- inflammatory molecules.
Comparative Evaluation of the Effect of Doxycycline As An Adjunct to Non-Surg...QUESTJOURNAL
Background: The association between diabetes and periodontal disease has long been discussed with conflicting conclusions. Earlier studies demonstrating the relationship between diabetes and severity of periodontal disease has been equivocal. However, recent studies have clearly proven that diabetes increases the risk of periodontal disease progression. Less clear is the impact of periodontal disease on diabetes. It has been hypothesised that periodontal therapy may improve the metabolic control of diabetes. Aim: To determine the effect of doxycycline as an adjunct to non-surgical periodontal therapy in improving the metabolic control of poorly controlled type 2 diabetic subjects with chronic generalized periodontitis. Method: 30 poorly controlled type 2 diabetic subjects with chronic generalized periodontitis and receiving antidiabetic therapy were selected for the study. The subjects were randomly allotted to either of two treatment groups containing 15 subjects each: Group 1 (scaling and root planing(SRP)+ 15 days Doxycycline) or Group 2 (scaling and root planing(SRP). The Glycated haemoglobin (HbA1c) values, Gingival Index(GI), and Probing pocket depth of both the groups were assessed at baseline and after 3 months. Results: Both the treatment groups exhibited reductions in HbA1c, G I and Probing pocket depth compared to baseline over time. The amount of reduction in the glycated haemoglobin and gingival parameters was higher in Group I compared to group 2 after 3 months. Conclusion: Both treatments improved glycemic control in patients with type 2 diabetes; however, the reduction in HbA1c values reached statistical significance only in the group receiving doxycycline as an adjunct to scaling and root planing.
Therapeutic Evaluation of 5% Topical Amlexanox Paste and 2% Curcumin Oral Gel in the Management of Recurrent Aphthous Stomatitis‑ A Randomized Clinical Trial
THE EFFECTS OF PERIODONTAL TREATMENT ON DIABETIC PATIENTS: THE DIAPERIO RANDO...sDJKFhjh
While many systemic diseases have been considered to be associated with periodontitis, the link between diabetes and periodontitis has been the subject of the most intensive research over the past decades.
Both periodontitis and diabetes are highly prevalent in modern societies and have a negative impact on quality of life.
Periodontal therapy might help to reduce local inflammation, and consequently, the putative systemic entry of bacterial by- products (e.g., lipopolysaccharides from Gram - negative bacterial walls) and pro- inflammatory molecules.
Comparative Evaluation of the Effect of Doxycycline As An Adjunct to Non-Surg...QUESTJOURNAL
Background: The association between diabetes and periodontal disease has long been discussed with conflicting conclusions. Earlier studies demonstrating the relationship between diabetes and severity of periodontal disease has been equivocal. However, recent studies have clearly proven that diabetes increases the risk of periodontal disease progression. Less clear is the impact of periodontal disease on diabetes. It has been hypothesised that periodontal therapy may improve the metabolic control of diabetes. Aim: To determine the effect of doxycycline as an adjunct to non-surgical periodontal therapy in improving the metabolic control of poorly controlled type 2 diabetic subjects with chronic generalized periodontitis. Method: 30 poorly controlled type 2 diabetic subjects with chronic generalized periodontitis and receiving antidiabetic therapy were selected for the study. The subjects were randomly allotted to either of two treatment groups containing 15 subjects each: Group 1 (scaling and root planing(SRP)+ 15 days Doxycycline) or Group 2 (scaling and root planing(SRP). The Glycated haemoglobin (HbA1c) values, Gingival Index(GI), and Probing pocket depth of both the groups were assessed at baseline and after 3 months. Results: Both the treatment groups exhibited reductions in HbA1c, G I and Probing pocket depth compared to baseline over time. The amount of reduction in the glycated haemoglobin and gingival parameters was higher in Group I compared to group 2 after 3 months. Conclusion: Both treatments improved glycemic control in patients with type 2 diabetes; however, the reduction in HbA1c values reached statistical significance only in the group receiving doxycycline as an adjunct to scaling and root planing.
Oral submucous fibrosis is defined as “An insidious chronic disease affecting any part of the oral cavity and sometimes the pharynx. A wide range of treatment including drug therapy, surgical therapy, and physiotherapy have been attempted till date, with varying degrees of benefit, but none have been able to cure this disease.
The treatment depends on the level of clinical involvement. At a very early stage, cessation of the habit is adequate. Medical/surgical treatment is necessary for moderate to severe cases. Surgical treatment is the method of choice in patients with marked limitation of mouth opening or in patients not responding to the conservative management.
Oral submucous fibrosis is defined as “An insidious chronic disease affecting any part of the oral cavity and sometimes the pharynx. A wide range of treatment including drug therapy, surgical therapy, and physiotherapy have been attempted till date, with varying degrees of benefit, but none have been able to cure this disease.
The treatment depends on the level of clinical involvement. At a very early stage, cessation of the habit is adequate. Medical/surgical treatment is necessary for moderate to severe cases. Surgical treatment is the method of choice in patients with marked limitation of mouth opening or in patients not responding to the conservative management.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
How to Give Better Lectures: Some Tips for Doctors
JC .pptx
1.
2. EFFICACY OF LYCOPENE IN
COMBINATION WITH VITAMIN E IN
MANAGEMENT OF ORAL SUBMUCOUS
FIBROSIS-ACLINICAL PROSPECTIVE
STUDY
JOURNAL OF ADVANCED MEDICAL AND DENTAL SCIENCE RESEARCH
I VOL.3I JULY-SEPTEMBER 2015
Presented by – Zareesh.S.Akhtar.
3. INTRODUCTION
•Pindborg in 1966
• an insidious chronic disease affecting in any part of the oral
cavity and sometimes the pharynx.
•Although occasionally preceded by and /or associated with vesicle
formation.
•It is always associated with juxta-epithilial inflammatory reaction
followed by fibro elastic change of lamina propria ,
•while epithelial atrophy leading to stiffness of oral mucosa and
causing trismus and inability to eat.
4. ETIOLOGY
•Capsaicin (chilli consumption)
•Betel nut alkaloids
•Hypersensitivity
•Autoimmunity
•Genetic complex deficiency
•Common is chewing areca nut
•Collagen disorder
•Nutritional deficiency
•Inhibition of collagen
phagocytes
•Chemical carcinogens
•Upregulation of COX-2
inflammatory changes
•Areca alkaloids causing
fibroblast proliferation
In indian subcontinent OSMF is though to be multifactorial
5. •Areca nut chewing is deep rooted in Indian culture used as mouth
freshening agent ,has various symbolic roles throughout Indian
history.
•Alarming fact is this habit is becoming popular among
adolescents ,adult male and female
6. LYCOPENE
•A carotenoid found in tomatoes
•It prevents oxidation of low density lipoprotein
•Its an powerful antioxidant and has a singlet oxygen quenching
ability twice as high as beta-carotene
•Being potent anticarcinogenic demonstrated profound benefit in
precancerous lesions and conditions.
• Lycopene increase GJC between cells and enhances the
expression of connexin 43, and thereby up-regulates GJC and acts
as an anti-carcinogen.
7. VITAMIN E
•Known as tocopherol
•Have antioxidant properties
•Prevents peroxidation of unsaturated fatty acids
•Retards carcinogenesis by maintaining the number of Langerhans
cells
•It possess anti-inflammatory properties.
•Vitamin E is an effective stimulant of humoral immune response
8. AIMS & OBJECTIVE
•Various tratment modalities ranging from conservative treatment to surgical
procedures have been attempted.
•Aim was to elucidate the role of lycopene in combination with vitamin e in
management of OSMF, this study is conducted.
9. MATERIALAND METHOD
•This was a clinical prospective study conducted between March 2015
and July 2015 on total of 90 patients,
• Who visited the Department of Oral Medicine and Radiology, Vyas
Dental College & Hospital, Jodhpur, Rajasthan, India,
• Patient selected for the study, where oral submucous fibrosis was
confirmed both clinically and histologically.
•Of these, 72 patients successfully completed the trial and reported for
follow-up
10. •The aim and purpose of the study was explained to each
patient and written consent was obtained.
•The habits like tobacco chewing and ethanol usage were
assessed on each visit and the patients were encouraged to
discontinue the habit.
•These 72 patients were randomly categorized (irrespective of
the size and severity of the lesions) into 3 groups:
11. •Group A (Lycopene Group): 24patients were treated with 8
mg of lycopene in two equally divided doses. The product
used in the study was soft gel Lycored TM, Jagsonpal
Pharmaceuticals, New Delhi
•Group B (Lycopene + Vit. E Group): 24 patients were
treated with 8 mg of lycopene + vitamin E (400 I.U.) +
selenium (200 mcg) in two equally divided doses. The
product used was LYC-O-MATO soft gels, manufactured by
Mano pharmaceuticals, Chennai, India.
•Group C (Placebo Group): 24 patients were given placebo
capsules once daily.
12. DATA COLECTION
•Patients were evaluated every 15 days during the treatment
period of three months.
•Patients were followed up for two months.
• The main parameters assessed were improvements in
mouth opening a in mm and burning sensation
•By visual analog scale (VAS) from 1 to 10.
13. •The two parameters were recorded weekly for 2 months.
•One-way ANOVA followed by post hoc Tukey’s test for
group-wise comparisons were used.
• During each visit, the patients were examined for presence
or absence of erythematous areas/ulceration/erosions,
burning sensation and mouth opening.
15. There was significant improvement in mouth opening in patients
subjected to lycopene as compared to placebo group. (Table 1, 2
and 3)
16.
17.
18. Patients also showed reduction in burning sensation and
erythematous/ ulceration/ erosions. (Table 4,5 and 6)
19.
20.
21. Discussion
•Gupta S et al observed there was significant reduction of vitamin
E in stage II and III OSMF .
•Which reflects increase in oxidative stress in progression of
OSMF
•So a newer antioxidant like lycopene in combination with vitamin
E with more potent properties is used in present study
22. •Lai DR et al stated that B vitamins was ineffective in improving
trismus
•Karemore et al observed improved mouth opening of 69.56%
with lycopene group
•Whereas Maher et al observed less improvement (41%) in
mouth opening using multiple micronutrients.
23. CONCLUSION
• Present study showed better tolerance to spicy food and burning
sensation along with absence of erythematous areas or ulcerations
or erosions
• In LYCOPENE with VITAMIN E group as compared to
LYCOPENE and PLACEBO group
•Lycopene in combination with vitamin E is a highly efficacious
drug in the management of oral submucous fibrosis which is
proven to be safe and reliable treatment method .
24. SUMMARY
1 group
24 people
Lycopene &
cessation of
habit
75%
Improvement in
mouth opening
2 group
24 people
Lycopene +vitamin
E & cessation of
habit
83% improvement
in mouth opening,
Burning sensation
ulcerations
3 group
24 people
Placebo drug &
cessation of
habit
60%
Improvement in
mouth opening
The study group included 72 patients with OSMF
26. Clinical evaluation of different treatment methods for
OSMF.A10-year experience with 150 cases .J Oral Pathol
Med.1995 Oct;24(9):402-6
Lai DRI,Chen HR,Lin LM,Huang YL,Tsai CC
27. AIM & OBJECTIVE
•Aim was to evaluate the different treatment methods(surgical &
Medical)
•In the management of early and advanced cases of OSMF over
past 10 years with 150 cases
•And proposed a effective regime for the treatment of OSMF.
28. Material & Method
•Over 10-year period total 150 patients (M=145 &
F=5)suffering from OSMF diagnosed clinically and
pathologically were treated at the Kaohsiung medical college
& hospital ,Taiwan.
•These 150 patients were divided into2 groups with varying
degree of OSMF were treated by either Medical or Surgical
Therapies
29. •Over 10 year period a total of 150 patients divided into two
groups with varying degree of OSMF
•Treated by
1-medical treatment group
2-surgical treatment group
30. •Medical treatment group involved patients with IID 20mm to >35
and were further divided into subgroups as follow (each group
containg 25 patients).
•Subgroup A-conservative oral administration of vitamin B complex
200mg B.D
•- buflomedial hydrochloride 400mg TDS and
•- topical triamcinolone acetonide 0.1% at bedtime
31. •Subgroup B-conventional submucosal injections of a
combination of
•- dexamethasone(4mg/ml) and
•-2 part hyaluronidase 200USP unit/ml diluted in 1.0ml of
2% xylocaine by 27 gauge dental needle.
•-Not more than 0.2ml solution /site for 20 weeks.
•Subgroup C-a combination of both (a) and (b).
32. •The surgical group included patient with IID <20mm and were
further divided into subgroups (each group containg 25 patients)
,was treated by the excision of fibrotic tissues and covering defect
with -
•Subgroup D Split thickness skin graft harvested from patients
thigh skin
•Subgroup E Fresh human amnion
•Subgroup F Buccal fat pad graft (BFP)
34. o Subgroup A patients were quickly relieved by ulcerations
,burning sensations but there was no improvement in trismus
o Subgroup B patients felt relief from stiffness of buccal
mucosa ,ulcerations ,burning sensation ,trismus
o Subgroup C patients who were treaded by both 1+2 had early
and marked relief from symptoms
35.
36. o In surgical group interincisal mouth opening was less than
20 mm after surgical intervention mouth opening achieved
was 30-35 mm
o But there was decrease in interincisal distance up to 5-
10mm after 2 year of follow up
o Grafts and wounds contracted in all patients by varying
amount .
37. Conclusion
•Subgroup A only provided symptomatic relief from ulcerations and
other lesions
•But not trismus it can be used as an adjuvant to other treatment
modes but cannot be used alone.
•Treatment course of subgroup B and C showed little difference in
improvement in trismus
• Subgroup B by 83% & Subgroup C by 86% at the end of
treatment course.
38. •During the 2 year follow up there was only 3-5mm range decrease in
interincisal distance which is less then surgical group and acceptable
.
•After surgical intervention mouth opening achieved was 30-35 mm
•But there was decrease in interincisal distance up to 5-10mm after 2
year of follow up as grafts and wounds contracted in all patients by
varying amount .
39. •Subgroup C treatment , and Surgical interventions proved to
be useful to manage OSMF in early and advanced stages of
progression.
40. Efficacy of lycopene in the management of OSMF
Oral Surg Oral Med Oral Pathol Oral Radio Endod
2007 ;103:207-13
Kumar A, Bagewadi A , keluskar V , Singh M
41. AIM & OBJECTIVES
To evaluate the efficacy of oral lycopene therapy in patients
with oral submucous fibrosis and to compare these effects
with a placebo.
42. MATERIAL & METHOD
•Total of 58 patients with OSMF were included for study
•The study population was randomly divided into 3 groups
•GROUPA -received 16 mg of lycopene( n=21)
•GROUP B - received 16mg of lycopene along with
biweekly intralesional steroid injections( n=19)
• GROUP C - given placebo drugs ( n=18)
Datacollection
•Paried and Unparied t test were used for statistical
evaluation.
43. RESULT
•Mouth opening for patients showed an average increase of
•3.4 mm in group A
•4.6mm in group B
•0.0mm in group C
•These values were statistically found to be highly significant
44. CONCLUSION
The observed effects suggest that lycopene can and should be
used as a first line of therapy in the initial management of oral
submucous fibrosis.
45. LYCOPENE IN THE MANAGEMENT OF OSMF
Asian journal of pharmaceutical and clinical research VOL 6 Issue
3;2013
NIRANZENA PANNEER SELVAM,ARJUN ANAND DAYANAND
46. AIM & OBJECTIVE
The aim of the study was to evaluate the efficacy of oral
lycopene therapy when used in combination with
conventional intralesional steroid therapy in the management
of oral submucous fibrosis.
47. MATERIAL & METHOD
•Totally 45 patients with signs and symptoms of OSF were recruited
for the study from the Department of Oral Medicine and
Radiology, Tamilnadu Government Dental College and Hospital,
Chennai, India.
•The Institute’s Ethical Committee approval was obtained.
48. INCLUSION CRITERIA
•History of the habit of chewing
arecanut or any commercial
products.
• Burning sensation on eating
spicy food.
• Restricted mouth opening with
or without palpable vertical
fibrous bands on the buccal
mucosa Stiffness and blanching
• Without tongue involvement -
Grade III and IV
EXCLUSION CRITERIA
•Patients with histologically proven
OSF turning into malignancy were
excluded from the study
49. •Informed consent was obtained from all the patients.
•Patients were explained about the disease condition and its
premalignant potential.
• The patients were counselled to stop the habit of using arecanut in
all its forms.
•Complete oral prophylaxis was done to improve the oral hygiene
as well as to motivate the patient to stop the habit.
50. •The patients were then randomly divided into three groups (A, B and
C) consisting of 15 cases each.
•Group A patients were given
-oral Lycopene capsules 16 mg (Lycostar®, Mankind Pharma
Ltd., New Delhi, India), one capsule/day. . Lycostar contains
Lycopene 5000 μg along with various micronutrients.
- Along with bi-weekly intralesional injections of Dexamethasone
1.5 ml & Hyaluronidase 1500 IU mixed with lignocaine
51. •Group B patients were given
-oral antioxidant capsules (Multivitamin A-Z soft capsules,
PrimePharm, Shangai, China), one capsule/day
-along with bi-weekly intralesional injections of Dexamethasone
1.5 ml & Hyaluronidase 1500 IU mixed with lignocaine.
• Group C patients were given bi-weekly intralesional injections of
Dexamethasone 1.5 ml & Hyaluronidase 1500 IU with lignocaine
alone without any other oral supplements.
52. RESULT
There was significant increase in mouth opening among all
the 3 groups. The results were statistically significant
between Group A and C and Group B and C.
53. CONCLUSION
• Lycopene in combination with intralesional steroids and
Hyaluronidase.
• Is highly efficacious in improving the mouth opening and
reducing other symptoms in patients with Oral Submucous
Fibrosis.
• No side effects were reported with its usage.
54. Levamisole and antioxidants in the management
of oral submucous fibrosis: A comparative study
Vasanti Jirge, M.C. Shashikanth, I.M. Ali, Nisheeth
Anshumalee Department of Oral Medicine and Radiology,
College of Dental Sciences, Davangere-577 004, India
55. AIM & OBJECTIVE
This study was carried out to evaluate the clinical effects of
levamisole (VERMISOL), and antioxidants (ANTOXID)
and its effect on serum immunoglobulins IgG, IgA and IgM.
56. MATERIAL & METHOD
•The present randomized, single blind study was conducted
in the Department of Oral Medicine and Radiology,
Department of Oral Pathology, College of Dental Sciences,
Davangere and Department of Microbiology, Maratha
Mandal Dental College, Belgaum.
•The study group comprised 45 OSMF patients of
57. •Patients who were healthy and well oriented in time, space and as
a person, patients who satisfied the characteristic clinical features
of OSMF with histopathologic confirmation.
• Patients who agreed to the biopsy, blood and immunological
examination and patients who were willing for follow-up visits, and
those who were willing to quit the habit of chewing areca nut/
gutkha/ and tobacco in any form were included in the study.
Inclusion criteria
58. Exclusion criteria
Patients with OSMF and any past or present systemic
diseases (e.g. diabetes, hypertension, liver disorders or
kidney diseases, autoimmune disorders), other mucosal
lesions, patients suffering from acute or chronic infection,
patients with a known allergy or contraindication to the
study drugs were excluded from the study
59. •Patients were randomly assigned into three groups.
• There were 15 patients in each group
• Group I patients received levamisole, 50 mg three times
daily for three alternate weeks
•Group II patients received 2 capsules of antoxid daily for six
weeks
•Group III patients received levamisole and antoxid.
• The results were analyzed with paired ‘t’ test and unpaired
‘t’ test
60. The results indicated that levamisole, antoxid and the
combination of levamisole and antoxid showed significant
improvement in mouth opening and reduction in burning
sensation.
Significant reduction of serum IgG, IgA and IgM was seen
in the levamisole group and combination group
whereas in the antoxid group significant reduction was
observed only in serum IgA and IgM
RESULT
61. Levamisole can bring about clinical improvement and is
better than antoxid and the combination regimen. The
addition of antoxid to the treatment regimen does not seem
to have an added advantage over levamisole alone.
CONCLUSION