PREVALENSI XEROSTOMIA PADA PENDERITA PENGGUNA OBAT ANTIHIPERTENSI DI POll JANTUNG RSUD DR.SOETOMO SURABAYA

Dari hasil penelitian maka dapat ditarik kesimpulan bahwa xerostomia pada kelompok ACE-Inhibitor + HCT sebesar 38.46% pada kelornpok Beta Adrenergic Blocker +HCT sebesar 20%, dan pada Kelompok Siow Channel Cilcium Entry Blocking Agent + HTC sebesar 50%

Stomatitis aftosa yang diperparah oleh iritasi kimiawi obat tradisional

Stomatitis aftosa adalah suatu kondisi inflamasi dengan etiologi yang belum diketahui, ditandai dengan ulserasi sangat nyeri di mukosa rongga mulut selama 7 hingga 14 hari. Berbagai faktor berpengaruh dalam pembentukannya, salah satunya adalah trauma lokal. Perawatan diberikan untuk meredakan nyeri, mengeliminasi sumber trauma, dan penyembuhan ulserasi. Tujuan laporan kasus ini adalah untuk melaporkan stomatitis aftosa yang diperparah oleh iritasi kimiawi obat tradisional. Seorang laki-laki berusia 64 tahun mengeluh sariawan pada gusi kiri bawah terasa nyeri sejak kurang lebih 1 minggu yang lalu. Pasien mengoleskan suatu obat cair tradisional untuk meredakan rasa nyeri tapi kemudian rasa nyeri timbul kembali dan belum mereda. Tanda vital normal kecuali skor VAS (visual analog scale) nyeri mulut 6/10. Pemeriksaan ekstra oral normal, pemeriksaan intra oral didapatkan ulkus soliter berukuran 1x1,5 cm pada lipatan bukal regio 34, 35 dengan peninggian tanpa indurasi dan nyeri. Tata laksana meliputi anamnesis untuk mengetahui faktor yang memperparah, pemeriksaan klinis, debridement lesi untuk menghilangkan jaringan nekrotik dan aplikasi obat topikal gel mengandung klorin dioksida. Pasien diinstruksikan untuk berhenti mengoleskan obat tradisionalnya dan menggunakan obat yang diresepkan. Lesi sembuh dalam waktu 13 hari. Stomatitis aftosa dapat diperparah oleh iritasi kimiawi. Anamnesis, pemeriksaan klinis, debridement lesi dan pemberian obat yang tepat dapat membantu tata laksana dan penyembuhan yang efektif

PENGARUH PEMBERIAN ZnSO4 1 % TOPIKAL TERHADAP EKSPRESI MMP-9 DAN JUMLAH FIBROBLAS PADA PENYEMBUHAN ULKUS TRAUMATIKUS TIKUS WISTAR DIABETES MELITUS

Diabetes mellitus adalah penyakit yang berdampak pada proses penyembuhan luka di dalam mulut. Pada penderita diabetes melitus, aktifitas prolifrasi fibroblast menurun dan aktifitas enzim kolagenese serta MMP-9 meningkat, sehingga penyembuhan ulserasi pada rongga mulut akan menjadi lebih lama. Zinc sulfat merupakan mineral yang dapat meningkatkan sinyal antar sel, proliferasi komponen penyembuhan, serta migrasi komponen pada tahapan penyembuhan.  Tujuan: untuk menganalisis pengaruh pemberian zinc sulfat 1% secara topikal pada ekspresi MMP-9 dan jumlah sel fibroblas jaringan mukosa mulut hewan coba pada kondisi diabetes mellitus, yang mengalami ulkus traumatikus. Metode: Pada penelitian ini hewan coba (48 ekor tikus wistar) berusia 2-3 bulan dan berat badan 150-200 gram, dibagi menjadi empat grup. Untuk mendapatkan tikus diabetes, maka subjek diinduksi dengan streptozotocin (30mg) yang dilarutkan dalam 1,33 ml buffer (asam sitrate). Untuk membuat ulser pada jaringan mukosa mulut, maka dilakukan dengan menempelkan burniser panas selama 10 detik pada mukosa bibir subjek. Pada setiap periode ekperimen (hari ke-5 dan ke-7) dilakukan pengambilan jaringan mukosa, dan dilanjutkan dengan pembuatan preparat histologi. Pada preparat histologi digunakan pengecatan HE untuk mengidentifikasi dan menghitung jumlah fibroblast, sedangakan IHS untuk mengidentifikasi dan menghitung ekspresi MMP-9. Metoda statistik one-way Anova digunakan untuk analisis perbandingan antara grup perlakuan dan grup kontrol. Signifikansi didasarkan pada nilai p<0.05. Hasil: Pemberian zinc sulfat 1% secara topikal pada ulkus traumtikus pada tikus diabetes mengakibatkan terjadi peningkatkan jumlah fibroblas (p<0,05) dan menurunkan ekspresi MMP-9 (p<0,05) yang diamati pada setiap periode eksperimen yang ditetapkan dalam penelitian ini. Kesimpulan: Zinc sulfat 1% dapat mempercepat proses penyembuhan ulkus traumatikus pada hewan coba dengan kondisi diabetes mellitus.   Kata kunci : diabetes melitus, ulkus traumatikus, zinc sulfat , MMP-9, fibroblas

Neuropathy complication of antiretroviral therapy in HIV/AIDS patients

Objectives: Significant pain from HIV-associated sensory neuropathy (HIV-SN) affects 40% of HIV-infected individuals treated with antiretroviral therapy (ART). The most salient symptom of the neuropathy is pain, which frequently is moderate-tosevere intensity, associated with reduced activities and physical function, sleep disruption, increased severity of depression, and anxiety. Yet, evidence for managing painful HIV-SN is poor. The purpose of this study was to verify by scientific evidence the neuropathy complication in HIV/AIDS patients to develop effective pain management strategies. Methods: Design: Systematic review. Data sources: PubMed (MEDLINE), Cochrane, www.controlled-trials.com. Selection criteria: the filter “English” was used, timeframed searched was 2009–2019, randomized controlled trials (RCT). Keywords were verified in MeSH “Peripheral Nervous System Disease” and “Antiretroviral Agents” or “Antiretroviral therapy.” Review method: the PRISMA flowchart was used. Result: A systematic search following PRISMA guidelines was carried out, and 12 specific articles/studies on the subject were selected. The results revealed that HIV therapy, aging, body mass index, height, and systemic conditions influence neuropathy conditions in HIV/AIDS patients. The multistudies focused on pain management approaches such as administration of pain medication, drug combination to prevent side effects, or ART with minimal side effects. Conclusion: Sensory neuropathy is a frequent complication of HIV infection and ART. An understanding of the mechanism and pathophysiology of neuropathy in HIV is urgently required to develop alternative treatment modalities and to evaluate preventive strategies

FREEZE-DRIED PLATELET-RICH PLASMA PROMOTES TRIGEMINAL NEUROPATHIC PAIN RELIEF IN A RAT MODEL

Objective: Neuropathic pain and treatment side effects decreasing quality of life, reducing productivity, and high costs due to long duration of treatment. Regenerative medicine is a new and effective alternative treatment for neuropathic pain, one of which is Platelet-Rich Plasma (PRP) therapy. The objective if this study is to prove that there are differences in neuroregeneration post-crush injury after FD-PRP administration. Materials and Methods: Neuropathic pain model was made with crushing method, by compressing the infraorbital nerve using the artery clamp for 15 seconds. Rats divided into six groups. Each group was observed on day 14 (A, B, C) and 21 (A', B', C') to observe the macrophages, lymphocytes, and Schwann cells with Hematoxylin Eosin staining seen on horizontal plane of the infraorbital nerve with 400x magnification. Face grooming observations were performed on day 0 (A0, B0, C0), day 7 (A7, B7, C7), day 14 (A14, B14, C14), day 21 (A21, B21, C21). Results: There were significant differences in face grooming frequencies between groups on day 0 (p = 0.002). ANOVA Same Subject test on A`, B`, and C` revealed significant differences in macrophages and lymphocytes with score 0.02 (p &lt;0.05) and 0.013 (p&lt;0.05), respectively. There were significant differences between group A' and B' and between B' and C' (p&gt;0.05). Conclusions: FD-PRP promotes nerve regeneration in axonotmesis, which was characterized by a decrease in face grooming frequency on day 7 and an increase in the number of lymphocytes, macrophages and Schwann cells on day 21

HIV-1 TAT: a Potential Diagnostic and Disease Progression Biomarker of HIV/AIDS

Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) constitutes a national threat to Indonesia from many perspectives because the number of new cases there is increasing faster than in any of the other countries in Asia. Susceptibility to opportunistic infection leads to high morbidity and mortality rates, especially because HAART is not widely distributed. A diagnosis of AIDS is often confirmed only after the patient is severely immunocompromised. HIV-1 TAT is a HIV regulatory protein which plays an important role in viral replication. Extracellular TAT has been associated with many pathological conditions related to AIDS. To detect the presence of TAT in plasma as a means of assessing its potency as a diagnostic and progression marker of HIV/AIDS. An analytic observational study was conducted on 80 HIV(+) patients and 30 control patients in Soetomo Hospital. The diagnosis of HIV was confirmed by reference to medical records. A CD4+ count was effected by flowcytometry, while the HIV-1 TAT plasma level was measured by means of ELISA. The correlation between the CD4+ count and HIV-1 TAT plasma level was analyzed by Pearson. HIV-1 TAT presented only in HIV(+) patients. Increased HIV-1 TAT plasma level correlates to a decreased CD4+ count (r=-0.912; p=0.000, p<0.049). HIV-1 TAT is a potential diagnostic biomarker indicating the degree of disease progression of HIV/AIDS. Clinical article (J Int Dent Med Res 2018; 11(1): pp. 124-127) Keywords: HIV/AIDS, HIV-1 TAT, disease progression, diagnostic, biomarker. Received date: 08 November 2017 Accept date: 01 December 201

CORRELATION OF Ki67 EXPRESSION TO DEGREE OF DYSPLASIA IN LINGUAL EPITHELIAL DYSPLASIA IN Rattus norvegicus EXPOSURED BY CIGARETTE SMOKE (Hubungan Ekspresi Ki67 Terhadap Derajat Displasia Pada Epitel Mukosa Lidah Rattus norvegicus yang Dipapar Asap Rokok)

Background: Dysplasia is malignant transformation of stratified squamous epithelium characterized by cellular atypia and loss of stratification and maturation. It can caused by cigarette smoke. Measuring the activity of cell proliferation as the beginning of dysplasia is very useful to know the development of malignancy. One of proliferation marker is Ki67 that expressed in all cell cycle phase except G0.Methods: 30 male wistar rats divided into: control grup (n=10), exposed to cigarette smoke for 4 weeks (n=10), 8 weeks (n=10) as much as 20 cigarettes/group/day/exposure used smoking pump. Specimen were stained HE to see dysplasia and Ki67 expression seen immunohistochemically. Statistical analyzed by Spearman correlation.Result: There was an increase in mean of Ki67 expression and significant differences between groups (p=0,000) and also significant difference of degree of dysplasia between groups (p=0,000). There was a strong correlation between Ki67 score to degree of dysplasia (p=0.001).Conclusion: Increased of Ki67 expression proportional to the Increase in degrees of dysplasi

Oral hyperpigmentation as an adverse effect of highly active antiretroviral therapy in HIV patients: a systematic review and pooled prevalence

Human Immunodeficiency Virus (HIV) infects patients via CD4+ cells which are later be destroyed subsequently causing the deteriotation of immune system. HIV generally manifests in the oral cavity as the first indicating sign and a marker of disease progression. HAART medications are used to reduce the incidence of oral manifestations, however it can also generate adverse effects in the oral cavity including oral hyperpigmentation. This review aimed to estimate the prevalence of oral hyperpigmentation which affect individual quality of life as a side effect of HAART.This systematic review applied Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 2020. Literature search was performed in ScienceDirect, PubMed, and Scopus by combining terms such as highly active antiretroviral therapy, oral manifestation, epidemiology or prevalence published between January 1998 to March 2022.Of 108 articles, eleven articles were included for systematic review and meta-analysis. The pooled prevalence of oral hyperpigmentation in HAART patients was 25% (95% CI: 11%, 38%; I2: 99%). Subgroup analysis based on geographical location showed varied result may be due to the type and duration of HAART used in study population. The most widely used type of ARV was from the NRTI group (n=7) and the study with the shortest duration showed the lowest oral hyperpigmentation prevalence (n=7).There is an increased prevalence of oral hyperpigmentation by the use of HAART. Future study should investigate the correlation between HAART duration and the degree of oral hyperpigmentation

Number of macrophages and transforming growth factor β expression in Citrus limon L. Tlekung peel oil-treated traumatic ulcers in diabetic rats

Purpose: To analyse the potential use of Citrus limon L. Tlekung peel oil in the treatment of traumatic ulcers in diabetic rats based on number of macrophages and transforming growth factor β (TGF-β) expression. Method: Standard steam distillation was performed to produce Citrus limon L. peel oil with its components subsequently analysed by gas chromatography-mass spectrometry (GC-MS). Diabetes was induced with streptozotocin (STZ) via administration of a single 50 mg/kg dose. A traumatic ulcer was subsequently induced with a 5 mm burnisher heated for 30 s and applied without pressure for 1 s to the lower labial mucosa of the animals. Citrus limon L. oil gel containing 3% carboxyl methyl cellulose sodium was then topically administered to the traumatic ulcer for a period of three or five days. TGF-β expression was analysed through immunohistochemical staining and the macrophage number calculated with haematoxylin-eosin stain. Results: The major identified compounds in Citrus limon L. peel oil include fumaric (31.78 %), dlimonene (17.38 %), z-citral (13.55 %), L-linalool (8.51 %), geraniol nerol (3.56 %), geraniol (2.94 %,), αterpineol (1.25 %) and γ-terpinene (1.03 %) together with other minor constituents. Treatment of traumatic ulcers with Citrus limon L peel oil produced higher number of macrophages and TGF-β expression (p = 0.000). Treatment over a period of five days also indicated higher expression of TGF-β and number of macrophages compared to that lasting three days with Citrus limon L peel oil (p = 0.000). Conclusion: Citrus limon L peel oil stimulates TGF-β expression and an increase of macrophage numbers in diabetic subjects during traumatic ulcer healing after three and seven days. Clinical application of Citrus limon L peel oil constitutes a potential therapy in the treatment of traumatic ulcers in diabetic subjects

Distilled liquid smoke coconut shell attenuates the cytokine profile of macrophages in oral ulcer in experimental model of diabetes mellitus

The effects of distilled liquid smoke coconut shell (DLS-CS) on the macrophages and nuclear factor erythroid- 2-related factor 2 (Nrf2) and cytokine profiles, that is, tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β), were analyzed in oral ulcer tissues affected by diabetes mellitus. Wistar rats were injected with alloxan to create diabetes mellitus, and an oral ulcer was made in the inferior labial fornix mucosa. The rats were treated with DLS-CS 20 µl/20 g body weight, topically, once a day for 3, 5, and 7 days. The Nrf2, TNF-α, IL-6, and IL-1β profiles were analyzed with immunohistochemistry staining and the macrophage count with hematoxylin-eosin staining. The Nrf2 profile was increased after 5 days of treatment and the IL-1β profile was consistently decreased (p < 0.05). The IL-6 profile started to decrease after 5 days, while the macrophages increased after 3 and 5 days. No significant difference was found in TNF-α expression. DLS-CS proved effective in decreasing IL-6 and IL-1β profiles as well as increasing Nrf2 and macrophage migration in oral ulcers with diabetes mellitus