Background: A comparative study to evaluate the efficacy of intravenous Dexmedetomidine as a hypotensive agent in comparison to oral Clonidine in Endoscopic Nasal Surgery or Functional Endoscopic Sinus Surgery (FESS).Methods: Forty patients ASA I or II scheduled for Endoscopic Nasal Surgery were equally randomly assigned to receive either dexmedetomidine 1μg/Kg over 10 min before induction of anesthesia followed by 0.5μg/Kg/h infusion during maintenance (Group D), or oral Clonidine (Group C) 2µg/kg with minimal water 1 hour prior starting of surgery. Rescue bolus doses of Propofol (10mg/dose) were given to maintain mean arterial blood pressure (MAP) between (50-70mmHg). General anesthesia was maintained with Isoflurane 1%-2%. The surgical field was assessed using Average Category Scale. Hemodynamic variables (MAP and HR) were recorded at 10 minutes interval.Results: Both group C and group D reached the desired MAP (50-70mmHg) with no intergroup differences in HR but a statistically significant lower MAP was noticed in group C. The quality of the surgical field in the range of MAP (50-70mmHg) were 2-3 as per average category Scale with significantly lower score in Group C. Mean intraoperative propofol consumption was significantly higher in group D than C group.Conclusions: Both Dexmedetomidine or oral clonidine with isoflurane are safe agents for controlled hypotension, but oral clonidine provides lower MAP and better surgical field. Compared with Dexmedetomidine, oral clonidine offers the advantage of less consumption of propofol.

Objectives: Smoking and tobacco leaf chewing are important predisposing factors of oral cancer. Chronic tobacco users are so much addicted that they are unable to get rid of their habits even after developing frank oral cavity cancers. Personal and psychological counseling, life style modifications have failed to de-addict these individuals. Serum nicotine level falls sharply and provokes them for further use of tobacco to keep sustained level of nicotine in blood. It has been observed that chewing of Indian medicinal plant root curcuma longa (turmeric, haldi) or its active ingredients curcumin is effective to de-addict tobacco users. Present paper is a pilot study to translate these clinical findings into scientifically explained observations. Methods: Patients with pre-cancerous lesions or oro-pharyngeal cancers with habits of chronic smoking or tobacco chewing were recruited for the study. The study conducted between September 2003 to August 2005 in collaboration with Department of Biochemistry and Radiotherapy, Medical College, Calcutta. Of total 256 patients (132 in control arm and 124 in study arm); M: F = 90:10; 196/256 (75%) were smokers and others were tobacco chewers. Serum nicotine level estimated at monthly interval for three months. Study arm patients were given simultaneously curcuma longa for consecutive three months and serum nicotine level was compared with control arm. Addiction potentiality was recorded by our counselor. Results: Control arm patients had the same addiction dependency as before but amongst study arm patients (n=132) 84/132 (63.6%) completely gave up smoking or tobacco chewing. 19 patients (14.3%) dropped smoking less than 10 cigarettes per day and 14 patients (10.6%) tobacco chewing decreased from 10-times to less than 2-times per day. The difference is statistically significant. Conclusion: Initial result of our ongoing study is very much encouraging. The details of the present study will be discussed at the time of presentation. Citation Information: Cancer Prev Res 2010;3(1 Suppl):B144.

Introduction: Acute radiation toxicity is a limiting factor of radiotherapy for head and neck cancers. This acute toxicity depends on number of factors like dose of radiation, dose per fraction, total dose, treatment portals, machines used etc. Nutritional status (NS) of the patient is also an important factor of head and neck cancer so far, development of acute toxicity and tolerance is concerned. Keeping other variables unchanged, how NS affects radiation induced toxicity was the main object of the study. Patients and Methods: Total 280 patients of squamous cell carcinoma of upper aero-digestive tract were selected for the study. NS of all patients were calculated. The degree of acute toxicity during the course of radiation and 3 weeks after completion of external radiation were noted. The acute toxicity was recorded as per RTOG acute toxicity criteria. NS is assessed by 1. clinical examination, 2. anthropometric measurement, 3. biochemical investigations, 4. hematological examinations, 5. dietetic assessment. Anthropometric measurement done by: 1. weight (kg), 2. height (cm), 3. wrist circumference, 4. waist circumference, 5. waist: hip ratio, 6. body mass index = weight (kg) height2 (m2), 7. triceps skin fold thickness. Biochemical Estimation is done by: 1. serum albumin, 2. serum transferrin, 3. serum ceruloplasmin. Immunologicalparameters are: 1. total circulating lymphocyte count (more than 2000 cells / cu mm normal value, 1200 – 2000 cells / cu mm mild malnutrition, 800 – 1200 cells / cu mm moderate malnutrition, less than 800 cells / cu mm severe malnutrition), 2. delayed cutaneous hypersensitivity (DCH) test, 3. DNCB challenge test, 4. Mantoux test Acute radiation morbidity scoring was done as per criteria (RTOG). Result Analysis: There was significantly increased toxicity in patients who were poorly nutritious (n=135) as compared to those who were normally nourished (n=88). Those patients who were under nutritious also showed poor standard of oral hygiene. Rest 57 patients NS were undetermined and were excluded from evaluation. In under nutritious group, acute radiation toxicity grading was: Gr.1 (0%), Gr.2 (42.96%), Gr.3 (55.55%), & Gr.4 (1.48%) respectively. On the contrary, the normal nutritious group acute toxicity developed Gr.1 (11.36%), Gr.2 (81.81%), Gr.3 (6.81%) & Gr.4 (0%) respectively. Oral hygiene of poor standard was 12.5% in under nutritious patients and 4.5% in normal nutritious patients. Conclusion: Aim of this paper lies in its attempt to explore the acceptability of “Nutritional Status” as a variable in development of radiation induced toxicity, as far as acute morbidity is concerned. In that sense it is a successful phase I trial. One can conclude that there exists some correlation between radiation morbidity and NS of the patients. Therefore correction of NS before onset of radiation provides better tolerance to radiotherapy. Citation Information: Cancer Prev Res 2010;3(1 Suppl):A142.