ABSTRACT
Background/aim: Quantification of oral mucositis that progresses during concomitant chemo-radiotherapy (CCRT) is essential for its management. It is important to determine the methods that are simple, reliable and beneficial in foreseeing mucositis at earlier stages of treatment. Materials and methods: A prospective study was conducted on 100 oral cancer patients receiving CCRT following the inclusion criteria. Patients were evaluated for mucositis i.e. erythema and ulcers by using the World Health Organization (WHO) scale and the oral mucositis assessment scale (OMAS), whereas mature and immature cells were identified by exfoliative cytology. Clinical examination and procedure of oral cavity were performed before, on days 5, 17, and at the end of treatment. Results: Oral mucositis was observed in all oral squamous cell carcinoma (OSCC) patients receiving CCRT on different days with noteworthy increase from day 5 of CCRT to the end of treatment. For OMAS grading related to ulceration and erythema, Grade 1 (7.2%; 34%) was most commonly seen on the 5th day of CCRT, Grade 2 (29%; 19%) and Grade 3 (19%) were most frequently seen at the 17th day and end of CCRT, accordingly. With respect to WHO scale grades 1 and 2 (18.3%; 21.5%) was most frequently observed at the 17th day of CCRT, whereas grades 3 and 4 (12.5%; 2%) was noted at the end of CCRT. There was statistically significant increase in the percentage of immature cells at the end of CCRT (99%). A significant association (P < 0.0000) was observed among the days of smear and maturation stages of epithelial cells as well as among WHO mucositis grading, OMAS and types of epithelial cells, respectively. Conclusion: According to the findings of the study, oral mucositis grade is directly proportional to the progressing days of CCRT. Oral mucositis is frequently related to adverse clinical outcomes, affecting the patient's quality of life. It is essential to develop methods that can be employed for the assessment of CCRT associated oral mucositis.
Subject(s)
Antineoplastic Agents/adverse effects , Chemoradiotherapy/adverse effects , Head and Neck Neoplasms/therapy , Mouth Mucosa/drug effects , Mouth Mucosa/radiation effects , Radiotherapy/adverse effects , Squamous Cell Carcinoma of Head and Neck/therapy , Stomatitis/etiology , Adult , Aged , Aged, 80 and over , Antineoplastic Agents/therapeutic use , Erythema , Female , Head and Neck Neoplasms/epidemiology , Head and Neck Neoplasms/pathology , Humans , Male , Middle Aged , Prevalence , Prospective Studies , Quality of Life , Squamous Cell Carcinoma of Head and Neck/epidemiology , Squamous Cell Carcinoma of Head and Neck/pathology , Stomatitis/epidemiology , Stomatitis/therapyABSTRACT
INTRODUCTION: Corona pandemic has resulted in a high mortality rate among health care professionals. The purpose of this study was to assess the knowledge and practices of health care providers during this pandemic in Punjab, Pakistan. METHODS: A web based cross sectional survey was conducted during 2nd of April to 20th April 2020 targeting health care professionals working in Punjab, Pakistan. A sample of 540 participants was collected using non probability, convenient sampling technique. Data was generated by using on line google forms after taking IRB approval from institution. RESULTS: Adequate knowledge was found among health care providers regarding diagnostic tests, modes of transmission, incubation period and preventive strategies. Significant association was seen in knowledge of post graduate and MBBS doctors (Bachelor of Medicine and Bachelor of Surgery) regarding viral etiology (p = 0.006), sign and symptoms (p = 0.000), risk factors (p = 0.000) and mortality rates (p = 0.001). Hand washing was considered as best preventive measure by 95% of the health care providers. CONCLUSION: Post graduate doctors have better knowledge regarding corona virus disease transmission, risk factors, incubation period and preventive strategies as compared to undergraduate doctors.
