Aims: To evaluate the effect of topical antifungal Clotrimazole on candida colonies and its correlation with clinical candidiasis in patients undergoing radiotherapy. Study Design: Randomised Clinical Trial Place and Duration of Study: Rashtrasant Tukdoji Maharaj Cancer Institute, Nagpur between June 2020 and July 2021. Methodology: 64 patients (52 males and 12 females) undergoing Co60 teletherapy for cervicofacial malignancies were randomly divided in two groups. 32 patients referred to as study group were put on antifungal treatment (1% Clotrimazole) for topical application and other group was the control group and was not given antifungal medication. During the radiotherapy and 6 weeks after the completion of radiotherapy, patients were examined every week for possible oral changes for clinical candidiasis, and swabs were taken at every end of the week for determining candidal colonies. Results: The overall incidence of clinical oral candidiasis was 46.9% throughout RT in the control group and there was no incidence of clinical candidiasis in the study group. Patients with clinical candidiasis 6-week post-radiation therapy showed continuous symptoms of clinical candidiasis but with the reduction in candidal colonies.22% of patients were oral carriers for candidal colonies. Also, the study group showed not a single patient with clinical candidiasis. Conclusion: During radiotherapy, although with the use of clotrimazole some patients with negative culture may also become positive for Candida albicans and there may be some increase in the several colonies of Candida albicans (very less in number as compared to the control group), but its use prevents the development of clinical candidiasis. Antifungal prophylaxis is useful in combating clinical candidiasis.

Aims: To evaluate the effect of Topical antifungal Clotrimazole in Radiotherapy induced mucositis, burning sensation, xerostomia and loss of taste sensation. Study Design:  Randomised Controlled Trial. Methodology: 64 patients (52 males and 12 females) undergoing Co60 teletherapy for cervicofacial malignancies. Patients who received a total 60 Gray radiation dose over a period of 6 weeks, with a daily dose of 2 Gray, were included in this study. Patients were randomly divided into 2 groups out of which one group was given topical 1% clotrimazole ointment and the other was control group. During the radiotherapy and 6 weeks after the completion of radiotherapy, patients were examined every week for possible oral changes such as mucositis, xerostomia, burning sensation, candidiasis and effect on taste. Results: There were considerable decrease in patients with severe mucositis and burning sensation in study group compared with control group whereas there was not any significant effect on xerostomia and loss of taste sensation. Conclusion: Simple topical application of antifungal Clotrimazole can be very effective in reducing the oral discomforts such as mucositis and burning sensation and improved the patient compliance to the treatment.

In this case report, a 32-year-old female patient from Central India was reported. Her primary complaint was pain and swelling in the lower left back region of her jaw, which had been present for one month. On extraoral examination, asymmetrical facial symmetry was observed, and a 3 cm swelling was present on the left side of her face. An intraoral examination showed a reddish-pink ulceroproliferative growth on the left buccal mucosa. Under local anesthesia, an incisional biopsy was performed. A conclusive diagnosis of well-differentiated squamous cell carcinoma affecting the left buccal mucosa was made based on clinical and histopathological testing. The patient was scheduled for a follow-up appointment after being referred to the Cancer Institute for the required treatment. After three months, the patient reported to the department with extensive swelling on the left side of the face, measuring 6 cm in diameter. On intraoral examination, a more restricted mouth opening compared to the previous examination. The ulceroproliferative growth was firm and tender and exhibited continuous bleeding. As the patient delayed seeking proper care, the condition became more aggressive, and she lost her life. This case of oral squamous cell carcinoma (OSCC) in a 32-year-old female patient is rare, as men are more commonly affected by OSCC in Central India due to their higher prevalence of unhealthy practices. This case highlights the rapid progression of the disease if appropriate treatment is not initiated promptly upon diagnosis.