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Papers by Amulya Thotambailu

Indian Journal of Otolaryngology and Head & Neck Surgery, Mar 15, 2018

In India, head and neck cancers account for 30–40% cancers of all sites. Due to lack of screening... more In India, head and neck cancers account for 30–40% cancers of all sites. Due to lack of screening program, wide variation in the availability of infrastructures and expertise, patients present at an advanced stage. The main stay of management of the head and neck tumours is surgery and chemoradiation. Radiation dermatitis and mucositis is one of the most common side effect encountered during the radiotherapy. Aim of our study was to study protective role of pomegranate extract on radiation induced dermatitis and mucositis in head and neck cancer patients. It was a prospective, clinical, double blind, case control study. 60 patients (30 active and controls) undergoing radiotherapy for head and neck cancer were studied for 12 months. Patients in study group were given whole fruit pomegranate extract. Each capsule contained 300 mg of whole fruit extract, each capsule contains 40% polyphenols and 27% punicalagin. Each patient were given 2 capsules every day for a period of 6–7 weeks. The skin and mucosal changes was graded according to the acute radiation morbidity scoring criteria (RTOG) for skin and mucous membrane. The results were statistically significant. Pomegranate extract proved to be radioprotective. Our study is one of the first study in humans to demonstrate the effectiveness of pomegranate extract in preventing radiation dermatitis and mucositis.

Indian Journal of Otolaryngology and Head & Neck Surgery, 2018

In India, head and neck cancers account for 30-40% cancers of all sites. Due to lack of screening... more In India, head and neck cancers account for 30-40% cancers of all sites. Due to lack of screening program, wide variation in the availability of infrastructures and expertise, patients present at an advanced stage. The main stay of management of the head and neck tumours is surgery and chemoradiation. Radiation dermatitis and mucositis is one of the most common side effect encountered during the radiotherapy. Aim of our study was to study protective role of pomegranate extract on radiation induced dermatitis and mucositis in head and neck cancer patients. It was a prospective, clinical, double blind, case control study. 60 patients (30 active and controls) undergoing radiotherapy for head and neck cancer were studied for 12 months. Patients in study group were given whole fruit pomegranate extract. Each capsule contained 300 mg of whole fruit extract, each capsule contains 40% polyphenols and 27% punicalagin. Each patient were given 2 capsules every day for a period of 6-7 weeks. The skin and mucosal changes was graded according to the acute radiation morbidity scoring criteria (RTOG) for skin and mucous membrane. The results were statistically significant. Pomegranate extract proved to be radioprotective. Our study is one of the first study in humans to demonstrate the effectiveness of pomegranate extract in preventing radiation dermatitis and mucositis.

Pomegranate

Pomegranate (Punica granatum) has been used since ages as a folk medicine. Studies have shown tha... more Pomegranate (Punica granatum) has been used since ages as a folk medicine. Studies have shown that pomegranate extracts have a role in various signaling pathways involved in inflammation, cellular transformation, hyperproliferation, angiogenesis, initiation of tumorigenesis, and eventually suppressing the final steps of tumorigenesis and metastasis. In this chapter, we have discussed some of the polyphenolic constituents present in pomegranate and their medical value, and we then discussed studies on chemopreventive/chemotherapeutic properties of pomegranate against various types of cancer, such as skin, prostate, colon, head and neck and lung cancers in cell culture systems, animal models and humans.

Although most take swallowing for granted when young, increasing dysfunction and dysphagia are as... more Although most take swallowing for granted when young, increasing dysfunction and dysphagia are associated with ageing and diseases of ageing. Oropharyngeal dysphagia is a neglected entity but common in old age and in certain neurological disorders. The resulting morbidity and mortality is usually a consequence of aspiration, but difficult medical and ethical issues also arise relating to provision of nutrition, especially in progressive neurodegenerative disease. Evidence to guide swallowing rehabilitation, and decisions on feeding methods and their benefits, is lacking, or limited to small studies.Management of Oropharyngeal dysphagia requires a Multidisciplinary approach.

International Journal of Otorhinolaryngology and Head and Neck Surgery, Mar 25, 2017

Background: Obstructive sleep apnoea syndrome (OSAS) is a spectrum which includes primary snoring... more Background: Obstructive sleep apnoea syndrome (OSAS) is a spectrum which includes primary snoring, upper airway resistance syndrome, obstructive hypoventilation and obstructive sleep apnoea. Sleep disordered breathing (SDB) is characterized by snoring, witnessed apnoea, frequent arousal, mouth breathing, restless sleep, irritability, recurrent upper respiratory tract infections etc. Methods: This was a prospective observational study which included 20 children who presented to the otorhinolaryngology, pulmonary medicine, paediatric, oral and maxillofacial department were included in the study with clinical symptoms of obstructive sleep apnoea. Results: 20 children, 13 (65%) males and 7 (35%) females were included. Snoring was the most common complaint.15 (75%) were obese, 5 had adenotonsillar hypertrophy(25%) as the risk factor for OSA. 15 out of the 20 children were graded under mallampati class 1(75%), 4 class 2(20%), 1under class 3(5%). There was no significant association in severity of OSA between 2 genders (p=0.82). Positive correlation (r=0.52) was found between AHI and BMI and is found to be statistically significant (p=0.02), which suggests that degree of obesity does predict the severity of OSA. Conclusions: Obesity is the most significant risk factor among them followed by adenotonsillar hypertrophy. Hence children who snore should undergo polysomnography and necessary corrective measures should be prescribed.

Indian Journal of Otolaryngology and Head & Neck Surgery

Salivary gland diseases usually present as a swelling of the affected gland. These lesions are co... more Salivary gland diseases usually present as a swelling of the affected gland. These lesions are commonly encountered in day to day practice. A salivary gland swelling can present in a variety of locations, depending on the salivary gland affected. The purpose of the study is to know the incidence of salivary gland swellings and the usefulness of FNAC in evaluating these swellings. The present study is a time bound prospective study of fifty consecutive cases of salivary gland swellings admitted in our hospital during the period November 2014–August 2016. Most of the patients underwent pre-operative work up with FNAC and patients indicated for surgery underwent surgery and HPE. Salivary gland swelling occurred more commonly in 3rd decade of life and equal number of cases were seen in both genders. Most of the patients presented with salivary gland swelling (98%). 21 (42%) were non neoplastic, 29 (58%) were neoplastic swellings, 18 (36%) were benign of which pleomorphic adenoma was the most common and 11 (22%) were malignant of which adenoid cystic carcinoma was the most common. Parotid gland was the most common gland involved. Fine needle aspiration cytology was highly sensitive for benign tumours and highly specific for malignant tumours. FNAC should be first choice of investigation in evaluating the salivary gland pathologies. Early diagnosis and subsequent appropriate management carries good prognosis.

Indian Journal of Otolaryngology and Head & Neck Surgery, Mar 15, 2018

In India, head and neck cancers account for 30–40% cancers of all sites. Due to lack of screening... more In India, head and neck cancers account for 30–40% cancers of all sites. Due to lack of screening program, wide variation in the availability of infrastructures and expertise, patients present at an advanced stage. The main stay of management of the head and neck tumours is surgery and chemoradiation. Radiation dermatitis and mucositis is one of the most common side effect encountered during the radiotherapy. Aim of our study was to study protective role of pomegranate extract on radiation induced dermatitis and mucositis in head and neck cancer patients. It was a prospective, clinical, double blind, case control study. 60 patients (30 active and controls) undergoing radiotherapy for head and neck cancer were studied for 12 months. Patients in study group were given whole fruit pomegranate extract. Each capsule contained 300 mg of whole fruit extract, each capsule contains 40% polyphenols and 27% punicalagin. Each patient were given 2 capsules every day for a period of 6–7 weeks. The skin and mucosal changes was graded according to the acute radiation morbidity scoring criteria (RTOG) for skin and mucous membrane. The results were statistically significant. Pomegranate extract proved to be radioprotective. Our study is one of the first study in humans to demonstrate the effectiveness of pomegranate extract in preventing radiation dermatitis and mucositis.

Indian Journal of Otolaryngology and Head & Neck Surgery, 2018

In India, head and neck cancers account for 30-40% cancers of all sites. Due to lack of screening... more In India, head and neck cancers account for 30-40% cancers of all sites. Due to lack of screening program, wide variation in the availability of infrastructures and expertise, patients present at an advanced stage. The main stay of management of the head and neck tumours is surgery and chemoradiation. Radiation dermatitis and mucositis is one of the most common side effect encountered during the radiotherapy. Aim of our study was to study protective role of pomegranate extract on radiation induced dermatitis and mucositis in head and neck cancer patients. It was a prospective, clinical, double blind, case control study. 60 patients (30 active and controls) undergoing radiotherapy for head and neck cancer were studied for 12 months. Patients in study group were given whole fruit pomegranate extract. Each capsule contained 300 mg of whole fruit extract, each capsule contains 40% polyphenols and 27% punicalagin. Each patient were given 2 capsules every day for a period of 6-7 weeks. The skin and mucosal changes was graded according to the acute radiation morbidity scoring criteria (RTOG) for skin and mucous membrane. The results were statistically significant. Pomegranate extract proved to be radioprotective. Our study is one of the first study in humans to demonstrate the effectiveness of pomegranate extract in preventing radiation dermatitis and mucositis.

Pomegranate

Pomegranate (Punica granatum) has been used since ages as a folk medicine. Studies have shown tha... more Pomegranate (Punica granatum) has been used since ages as a folk medicine. Studies have shown that pomegranate extracts have a role in various signaling pathways involved in inflammation, cellular transformation, hyperproliferation, angiogenesis, initiation of tumorigenesis, and eventually suppressing the final steps of tumorigenesis and metastasis. In this chapter, we have discussed some of the polyphenolic constituents present in pomegranate and their medical value, and we then discussed studies on chemopreventive/chemotherapeutic properties of pomegranate against various types of cancer, such as skin, prostate, colon, head and neck and lung cancers in cell culture systems, animal models and humans.

Although most take swallowing for granted when young, increasing dysfunction and dysphagia are as... more Although most take swallowing for granted when young, increasing dysfunction and dysphagia are associated with ageing and diseases of ageing. Oropharyngeal dysphagia is a neglected entity but common in old age and in certain neurological disorders. The resulting morbidity and mortality is usually a consequence of aspiration, but difficult medical and ethical issues also arise relating to provision of nutrition, especially in progressive neurodegenerative disease. Evidence to guide swallowing rehabilitation, and decisions on feeding methods and their benefits, is lacking, or limited to small studies.Management of Oropharyngeal dysphagia requires a Multidisciplinary approach.

International Journal of Otorhinolaryngology and Head and Neck Surgery, Mar 25, 2017

Background: Obstructive sleep apnoea syndrome (OSAS) is a spectrum which includes primary snoring... more Background: Obstructive sleep apnoea syndrome (OSAS) is a spectrum which includes primary snoring, upper airway resistance syndrome, obstructive hypoventilation and obstructive sleep apnoea. Sleep disordered breathing (SDB) is characterized by snoring, witnessed apnoea, frequent arousal, mouth breathing, restless sleep, irritability, recurrent upper respiratory tract infections etc. Methods: This was a prospective observational study which included 20 children who presented to the otorhinolaryngology, pulmonary medicine, paediatric, oral and maxillofacial department were included in the study with clinical symptoms of obstructive sleep apnoea. Results: 20 children, 13 (65%) males and 7 (35%) females were included. Snoring was the most common complaint.15 (75%) were obese, 5 had adenotonsillar hypertrophy(25%) as the risk factor for OSA. 15 out of the 20 children were graded under mallampati class 1(75%), 4 class 2(20%), 1under class 3(5%). There was no significant association in severity of OSA between 2 genders (p=0.82). Positive correlation (r=0.52) was found between AHI and BMI and is found to be statistically significant (p=0.02), which suggests that degree of obesity does predict the severity of OSA. Conclusions: Obesity is the most significant risk factor among them followed by adenotonsillar hypertrophy. Hence children who snore should undergo polysomnography and necessary corrective measures should be prescribed.

Indian Journal of Otolaryngology and Head & Neck Surgery

Salivary gland diseases usually present as a swelling of the affected gland. These lesions are co... more Salivary gland diseases usually present as a swelling of the affected gland. These lesions are commonly encountered in day to day practice. A salivary gland swelling can present in a variety of locations, depending on the salivary gland affected. The purpose of the study is to know the incidence of salivary gland swellings and the usefulness of FNAC in evaluating these swellings. The present study is a time bound prospective study of fifty consecutive cases of salivary gland swellings admitted in our hospital during the period November 2014–August 2016. Most of the patients underwent pre-operative work up with FNAC and patients indicated for surgery underwent surgery and HPE. Salivary gland swelling occurred more commonly in 3rd decade of life and equal number of cases were seen in both genders. Most of the patients presented with salivary gland swelling (98%). 21 (42%) were non neoplastic, 29 (58%) were neoplastic swellings, 18 (36%) were benign of which pleomorphic adenoma was the most common and 11 (22%) were malignant of which adenoid cystic carcinoma was the most common. Parotid gland was the most common gland involved. Fine needle aspiration cytology was highly sensitive for benign tumours and highly specific for malignant tumours. FNAC should be first choice of investigation in evaluating the salivary gland pathologies. Early diagnosis and subsequent appropriate management carries good prognosis.