scholarly journals Comparative evaluation of efficacy of muscle relaxant, vasodilator and combined intralesional steroid with hyalaronidase use in oral submucous fibrosis

2021 ◽  
Vol 4 (3) ◽  
pp. 83-88
Author(s):  
Zafar Saleem ◽  
Shivesh Kumar ◽  
Amit Kumar Rana
Keyword(s):  
Muscle Relaxant ◽  
Oral Submucous Fibrosis ◽  
Treatment Protocol ◽  
Mouth Opening ◽  
Study Groups ◽  
Symptomatic Improvement ◽  
Intralesional Injection ◽  
Main Concern ◽  
Spicy Food ◽  
Group B

Oral Sub Mucous Fibrosis (OSMF) is a disease , which predominately occurs in Indians and South East Asians. It is characterised by mucosal rigidity of varying intensity due to fibroelastic changes of the juxta-epithelial layer, resulting in a progressive inability to open mouth. The main concern in the condition is the management of trismus and burning sensation of oral mucosa. this study was conducted to compare various medical treatment protocol of OSMF, so as to arrive at definitive and effective protocol for the management of OSMF. 105 patients of OSMF attending the ENT OPD and satisfying the criteria for inclusion were enrolled for the study. The subjects were randomly divided into age sex matched into three study groups( Dexa with hyaluronidase , Oral vasodilator, Muscle relaxant) in which the relief in symptoms was noted. Lycopene was given in all patients. Group A, patients were given intralesional injection Dexamethasone with Hyaluronidase biweekly for five weeks and marked improvement was seen in cases of pain with spicy food 13 cases (76.47%), followed by decreased in mouth opening 9 cases (56.25%). In Group B, oral vasodilator Tablet Pentoxifylline 400 mg TDS was given and showed improvement in difficulty in protruding tongue in 9 cases (60%), pain with spicy food 8 cases (50%), decreased mouth opening 6 cases (37.5%), oral ulceration 3 cases (42.85%). In Group C with muscle relaxant Tablet Myosone 50 mg BD showed improvement pain with spicy food 8 cases (42.10%), decreased mouth opening 8 cases (42.10), difficulty in swallowing 3 cases (37.5%). As there is still paramount of controversy regarding the ethology of OSMF there is no definite treatment protocol. Patients which received intralesional dexamethasone and hyaluronidase along with oral lycopene showed better clinical and symptomatic improvement in comparison to others groups, which at present appears to the best option for OSMF.

scholarly journals Oral submucous fibrosis: a study of qualitative and analytical treatment using intralesional injections: placental extract versus combination of steroid with hyaluronidase

2020 ◽  
Vol 6 (7) ◽  
pp. 1320
Author(s):  
Meena Vishwanath Kale ◽  
Ninad Subhash Gaikwad
Keyword(s):  
Symptomatic Relief ◽  
Oral Submucous Fibrosis ◽  
Mouth Opening ◽  
Definitive Treatment ◽  
Unknown Etiology ◽  
Intralesional Injection ◽  
Group A ◽  
Submucous Fibrosis ◽  
Group B ◽  
Placental Extract

<p class="abstract"><strong>Background:</strong> One of the premalignant conditions in oropharynx is oral submucous fibrosis (OSMF). It is a chronic debilitating condition of unknown etiology leading to fibrosis of mucosa affecting the oropharynx, esophagus and thus causes decreased mouth opening and dysphagia respectively. The disease is of multifactorial etiology with addictions, nutritional, micro elements and antioxidants deficiencies. In India males are more affected than females, due to their stress related excessive, irresponsible chewing habits. The available management is for symptomatic relief and at present there is no definitive treatment is available.</p><p class="abstract"><strong>Methods:</strong> We have studied 60 cases diagnosed with OSMF with mild to moderate restricted mouth opening. Most of patients were between 17 to 55 years of age selected by randomized clinical trial. Its management was divided into 2 groups where group A was treated with a combined intralesional regimen of injection triamcinolone 40mg and hyaluronidase 1500 IU, while group B was treated with injection of 2ml placental extract. Each group has given a single dose intralesional injection per week for six weeks.  </p><p class="abstract"><strong>Results:</strong> It was a comparative study of improvement in effectiveness on mouth opening and reduction in burning sensation of oral cavity seen in group A regimen than group B. Those having persistent trismus, needed surgery.</p><p class="abstract"><strong>Conclusions:</strong> No effective treatment available but along with intralesional injection can give symptomatic relief. In addition, cessation of habits, antioxidants oral hygiene helps in improvement of OSMF.</p>

scholarly journals Comparative study of intralesional injection of triamcinolone versus placental extract in cases of oral submucous fibrosis

2020 ◽  
Vol 6 (8) ◽  
pp. 1504
Author(s):  
Ankur N. Dhanani ◽  
Alpesh V. Patel ◽  
Vijay S. Laungani ◽  
Margi H. Patel ◽  
Pooja A. Sharma
Keyword(s):  
Symptomatic Relief ◽  
Oral Submucous Fibrosis ◽  
Mouth Opening ◽  
Burning Sensation ◽  
Intralesional Injection ◽  
Oral Ulceration ◽  
Therapeutic Modalities ◽  
Spicy Food ◽  
Submucous Fibrosis ◽  
Placental Extract

<p class="abstract"><strong>Background:</strong> Oral submucous fibrosis (OSMF) is a common premalignant condition caused by chewing arecanut, betel quid and gutkha with tobacco. One of the important therapeutic modalities is intralesional injection therapy. The most commonly used intralesional agents are placental extract, corticosteroids and hyaluronidase.</p><p class="abstract"><strong>Methods:</strong> Patients of OSMF (30) were randomly allocated and 15 patients were given 1 ml placental extract submucosally in each retromolar trigon weekly for 8 weeks and 15 patients were injected with 40 mg/ml of triamcinolone submucosally on each side weekly for 8 weeks. The mouth opening was measured as the inter-incisor distance by Vernier calliper at maximal active mouth opening by patient at initial visit and every follow up visit and recorded. Treatment outcome was evaluated on the basis of improvement in trismus, oral mucosal pattern and reduction in burning sensation.  </p><p class="abstract"><strong>Results:</strong> Out of 30 patients, 27 were males and 3 females. 16 patients (53.33%) were in the age group of 21-30 years. Most of patients in our study had complain of reduced mouth opening and inability to take spicy food which is 93.33% of cases followed by burning sensation in mouth 90%, oral ulceration 83.33%, dryness of mouth 30%, difficulty/pain in swallowing 13.33% and halitosis 2%. 60% of patients mouth opening was improved &gt;10 mm with triamcinolone while in placental extract 26.6%. Symptomatic relief were obtained more with injection placental extract.</p><p class="abstract"><strong>Conclusions:</strong> Triamcinolone injection has more improvement in mouth opening compared to placental extract. It was observed that injection placental extract gives good symptomatic relief in the major symptoms like burning sensation in mouth, inability to take spicy food, oral ulceration compared to injection triamcinolone.</p>

scholarly journals Comparative Study of Intralesional Dexamethasone Plus Hyaluronidase & Oral Colchicine in Patients with Oral Submucous Fibrosis

2018 ◽  
Vol 14 (2) ◽  
pp. 60-65
Author(s):  
Ganesh Prasad Neupane ◽  
Maya Rai ◽  
R. S. Rathore ◽  
V. K. Bhargava ◽  
A. K. Mahat ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Oral Mucosa ◽  
Oral Submucous Fibrosis ◽  
Mouth Opening ◽  
Study Groups ◽  
T Test ◽  
Significant Difference ◽  
Intralesional Injections ◽  
Submucous Fibrosis ◽  
Larger Sample

Introduction: Oral Submucous Fibrosis (OSMF) is a precancerous condition of the oral mucosa. It is characterized by excessive production of collagen leading to inelasticity of the oral mucosa and atrophic changes of the epithelium.Aim and objective: To evaluate the efficacy of oral Colchicine in comparison to intralesional injections of Dexamethasone plus Hyaluronidase in the management of OSMF patients.Materials and Methods: Fourty patients with OSMF were randomly divided equally into two groups. 20 patients in Dexamethasone group received biweekly intralesional injections of Dexamethasone (4mg/ml) plus Hyaluronidase 1500 IU in buccal mucosa for a period of 12 weeks. Other 20 patients in Colchicine group received oral Colchicine 0.5 mg tablets twice daily for 12 weeks. Parameters taken in the study were burning sensation, and mouth opening. Descriptive statistics, paired t test and unpaired t test were used for statistical analysis.Results and Conclusions: The pre- and post-treatment differences were found to be statistically significant for both the groups (p<0.001) and for both the treatment outcomes. When the average difference of the treatment outcomes was compared between the two study groups, statistically highly significant difference was noted (p <0.001) only in mouth opening but not in burning sensation.These encouraging results should prompt further clinical trials with Colchicine on a larger sample size to broaden the therapeutic usefulness of the drug in the management of OSMF. JNGMC,  Vol. 14 No. 2 December 2016, Page: 60-65

Comparison Of Collagen-Curcumin Blend (Collaper Rtu)With Intralesional Steroid Injections in Oral Submucous Fibrosis a Randomized, Open-Label Interventional Study.

2021 ◽  
Author(s):  
Bharat Kwatra ◽  
Manya Pahwa
Keyword(s):  
Oral Submucous Fibrosis ◽  
Mouth Opening ◽  
Burning Sensation ◽  
Current Therapy ◽  
Intralesional Injection ◽  
Complete Regression ◽  
Open Label ◽  
Tongue Protrusion ◽  
Interincisal Distance ◽  
Submucous Fibrosis

Abstract Introduction: Oral Submucous Fibrosis (OSMF) is a precancerous condition characterized by limited mouth opening, burning sensation, stiffness, and blanching of the oral mucosa induced by areca nut eating. With any of the current therapy regimens, complete regression of the illness has not been accomplished in all patients. Curcumin is a yellow pigment found in curry powder that has antioxidant, anti-inflammatory, and pro-apoptotic properties. As a result, interventional research was conducted to determine the efficacy of Collaper RTu a proprietary collagen-curcumin based product in patients with OSMF.Setting and design: Forty patients with clinically and histologically confirmed Oral Submucous Fibrosis participated in a randomized open label interventional research. Method & materials: For the research, forty patients with clinically and histologically verified Oral Submucous Fibrosis were randomly assigned to one of two groups. The first group was given a weekly intralesional injection of 4 mg Dexamethasone and 1500 I.U Hyaluronidase, whereas the second was given two Collagen-Curcumin pills (Collaper Rtu 60mg Collagen with 100 mg Curcumin) every day for three months. On a weekly basis, the improvement of burning sensation, interincisal distance, and tongue protrusion was assessed.Results: From early to late stages, the burning feeling improved in both groups. Collaper Rtu was found to eliminate the burning feeling. In groups 1 and 2, the mean increase in interincisal distance was 3.13 mm and 1.25 mm, respectively. The interincisal distance improved significantly in both groups by the end of the first month. When compared to group 2, group 1's tongue protrusion recovered faster at the conclusion of the first month. Conclusion: Collaper RTu is useful and effective in lowering the burning feeling in people with early OSMF.

scholarly journals Effectiveness of Pentoxifylline Therapy for Management of Oral Submucous Fibrosis

2022 ◽  
Vol 19 (1) ◽  
pp. 51-54
Author(s):  
Dwarika Prasad Bajgai ◽  
Bela Agrawal ◽  
Abadhesh Yadav
Keyword(s):  
Oral Submucous Fibrosis ◽  
Mouth Opening ◽  
Burning Sensation ◽  
Oral Disease ◽  
Medical College ◽  
Adjacent Structures ◽  
Group A ◽  
Submucous Fibrosis ◽  
Group B

Introduction: Oral submucous fibrosis is a chronic oral disease characterized by progressive buildup of constricting collagen bands in the cheeks and adjacent structures of the mouth due to chewing of areca nut. This can severely restrict mouth opening and tongue movement causing pain and burning sensation in the mouth. Aims: This study evaluates the efficacy of pentoxifylline in the management of oral submucous fibrosis. Methods: A hospital-based study, conducted in the dental outpatient department of Nepalgunj Medical College from October 2019 to September 2020. Forty-nine patients who were diagnosed histopathologically with oral submucous fibrosis were included. The patients were divided into two groups. In group A, patients were given, 200 mg thrice daily for first 30 days, then dose hiked to 400 mg thrice daily for two more months. Group B patients received treatment with multi-vitamin capsules (B-complex one capsule before sleep daily) for three months. All patients were followed up for six months and were assessed for maximum inter-incisor opening, pain on opening of mouth and burning sensation. Results: There was no statistical difference in mouth opening at baseline and first follow up. The mouth opening was significantly more in group A compared to group B from second follow up which persisted till third follow up (p <0.05). Pain and burning sensation significantly reduced in group A compared to group B from 2nd follow up which persisted till 3rd follow up (p <0.05). Few patients had nausea, dyspepsia and vomiting during treatment in group A which resolved within a few days without the need for cessation of the drug. Conclusion: Pentoxifylline can bring about significant clinical improvements in the symptoms of oral submucous fibrosis like mouth opening, pain and burning sensation, thereby improving the quality of life of the affected individuals.

scholarly journals Prevalence of OSMF cases in various age groups correlating with habits and treatment outcomes in Saveetha Dental College: A prevalence study

2020 ◽  
Vol 11 (SPL3) ◽  
pp. 1799-1804
Author(s):  
Aklesha Behera ◽  
Abilasha R ◽  
Pratibha Ramani ◽  
Gheena S ◽  
Hannah R
Keyword(s):  
Indian Subcontinent ◽  
Oral Submucous Fibrosis ◽  
Age Groups ◽  
Mouth Opening ◽  
Study Groups ◽  
Patient Records ◽  
Tobacco Products ◽  
Precancerous Condition ◽  
Male Preponderance ◽  
Submucous Fibrosis

Oral submucous fibrosis is a chronic, progressive, scarring precancerous condition of the oral cavity seen predominantly in the Indian subcontinent and southeast Asia. OSMF is caused by consumption of areca nuts and tobacco products. Patients suffer from trismus and other related problems. Interincisal mouth opening ranges between 24 to 55 mm in this study, hence making the study groups between I to III. The aim of the study is to find a correlation between age, habits and treatment outcome in OSMF patients. Data was procured from patient records of 86000 patients who visited from between June 2019 and March 2020 and analysis was done. Age is between 21 to 64 years. Male preponderance is seen 92.4% pan chewing is common (35.9%) Interincisal opening is between 24 to 55 mm, making the OSMF grade I and II. OSMF affects people aged 21 to 64 years and the interincisal mouth opening is between 24 to 55 mm, making the grades I and II.

scholarly journals Comparative study of rebamipide & betamethasone in managing stomatopyrosis in oral submucous fibrosis (OSMF) patients

2021 ◽  
Vol 7 (3) ◽  
pp. 157-160
Author(s):  
Md. Asdullah ◽  
Nasir A Salati ◽  
Masood H Khan ◽  
R K Tiwari ◽  
Pradhuman Verma ◽  
...  
Keyword(s):  
Indian Subcontinent ◽  
Oral Submucous Fibrosis ◽  
Age Groups ◽  
Mouth Opening ◽  
Standard Of Care ◽  
Burning Sensation ◽  
Intralesional Injection ◽  
Vas Score ◽  
Group I ◽  
Potentially Malignant

Oral sub mucous fibrosis (OSF) is commonly seen in the Indian subcontinent affecting individuals of all age groups. It is a potentially malignant disorder caused almost exclusively by the use of smokeless form of tobacco products. The malignant transformation rates vary from 3 to 19%. The standard of care (SOC) in managing OSF includes habit cessation, intralesional steroid and hyaluronidase injections, and mouth opening exercises. To evaluate the efficacy of rebamipide to reduce the oral burning sensation associated with OSMF as compared to coventional Betamethasone intralesional injection.After providing information about the study and obtaining consent, these individuals were divided into two groups of 15 each using random sampling method. Patients in the rebamipide group (group I) were prescribed 100 mg tablets of rebamipide thrice a day for 21 days. The other 15 patients (group II) were given SOC, intralesional betamethasone injection 4 mg/mL once a week for 4 weeks. Visual analog scale (VAS) with 11 points (0–10) was used to assess burning sensation in the first visit, and change in the burning sensation was assessed after every 7th day on VAS in both the groups.: The improvement in the VAS score in each visit was significant (p &#60; 0.05) in the 1st, 2nd, 3rd, and 4th visit. The VAS score between the 4th and 5th visit failed to reach a statistically significant level (p &#62; 0.05). The VAS score was significantly different between the rebamipide and betamethasone group (p &#62; 0.05) in third & fourth visit. Our results showed that rebamipide was equally efficacious if not better than the betamethasone intralesional injections.

scholarly journals Quality of Life in Oral Submucous Fibrosis- A Case Report with a Literature Review

2021 ◽  
Vol 15 (1) ◽  
pp. 4-10
Author(s):  
Shishir Ram Shetty ◽  
Sesha Reddy ◽  
Pooja Narain Adtani ◽  
Raghavendra Shetty ◽  
Ashwin Lakshminarayanan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Oral Submucous Fibrosis ◽  
Mouth Opening ◽  
Specific Questionnaire ◽  
Spicy Food ◽  
Potentially Malignant ◽  
Submucous Fibrosis ◽  
Published Research

Introduction: Oral Submucous Fibrosis (OSMF) is a potentially malignant disorder commonly found in the Southeast Asian region, classically characterized through restricted mouth opening and burning sensation in the mouth on consuming spicy food. The etiopathogenesis and treatment aspects of OSMF have been extensively researched and reviewed. However, the effect of this condition on the Quality of Life (QoL) of patients has not gained much consideration. The aim of our case report is to highlight the importance of evaluating the QoL in an OSMF patient by using discipline-specific questionnaire and also to present to the readers a review of the recently published research articles on the application of QoL questionnaires in OSMF patients. Results: It was observed that most of the researchers used generic and discipline-specific questionnaire for evaluating the quality of life in OSMF patients. Conclusion: Evaluation of QoL is recommended during the treatment of OSMF patients. There is a need to develop and employ more of disease-specific QoL instruments for OSMF patients.

scholarly journals Comparative study of rebamipide & betamethasone in managing stomatopyrosis in oral submucous fibrosis (OSMF) patients

2021 ◽  
Vol 7 (3) ◽  
pp. 157-160
Author(s):  
Md. Asdullah ◽  
Nasir A Salati ◽  
Masood H Khan ◽  
R K Tiwari ◽  
Pradhuman Verma ◽  
...  
Keyword(s):  
Indian Subcontinent ◽  
Oral Submucous Fibrosis ◽  
Age Groups ◽  
Mouth Opening ◽  
Standard Of Care ◽  
Burning Sensation ◽  
Intralesional Injection ◽  
Vas Score ◽  
Group I ◽  
Potentially Malignant

Oral sub mucous fibrosis (OSF) is commonly seen in the Indian subcontinent affecting individuals of all age groups. It is a potentially malignant disorder caused almost exclusively by the use of smokeless form of tobacco products. The malignant transformation rates vary from 3 to 19%. The standard of care (SOC) in managing OSF includes habit cessation, intralesional steroid and hyaluronidase injections, and mouth opening exercises. To evaluate the efficacy of rebamipide to reduce the oral burning sensation associated with OSMF as compared to coventional Betamethasone intralesional injection.After providing information about the study and obtaining consent, these individuals were divided into two groups of 15 each using random sampling method. Patients in the rebamipide group (group I) were prescribed 100 mg tablets of rebamipide thrice a day for 21 days. The other 15 patients (group II) were given SOC, intralesional betamethasone injection 4 mg/mL once a week for 4 weeks. Visual analog scale (VAS) with 11 points (0–10) was used to assess burning sensation in the first visit, and change in the burning sensation was assessed after every 7th day on VAS in both the groups.: The improvement in the VAS score in each visit was significant (p &#60; 0.05) in the 1st, 2nd, 3rd, and 4th visit. The VAS score between the 4th and 5th visit failed to reach a statistically significant level (p &#62; 0.05). The VAS score was significantly different between the rebamipide and betamethasone group (p &#62; 0.05) in third & fourth visit. Our results showed that rebamipide was equally efficacious if not better than the betamethasone intralesional injections.

scholarly journals MANAGEMENT OF ASRIGDARA WITH DRAKSHADI YOGA AND KUTAJASHTAKA GHANA WITH SPECIAL REFERENCE TO DYSFUNCTIONAL UTERINE BLEEDING: A COMPARATIVE CLINICAL STUDY

2021 ◽  
Vol 09 (1) ◽  
pp. 73-80
Author(s):  
Meemansa 1 ◽  
Manish Kumar Saini ◽  
Sushila Sharma
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Symptomatic Improvement ◽  
Uterine Bleeding ◽  
Main Concern ◽  
Dysfunctional Uterine Bleeding ◽  
Average Percentage ◽  
Prolonged Duration ◽  
Comparative Clinical Study ◽  
Group A ◽  
Group B

Introduction: Asrigdara is of more concern, because excessive or prolonged bleeding may cause undue disruption of woman’s daily activities & affects woman's health both physically and psychologically. As per Ayurveda classics, Asrigdara is defined as excessive menstrual bleeding for prolonged duration and / or scanty intermenstrual bleeding for a shorter duration, denoting the features of specific Dosha. Asrigdara can be correlated with abnormal uterine bleeding especially dysfunctional uterine bleeding on the basis of its description in literature. Thus, according to its pathogenesis Pittashamaka, Vatanulomana, Rakta-sthapaka, Rakta-samgrahi, Agni-deepana and Garbhashaya-balya Chikitsa is beneficial in Asrigdara. Though the main concern is to reduce bleeding, hence Rakta Sthapana chikitsa becomes important. Acharaya Charaka said it to be treated on the principles of management of Raktatisara, Raktapitta and Rakta arsha. Aim & Objectives: To compare the efficacy of Drakshadi Yoga and Kutajashtaka Ghana in management of Asrigdara. Materials & Methods: Study was conducted on clinically diagnosed 30 patients of Asrigdara in P.G. department of Prasuti Tantra and Stri Roga, N.I.A., Jaipur. Drakshadi yoga was taken in this study from Sushruta Samhita Uttar Tantra 45/34 in reference to Raktapitta chikitsa. Kutajashtaka ghana (Chakradutta 3/86-89) was taken from Chakradutta from Atisaar Chikitsa, having indication in asrigdara. Result: Comparing the symptomatic improvement in both groups it was found that average percentage of relief was a little bit higher in ‘Group B’ Kutajashtaka Ghana i.e. 74.79 %, followed by ‘Group A’ Drakshadi Yoga i.e. 74.21 %. Keywords: Kutajashtaka Ghana, Drakshadi Yoga, Raktapitta chikitsa, Atisaar Chikitsa

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