Propolis mouthwash for preventing radiotherapy-induced mucositis in patients with nasopharyngeal carcinoma.

BACKGROUND: Nasopharyngeal carcinoma (NPC) is the most common head and neck cancer in Malaysia. The gold standard treatment of NPC is radiotherapy (RT), as NPC is a radiosensitive tumour. Although RT is successful in treating NPC, patients cannot avoid the resulting RT complications. Oral mucositis is the most frequently encountered debilitating complication of RT and has no specific preventive treatment. The aim of this study was to evaluate the efficacy and safety of a 2.5% propolis mouthwash for preventing RT-induced mucositis in patients with NPC. MATERIALS AND METHODS: The study was a prospective, double-arm, randomised control trial with intervention. The patients were randomly divided into an experimental group receiving propolis mouthwash and a placebo group receiving normal saline mouthwash. All patients were instructed to rinse their mouths with 7mL mouthwash three times daily for six weeks. The severity of oral mucositis was then evaluated by the World Health Organization Oral Toxicity Scale at the second, fourth, and sixth weeks of the study. RESULTS: In total, 17 patients completed the study: 10 patients used the propolis mouthwash and seven used the placebo mouthwash. The mean mucositis scores for the propolis mouthwash compared to the placebo at the second, fourth, and sixth weeks were 0.10 vs. 1.14, 0.50 vs. 2.00, and 1.20 vs. 2.86, respectively, and the differences between the two groups were statistically significant (p<0.001). CONCLUSION: A 2.5% propolis mouthwash was both safe and effective for reducing the severity of oral mucositis following RT for NPC.

Optimization of subcritical water pre-treatment for biogas enhancement on co-digestion of pineapple waste and cow dung using the response surface methodology.

The optimal pre-treatment method and conditions depend on the types of lignocellulose present due to the complexity and the variability of biomass chemical structures. This study optimized subcritical water pre-treatment to ensure maximum methane production from pineapple waste prior to anaerobic co-digestion with cow dung using the response surface methodology. A central composite design was achieved with three different factors and one response. A total of 20 pre-treatment runs were performed at different temperatures, reaction times and water to solid ratios suggesting optimum values for subcritical water pre-treatment at 128.52℃ for 5 min with 5.67 to 1 water to solid ratio. Under these conditions, methane yield increased from 59.09 to 85.05 mL CH4/g VS with an increase of 23% biogas yield and 44% methane yield from the untreated. All pre-treatments above 200℃ showed reductions in biogas yield. Compositional analysis showed slight reduction of lignin and increase in α-cellulose content after the pre-treatment. Analysis using Fourier transform infrared spectroscopy and thermogravimetric analysis verified the presence of cellulosic material in pre-treated pineapple waste. Most of the hemicellulose was solubilized in the liquid samples after SCW pre-treatment. The crystallinity index of pineapple waste was reduced from 57.58% (untreated) to 54.29% (pre-treated). Scanning electron microscopy confirmed the structural modification of pre-treated pineapple waste for better microbial attack. Subcritical water pre-treatment is feasible as a promising method to enhance the anaerobic co-digestion process. Further study should be conducted to assess the scale-up of the process from pre-treatment to anaerobic digestion at the pilot plant level.