Role of honey as adjuvant therapy in patients with sore throat

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Jan 8, 2017 - Conclusion: Honey is effective in faster recovery of signs and symptoms of sore throat having antibacteria...

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National Journal of Physiology, Pharmacy and Pharmacology RESEARCH ARTICLE

Role of honey as adjuvant therapy in patients with sore throat Manpreet Singh Nanda1, Shiv Parshad Mittal2, Vipan Gupta1 Department of Otolaryngology, Head and Neck Surgery, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India, 2Department of Medicine, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India 1

Correspondence to: Manpreet Singh Nanda, E-mail: [email protected]

Received: December 02, 2016; Accepted: December 25, 2016 ABSTRACT Background: Honey is a natural product which has been used since ages for curing of various ailments. Aims and Objectives: To evaluate the effect of honey for control of infection and inflammation in patients with sore throat. Materials and Methods: A total of 200 patients with sore throat were taken up for the study. 100 patients, in the study group, were given one tablespoon of honey twice a day along with anti-inflammatory drugs, antibiotics, and antiseptic gargles. Remaining 100 patients in control group were given other same medications without honey. Patients were evaluated after 5, 10 and 15 days for throat congestion, fever, pain, patient satisfaction, and other criteria. Results: There was faster relief of signs and symptoms of sore throat in the study group as compared to control group. There was greater patient satisfaction in the study group. Conclusion: Honey is effective in faster recovery of signs and symptoms of sore throat having antibacterial and anti-inflammatory properties without causing any side effects. KEY WORDS: Fever; Honey; Inflammation; Pharyngitis; Tonsillitis INTRODUCTION Medicinal importance of honey is known since ancient times. It is said to possess antimicrobial property as well as wound healing activity.[1] Honey though mainly made up of sugars and water also contains vitamin B complex and C with lots of minerals such as calcium, potassium, and zinc.[2] Its broad spectrum antibacterial property against pathogenic bacteria and oral bacteria like staphylococcus and pseudomonas has been proved.[3] Honey is hygroscopic so it can draw moisture out of the environment and dehydrate bacteria and its high sugar content and low-level pH also prevent microbes from growth.[4] Honey is known Access this article online Website: www.njppp.com

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for its anti-inflammatory and antioxidant properties in literature.[5] Sore throat is one of the common symptoms of patients visiting our ear, nose and throat (ENT) outpatient department (OPD). It can be because of various inflammatory and infective causes such as allergies, reflux disease, sinus drainage, and tonsillitis. Sore throat can be of viral or infective etiology.[6] Various treatments tried for sore throat have not given satisfactory results. In various studies, local residents have been found to use honey for pharyngitis and respiratory ailments.[7] However, no scientific data are available in literature regarding the same. Hence, we plan to conduct this study to find out if honey has some role as an antibacterial, anti-inflammatory, and antioxidant in treatment of sore throat MATERIALS AND METHODS

DOI: 10.5455/njppp.2017.7.1233125122016

This study was conducted on the patients visiting ENT and medicine OPD of our medical college and hospital with National Journal of Physiology, Pharmacy and Pharmacology Online 2016. © 2016 Manpreet Singh Nanda et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creative commons.org/licenses/by/4.0/), allowing third partiesto copy and redistribute the materialin any medium or for mat and to remix, transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license.

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National Journal of Physiology, Pharmacy and Pharmacology

2017 | Vol 7 | Issue 4 (Online First)

Nanda et al.

Honey as adjuvant therapy in patients with sore throat

symptoms of sore throat from December 2015 to November 2016. 200 patients with signs and symptoms of sore throat aged above 18 years of age were enrolled in this study after taking written consent from the patients. The approval of Institutional Ethical Committee was taken. Exclusion criteria were patients with a history of diabetes, history of pollens and bees allergy, allergic to honey those who were already on treatment for sore throat and those with dislike to intake honey. All the patients were examined and followed up by the authors performing this study. The patients were randomized alternatively into study and control group. 100 patients in the study group were advised to intake one tablespoon of honey twice a day slowly over few minutes along with anti-inflammatory drugs, antibiotics, and antiseptic gargles. Remaining 100 patients in the control group were put only on antibiotics, anti-inflammatory drugs and gargles without honey. The above treatments were given maximum for 15 days or till the patients fully recovered from sore throat whichever is earlier.

The patients were assessed after 5 days, 10 days, and 15 days after starting the treatment. The assessment points were as follows: 1. Time to recovery - time taken to resolution of all signs and symptoms of sore throat 2. The patients were assessed for subjective symptoms like pain in throat, difficulty in swallowing and fever at each visit 3. The oropharynx was examined at each visit for congestion and other signs of sore throat 4. Complications - The patients were assessed for need for hospitalization during the treatment period due to any complications of sore throat such as high-grade fever, dehydration, and severe painful swallowing 5. The patient satisfaction was assessed according to LIKERT SCALE as 1 - completely satisfied, 2 - somewhat satisfied, 3 - no change/painful, 4 - not satisfied/increased pain at each visit 6. The patients were enquired about any side effects on taking honey. RESULTS A total of 200 patients who gave consent were enrolled in this study. All the patients had complaints of sore throat. Data were collected and analyzed. Patients above the age group of 18 years were taken in the study. There was an equal incidence of sore throat in all the age groups. Male and female patients were almost equal (Table 1). About 200 patients with sore throat were taken up for the study. 100 patients in the study group were given one tablespoon of honey twice a day along with anti-inflammatory drugs, antibiotics, and antiseptic gargles. Remaining 100 patients

Volume 2017 | Vol 2 | 7Issue | Issue 4 | 4Sep-Oct (Online2015 First)

in control group were given other same medications without honey. Patients were evaluated after 5, 10 and 15 days for throat congestion, fever, pain, patient satisfaction, and other criteria. There was faster recovery from sore throat in study group using honey than control group (Table 2). Regarding individual signs and symptoms, there was much faster recovery from fever within 5 days in the study group as compared to control group (Table 3). The signs of oropharyngeal congestion also had faster recovery in the study group. There was no significant difference in patients lost to follow-up in both groups (Table 3). Regarding complications of sore throat, almost equal number of patients in both groups needed hospitalization due to high grade fever, severe odynophagia, dehydration, or other upper respiratory tract complications (Figure 1). Regarding patient satisfaction, patients in study group with honey were more satisfied as compared to control group. These results were more evident at first follow-up visit after 5 days (Table 4). There were no side effects noted of honey in patients using honey in the study group. DISCUSSION The role of honey as anti-inflammatory, antibacterial, and antioxidant agent was investigated in this study. The aim of the study was to evaluate honey in controlling inflammation and infection in patients with sore throat and its affect on patient satisfaction and to study its adverse effects if any. We have used commercially available honey for this study. All the patients were initially examined and followed up Table 1: Age and sex distribution Age group

Male

Female

Total

18-40 years

43

39

82

41-60 years

33

37

70

>60 years

23

25

48

Total

99

101

200

Table 2: Time to total recovery from sore throat Time taken

Study group (n = 100)

Control group (n = 100)

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