Dewesh Kumar

A randomized controlled trial evaluating the role of honey in reducing pain due to radiation induced mucositis in head and neck cancer patients

Background: There are various drugs tried for relieving pain associated with radiation-induced mucositis. This paper aims to study role of honey in relieving pain due to radiation induced mucositis in head and neck cancer patients receiving concomitant chemoradiation. Materials and Methods: A randomized controlled trial on 78 subjects (40 in test group and 38 in control group) was undertaken to study the analgesic effect of honey, but the analysis of 69 patients was done as nine patients (four in test and five in control group) were lost to follow-up or left treatment in between the study. All patients were advised to do salt-soda and benzydamine mouth gargles, alternatively every 3 hours. Test group patients additionally received 20 ml honey three times a day during the entire course of radiation treatment and 3 months following radiation therapy (RT). Results: Honey significantly reduced the severity of mucositis associated pain and resulted in lesser treatment gaps and a decrease in overall radiotherapy treatment duration. None of the test group and majority of controls (51.5%) had severe pain score during the 7th week of RT. The same pattern was seen in the post-RT period. Mean pain score was significantly different in both groups during all weeks during and upto 6 weeks post-RT (mean score of 3.08 and 6.54 for test and control respectively at 7th week RT, P < 0.001). Conclusion: Honey being a cheap, palatable, and natural medicament can be used for decreasing pain associated with radiation-induced mucositis in cancer patients.

Current trends of carcinoma tongue at a Medical College in Central India: A retrospective study

Context : Oral cancer is the most common cancer in India and tongue is one of the most commonly affected site. Aims and Objectives : The current study assesses the clinico-epidemiological trends of carcinoma tongue, its survival rates in different stages and relationship between different variables in central India. Materials and Methods : This was a retrospective study of 121 carcinoma tongue patients admitted between the period of 2½ years in a hospital of central India. The data collected were age and sex distribution, location and site of the tumor, tumor stage, histopathological type and grade, nodal status, modality of treatment, recurrences and survival. The disease free survival (DFS) was analyzed against stage, nodal status and recurrences using log rank test. Results : In this study, the incidence of cancer was more in males (male: female = 6.1:1) particularly in their fifth decade (mean 52.7 years) and the most common location was anterior 2/3 rd of the tongue mainly on right lateral side. Most of the patients presenting to out-patient department were having neck nodes positive status. The clinical stage at presentation was mainly advanced stages with well-differentiated squamous cell carcinoma. The most common treatment offered was surgery with radiotherapy (RT), followed by chemotherapy plus RT. The mean DFS time was of 27.8 ± 1.68 months, and it was directly related to tumor stage ( P Conclusion : The study signifies better prognosis of carcinoma tongue in early stages and warrants more awareness campaigns and health education in the health facilities as well as in community for early diagnosis of the disease with proper staging and subsequently multimodal treatment for increasing survival rates.

A Swot Analysis of Different Insecticides Used For Indoor Residual/Space Spray in Aiims Jodhpur - an Effective Instrument for Measuring Community Acceptability

Department of Community Medicine and Family Medicine in AIIMS Jodhpur is the nodal office for mosquito control activities and its surveillance in AIIMS Jodhpur since 10th October 2012. The department is responsible for carrying out antilarvicidal and antiadult measures in the whole AIIMS campus. We have been using Temephos/Abate for potable water and MLO(Mosquito larvicidal oil) for dirty water as antilarval measures successfully with >95% acceptability. But antiadult measures received a set back with precedented failure. Since October the department has tried three different chemicals for IRS (Indoor Residual Spray) with different levels of acceptance. A round of focussed discussions were carried out within the college amongst different strata of community to determine the different reasons of lower coverage of Pyrethrum (98.4%) and Malathion-I (89.7%) and Malathion-II(82.9%) with highest of Deltamethrin (99%). It was concluded that Deltamethrin was a grand success amongst residents albeit high cost and the reason attributed were strong administrative will and commitment, stringent monitoring, rising trend of dengue cases in Jodhpur during the season and odourless and stainless nature of the chemical. A Swot Analysis of Different Insecticides Used For Indoor Residual/Space Spray in Aiims Jodhpur – an Effective Instrument for Measuring Community Acceptability