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.

Radiation recall phenomenon after administration of the mRNA-1273 SARS-CoV-2 vaccine

Several types of SARS-CoV-2 vaccine have been developed. However, the relationship between SARS-CoV-2 vaccine and radiation therapy (RT) is unclear. Recently, there have been some reports of radiation recall phenomenon (RRP) caused by a SARS-CoV-2 vaccine. We report a case of RRP after administration of the mRNA-1273 SARS-CoV-2 vaccine. A 51-year-old female was diagnosed with breast cancer (cT4N1M0, cStage IIIB) and underwent breast total mastectomy with axillary lymph node dissection after neoadjuvant chemotherapy. After mastectomy, the patient received RT with 50 Gy in 25 fractions. An acute side effect of grade 2 dermatitis according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. occurred after RT. The patient had not started any new systemic medication after RT; however, the patient received the mRNA-1273 SARS-CoV-2 vaccine (Moderna) 1 month after the end of the initial RT. Seven days after vaccination, the patient had a skin reaction with burning sensation and redness. This skin reaction was induced in an area corresponding to the irradiation field of the chest wall. There was no skin reaction in areas other than that described. The reaction was cured within 1 week with topical hydrocortisone. This report is an interesting case report with a RPP after administration of the mRNA-1273 SARS-CoV-2 vaccine.

Trial Assay for Safe First-Aid Protocol for the Stinging Sea Anemone Anemonia viridis (Cnidaria: Anthozoa) and a Severe Toxic Reaction

Anemonia viridis is an abundant and widely distributed temperate sea anemone that can form dense congregations of individuals. Despite the potential severity of its sting, few detailed cases have been reported. We report a case of a severe toxic reaction following an A. viridis sting in a 35-year-old oceanographer. She developed severe pain, itching, redness, and burning sensation, which worsened one week after treatment with anti-inflammatories, antihistamines and corticosteroids. Prompted by this event, and due to the insufficient risk prevention, lack of training for marine-environment users, and lack of research into sting-specific first-aid protocols, we evaluated the cnidocyst response to five different compounds commonly recommended as rinse solutions in first-aid protocols (seawater, vinegar, ammonia, baking soda, and freshwater) by means of the Tentacle Solution Assay. Vinegar and ammonia triggered an immediate and massive cnidocyst discharge after their application and were classified as activator solutions. Baking soda and freshwater were also classified as activator solutions, although with a lower intensity of discharge. Only seawater was classified as a neutral solution and therefore recommended as a rinse solution after A. viridis sting, at least until an inhibitory solution is discovered.

Testing Accommodation in Children

Accommodation disorders are associated with a host of etiologies. Children with accommodative disorders can present with various symptoms including blur, fluctuating vision, eye pain, burning sensation, tired eyes, asthenopia, headaches, fatigue with near work, and excessive rubbing, blinking, or tearing. This chapter provides an overview of accommodation testing on pediatric patients in the clinical setting. The author describes the indications for accommodation testing and provides clinical pearls for testing accommodative function in children. The chapter covers the specific tests, equipment required, and step-by-step procedures for testing accommodative amplitude, accommodative response, and accommodative facility.

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

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.

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

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.

A Case Report on Ayurvedic Management of Dushta Vrana

Dushta vrana is a commonly encountered problem in day-to-day practice. Contemporary progress in the field of surgery has reduced the incidence of wound infection to a great extent along with the use of antibiotics. But still the management of ulcer encounters many glitches. This case study discusses about a 58-year-old male patient who presented with a chronic non healing ulcer in the anterior aspect of the left ankle joint associated with pain, burning sensation, foul smelling and inflammation with no history of varicose veins. Patient was treated with Karaskara ksheera kashaya dhara followed by dressing with Jathyadi ghrta. Punarnavadi kashayam and Guggulupanchapala choornam was given internally for a period of 35days. Virechana with Avipathy Choornam was given once during the whole course of the treatment. Raktamokshana was done twice as Jaloukavacharana. In order to enhance the speedy recovery, traditional use of Kupeelu was considered. A highly potent drug among the Upavisha which is well known for properties like Vranahara, Soolahara, Kushtahara, Sothaghna etc. which augments the peripheral blood circulation, reduces pain, burning sensation and inflammation. The wound healed within a period of 35 days and got complete relief from pain, burning sensation and swelling. Thus, the patient was successfully treated with no complications.

ROLE OF ASPHOTA (HEMIDESMUS INDICUS R.BR.) KSHARASUTRA IN THE MANAGEMENT OF LOW-ANAL FISTULA

In this modern era, due to a sedentary lifestyle and improper dietary habit digestive disorder shows greater inci- dence. Among them, fistula-in-ano is troubleshooting one, which is a communicating tract between two epithelial surfaces lined by granulation tissues. Due to the higher recurrence rate and postoperative complication fistula-in- ano is a headache in the present era. In Ayurvedic classics, Ksharasutra prayoga is mentioned for the treatment of Nadi Vrana, which can be adopted in the management of anal fistula. The objective of the present study was to be evaluated the efficacy of Asphota Kshara sutra in the management of low anal fistula. The clinical trial was con- ducted in OPD and IPD of Shalyatantra department at Pankajakasthuri Ayurveda Medical College. The intervention was ligation of the fistulous tract with Asphota Ksharasutra. 25 subjects were selected satisfying inclusion and exclusion criteria. The clinical assessment was done before treatment, after treatment and follow up on the 30th day after cutting through of the tract. The assessment was done based on parameters prepared for anal fistula by Paul O Madson and Peter. Pain, burning sensation, inflammation, itching, discharge and unit cutting time was statistically analysed in different periods. Outcome variables were analysed statistically by using the Friedman test and Wilcox- son signed-rank rest, and a conclusion was drawn. Pain, burning sensation, inflammation, discharge, itching was effectively managed using Asphota Ksharasutra. The unit cutting time of Aspota ksharasutra was found to be more than standard Ksharasutra. The result showed that Aspota Ksharasutra is effective in the management of low anal fistula. Keywords: Fistula-in-ano; Asphota ksharasutra.

EFFECT OF POLYHERBAL FORMULATION IN SHEETAPITTA (URTICARIA): A CASE STUDY

Aim: Urticaria is a common condition in children for which Paediatricians are consulted. In Ayurveda, it can be correlated with Sheetapitta which is a Tridoshaja vyadhi. The present study is aimed to show the effect of Polyherbal formulation in Sheetapitta (Urticaria) in children. Background: Urticaria is defined as a transient eruption of cir- cumscribed oedematous and usually itchy swellings of the dermis. As per Ayurveda, Urticaria can be correlated with Sheetapitta in terms of clinic features, causative factors and pathogenesis. Case Description: A 14-year-old female patient with her mother from Haridwar district came in OPD of Department of Kaumarbhritya, Rishikul Campus, Uttarakhand Ayurved University, Haridwar with the presenting complaints of red rashes all over the body along with itching, burning sensation and swelling since 2 years also having associated complaints like nasal con- gestion, sneezing and swelling B/L eyes from 2 months. On examining upper respiratory tract left-sided nasal hy- pertrophy, chapped lips, white-coated tongue, rt. sided slightly enlarged tonsils were found. On examining the In- tegumentary system, maculopapular lesions were present mainly over the upper limb, lower limb, chest and back. Swelling underneath B/L eyes was also present. The effect of the treatment was assessed on the basis of relief in itching and clearance of lesions. Conclusion: After the intervention of the polyherbal formulation for 45 days, there was a marked improvement in symptoms like Kandu, Vidaha and Shotha etc. So, it was concluded that internal use of Polyherbal formulation along with external use of Anu taila and the local application of Urtiplex lotion is highly effective in the management of Sheetapitta (Urticaria). Keywords: Urticaria, Sheetapitta, Kandu, Allergic disease

Devastating tornado -of Kandi (9 April 1993) -A case study

A case study of the devastating tornado which occurred in Murshidabad district of West Bengal on 9 April 1993 is described, The synoptic situation and radar evidence in association with this tornado have been discussed. Also, how certain features of this tornado compared with some of tornadoes reported over West Bengal and attempt to provide an explanation regarding a burning sensation felt by people with passage of this tornado has been made.