Efficacy of Alpha Lipoic Acid in Adjunct with Intralesional Hydrocortisone and Hyaluronidase in the Management of Oral Submucous Fibrosis

Amirthagani, A (2013) Efficacy of Alpha Lipoic Acid in Adjunct with Intralesional Hydrocortisone and Hyaluronidase in the Management of Oral Submucous Fibrosis. Masters thesis, Thanjavur Medical College, Thanjavur.


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INTRODUCTION: Oral sub mucous fibrosis is a precancerous lesion, predominant condition seen in South Asian ethnic group ,more in India. No age or sex predilection has been found. OSMF is primarily a cell mediated immune reaction to areca nut chewing and betel quid. It is prevalent in people belonging to poor socioeconomic status associated with nutritional deficiency. In 1953 S.G.Joshi termed this condition as Oral sub mucous fibrosis. And latter it was described by Pindborg and Sirsat in (1966). In simple words Oral sub mucous fibrosis is a chronic progressive crippling fibrotic but preventable disease. Manifestations are dryness and burning sensation in the mouth, blanching of oral mucosa and reduced mobility of tongue. It is a chronic pre-cancerous condition leading to juxtaepithelial fibrosis mainly at Retro molar trigone and Soft palate. Young people are attracted by the media publicity of areca nut preparations thereby getting addicted to the same. There are 5 million young Indians affected from this crippling disease. Most important aspect of the treatment is cessation of the habits. Intralesional steroids are commonly used, but the dose and duration of the treatment have not been standardized so far. Other treatments include placentrex, hyaluronidase, collagenase, elastase and oral zinc and pentoxiphylline. Five of the study population including two school students are below the age of 20, since there is no restriction for sale of areca products in public places, these age groups are more vulnerable for addiction. There must be careful observation and long term follow up, Patients are instructed that at any time it may recur and may worsen even to malignancy. AIMS AND OBJECTIVES: 1. To study the clinical features of the patients with Oral submucous fibrosis attending the Outpatient Department of Otorhinolaryngology, Thanjavur Medical College Hospital, Thanjavur. 2. To measure the Efficacy of Alpha lipoic acid in the management of Oral submucous fibrosis. MATERIALS AND METHODS: Study Design: Randomised Controlled Trail. Settings and Subjects: This study includes the patients having newly diagnosed and histopathologically confirmed Oral submucous fibrosis (OSMF) in Thanjavur Medical College Hospital ,Thanjavur during the period from January 2011 to July 2012. Sample Size: All the eligible patients according to the inclusion and exclusion criteria within the study period will form the study population. It is expected to be around 60. Inclusion criteria: 1. Both males and females. 2. Age 13 and above. Exclusion criteria: 1. Patients with other pre cancerous and cancerous lesions of oral cavity. 2. Severe Trismus, Inter incisor distance less than 1cm. CONCLUSION: To conclude, both educated and uneducated people are getting affected knowingly or unknowingly. Even if some people realize, they could not come out from this habit due to addiction. Areca nut and tobacco are the precipitating factors. Therefore preventive measures must be taken. These products are neither bearing proper labels nor the health warnings. Pre-treatment and post-treatment signs and symptoms score of ALAGroup compared with paired t-test. And it revealed that, all the individual signs and symptoms and overall sign and symptoms were highly significant. In younger individuals, popularity of commercially available products are on the rise rather than traditional betel quid, leading to adoption of this habit at a younger age. Even though the educated people in the study populations are habitual chewers, there is a need for proper health education in our community. According to the table 6.3 nearly 20% of study populations are not educated and only 8.3% are having degree and only 35% of them studied up to primary school. There is definite improvement in the symptom especially burning sensation of mouth and mouth opening that is interincisor distance measured with a caliber in all patients who were included in this study. Mean Pretreatment trismus score in group I is -3.3 has became reduced after treatment as 1.97,whereas Mean Pre-treatment trismus score in group II is 3.4 has become reduced after treatment as 2.1 It reveals the efficacy of the therapy to the patient. And at the end of the study a significant difference between the two groups were observed. Even though there is clinical improvement in both these groups, ALA group is proved to be better than Non ALA group. A statistically significant difference has been observed. In our hospital set up, • we colleagues advice and also make patients who come with tobacco stained tooth, in earlier stage of the disease, to stop this habit which is only 50% fruitful with our maximum care. • Last, but not the least, there should be individual awareness and motivation to restrain from this habit. The antioxidant Alpha lipoic acid, has a definitive protective role as demonstrated in this study, and it can certainly be recommended for clinical use as routine.

Item Type: Thesis (Masters)
Additional Information: Reg.No.22102221
Uncontrolled Keywords: Alpha Lipoic Acid, Adjunct, Intralesional Hydrocortisone, Hyaluronidase, Management, Oral Submucous Fibrosis.
Subjects: MEDICAL > Otolaryngology
Depositing User: Devi S
Date Deposited: 27 Mar 2020 06:31
Last Modified: 27 Mar 2020 06:31
URI: http://repository-tnmgrmu.ac.in/id/eprint/12481

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