Abstract
Objective
To evaluate the effectiveness of topical application of honey on Oral Mucositis (OM) associated with chemotherapy.
Methods
An observational blind study is performed upon a sample of 100 children receiving chemotherapy who developed oral mucositis. All children are divided into two groups (control and experimental) who received different regimens. Both groups received routine practice of analgesic and antiseptic gel application whereas children in experimental group also received the topical application of honey on oral mucosa for the management of OM. All children are monitored from the day they developed oral mucositis until the subsidence of signs and symptoms of oral mucositis. The severity of OM was assessed with WHO-STC (Stomatitis Toxicity Criteria) scale by a observer blind.
Results
There was statistically significant difference in reduction of severity of OM in both groups of children (p < 0.01). The duration of management of OM was significantly small in the experimental group (median 4 d, IQR: 4–6 d) as compared to the control group (median 6 d, IQR: 6–8 d) (p < 0.01).
Conclusions
The topical application of honey on oral mucosa was effective in reducing the severity and duration of management of chemotherapy induced oral mucositis (CIOM; p < 0.05) and that means honey is a good quality product with rich nutritious value and would be a pleasant, simple and cost-effective modality for the management of oral mucositis associated with chemotherapy.
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References
Eteraf-Oskouei T, Najafi M. Traditional and modern uses of natural honey in human diseases: a review. Iran J Basic Med Sci. 2013;16:731–42.
Udaykar S, Mali N, Shinde M. Topical application of orasep verses honey on radiation induced mucositis. Int J Sci Res. 2014;3:223–31.
Rosenberg SW. Oral complications of cancer chemotherapy -- a review of 398 patients. J Oral Med. 1986;41:93–7.
Raber-Durlacher JE, Weijl NI, Abu Saris M, deKoning B, Zwinderman AH, Osanto S. Oral mucositis in patients treated with chemotherapy for solid tumors: a retrospective analysis of 150 cases. Support Care Cancer. 2000;8:366–71.
McGuire DB, Correa ME, Johnson J, Wienandts P. The role of basic oral care and good clinical practice principles in the management of oral mucositis. Support Care Cancer. 2006;14:541–7.
Worthington HV, Clarkson JE, Eden OB. Interventions for preventing oral mucositis for patients with cancer receiving treatment. Cochrane Database Syst Rev. 2006;2:CD000978.
Patel S, Cichello S. Manuka honey: an emerging natural food with medicinal use. Nat Prod Bioprospect. 2013;3:121–8.
Rashed MN, Soltan ME. Major and trace elements in different types of Egyptian mono-floral and non-floral bee honeys. J Food Compos Anal. 2004;17:725–35.
Lachman J, Kolihova D, Miholova D, Kosata J, Titera D, Kult K. Analysis of minority honey components: possible use for the evaluation of honey quality. Food Chem. 2007;101:973–9.
Rashad UM, Al-Gezawy SM, El-Gezawy E, Azzaz AN. Honey as topical prophylaxis against radiochemotherapy induced mucositis in head and neck cancer. J Laryngol Otol. 2009;123:223–8.
Motallebnejad M, Akram S, Moghadamnia A, Moulana Z, Omidi S. The effect of topical application of pure honey on radiation induced mucositis: a randomized clinical trial. J Contemp Dent Pract. 2008;9:40–7.
Pediatric oncology cancer registry. Haemato-oncology unit; Advance Pediatric Center. Chandigarh: PGIMER; 2015.
Cho HK, Jeong YM, Lee HS, Lee YJ, Hwang SH. Effects of honey on oral mucositis in patients with head and neck cancer: a meta-analysis. Laryngoscope. 2015;125:2085–92.
Abdulrhman M, Elbarbary NS, Ahmed Amin D, Saeed ER. Honey and a mixture of honey, beeswax, and olive oil–propolis extract in treatment of chemotherapy-induced oral mucositis: a randomized controlled pilot study. Pediatr Hematol Oncol. 2012;29:285–92.
Sedighi I, Molaee S, Amanati A, Khoeinipourfar H, Nouri S. Antimicrobial activity of natural honey: topical application of pure natural honey in prevention of chemotherapy induced oral mucositis. J Comprehens Pediatr. 2013;4:138–42.
Acknowledgements
The authors would like to thank principal ma’am Dr. Sandhya Ghai, NINE to allow them to under-take this study and Dr. Sunit Singhi, HOD pediatrics to permit them to complete this study in the medicine wards APC, PGIMER, Chandigarh. The authors also appreciate the cooperation of bedside nurses for the study.
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RS: Conceptualized and designed the study, did data collection and analysis, drafted the initial manuscript; SKB: Helped in drafting, critical revision and finalization of the manuscript; SS, SK, BM and AT: Contributed to the study design, data collection, analysis and interpretation, and also critically reviewed the manuscript. BM will act as guarantor for this paper.
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Singh, R., Sharma, S., Kaur, S. et al. Effectiveness of Topical Application of Honey on Oral Mucosa of Children for the Management of Oral Mucositis Associated with Chemotherapy. Indian J Pediatr 86, 224–228 (2019). https://doi.org/10.1007/s12098-018-2733-x
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DOI: https://doi.org/10.1007/s12098-018-2733-x