Comparison of antifungal efficacy of ethanolic extracts of Woodfordia fruticosa leaf and Punica granatum peel in uncontrolled diabetic patients wearing removable dentures: A randomized controlled clinical trial.

BACKGROUND AND PURPOSE: The search for the development of a suitable novel antimicrobial agent for fungal diseases continues to be a key problem in the current clinical field. The present investigation was aimed to determine the antifungal effect of the ethanolic crude extracts of Woodfordia fruticosa leaf (Wfl) and Punica granatum peel (Pgp) in uncontrolled diabetic patients wearing removable dentures. MATERIALS AND METHODS: The ethanolic extracts of both plants were prepared using the soxhlet extraction method, and the obtained metabolites were confirmed by thin- layer chromatography. After the preparation of the mouthwash, a total of 100 subjects were randomly divided into two groups. Each subject was given physiological saline at the baseline. Group I was provided with P. granatum mouthwash, while Group II was given W. fruticosa mouthwash. Following the administration of the mouthwash, the patients were requested to rinse the mouthwash using the oral rinse technique twice daily 5 ml/rinse for 30 sec. Subsequently, colony-forming units (CFU) were evaluated in the participants. Post-therapeutic samples were collected 1 h and 1 week after the mouthwash use. RESULTS: The mean reduction of CFU was calculated at the baseline, as well as 1 h and 1 week after using mouthwash. The results indicated a drastic reduction in CFU 1 h and 1 week after the application of Wfl mouthwash. CONCLUSION: The obtained data revealed that Wfl had potential anticandidal activity against Candida yeast cells, probably owing to its bioactive compounds like glycosides. Therefore, this agent can be used effectively as a natural remedy for the treatment of oral candidiasis. However, the exact mechanism of action of this plant needs to be elucidated.

Quantitative Immunoexpression of EGFR in Oral Potentially Malignant Disorders: Oral Leukoplakia and Oral Submucous Fibrosis.

Background and aims. Many oral squamous cell carcinomas develop from potentially malignant disorders (PMDs)which include a variety of lesions and conditions characterized by an increased risk for malignant transformation. Thisstudy evaluated the quantitative expression of EGFR in normal oral mucosa, oral leukoplakia and oral submucous fibrosis to predict the malignant risk in compliance with the intensity of staining with EGFR. Materials and methods. Thirty subjects were included in the study, consisting of 10 oral leukoplakia (OL), 10 oral submucous fibrosis (OSMF) and 10 normal oral mucosa (NOM) as the control group. Owing to the histopathological confirmation of precancerous state of tissue, 4-µm-thick sections of tissue were taken from paraffin-embedded wax blocks for immunohistochemical staining for EGFR. Results. All the control cases showed positive expression for EGFR, while 20% of oral leukoplakia and 40% of OSMF cases showed strong expression (3+), 40% of OL and 30% of OSMF cases showed weak expression (2+), and 40% of OLand 30% of OSMF cases showed poor expression (1+) compared to controls (P=0.012). Conclusion. EGFR expression levels in the premalignant lesion appear to be a sensitive factor in predicting the neoplastic potential. This suggests that EGFR may serve as a biological marker to identify high-risk subgroups and guide prophylactic therapy with chemopreventive drugs or surgical intervention to prevent progression to carcinoma. Hence, further investigations in the direction of chemopreventive trials with a larger sample size are suggested to determine its role in the head and neck tumorigenesis.