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Fenugreek
Published in Dilip Ghosh, Prasad Thakurdesai, Fenugreek, 2022
Ujjwala Kandekar, Sunil Ramdasi, Prasad Thakurdesai
Buccal patches are the formulations are targeted to buccal mucosa for the benefits such as prevention of first pass metabolism and faster delivery (Guo and Pratap-Singh 2019). The use of increasing concentrations of fenugreek seed mucilage (500 mg to 800 mg) with decreasing proportion of hydroxypropyl methyl cellulose (HPMC K4M, 500 mg to 200 mg) and a backing membrane of ethyl cellulose (1%) in buccal patch formulations of atenolol (anti-hypertensive drug) were found satisfactory in terms of average weight, thickness, drug content, folding endurance, and moisture content. The formulation with combination of 800 mg of fenugreek seed mucilage and 200 mg of HPMC K4M produced buccal patch with optimum mucoadhesive strength, force of adhesion, bond strength, first order drug permeation kinetics across the excised porcine buccal mucosa over 12 h (ex vivo) and maximum permeation flux (Adhikari et al. 2010).
Mouth, tongue, lips and ears
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
In granulomatous cheilitis, the whole lip (upper or lower) is swollen. Initially this may fluctuate quite a lot, but eventually the swelling becomes permanent. The cause is unknown, although it can sometimes be due to an allergic contact dermatitis to toothpaste. If the buccal mucosa is also thickened, consider Crohn's disease. Ask about abdominal symptoms and look inside the mouth for the characteristic cobblestone appearance of the buccal mucosa. If necessary, do a barium follow through and a biopsy. If there is an associated facial nerve palsy and/or a fissured tongue (see p. 111) consider the Melkersson-Rosenthal syndrome. Injection of triamcinolone 5 mg/ml into the swollen lip is often helpful.
DRCOG MCQs for Circuit B Answers
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
The causes of vulval ulcers include Behçet's, primary syphilis (painless ulcer), chancroid, lymphogranuloma inguinale, granuloma inguinale, Herpes simplex, squamous cell carcinoma of the vulva and tuberculosis. Lichen planus is a cause of oral ulcers on the buccal mucosa.
Epidemiological Assessment of Oral Cancer Burden in Pakistan
Published in Cancer Investigation, 2021
Naila Malkani, Sara Kazmi, Muhammad Usman Rashid
OSCC is the most common form of oral cancer (17) and the tongue is a common site of origin. As compared to other populations, the majority of patients in the Pakistani population are presented at an early age (18). Siddiqui et al. reported cancer of buccal mucosa was predominantly reported among males in Pakistan (19). However, the oral cancer prevalence is the same in both genders in Karachi. This could be because of similar exposure to risk factors in both genders (20). The increased prevalence rate is reported in Sindh, especially in Jamshoro and Karachi (21). Karachi is also considered among higher-risk regions for the incidence of cancers in the world, oral cancer is ranked second among both genders. At the time of diagnosis, the majority of the oral cancer patients (75%) presented at advanced disease stage (22).
Incidence and impact of dysplasia at final resection margins in cancers of the oral cavity
Published in Acta Oto-Laryngologica, 2020
Arjun Singh, Manish Mair, Hitesh Singhvi, Natarajan Ramalingam, Munita Bal, Komal Lamba, Deepa Nair, Sudhir Nair, Pankaj Chaturvedi
We found the incidence of dysplasia at final resected margins in 2.3% (n = 39) of our population. Out of these, we had 25.6% mild, 53.8% moderate and 20.5% severe dysplasia, while 76.9% had only a single margin with dysplasia and 23.1% had multiple. The median age of the groups ranged from 52 to 55 years with a higher proportion of males. Cancers of the buccal mucosa were most common (27.3–48.7%), followed by oral tongue (9.1–19.2%) and lower alveolus lesions (12.8–50%). 87.1% of the cases had a history of tobacco use, most commonly smokeless tobacco use, while the data were not available for 8.3% of cases. Since the rate of P-FRM was less than the D-FRM, the propensity scoring was not possible and the entire group was included for comparison of survival. There was a uniform distribution across the D-FRM and the other matched groups for pathological stage of tumor, presence of perineural invasion (PNI), extranodal extension (ENE), tumors differentiation and the type of adjuvant therapy received. The P-FRM group had a higher rate of advanced stage tumors (95.5% vs 51.3–52.6%) with ENE (54.5% vs 12.8%) compared to the other groups. All groups had a similar distribution of the type of adjuvant therapy received. The demographic distribution is present in Table 1.
Off-label studies on apremilast in dermatology: a review
Published in Journal of Dermatological Treatment, 2020
Nolan J. Maloney, Jeffrey Zhao, Kyle Tegtmeyer, Ernest Y. Lee, Kyle Cheng
The largest study to date on apremilast in lichen planus is an open-label study on 10 patients refractory to treatment with topical steroids (26). In this, three of the 10 patients achieved the primary endpoint of an improvement in the Physician Global Assessment (PGA) by 2 grades or more. The overall cohort demonstrated significant differences in lesion counts and other secondary endpoints at the end of the 12-week treatment period (Table 1). Notably, only one patient in this study had oral mucosal involvement. In this patient, the involvement of the buccal mucosa decreased from 40% to 12% over the course of treatment (26). In addition, there was no significant difference in any primary or secondary endpoints of the study between the end of treatment period, and 4 weeks after this point in time (26).