MyMedR

Fulltext Oropharyngeal flora changes in patients with head and neck malignancy post radiotherapy

Muthu K, Raman R, Gopalakrishnan G

Med J Malaysia, 2004 Dec;59(5):585-90.

Radiotherapy has been recognized as a valuable modality of treatment in the management of head and neck cancers. It can have a direct bactericidal effect on the normal flora of the oropharynx. The objective of this study is to determine the changes in the oropharyngeal flora after external beam radiation. This prospective non randomized control study was performed to aid in identification of organisms involved in sepsis, as well as aid in choosing appropriate antibiotics for surgical procedures in irradiated patient. Forty patients with various head and neck malignancy and thirty control patients were selected. Oropharyngeal swabs were taken prior to radiotherapy, at the end and one month after radiotherapy. A single swab was taken from the control group. A full bacteriological analysis was performed. There was a statistically significant decrease in Alpha Hemolytic Streptococci and Neisseria species post radiotherapy. B Proteus and Candida Albicans showed a statistical significant increase in patients with head and neck cancer post radiotherapy. These changes remained even one month after radiotherapy.

Melamine foam in Dentistry

Sidhu P, Muthusamy S, Kannan S, Muthu K

Int J Dent Hyg, 2015 Nov;13(4):239-40.

PMID: 25847230 DOI: 10.1111/idh.12137

Fulltext Endonasal endoscopic dacryocystorhinostomy

Krishnan G, Prepageran N, Muthu K

Med J Malaysia, 2002 Dec;57(4):404-7.

PMID: 12733164

A review of endoscopic dacryocystorhinostomy (EDCR) performed in University Hospital from 1998 till early 2001 were carried out. They were reviewed for indication, functional results, complications and other associated factors. Eleven patients (6 female and 5 male) were reviewed. All had unilateral nasolacrimal duct (NLD) obstruction (6 right, 5 left). Their ages range from 6 to 73 years. All 11 had persistent epiphora while 4 had concurrent recurrent dacryocystitis with purulent discharge. Two patients had history of lacrimal sac abscess that needed drainage. Ten patients had the procedure performed successfully. Functional results were excellent in 8 patients (80%) while two patients still had occasional epiphora although markedly reduced. Complications include synachae (1 patient), premature dislodgement of Jones tube (1 patient) and impacted tube in a child. Our experience with EDCR concludes it to be an easy, efficient treatment for nasolacrimal duct obstruction with minimal complications.

Oral health: bamboo salt

Sidhu P, Kannan S, Muthusamy S, Muthu K

Br Dent J, 2014 Jul;217(2):54.

PMID: 25060430 DOI: 10.1038/sj.bdj.2014.601

Fulltext Multiple bony overgrowths in the mouth - report of two cases

Kannan S, Muthusamy S, Muthu K, Sidhu P

Clin Cases Miner Bone Metab, 2015 12 29;12(3):260-1.

PMID: 26811708 DOI: 10.11138/ccmbm/2015.12.3.260

Tori and exostoses are benign bony protuberances that arise from bone surfaces in the oral cavity. The etiology of these growths has been implicated as multifactorial, but no consensus has been reached so far. These painless overgrowths seldom present as a complaint in the dental office unless functional or esthetic complications set in, and there is a fear for cancer. Here we discuss two rare cases where bony overgrowths present in the mouth were extensive and multiple.

Fulltext Palatal ecchymosis associated with irrumation

Muthu K, Kannan S, Muthusamy S, Sidhu P

Indian J Dermatol Venereol Leprol, 2015 Sep-Oct;81(5):505-7.

PMID: 26261150 DOI: 10.4103/0378-6323.162343

Apprising the diverse facets of Platelet rich fibrin in surgery through a systematic review

Nanditha S, Chandrasekaran B, Muthusamy S, Muthu K

Int J Surg, 2017 Oct;46:186-194.

PMID: 28827058 DOI: 10.1016/j.ijsu.2017.08.558

CONTEXT: Comprehensive reviews on clinical applications of Platelet rich fibrin (PRF) in surgery are limited despite its extensive utilization resulting in a dearth of knowledge on its effectiveness. Hence this article focuses on shedding light to the various applications of PRF pertaining to surgery through a systematic review.

OBJECTIVE: The systematic review is aimed at evaluating the value of PRF in different areas of surgery.

DATA SOURCES: A systematic review of articles sourced from MEDLINE-pubmed (2008-2017(July)) was done. Additional articles were searched through GOOGLE SCHOLAR and SCIENCE DIRECT. Search terms such as Platelet rich fibrin; Platelet rich fibrin, surgery; Platelet concentrate; second generation concentrate; Applications of PRF in surgery were used.

STUDY SELECTION: Systematic reviews, Randomized control trials, Pilot studies and Case reports were included. Non English articles, in-vitro and animal studies were excluded.

DATA EXTRACTION: Independent sourcing of articles by 3 authors using a set of predefined criteria.

DATA SYNTHESIS: Out of the 25 articles covering various surgical procedures that met the inclusion criteria, positive outcomes were noted in most. Although categorization into one specific type of study was not done, the overall success rate with PRF usage was 78%.No differences between test and control groups were observed in 2 studies and 3 studies showed no significant improvements with the usage of PRF.

LIMITATIONS: The systematic review did not categorize the study designs while evaluating success rates which might be considered as a shortcoming as case reports were also included.

CONCLUSIONS: The future propositions are vast and point towards innovative applications of this bio-material possibly in transplant and burn cases if a method of obtaining large amounts can be devised. However since we rely on evidence-based results, further long term studies are needed in distinct areas of applications to decisively prove its effectiveness.

Fulltext Application of platelet rich fibrin for management of an electrosurge induced osteonecrosis involving maxillary alveolus

Suresh N, Chandrasekaran B, Muthusamy S, Kannan S, Muthu K

Singapore Dent J, 2015 Dec;36:39-43.

PMID: 26684495 DOI: 10.1016/j.sdj.2014.11.004

BACKGROUND: Application of principles of electrocautery for hemostasis dates back to prehistoric times. Its modern implementation in various fields of general and head and neck surgeries have been well documented. However its usage in minor oral surgical procedures has gained popularity only recently. Complications associated with electro-surgery in the dental field are relatively rare and there is insufficient literature on its management.

CASE REPORT: We present a case report on management of an electrosurgery induced osteonecrosis involving maxillary alveolus of left premolars.

DISCUSSION: Inadvertent contact of the electrosurgery tip on bone can result in necrosis making it necessary to remove the sequestrum and graft the defect. Platelet rich fibrin in combination with bone grafts have been well documented to provide successful periodontal regeneration.

CLINICAL IMPLICATIONS: Our aim of presenting this report is to create awareness among the health care providers regarding electrosurgical injuries. To our knowledge, this is the first time platelet rich fibrin has been used in the management of intraoral electrosurgical injury. Combining bone grafts with platelet rich fibrin is a good alternative as it can be done with relative ease and predictable outcome.

Radiographic assessment of the prevalence of pulp stones in Malaysians

Kannan S, Kannepady SK, Muthu K, Jeevan MB, Thapasum A

J Endod, 2015 Mar;41(3):333-7.

PMID: 25476972 DOI: 10.1016/j.joen.2014.10.015

The aim of this study was to determine the prevalence of pulp stones in the Malaysian population using radiographs, and to assess the association of pulp stones with gender, age, tooth type, dental arch and tooth status. Occurrence of pulp stones among the three races in Malaysia (Malay, Chinese and Indians) was also studied.

Fulltext Fracture synthetic tracheostomy tube: an ENT emergency

Shashinder S, Tang IP, Kuljit S, Muthu K, Gopala KG, Jalaludin MA

Med J Malaysia, 2008 Aug;63(3):254-5.

PMID: 19248703 MyJurnal

A synthetic tracheostomy tube [non-metallic type] fracturing within three days of insertion is very rare but it could lead to serious complications such as acute asphyxia or sudden death. We report three such cases at our centre. Recommendations are made to closely observe patients on tracheostomy tube in the first seven days post-insertion of the tube.

Targeting multiple oncogenic pathways for the treatment of hepatocellular carcinoma

Swamy SG, Kameshwar VH, Shubha PB, Looi CY, Shanmugam MK, Arfuso F, et al.

Target Oncol, 2017 02;12(1):1-10.

PMID: 27510230 DOI: 10.1007/s11523-016-0452-7

Hepatocellular carcinoma (HCC) is one of the most common forms of liver cancer diagnosed worldwide. HCC occurs due to chronic liver disease and is often diagnosed at advanced stages. Chemotherapeutic agents such as doxorubicin are currently used as first-line agents for HCC therapy, but these are non-selective cytotoxic molecules with significant side effects. Sorafenib, a multi-targeted tyrosine kinase inhibitor, is the only approved targeted drug for HCC patients. However, due to adverse side effects and limited efficacy, there is a need for the identification of novel pharmacological drugs beyond sorafenib. Several agents that target and inhibit various signaling pathways involved in HCC are currently being assessed for HCC treatment. In the present review article, we summarize the diverse signal transduction pathways responsible for initiation as well as progression of HCC and also the potential anticancer effects of selected targeted therapies that can be employed for HCC therapy.

Cancer prevention and therapy through the modulation of transcription factors by bioactive natural compounds

Shanmugam MK, Lee JH, Chai EZ, Kanchi MM, Kar S, Arfuso F, et al.

Semin Cancer Biol, 2016 10;40-41:35-47.

PMID: 27038646 DOI: 10.1016/j.semcancer.2016.03.005

The association between chronic inflammation and cancer development has been well documented. One of the major obstacles in cancer treatment is the persistent autocrine and paracrine activation of pro-inflammatory transcription factors such as nuclear factor-κB, signal transducer and activator of transcription 3, activator protein 1, fork head box protein M1, and hypoxia-inducible factor 1α in a wide variety of tumor cell lines and patient specimens. This, in turn, leads to an accelerated production of cellular adhesion molecules, inflammatory cytokines, chemokines, anti-apoptotic molecules, and inducible nitric oxide synthase. Numerous medicinal plant-derived compounds have made a tremendous impact in drug discovery research endeavors, and have been reported to modulate the activation of diverse oncogenic transcription factors in various tumor models. Moreover, novel therapeutic combinations of standard chemotherapeutic drugs with these agents have significantly improved patient survival by making cancer cells more susceptible to chemotherapy and radiotherapy. In this review, we critically analyze the existing literature on the modulation of diverse transcription factors by various natural compounds and provide views on new directions for accelerating the discovery of novel drug candidates derived from Mother Nature.

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