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.
Introduction: Tuberculosis (TB) is a chronic infectious disease that also causes lipid abnormalities. Limited studies are focusing on metabolic abnormalities in TB patients with Diabetes Mellitus (DM). While studying lipid abnormalities in pulmonary TB patients, there were no marked differences between serum levels of cholesterol, triglycerides, Low Density Lipoprotein (LDL) and High Density Lipoprotein (HDL). However, it was suggested that increased levels of lipoprotein (a) in patients with pulmonary TB may be a risk for atherosclerosis. Aim: To study the lipid abnormalities in TB patients with DM. Materials and Methods: This cross-sectional study was conducted in Department of Pulmonary Medicine at a tertiary care teaching institute {PES Institute of Medical Sciences and Research (PESIMSR} Andhra Pradesh, India, between October 2015 to March 2016 (six months). Four groups were made, Group I included 30 patients with TB and no DM, Group II included 25 patients with TB with DM, Group III had 30 patients with DM only and Group IV was control group with 30 healthy individuals. Lipid profile testing was done for all the participants and the values obtained were compared. Analysis of Variance (ANOVA) test was used to compare the means between the groups and Kruskal-Wallis test when data did not follow the normal distribution. The p-value <0.05 was considered statistically significant. Results: Total 25 patients in group II had 18 male and 7 female with mean age of 48.5±11.12 years. The total cholesterol, triglycerides, Very Low Density Lipoprotein (VLDL) was high in group III (176.33±43.35 mg/dL, 221.733±39.2 mg/dL, 34.8±17.81 mg/dL respectively). The HDL was lowest in group II (27.88±8.03 mg/dL). However, the LDL values showed no significant difference between the groups (p-value=0.162). group I had Low Body Mass Index (BMI) (18.61±3.6 kg/ m2). The atherogenic index was high in group II especially in males. Conclusion: In patients with TB and DM, screening of lipid profile can provide markers of atherogenicity which may help to predict and prevent cardiovascular events. A good nutritious diet is recommended alongside chemotherapeutics in the treatment for TB patient's management and their lipid profile status should be monitored while managing the patients.
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