Introduction: Oral mucositis is known to hamper the quality of life in patients treated for oral cancer. Many pharmacological agents have been tried and tested in its management, especially vitamin supplements including A, E and their combinations.Aim: A Meta-analysis was carried out to evaluate the efficacy of vitamins individually used for prevention or treatment of oral mucositis separately for chemotherapy, concurrent chemo radiotherapy, radiotherapy and Haematopoietic Stem Cell Transplantation (HSCT) individuals. Materials and Methods:The literature study was done using PUBMED, MEDLINE, EBSCO, GOOGLE SCHOLAR and COCHRANE data bases with keywords vitamin A, vitamin E, vitamin B, vitamin C, Oral mucositis, Chemotherapy, Radiotherapy, Concurrent chemo radiotherapy and Haematopoietic stem cell transplantation individually, from the year 1980 to 2016. Only randomized controlled trials were included. The data was extracted, tabulated and was subjected to statistical analysis with CI of 95%.Results: Among 201 subjects the analysis clearly demonstrated a male predominance to females in studies where male to female ratio was given. Out of 8 studies, 2 were studies in children and remaining 6 studies concentrated on adult population. WHO and NCI-CTC criteria were followed except for one study which used customised assessment. A meta-analysis was performed regarding usage of topical medication of Vitamin E group in all three cancer treatment modalities, which showed significant reduction in oral mucositis (p < 0.001). There was reduced oral mucositis in a small group of patients with Vitamin A when compared to controls. No information on the agent used for chemotherapy, the dose of radiotherapy and the type of tumours in 4 studies. Conclusion:Topical Vitamin E had performed better on oral mucositis than Vitamin E systemic administration. Though the efficacy of topical treatment with Vitamin A showed reduction in oral mucositis, it was evaluated in a very small sample which cannot be attributed to a larger sitting.www.jcdr.net Nallan CSk Chaitanya et al., Role of Vitamin E and Vitamin A in Oral Mucositis

Estimation ofcadmium and vitamin C was performed in the blood and lens of smokers in three age groups up to a maximum age of 58, habituated to smoking a minimum of 10 beedies a day for many years, as well as those of non-smokers in the same age groups. Only nuclear cataracts with or without posterior or anterior subcapsular cataract were chosen. It was found that there was a significant accumulation of cadmium in both the blood and the lens of the smokers. Such an accumulation of cadmium might have a role in cataractogenesis in chronic smokers. In a similar experiment, with smokers and non-smokers of two age groups up to a maximum age of 40, both without cataract, increased levels of cadmium were found in the blood of smokers only, though the extent of accumulation was not as high as in chronic smokers ofhigher age groups. Vitamin C content of lens was on the lower side of normal in both chronic smokers of beedies in the two age groups and non-smokers with nuclear cataract with or without posterior and anterior subcapsular cataract, and there was no significant change brought about by smoking. Vitamin C levels in blood were towards the lower side of the normal in smokers and non-smokers with and without cataract. (BrJ Ophthalmol 1995; 79: 202-206)

Background: Racecadotril, an enkephalinase inhibitor with antisecretory action is a safe and effective treatment for acute diarrhea for children and adults. As an adjunct to oral rehydration therapy (ORT) in Indian children, its efficacy and safety data are scarce. Methods: A total of 117 children with acute watery diarrhea for not more than 7 days were randomized into two groups. Group A (control group) received ORT and zinc only while Group B (study group) received a combination of racecadotril (1.5 mg/kg q8 h), zinc and ORT. Primary end point was the number of loose stools during first 48 h of treatment. Time to cure as well as total volumeof oral rehydration solution (ORS) consumed was also measured. Results: Baseline characteristics were not significantly different between the groups. Mean 48 h stool frequency in the study group was 10.47±3.2 episodes and that in control group was 15.87±4.6 episodes indicating a significant reduction of 34.1% with racecadotril (p=0.00016). The mean time for recovery in the study group was 37.98±6.1 h and 51.02±9.4 h in control group indicating a significant reduction of 25.6% with racecadotril (p=0.002). The  mean volume of ORS consumed before recovery in the study group was 162.72 ml as compared to 232.68 ml in control grouppointing to a significant reduction of 30.1% in the study group. Conclusions: Racecadotril is effective as an adjunct to ORT and early continued feeding in infants and children with acute watery diarrhea.

Objective: To assess the proportion of children less than 2 years of age with urinary tract infection (UTI) having structural anomalies detected by screening ultrasonography (USG) and voiding cystourethrography (VCUG).Method: A prospective observational study was done in a tertiary care hospital in South India from May 2014 to April 2015 on children less than 2 years of age, attending the paediatric or paediatric urology outpatient department and paediatric and neonatal wards, with symptoms suggestive of UTI. All urine culture positive cases were included in the study except for cases who had undergone operative procedures and catheterisation of urinary tract. Screening USG and VCUG were performed. Results:The radiological profile of UTI was analysed in the study group comprising 216 children less than 2 years of age. Radiological abnormalities were detected in 82 (38%) cases with female predominance. Fifty three (64.6%) of the abnormalities were identified by USG and 41 (50%) by VCUG. On USG, cystitis and pyelonephritis were the common abnormalities seen whilst vesicoureteral reflux (VUR) and posterior urethral valves (PUV) were the common abnormalities seen on VCUG. The 34 children with VUR had grades I and II reflux in 73.4%, grade III and IV reflux in 23.4% and grade V reflux in 3.2% cases. Four (11.7%) The authors declare that there are no conflicts of interest Personal funding was used for this project.Open Access Article published under the Creative Commons Attribution CC-BY License. Conclusions:Radiological abnormalities were detected in 38% children less than 2 years of age with UTI by screening USG and VCUG.