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Background: Systemic Lupus Erythematosus (SLE) is an autoimmune disease with unknown etiology resulting in chronic multi-organ inflammation. Juvenile Systemic Lupus Erythematosus (JSLE) is a specific diagnosis of SLE in juvenile, characterized by oral ulceration. Purpose: This case report attempts to provide information for oral medicine specialists in managing JSLE patients with hepatosplenomegaly. Case Presentation: A 17-year-old female patient was referred from the Pediatrics Department with mouth ulcers accompanied by dry lips and a tendency to bleed. The most concerning lesion was located on the left buccal mucosa, a single ulceration measuring 5x6mm. Multiple ulcerations spread over the upper and lower labial mucosa, with haemorrhagic crusts on the lips. Painful ulceration can lead to difficulties in mouth opening and impaired function in eating and drinking. Central erythema was seen on the palate. Pseudomembranous candidiasis was also seen on the patient's tongue. The hepatosplenomegaly was confirmed by CT scan, with enzyme values of SGPT (386 U/L) and SGOT (504 U/L). Case Management: Administration of 0.9% NaCl was instructed to the patient to maintain oral hygiene and help moisturize lips in order to remove haemorrhagic crusts. Administration of 0.025% hyaluronic acid mouthwash and topical steroid ointment mixture for ulcerated and inflammatory conditions. Drug adjustments were made based on laboratory tests and the patient's clinical condition was improving. Conclusion: Managing oral symptoms helps reduce morbidity in JSLE patients. Topical corticosteroids are considered the first line in controlling oral inflammation. Dentists play a role in improving patients' oral hygiene with the aim of reducing the risk of other opportunistic infections.
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Background: Recurrent oral erythema multiforme (ROEM) is an uncommon subtype of erythema multiforme. Immunoglobulin E (IgE) is essential in acute allergy reactions and chronic allergic inflammatory disorders. Purpose: This report aims to describe the advantages of total IgE screening for detecting mouthwash allergic reactions associated with ROEM. Case Presentation: A 29-year-old woman came to the Oral Medicine clinic complaining of canker sores all over her mouth and swollen lips accompanied by crusts that had been bleeding easily two months prior. Complaints worsened after the patient used alcohol-containing mouthwash without a history of fever or other symptoms. Extra-oral examination showed upper and lower lip edema with hemorrhagic crusts that bleed easily. No lesions were found in other parts of the body. Intra-oral examination showed ulcers, multiple, irregular in almost the entire oral mucosa. Laboratory examination revealed non-reactive anti-HSV-1 IgG and a total IgE serum level of 612.00 IU/mL. The diagnosis based on the examination results is recurrent oral erythema multiforme. Case Management: The patient was instructed to stop using alcohol-containing mouthwash, maintain oral hygiene, a healthy lifestyle, adequate hydration, and a balanced diet. Prednisone, benzydamine HCL mouthwash, 0.025% hyaluronic acid mouthwash, multivitamins, and hydrocortisone cream were given as pharmacological therapy. The oral lesions improved in 12 days and the total IgE serum level examination showed a decrease (385 IU/mL). Conclusion: The total IgE examination can be a screening tool for mouthwash allergy-related reactions to disease and represents the response of ROEM therapy as evidenced by clinical improvement.
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Introduction: Erythema multiforme is a hypersensitivity reaction caused by various factors, such as viruses, chemicals, and drugs. Electronic cigarettes (e-cigarettes) or vape is a battery-powered nicotine delivery device that substitutes for traditional cigarettes. The chemical components of vaping, including propylene glycol and nicotine, can cause hypersensitivity reactions. Objective: To report a case of oral erythema multiforme in an e-cigarettes user, treatment, and review the literature regarding the impact of these devices on oral health. Clinical Case: A 22-year-old woman came to the Oral Medicine Department with complaints of stomatitis causing pain, eating, and drinking difficulty, which started with fever and pimple-like on the lips. She was an active vape user for one year. Extraoral examination revealed no lesions on other body parts. The serosanguinolent crusts on the lips, an erosive area on the labial commissures and tended to bleed. Intraoral examination revealed white ulcers with yellowish edges and irregular, varying sizes in several parts of the oral mucosa. The anti-HSV-1 IgG laboratory results showed non-reactive, leading to a diagnosis of oral erythema multiforme. Management of oral conditions using 0.9% NaCl compress, dexamethasone mouthwash, and hyaluronic acid, applying 2% miconazole cream on labial commissures and vaseline album cream on the dry lips, and stopping vaping. Oral condition improved in a week of therapy. Conclusion: Erythema multiforme restricted to the mouth is rare, especially associated with electronic cigarettes. Early identification of oral ulcerative disorders is crucial for accurate diagnosis and treatment, where clinicians should consider oral erythema multiforme as a possible diagnosis.
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Introduction: Psoriasis is a complex autoimmune disease associated with chronic systemic keratinization and inflammation, which can affect the skin, joints, and oral cavity. Xerostomia is a subjective feeling of oral dryness that impairs patient comfort and lowers the quality of life. The aim of this case report is to describe the clinical mechanism of xerostomia in a psoriasis patient with multiple systemic diseases. Case Report: A 51-year-old inpatient man with psoriasis vulgaris was referred to the Oral Medicine Department with complaints of difficulty swallowing due to a sore throat and dry tongue since last week. The patient had psoriasis vulgaris 15 years ago, chronic adrenal insufficiency, psoriatic arthritis, acute circulatory collapse, anemia of inflammation, acute kidney injury, dehydration, gastritis, urinary tract infections, and malnutrition. A complete anamnesis and oral examination were done. The patient was diagnosed with severe xerostomia, a fissured tongue, exfoliative cheilitis, angular cheilitis, and gingivitis by the Oral Medicine Department. Case Management: The patient was treated with petroleum jelly, chlorine dioxide mouthwash, miconazole cream, and benzydamine HCl lozenges. Conclusion: Based on case reports and reviews, multiple systemic diseases may not only increase the risk of xerostomia but also aggravate its severity.
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Introduction: The potato (Solanum tuberosum L.) is a short-lived tuber plant with a round to oval shape and varying colors, depending on the variety. It is known that only the inside of the potato is used, while the peel is generally discarded. However, recent studies have shown that potato peels contain many health-beneficial compounds. Purpose: This study aimed to investigate the compounds present in potato peels and their in vitro activities. Methods: A scoping review following the PRISMA guidelines was conducted. The selection process involved identifying articles of in vitro research published within the last 10 years (2012-2022). Electronic searches were conducted using the portals Scopus, ScienceDirect, EBSCOhost, and Portal Garuda by using the keywords "potato" or "Solanum tuberosum" and "peel" or "skin". The search was limited to articles in English with full text availability. Results: The screening process resulted in a total of 4773 articles from the four search engines; 14 articles were obtained that met the requirements for the review, most of which use extract preparations in their research. Extracts of flavonoids, phenols, and glycoalkaloids are the most frequently studied compounds, and their antioxidant and anti-inflammatory activity have undergone extensive research. Conclusion: The potential compounds contained in potato peels, including flavonoids, phenols, and glycoalkaloids, are highly abundant and offer numerous benefits. Provides opportunities for further research to prove the potential pathway activity of the compound. These compounds have been the subject of extensive research, suggesting their significance in the context of health and nutrition.
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INTRODUCTION: The most effective means for reducing oral cancer (OC) mortality is by preventing late-stage disease. Early diagnosis can be improved by increasing awareness among healthcare providers, specifically general dental practitioners (GDP). Therefore, our study aimed to assess GDPs' knowledge of OC risk factors and perceived competence in performing conventional oral examination (COE) in routine dental practice. MATERIAL AND METHODS: This was a cross-sectional study conducted in five provinces of Indonesia, namely: Aceh, Banda Aceh (BA); Bandung, West Java (WJ); special district Jakarta (JKT), JKT; Pontianak, West Kalimantan (WK); and Sorong, West Papua (WP). The local Dental Association or Faculty of Dentistry invited the GDPs to attend an education program and complete the survey. RESULTS: One hundred seventy-seven GDPs completed the survey (WJ, n = 63; BA, n = 44, JKT, n = 27; WP, n = 23; and WP, n = 20). A large proportion (164 out of 177, 92.66%) of GDPs felt they had received insufficient training to equip them to diagnose OC and as many as 22.6% (n = 40) did not refer to specialists when they found suspicious mucosal lesions. Notwithstanding the significant regional variations, the majority of Indonesian GDPs self-reported inadequate knowledge and awareness of OC and scarce confidence in performing COE. CONCLUSION: GDP knowledge of OC risk factors and COE is key to improving early diagnosis of OC at a community level. Therefore, it is suggested that the lack of knowledge and confidence of GDPs reported here should be addressed through the national dental curriculum in Indonesia.
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Odontólogos , Neoplasias Bucais , Humanos , Odontologia Geral/educação , Indonésia/epidemiologia , Estudos Transversais , Papel Profissional , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/epidemiologia , Neoplasias Bucais/prevenção & controleRESUMO
Introduction: In the world, the second most common cause of mortality is cancer, and its prevalence is increasing in both developing and developed states. Cancer therapy has severe side effects for people with cancer. The selection of natural ingredients in the form of herbal plants is expected to provide therapeutic effectiveness with low side effects. A total of 6000 plant species are utilized as herbal medicines in Indonesia by the local population for various ailments. Objective: To describe the potential of Indonesian herbal plant products as a cancer therapy in vitro. Methods: This systematic review is based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-SR) guidelines. The selection of articles published in the last 5 years (2018-2023) from Pubmed, Ebsco, Garuda portal, ScienceDirect, Cochrane, and Webscience was carried out in January 2023 with the keyword "Indonesian herbal" AND/OR "Anti-cancer" AND/OR "In Vitro". Risk of bias assessment using OHAT tools. Results: A total of 1,816,511 articles then through inclusion, exclusion criteria screening, and the risk of bias were obtained 23 (twenty-three) low risk of bias articles. Some herbal plant products such as Soursop (Annona muricata L.), Nyamplung (Calophyllum spp.), Benalu Cengkeh/Clove Benalu (Dendrophthoe pentandra), Rumput Mutiara/Pearl Grass (Hedyotis corymbosa L.), Rasamala (Altingia excelsa), Sarang Semut/Anthill plant (Myrmecodia pendans), Basil (Ocimum sanctum Linn.), and Tepus (Zingiber griffithii) showed different potentials for activity as an in vitro anti-cancer therapy. The three Indonesian herbal plants that are most studied in vitro as anti-cancer are Soursop, Rasamala, and Benalu Cengkeh/Clove Benalu. Conclusion: The most widely studied Indonesian herbal plant in vitro as an anti-cancer is Soursop, while the anti-cancer activity that is widely reported is by inhibiting cell proliferation through intrinsic pathways.
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Introduction: Vitamin D is an essential steroid hormone that consists of two forms, namely vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol), which can be obtained from exposure to sunlight, synthesis of vitamin D in the skin, food and dietary supplements. Prevalence of vitamin D deficiency in several countries including Indonesia is still high, while the role of vitamin D is very important including accelerating the wound healing process, increasing the immune system, anti-inflammatory, and anti-bacterial. Purpose: This case report aims to find out the role of vitamin D in the wound-healing process in the oral mucosa. Case Reports: Two men went to the Oral Disease Clinic with complaints of canker sores on the oral mucosa for more than a month accompanied by pain. Intra-oral condition in the first patient showed multiple ulcers with yellowish white base surrounded by erythematous areas, well-defined, irregular with a size of 1.5 × 1 cm and 1 × 0.5 cm on the right and left buccal mucosa, while intra-oral in the second patient, a single ulcer with a base was found yellowish colour surrounded by erythematous area, oval measuring 3x1 cm, clearly demarcated with induration. Results: Laboratory examination of vitamin D in both patients showed decreased levels of vitamin D with values of 28.7 and 9.8 ng/mL. Conclusion: Vitamin D supplementation has shown effectiveness in wound-healing processes in the oral mucosa.
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Introduction: Traumatic ulcer commonly occurs in the oral cavity, resulting in the loss of the entire epithelium. Traumatic ulcers often appear to mimic other lesions of the oral mucosa but the causative factors and other characteristic features rule out the differential diagnosis. It may have a similar appearance to some oral ulcer lesions such as traumatic ulcer granuloma with stromal eosinophilia (TUGSE) and oral squamous cell carcinoma (OSCC). Objective: To identify traumatic ulcers from other chronic lesions such as TUGSE and OSCC. Case: First case, a 63-year-old female complained of pain on the right side of the tongue for 4 months. Intraoral examination showed a painful single ulcer, mild keratosis white halo, and induration on the right lateral of the tongue. The second case, a 38-year-old male complained of pain on the left side of the tongue for 2 months. Intraoral examination showed a painful single ulcer, mild keratosis white halo, and induration on the left lateral of the tongue. In both cases, there were some retained roots where the ulcer was located, and due to its contact with lateral of the tongue and the appearance of the lesion, we got a provisional diagnosis of traumatic ulcer. Case Management: These ulcers had a visual appearance similar to OSCC and TUGSE, so eliminating etiological factors and a comprehensive treatment plan were needed. We planned to extract teeth close to the lesion that was suspected to be the etiology of traumatic ulcer. We also prescribed 0.1% triamcinolone acetonide in orabase to improve healing. One week later, the ulcer in both patients had healed. Conclusion: Recognition of traumatic ulcer characteristics is crucial in eliminating local factors to get rid of any differential diagnosis.
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Early detection of PAD and neuropathy is essential to prevent diabetic foot ulcers (DFU). The study aimed to identify the inter reliability of diabetic foot check-up (Ipswich touch test [IpTT] and palpation of the dorsal pedis and posterior tibialis) between nurses and caregivers. An inter-operator observation study between nurses and caregivers was conducted to evaluate the reliability of diabetic foot check-up in eight public health centers in eastern Indonesia. Patients with diabetes mellitus (DM) with and without diabetic foot ulcer (DFU, n = 144) were included in this study. The nurse demonstrates IpTT and palpation of the dorsal pedis and posterior tibial artery, followed by the caregiver. The McNemar test confirmed no difference in IpTT between nurses and caregivers on the left foot at the first, third, and fifth finger (P > 0.05), similar to the right foot (P > 0.05). The sensitivity of palpation dorsal pedis was (47.3%-50%) and (50%-52%) for the left and right foot, respectively. The insights gained from this study may assist in implementing diabetic foot check-up as an early screening tool for risk DFU in the community setting.
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This study aimed to evaluate and compare the effects of oil- and air-heat treatments on the durability of Paulownia tomentosa and Pinus koraiensis woods against Fomitopsis palustris and Trametes versicolor. The wood samples were treated in palm oil and air at 180, 200, and 220 °C for 2 h. The weight loss, morphology, crystalline properties, and chemical compounds of untreated and heat-treated wood after fungal attack were investigated. The significant difference in weight loss between oil- and air-heat-treated samples was shown at 220 °C. Heat-treated wood exposed to white-rot fungus showed a lower weight loss than that exposed to brown-rot fungus. The cell components in the untreated- and heat-treated Paulownia tomentosa and Pinus koraiensis at 180 °C were severely damaged due to fungal exposure compared to those at 220 °C. A fungal effect on the relative crystallinity was observed in heat-treated wood at 180 °C, whereas the effect was not observed at 220 °C. Following brown-rot fungus exposure, untreated- and heat-treated wood at 180 °C showed a notable change in the Fourier transform infrared (FTIR) peaks of polysaccharides, whereas no noticeable change in lignin peaks was observed. Heat-treated wood at 220 °C showed no noticeable change in the FTIR spectra owing to brown-rot fungus exposure. Exposure to white-rot fungus did not noticeably change the FTIR spectra of untreated and heat-treated wood.
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Temperatura Alta , Magnoliopsida , Pinus , Doenças das Plantas , Madeira , Fungos , Lignina/análise , Óleo de Palmeira , Pinus/microbiologia , Trametes , Redução de Peso , Madeira/química , Madeira/microbiologia , Doenças das Plantas/microbiologia , Doenças das Plantas/prevenção & controle , Magnoliopsida/microbiologia , ArRESUMO
This case highlights the role of stress as trigger factor of HSV-1 reactivation causing recurrent intraoral herpes mimicking herpes-associated erythema multiforme (HAEM). A 24-year-old female came with chief complaints of pain in the oral cavity followed by painful swallowing and fever. She admitted under stress due to family problems and also had insomnia for the last three years. Extra-oral examination revealed serosanguineous crusts on lips that were painful and easily bleed. Intra-oral examination showed the white-yellowish multiple and coalescent ulcers, irregular, and painful on the left and right buccal mucosa, upper and lower labial mucosa, dorsum of the tongue, the floor of the mouth, and oropharynx. The results of the Depression Anxiety and Stress Scale (DASS)-21 examination were moderate depression, extremely severe anxiety, and moderate stress. The results of the HSV-1 IgG examination before and after therapy were positive with titer > 200 U/mL. Pharmacological therapy included acyclovir 200 mg tablets, multivitamin, benzydamine HCl lozenges, 0.025% hyaluronic acid mouthwash, 0.9% NaCl, and 100% petroleum jelly. Non-pharmacological therapy included stress management such as self-encouragement and referral to consult with a professional. This therapy generated significant result. In conclusion, stress affects many systems in the body, including the oral cavity. Stress is one of the trigger factors for HSV-1 reactivation which can cause oral manifestation. Early detection of trigger factors is important for better treatment result.
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Introduction: Down syndrome is a congenital genetic disorder caused by an error in cell division, resulting in the presence of an additional third chromosome 21. Down syndrome is one of the leading causes of intellectual disability. Millions of these patients face various health issues. This study aimed to provide information about the challenges in the management of chronic ulcer mimicking OSCC in Down Syndrome child with motoric disorders. Case: A 12-year-old boy with Down Syndrome and motoric disorders was referred to Oral Medicine Department. In the extraoral examination, the patient had a dysmorphic face and dry lips. Lymph node examination could not be assessed because the patient wore a cervical collar. The intraoral examination showed an irregular ulcer with 1×0.7 cm in diameter, indurated margin, and white-yellowish base at the right lateral border of the tongue. The 55 teeth were sharp and caused an occlusion trauma to the right lateral border of the tongue. The patient was diagnosed with a chronic traumatic ulcer mimicking OSCC based on clinical examination. The medication given to the patient were sodium chloride 0.9%, povidone-iodine mouthwash 1%, and petroleum jelly. Conclusion: Children with Down syndrome often suffer from orofacial abnormalities which can affect their oral health and their family's quality of life. Dental and oral care for Down Syndrome children with motoric disorders required some challenges and collaboration with their parents, families, and caregivers.
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This study aimed to analyze the basic properties (chemical composition and physical and mechanical properties) of belangke bamboo (Gigantochloa pruriens) and its potential as a particleboard reinforcement material, aimed at increasing the mechanical properties of the boards. The chemical composition was determined by Fourier transform near infrared (NIR) analysis and X-ray diffraction (XRD) analysis. The physical and mechanical properties of bamboo were evaluated following the Japanese standard JIS A 5908 (2003) and the ISO 22157:2004 standard, respectively. The results showed that this bamboo had average lignin, holocellulose, and alpha-cellulose content of 29.78%, 65.13%, and 41.48%, respectively, with a degree of crystallinity of 33.54%. The physical properties of bamboo, including specific gravity, inner and outer diameter shrinkage, and linear shrinkage, were 0.59%, 2.18%, 2.26%, and 0.18%, respectively. Meanwhile, bamboo's mechanical properties, including compressive strength, shear strength, and tensile strength, were 42.19 MPa, 7.63 MPa, and 163.8 MPa, respectively. Markedly, the addition of belangke bamboo strands as a reinforcing material (surface coating) in particleboards significantly improved the mechanical properties of the boards, increasing the modulus of elasticity (MOE) and bending strength (MOR) values of the fabricated composites by 16 and 3 times.
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Presently, the quality assurance of agarwood oil is performed by sensory panels which has significant drawbacks in terms of objectivity and repeatability. In this paper, it is shown how an electronic nose (e-nose) may be successfully utilised for the classification of agarwood oil. Hierarchical Cluster Analysis (HCA) and Principal Component Analysis (PCA), were used to classify different types of oil. The HCA produced a dendrogram showing the separation of e-nose data into three different groups of oils. The PCA scatter plot revealed a distinct separation between the three groups. An Artificial Neural Network (ANN) was used for a better prediction of unknown samples.