scholarly journals Effect of Povidone Iodine Versus Chlorhexidine Mouthwash on Oral Mucositis among Cancer Patients

Author(s):  
. Jyothi ◽  
S Latha ◽  
K Pavithra ◽  
M Nalini ◽  
Sowmya J Rao ◽  
...  

Introduction: Radiation therapy and chemotherapy are the standard treatment given for cancer, which leads to the variety of adverse effects of which Oral Mucositis (OM) is one of the common side-effects. It is responsible for patient discomfort and decreases their level of functioning. Both Chlorhexidine and Povidone Iodine have got antimicrobial and antifungal activity which decreases the severity of mucositis. Aim: To compare the effectiveness of Povidone Iodine and Chlorhexidine mouthwash on OM among cancer patients undergoing radiation therapy or chemotherapy. Materials and Methods: A prospective observational study was conducted in the tertiary care hospital of Mangaluru, Karnataka, India for the duration of one year and three months from December 2015-March 2017. Fifty cancer subjects aged between 25 to 65 years and who developed OM after radiation therapy or chemotherapy were selected by purposive sampling technique. Data were collected using the demographic profile, clinical proforma and World Health Organisation (WHO) OM grading scale (2004) from 19.09.2016 to 17.12.2016. Experimental group I received 10 mL of diluted Povidone Iodine mouthwash and group II received 10 mL of diluted chlorhexidine mouthwash. Level of OM in the group I and group II were assessed on the 1st, 3rd, 5th and 7th day using WHO OM grading scale (2004). The data were analysed by descriptive and inferential statistics (Wilcoxon signed- rank test, Mann-Whitney U test, Repeated measures ANOVA) using SPSS version 16.0. Results: Among the 50 cancer subjects, majority 30 (60%) were in the age group between 55-64 years and majority 35 (70%) were receiving radiation therapy. On day seven, in the group I (Povidone Iodine) majority 14 (56%) subjects had mild level of mucositis whereas in the group II (Chlorhexidine) majority 14 (56%) subjects had moderate mucositis. Comparison of the effect of Povidone Iodine and Chlorhexidine mouthwash using Friedman’s ANOVA showed that there was a difference in the level of mucositis (p<0.05) at 5% level of significance among two groups. The study findings also revealed a difference in the level of mucositis between day 1 to day 3, 5 and 7 (Mann-Whitney U test) (p<0.05) in both the groups. Conclusion: Povidone Iodine mouth wash was more effective than Chlorhexidine mouthwashes in reducing OM, and the patients were more comfortable after the use of the mouthwash.

Background: Breast Cancer is one of the leading causes of death worldwide. Pakistan alone has the highest rate of Breast Cancer than any other Asian country as approximately 90000 new cases are diagnosed every year out of which 40000 dies. Obesity is also a critical public health problem growing with every passing year in Pakistan and worldwide. Research studies are being conducted worldwide regarding the relation between the two problems. Objective: The objective of this study is to determine the prevalence of obesity in breast cancer patients in a tertiary care hospital in Karachi, Pakistan. Methods: BMI is used as a screening tool for overweight and obesity. According to World Health Organization, a body mass index (BMI) over 25 is considered overweight, and over 30 is obese. A retrospective analysis of 262 patients diagnosed with Breast Cancer during 2019 and 2020 was performed. Patients’ hospital records in Oncology were reviewed. The weight in kilograms and height in centimeters of patients were reviewed. Their BMI was calculated and recorded using the SPSS system. Results: The median BMI was 28.25 kg/m2 with an interquartile range of 25.15 - 31.99 kg/m2. Nearly 80% of the study participants had body mass index higher than normal levels (n=203, 77.5%) and out of them approximately half were overweight (n=104, 51.2%) and the remaining were obese (n=99, 48.7%). Conclusion: We conclude from our study that body mass index is positively correlated with breast cancer occurrence and thus the proportion of females having BMI >= 25 was significantly higher among patients.


2018 ◽  
Vol 41 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Madhabi Baidya ◽  
Mahfuza Shirin ◽  
Liton Chandra Saha

Background: Adequate neonatal transport is a key component of care of the sick newborns who require referral to tertiary care center. Poor transportation is one of the iatrogenic factors associated with greater neonatal mortality. Neonatal transport is the greatest challenge faced today in our country. The purpose of this study was to find out characteristics of transport of referred neonates and to idention the factors that contribute to mortality.Methodology: This cross sectional study was conducted in Dhaka Shishu (Children) Hospital from June 2013 to November 2013. Both term and preterm neonates who were referred within first seven days of life were included and those with gross congenital abnormalities and left against medical advice were excluded from the study. After enrollment, data were collected using a structured questionnaire including birth details, interventions before transportation, reasons for referral, and details of transportation. Outcome & duration of hospital stay were also recorded. Neonates who were expired considered as group I and who were survived considered as group II. The study variables were analyzed for their association with immediate outcome by applying chi square test and t test. P value <0.05 was considered significant.Results: This study found that out of 332 neonates 181 were expired with 54.5% mortality rate. One eighty one neonates who were expired, considered as group I and one fifty one neonate were survived, considered as group II. The mortality was significantly high in male neonates [RR 0.80 (0.66-0.97)] and neonates those delivered at home [RR 1.34(1.10-1.64)] (p<0.05). Perinatal asphyxia, pre-term low birth weight, neonatal sepsis were the main causes of referral. It was found that transportation without any referral note [RR 1.40 (1.14- 1.71)], no advice regarding maintenance of airway[RR 1.50(1.17- 1.92)]and keeping warm [RR 1.51(1.17-1.950], resuscitation on admission [RR 1.63(1.23-2.17)] and transportation required > 3hours [RR 1.36(1.09-1.69)] were associated with significantly higher mortality among referred transported neonates(p<0.05).Conclusions: This study found that male neonates, home delivery, transportation without any referral note, no advice regarding maintenance of airway and keeping warm, resuscitation needed on admission and prolonged transportation time were significantly associated with mortality of referred transported neonates.Bangladesh J Child Health 2017; VOL 41 (3) :159-164


2015 ◽  
Vol 13 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Sundari Joshi ◽  
Megha Pradhan Pradhan ◽  
Ujjwal Joshi

Introduction: Anaemia is a pathologic deficiency in oxygen-carrying haemoglobin in red blood cells which may be the result of genetic diseases, infections and deficiency of several nutrients. Nepal is one of the developing countries where anaemia is one of the most serious public health problems. So, a study was planned to evaluate the prevalence of anaemia among children under five years in tertiary care hospital of Nepal. Methods: A cross-sectional study was carried out from August 2011 to January 2012 using a structured questionnaire interview and observation. The children were divided into three groups: group I (0-1 years), group II (>1-3 years), group III (>3-5 years). Anaemia was assessed using  haemoglobin measurement in gram in decilitre on Sysmex KX -21 (automated haematology analyzer). The severity of anaemia were grouped as follows: severe anaemia, < 7.0 g/dL; moderate anaemia, 7.0 to 8.9 g/dL; and mild anaemia, 9.0 to 10.9 g/dL as per WHO classification. Stool test was also carried out to assess worm infestation. Data were analysed using SPSS 11.5. Results: There were 208 children among which 52.9 % were male while 47.10 % were female.  The overall prevalence of anaemia was found to be 49.5% of which 43.3% had mild, 15.8% had moderate and 0.5% had severe anaemia. Out of 20 children in group I, 70 % were anaemic. Among the 94 each in group II and group III, children suffering from anaemia were 51% and 43% respectively. The stool investigations showed that 5.3 % children suffered from worm infestations.   Conclusions: prevalence of anaemia was seen in 49.5% of children below five years age group and the diet and worm infestations didn’t affect it.doi:  http://dx.doi.org/10.3126/mjsbh.v13i1.12998


Author(s):  
Nachiket Madhukarrao Palaskar ◽  
Nitin Dinkar Chaudhari ◽  
Garima Laxminarayan Balpande ◽  
Swapna Subhash Khatu

<p class="abstract"><strong>Background:</strong> Female pattern hair loss (FPHL) is a common form of nonscarring hair loss. We compared the usefulness and safety of topical minoxidil alone with combination of oral spironolactone and topical minoxidil in the treatment of FPHL.</p><p class="abstract"><strong>Methods:</strong> This prospective, single-centre, randomised open label study over 100 patients attending tertiary care hospital in Mumbai during period December 2011 to June 2012. The data were entered into SPSS version 21 for analysis. Data collected were coded and described as frequency and percentage for qualitative data and means and standard deviation for quantitative data. Statistical analysis was done using chi-square and student t test. Statistical significance was considered if p value was less than 0.05.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 48 patients in Group I and 46 patients in Group II. At 6 months, significantly higher mean Sinclair grade was observed among Group I patients as compared to Group II patients (2.85±0.68 vs 2.56±0.50, p=0.02). We observed a significant improvement in women’s androgenetic alopecia quality of life questionnaire in Group I patients at 12 months after treatment (26.93±2.25 vs 23.47±2.95, p&lt;0.001). Minoxidil and spironolactone were tolerated well by the patients.</p><p class="abstract"><strong>Conclusions:</strong> Combination therapy of topical minoxidil and oral spironolactone has an additive effect. However, plateau of effectiveness of the combination therapy in normoandrogenic patients at 6 months of therapy was observed. We recommend the combination for 6 months and continuation of therapy with minoxidil only.</p>


Author(s):  
Laxman Verma ◽  
Pankaj Kumar Chaudhary ◽  
Chandresh Gupta ◽  
Umesh Saroj

Background: Nontraumatic musculoskeletal disorders are the main reason for presentation to the emergency department with Rachialgia being the most common reason to request medical assessment among them. Methods: This was a prospective, randomized, parallel group open labelled study conducted in a district level tertiary care hospital attached to a medical teaching institute. Patients were randomized into two groups. Group I (63 patients) received tablet tramadol 50 mg twice daily orally and group II (63 patients) received tablet tapentadol 50 mg twice daily orally.Results: The mean age of the patients of group I was 40.6±9.6 years and in the group II was 42.7±10.6 years. A total of 61 males participated in the study of which 31 males were enrolled in group I and 30 in group II while 65 females participated in the study of which 32 females were enrolled in group I and 33 in group II. The mean reduction of pain intensity VAS score at the end of 4 weeks from baseline in group I and group II were 34.57 and 37.55 respectively. The difference in the mean reduction of pain intensity VAS between the two groups was not statistically significant.Conclusions: We conclude that both the drugs show significant reduction in the pain intensity in moderate to severe CLBP patients. Tapentadol is as efficacious as tramadol in moderate to severe CLBP. However, tapentadol is better tolerated than tramadol.


Author(s):  
Rakesh Kumar ◽  
Haresh Kumar ◽  
Sarika Bai ◽  
Azra Shaheen ◽  
Safdar Ali Pervez ◽  
...  

Introdution: Cancer and depression, independently, cause massive human suffering worldwide. By the end of 2030 the unipolar major depression disorder could be as the chief source of ailment as estimated by World Health Organization. Objective: Objective of this study is to detect prevalence the frequency and severity of the depression in cancer patients presenting to tertiary care hospital of Karachi. Methodology: The current prospective cross-sectional research was performed over a period of six months from August 2020 to January 2021 on 179 patients in the Department of Oncology of Civil Hospital Karachi, after approval of synopsis from CPSP and the ethical committee of Civil Hospital. All patients who fulfilled the inclusion criteria and visited OPD of Civil hospital were selected in the study. Informed consent was taken after explaining the procedure, risks and benefits of the study.Patients were assessed clinically by using ICD-10 criteria and then for validity and reliability, patients were screened for presence of depression and its severity through PHQ-9.Patients scoring higher than 4 was labeled as having depression and PHQ-9 score of 5 to 9, 10 to 14, 15 to 19, 20-27 were labeled mild, moderate, moderately severe and severe depression correspondingly. Observed data was entered in the predesigned Performa was gathered and SPSS version 20.0 was used for data analysis. Mean ± SD of age was 47.75±14.901years. Out of 179 patients 95 (53.1%) were male and 84 (46.9%) were female. 93(52%) cancer patients were depressed while 86(48%) were normal. Patients suffering from mild depression were 3.2%, moderate depression were 54.85%, moderately severe depressed were 19.4%, while 22.6% cancer patients were severely depressed. It is to be concluded that out of 179cancer patients 93(52%) diagnosed to have depression while 86(48%) did not have depression. Based on our study findings, it is suggested that depression commonly presented in cancer patients and there is a need to screen all cancer patients for depressive disorder.


2021 ◽  
pp. 49-53
Author(s):  
Surabhi Gupta ◽  
Preeti Sharma

Introduction: Although labor is a natural physiological process characterized by progressive increase in frequency, intensity and duration of uterine contractions, resulting in effacement and dilatation of cervix, with descent of the fetus through the birth canal, this physiologic process many a time may lead to prolonged labor. The partograph developed by World Health Organization is the best-known partograph in the lowresource setting. Partograph when used with dened management protocol is an inexpensive tool which can effectively monitor labor and be helpful in reducing incidences of both maternal and fetal morbidity and mortality by reducing the number of operative interventions, prolonged labor, obstructed labor and caesarean section. Then WHO in 1994 endorsed the partogram and later modied in 2000 and removed latent phase and dened active phase at 4 centimetres instead of previously used 3 centimetres. WHO advocated its use as a necessary tool in management of labor and recommended its universal use during labor. Objective: To analyse the patterns of labor amongst spontaneous parturient using a WHO modied partogram and to compare outcome of labor and neonatal outcomes in relation to partogram ndings. Methods: This prospective study was carried over a period of 18 months on 100 parturients. Modied WHO Partogram was used to assess the progress of the labor. Parturients were divided on basis of partogram ndings. Group-I (n=64), where parturients partogram remained to the left of alert line, Group-II (n=20), where parturients partogram remained between the alert and action lines and Group-III (n=16), where parturients partogram crossed the action line. In these three groups, the maternal and fetal outcomes were assessed. Results: Normal vaginal delivery was done in 95.3% of Group-I, 80% of Group-II and 43.75% of Group-III parturients. Instrumental delivery was done in 1.56% of Group-I, 10% of Group-II and 18.75% of Group-III parturients. LSCS was done in 3.1% of Group-I, 10% of Group-II and 37.5% of Group-III parturients. Instrumental / LSCS deliveries were higher in Group-II and Group-III parturients. Alarge proportion of newborns of Group-II and Group-III parturients had Apgar Score <7. Conclusion: The Modied WHO partogram is very helpful in the prediction of maternal and fetal outcome. It is highly recommended for use in resource decient medical facilities, where early decision for delivery or referral can be taken on the basis of partogram ndings..


2021 ◽  
Vol 8 (3) ◽  
pp. 146-153
Author(s):  
Sunil Arya ◽  
◽  
Chetan Panwar ◽  
Jyoti Prajapati ◽  
◽  
...  

Introduction: Neonatal Hyperbilirubinemia is the most common abnormal physical finding and themajor cause of neonatal morbidity during the early neonatal period. Early identification of infants atrisk might help in providing preventative therapy and follow-up. We aimed to assess whether arterialumbilical cord albumin level at birth predicts the development of neonatal hyperbilirubinemia in termnewborns at 48 hrs of life. Methods: This prospective observational cohort study was conducted ina tertiary care hospital over 1 year in 200 term healthy neonates. Cord blood albumin was estimatedat birth followed by serum bilirubin level on the 3rd postnatal day(48 hrs of age). Results: Total of200 neonates were divided into three groups based on cord blood albumin level of <2.8 g/dl(groupI), 2.8-3.4 g/dl(group II) and >3.4 g/dl(groupIII) with 32, 100 and 68 in three respective groups.19 newborns (59.4%) in group I,14 in group II, and 7 newborns (10.3%) in group III developedserum bilirubin levels above an intermediate high-risk zone in Bhutani nomogram at 48 hrs of age.newborn with low cord albumin (<2.8g/dl) were significantly associated with higher bilirubin levelsat 48 hrs of age. Conclusion: Neonates with cord blood albumin <2.8 gm/dl had a significantassociation of the development of hyperbilirubinemia at or above intermediate high-risk zoneaccording to Bhutani nomogram at 48 hrs of life.


2020 ◽  
Vol 10 (2) ◽  
pp. 92-96
Author(s):  
Farzana Islam Bithi ◽  
TA Chowdhury ◽  
Ferdousi Begum ◽  
Farhana Sharmin Emu

Background: Thyroid hormones have profound effects on reproduction and pregnancy. A relationship betweenthe thyroid gland and the gonads is suggested by the far more frequent occurrence of thyroid disorders inwomen. Hormonal disorders of female reproductive system are comprised of a number of problems resultingfrom dysfunction of hypo-thalamic-pituitary ovarian axis. These relatively common disorders often lead toinfertility. Concomitant Diabetes and other metabolic abnormalities or endocrinopathy flare up the condition.This study was conducted to find out any difference in thyroid function among diabetic and non-diabeticpatient presenting with primary infertility. Methods: In this study total 174 patients were included and allocated into two groups, 87 in each group.Group I were diabetic infertile women and group II were non diabetic infertile women. Thyroid hormoneprofile were done and compared between groups. The data were based on the answers came from interviewsand medical records registered in the OPD follow up, investigation report, treatment paper and notes inhospital file sheet. Data processing work was consisted of registration schedules, editing computerization,preparation of dummy table, analyzing and matching of data. Results: No difference was observed in respect of demographic profile. It was observed that, majority ofpatients 73(41.9%) belonged to age 26-33 years, mean age was found 26.3±10.9 years in Group-I and 26.7±11.6years in Group-II. Low T3 was found in 15(17.2%) patients and in 9(10.3%) patients group I and group IIrespectively. Mean FT4 was found 8.25±1.5 pmol/L in group I and 10.57±1.82 pmol/L in group II. Raised TSHwas found in 23(26.4%) patients and 13(14.9%) patients in group I and group II respectively. On interpretationof thyroid function test, 71.8% (125/174) patients had normal finding or in euthyroid status (64.3% in group Iand 79.3% in group II). Present study shows that, frequency of thyroid dysfunction was common in group-Ipatients than group-II (35.6% vs. 20.6%). primary hypothyroidism was predominant abnormality, noted15(17.2%) patients in group I and 9(10.3%) patients in group II patients. Conclusion: Hypothyroidism is the most common thyroid dysfunction found in infertile females and it ispredominant in diabetic infertile group. Hence assessment of thyroid function should be considered as animportant component in infertility work up of women. Birdem Med J 2020; 10(2): 92-96


2020 ◽  
Vol 42 (3) ◽  
pp. 32-37
Author(s):  
Binod Raut ◽  
Nimesh Paudel ◽  
Deepti Shrestha ◽  
Anant Bhosekar

Introduction Hyperlipidemia is one of the most contributing factors to coronary heart diseases. Statins have become standard medicine in clinical practice to reduce total cholesterol, low density lipoprotein and to increase high density lipoprotein cholesterol. This study is conducted to compare the effectiveness and safety of atorvastatin with rosuvastatin in hyperlipidemic patients. MethodsThis is a prospective observational study involving 150 patients conducted in the Department of Internal Medicine of Kathmandu Medical College and Teaching Hospital from July 2019 to March 2020. Patients newly diagnosed with hyperlipidemia were enrolled. Patients that were prescribed with 10 mg of atorvastatin and 5 mg of rosuvastatin by the treating physician once daily for 6 weeks were divided into two groups. Data was recorded in the customized proforma and the SPSS package version 20 was used for analysis. ResultsPatients that were prescribed with atorvastatin were put in group I and those prescribed with rosuvastatin were included in group II with 75 participants in each group. The mean age of the patients were 50.56± 10.08 years in group I and 52.45±10.20 years in group II with male to female ratio of 3:1. The mean BMI of group I was 25.36±1.74 and that of group II was 26.48±2.21 before therapy. There was a significant main effect of duration (F1,74=401.02, p<0.001) on the TG and TC levels (F1,74=1134.23, p<0.001) as well as (F1,74=614.99, p<0.001) on the LDL and HDL levels (F1,74=146.38, p<0.001). ConclusionRosuvastatin was significantly more effective than atorvastatin in reducing levels of TG, TC and LDL-C. Rosuvastatin also significantly increased the level of HDL.


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