Effectiveness of Pentoxifylline Therapy for Management of Oral Submucous Fibrosis

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.

Download Full-text

Tulasi a magical herb and a boon for management of oral submucous fibrosis: a clinical study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20174644 ◽

2017 ◽

Vol 5 (11) ◽

pp. 4719 ◽

Cited By ~ 1

Author(s):

G. Madhulatha ◽

N. Vijayalaxmi ◽

T. Harshavardhan

Keyword(s):

Oral Submucous Fibrosis ◽

Mouth Opening ◽

Modern Medicine ◽

Burning Sensation ◽

Rank Test ◽

P Value ◽

Signed Rank ◽

Signed Rank Test ◽

Submucous Fibrosis

Background: Plants are a good source of drugs in traditional and modern medicine. One among these plants is “tulasi” The queen of herbs” which is used in ayurveda for its diverse properties like antioxidant, analgesic, anti-inflammatory, antidiabetic, and others. It belongs to labiate family and is the most sacred and valued in traditional culture of India. AIMS of the study was to evaluate the efficacy of Tulasi in the treatment of OSMF.Methods: The study included 20 individuals, females and males of age group 20-50yrs who visited the outpatient department who were diagnosed clinically as having OSMF, categorized according to pindborg’s classification. Patients were asked to apply 500mg of Tulasi medicine paste (Tulasi powder mixed with glycerine) twice daily for 1month and were recalled for follow up every week for 1month. All the clinical parameters - mouth opening, burning sensation, pain with the lesion and others were evaluated and recorded in specially designed proforma.Results: Friedman test and wilcoxon signed rank test was used for statistical evaluation. Significant improvement with P value <0.05 was noticed in burning sensation, mouth opening and pain associated with the lesion.Conclusions: The study concludes that Tulasi can be used as a main treatment modality in the management of patients with OSMF.

Download Full-text

Role of Laser Biostimulation in Treatment of Oral Submucous Fibrosis: A Clinical Trial

International Healthcare Research Journal ◽

10.26440/ihrj/01_07/118 ◽

2017 ◽

Vol 1 (7) ◽

pp. 22-26 ◽

Cited By ~ 1

Author(s):

Kesari Singh ◽

Achint Garg ◽

Mayank Jain ◽

Mansimranjit Kaur Uppal

Keyword(s):

Oral Submucous Fibrosis ◽

Mouth Opening ◽

Burning Sensation ◽

Low Level Laser Therapy ◽

Entire Study ◽

Level Laser ◽

Significant Difference ◽

Study Population ◽

Submucous Fibrosis

AIM: To evaluate the efficacy of Low Level Laser Therapy (LLLT) in treatment of Oral Submucous Fibrosis (OSMF).MATERIAL & METHODS: 20 patients with a clinical diagnosis of OSMF were included in the study after informed consents and measurements of mouth opening (mm) and burning sensation (VAS) were made at day 0. Laser biostimulation was performed on right and left cheeks in anterior and posterior bands for 3 cycles of 10 seconds each. They were recalled for follow-up measurements and Laser biostimulation at 3rd, 7th and 15th day. The paired t-test was applied for analysing significant differences, if any, using SPSS version 21.0.RESULTS: In the follow up recordings, generally, there was an increase in mouth opening after LLLT therapy and a significant difference was seen in males(p=.04) as well as the total population(p=0.02). Burning sensation(VAS Scale), on day zero was 5.5±1.20, which was reduced to 3.4±.084 on the 15th day with a significant difference seen in the entire study population(p=0.03).CONCLUSION: Biostimulation by Laser in the treatment of OSMF is a good non-invasive, painless and quick alternative treatment modality for the management of diseases.

Download Full-text

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

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20202786 ◽

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

Background: 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.Methods: 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. Results: 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.Conclusions: 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.

Download Full-text

Comparative Study of Intralesional Triamcinolone Acetonide and Hyaluronidase vs Placental Extract in 60 Cases of Oral Submucous Fibrosis

International Journal of Head and Neck Surgery ◽

10.5005/jp-journals-10001-1096 ◽

2012 ◽

Vol 3 (2) ◽

pp. 59-65 ◽

Cited By ~ 1

Author(s):

Sudhir Naik ◽

Sarika S Naik ◽

S Ravishankara ◽

Mohan K Appaji ◽

MK Goutham ◽

...

Keyword(s):

Comparative Study ◽

Medical Treatment ◽

Triamcinolone Acetonide ◽

Oral Submucous Fibrosis ◽

Burning Sensation ◽

Mucosal Pattern ◽

Group A ◽

Submucous Fibrosis ◽

Group B ◽

Placental Extract

ABSTRACT Background Oral submucous fibrosis (OSMF) is a common premalignant condition caused by chewing arecanut, betel quid and gutkha with tobacco. Its medical treatment is not yet fully standardized, although the optimal doses of its medical treatment is in the form of triamcinolone acetonide combined with hyaluronidase or intralesional placental extract. Objectives We compared the efficacy of intralesional triamcinolone acetonide combined with hyaluronidase in group A vs placental extract in group B. Design Comparative case series analysis series study with random allocation of 60 patients equally into two groups. Materials and methods Patients of OSMF (60) were randomly allocated into two groups A and B. Group A (n = 30) patients received combination of triamcinolone acetonide (10 mg/ml) + hyaluronidase (1,500 IU) at weekly intervals for 8 weeks. Group B (n = 30) patients received 2 ml of placentrex injection intralesionally at weekly interval for 8 weeks. Treatment outcome was evaluated on the basis of improvement in trismus, oral mucosal pattern and reduction in burning sensation. Results Trismus improvements in group A with combination of triamcinolone acetonide + hyaluronidase were significantly better to that in group B where placentrex was used. No significant difference in results in the two groups were observed as far as improvement in oral mucosal pattern and burning sensation were compared in the two groups. Conclusion Combination of triamcinolone acetonide and hyaluronidase intralesionally is more effective than placental extract intralesionally in treatment of OSMF. But placental extract injections are cost-effective. No side effects were seen in both study groups. How to cite this article Naik SM, Appaji MK, Ravishankara S, Goutham MK, Devi NP, Mushannavar AS, Naik SS. Comparative Study of Intralesional Triamcinolone Acetonide and Hyaluronidase vs Placental Extract in 60 Cases of Oral Submucous Fibrosis. Int J Head Neck Surg 2012;3(2):59-65.

Download Full-text

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

10.21203/rs.3.rs-1214976/v1 ◽

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.

Download Full-text

Comparative Study of Surgical Treatment of Chalazion

Faridpur Medical College Journal ◽

10.3329/fmcj.v9i2.25676 ◽

2015 ◽

Vol 9 (2) ◽

pp. 68-69

Author(s):

Khandaker Anowar Hossain ◽

Md Abdur Rashid ◽

AKM Rafiqul Islam

Keyword(s):

Inflammatory Lesion ◽

Skin Surface ◽

Meibomian Gland ◽

Medical College ◽

Large Size ◽

Intralesional Steroid ◽

Intralesional Steroid Injection ◽

Group A ◽

Group B

A chalazion is chronic lipogranulomatous inflammatory lesion caused by blockage of meibomian gland orifices & stagnation of sebaceous secretion. Common practices in treatment of chalazion are intralesional steroid injection, incision & curettage and excision of chalazion. Recurrence rate is high for incision & curettage in case of large chalazion. The aim of the study is to established that excision large chalazion give better result than incision & curettage. The study was carried out at Diabetic Association Medical College & Hospital, Faridpur and General Hospital, Fadidpur. A total 100 cases were selected for study. Technique of operation were incision & curettage through conjunctival surface and excision of chalazion through skin surface. In 50 % cases we performed incision & curettage both in small (size <5mm) and large (size >5mm) chalazion. In 50 % cases of large chalazion we performed excision of chalazion. The follow up period was 3 months to 6 months. In group -A with incision & curettage through conjunctival surface, in case of small chalazion 27 out of 30 patients were cured (90%). In case of large chalazion 14 out of 20 patients were cured (70%). In group B with excision of chalazion through skin surface, in case of large chalazion 49 out of 50 patients were cured (98%). So higher success rate after excision of large chalazion through skin surface.Faridpur Med. Coll. J. 2014;9(2): 68-69

Download Full-text

Hearing Efficiency in Oral Submucous Fibrosis: A Clinical Study

Indian Journal of Otolaryngology and Head & Neck Surgery ◽

10.1007/s12070-020-02246-5 ◽

2020 ◽

Author(s):

J. S. Shah ◽

Nutan Lunagariya

Keyword(s):

Oral Mucosa ◽

Conductive Hearing Loss ◽

Oral Submucous Fibrosis ◽

Hearing Threshold ◽

Mouth Opening ◽

Burning Sensation ◽

Areca Nut ◽

Gradual Reduction ◽

Submucous Fibrosis ◽

Conductive Hearing

Abstract Oral Submucous fibrosis (OSMF) is a chronic insidious disease of oral mucosa that occurs due to areca-nut chewing, consumption of chillies, autoimmunity and genetic predisposition. The disease starts with burning sensation and inability to tolerate spicy foods with gradual reduction in mouth opening due to fibrosis of the oral mucosa. The extension of fibrosis into the naso pharynx leads to reduction in hearing efficiency. As very few studies had been done to evaluate the hearing disability in OSMF patients, this study had been undertaken to prove the same. To evaluate hearing efficiency in patients with Oral Submucous Fibrosis of various grades of severity. Presentation includes 30 patients of osmf with various grades and evaluated for hearing efficacy by audiometry. Hearing threshold was compared in different grades of osmf. The present study revealed a significant association between OSMF and hearing deficit. Involvement of the palatal muscles with OSMF may decrease the patency of the Eustachian tube, leading to conductive hearing loss. Therefore, the protocol for managing OSMF patients should include ENT consultation and treatment for hearing deficit in order to increase the success rate of treatment.

Download Full-text

A Comparative Study on Efficacy of Polymyxin B, Neomycin and Polymyxin B, Neomycin, Hydrocortisone in the Treatment of Otitis Externa at Nepal Medical College and Teaching Hospital, Kathmandu

Birat Journal of Health Sciences ◽

10.3126/bjhs.v2i2.18516 ◽

2017 ◽

Vol 2 (2) ◽

pp. 162-167

Author(s):

Mayuri Gupta ◽

S Aryal

Keyword(s):

Teaching Hospital ◽

Otitis Externa ◽

Clinical Signs ◽

Polymyxin B ◽

Medical College ◽

Significant Difference ◽

Group A ◽

Group B ◽

Cure Rates

IntroductionAcute otitis externa (AOE) is a common but preventable ear condition. Tenderness with movement of the tragus or pinna is a classic feature of otitis Externa. Polymyxin B, neomycin, hydrocortisone preparations are the choice for first-line therapy when the tympanic membrane is intact. This study atiempted to compare the efficacy of polymyxin B, neomycin and polymyxin B, neomycin, hydrocortisone in the treatment of otitis Externa.ObjectiveTo compare the efficacy of polymyxin B, neomycin and polymyxin B, neomycin, hydrocortisone in the treatment of otitis Externa.MethodologyTo evaluate the efficacy of polymyxin B, neomycin and polymyxin B, neomycin, hydrocortisone in the treatment of otitis Externa, a hospital based, randomized, prospective study was conducted in Nepal Medical College and Teaching Hospital (NMCTH), Atiarkhel, Kathmandu from August 2012 to May 2014. 70 outpatients suffering from otitis Externa who met the inclusion and exclusion criteria were included. Patients were randomized into group A and group B with lotiery system. Odd number patients were included in group A and even number patients in group B. Group A patients received pack soaked with ribbon gauge in polymyxin B, neomycin ointment and Group B patients received pack soaked with ribbon gauge in polymyxin B, neomycin, hydrocortisone ointment. The patients were called for follow up after 48 hours and 96 hours to assess the improvement on the basis of tragal and circumduction tenderness either present or absent (present 1 or absent 2). A decrease in the clinical signs and symptoms (i.e. tragal and circumduc_on tenderness) was noted. Absence of pain was considered as clinically cured.ResultsIn comparison to polymyxin B, neomycin group, hydrocortisone group exhibited statistically significant effectiveness after 48 hours of treatment (p<0.05), but in cure rates after 96 hours, no statistical significant difference was observed between two groups (p>0.05).ConclusionPolymyxin B, neomycin, hydrocortisone group showed higher and faster cure rates than polymyxin B, neomycin group in the treatment of otitis Externa at 48 hours follow up. Birat Journal of Health SciencesVol.2/No.1/Issue 2/ Jan - April 2017, Page: 162-167

Download Full-text

EFFICACY OF ANTIOXIDANT WITH ALOE VERA GEL VERSUS INTRA-LESIONAL STEROIDS IN THE MANAGEMENT OF ORAL SUBMUCOUS FIBROSIS - A PROSPECTIVE COMPARATIVE STUDY

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71isuppl-3.7921 ◽

2021 ◽

Vol 71 (Suppl-3) ◽

pp. S526-29

Author(s):

Muhammad Tahir ◽

Asim Abbas ◽

Faiz Ul Hassan Nawaz ◽

Mohsin Raza ◽

Atif Rafique ◽

...

Keyword(s):

Comparative Study ◽

Lipoic Acid ◽

Oral Submucous Fibrosis ◽

Aloe Vera ◽

Mouth Opening ◽

Burning Sensation ◽

Alpha Lipoic Acid ◽

Aloe Vera Gel ◽

Prospective Comparative Study ◽

Submucous Fibrosis

Objective: To compared efficacy of alpha lipoic acid (antioxidant medication) and aloe vera gel together versus intralesional steroids (hydrocortisone) in management of oral submucous fibrosis by evaluating post treatment clinical features of mouth opening and burning sensation. Study Design: A prospective comparative study. Place and Duration of Study: Department of ENT, Combined Military Hospital, Malir Karachi, from Jul 2018 to Mar 2020. Methodology: Twenty-eight patients were involved in the research and were distributed into two groups, I and II. Alpha lipoid acid with aloe vera gel was given in group I and hydrocortisone was given in group II. Burning sensation and mouth opening were recorded both at start and at monthly interval later on for three consecutive months. The data collected were statistically analyzed by using SPSS-22. Results: A significant lessening in burning sensation (p<0.001) and improvement in mouth opening were noticed in both groups. However, comparison between alpha lipoic acid with aloe vera gel group versus hydrocortisone group showed almost similar results. Conclusion: Alpha lipoic acid and aloe vera gel can significantly improve oral submucous fibrosis clinically. So, these can be utilized as an alternative option in cases where intralesional steroid is poorly tolerated or is contraindicated.

Download Full-text

DACRYOCYSTORHINOSTOMY

The Professional Medical Journal ◽

10.29309/tpmj/2008.15.01.2701 ◽

2008 ◽

Vol 15 (01) ◽

pp. 81-86

Author(s):

MUHAMMAD NAWAZ ◽

MUHAMMAD SULTAN ◽

QAISAR HANIF ◽

Muhammad Sadiq

Keyword(s):

Symptomatic Relief ◽

Cost Effective ◽

Medical College ◽

Chronic Dacryocystitis ◽

Department Of Ophthalmology ◽

Silicon Tube ◽

Group A ◽

Group B ◽

Study Setting

Purpose: To compare the results of standard dacryocystorhinostomy with the results ofdacryocystorhinostomy done with silicon tube stentting of the lacrimal canaliculi. Study design: This is a hospitalbased, prospective, comparative and interventional study. Setting: Department of Ophthalmology, Allied HospitalPunjab Medical College Faisalabad. Period: January 2006 to December 2006. Methods: Twenty seven patients ofchronic dacryocystitis fulfilling the inclusion criteria were selected and divided in two groups. Group A consisted of 15patients who underwent standard dacryocystorhinostomy and Group B consisted of 12 patients who underwentdacryocystorhinostomy along with intubation of the lacrimal canaliculi with silastic tubes. All the patients were followedup for at least six months post-operatively. Success of the procedure, defined as the symptomatic relief of epiphoraand infection was assessed at the end of follow-up period. Results: Of the total 27 patients of chronic dacryocystitis23 (85%) were female and 4(15%) were male. The mean age of the patients was 45 years. The success of theprocedure was recorded in 14 (93.33%) patients in group-A and in 10 (83.33%) patients in group B. Quite a few andsimple complications were recorded during the study period. Conclusions: 1. Standard externaldacryocystorhinostomy is a simple and cost effective procedure forthe management of chronic dacryocystitis. 2. Silicontube stentting of the lacrimal canaliculi does not have any extra advantage in the management of chronic dacryocystitiswithout canalicular obstruction.

Download Full-text