Toxic epidermal necrolysis dipicu oleh parasetamol dan kloramfenikol

Toxic epidermal necrolysis (TEN) adalah peradangan sistemik akut yang melibatkan kulit, membran mukosa, epitel pernafasan dan pencernaan. Dalam banyak kasus, obat-obatan merupakan penyebab utama TEN akan tetapi dapat juga disebabkan oleh infeksi dan faktor resiko lain. Membran mukosa (rongga mulut, konjungtiva dan anogenital) adalah bagian tubuh yang paling awal terlibat pada TEN. Tujuan dari studi kasus membahas mengenai Toxic epidermal necrolysis yang dipicu oleh parasetamol dan kloramfenikol serta manajemen terapinya. Seorang wanita berumur 34 tahun mengeluh, empat hari sebelum rawat inap merasa pusing dan nyeri menelan, ia minum obat parasetamol dan kloramfenikol untuk mengobatinya. Tiga hari kemudian timbul luka pada kelopak mata dan bibir sehingga terasa nyeri saat membuka mata dan mulut. Pada bibir ditemukan krusta serosanguis yang mudah berdarah dan epidermolysis 32% pada kulit serta di mukosa oral terdapat lesi erosif, pseudomembran, eritem dan edema. Berdasarkan gambaran klinis, ditegakkan diagnosis TEN yang dipicu oleh parasetamol dan kloramfenikol. Terapi yang diberikan pada kunjungan pertama adalah kompres bibir dengan NaCl 0,9 %, 3 hari kemudian ditambahkan obat kumur chlorhexidine gluconate 0,1%. Mulai hari ke-7 ditambahkan terapi deksametason racikan dalam bentuk salep dan obat kumur. Setelah 10 hari menjalani perawatan, perih serta luka pada bibir dan rongga mulut sudah mengalami perbaikan, nyeri menelan pun berkurang. Kesimpulan: Tanda awal TEN adalah ruam dan lepuh pada mulut sehingga dokter gigi memiliki peranan penting dalam deteksi dini kelainan ini. Dokter gigi harus tanggap dan segera merujuk ke dokter spesialis kulit jika ditemukan tanda awal TEN, sehingga dapat segera diterapi sejak dini

ISOLATION OF ACTIVE COMPOUND FROM RED POMEGRANATE (PUNICA GRANATUM L.) SEEDS ETHANOLIC EXTRACTS

Objective: Pomegranate (Punica granatum L.) is rich in antioxidants and antibacterials, lending itself to beneficial effects on health improvement. The seeds contain a variety of active compounds. The purpose of this research was to isolate the active compound of red pomegranate seeds through ethanolic extraction. Methods: Pomegranate seeds were extracted into 24 hexane fractions of the concentrated crude extract and left in open vials until all the solvent evaporated, leaving behind crystals. Crystals in vials 11, 12, and 13 were purified using n-hexane, ethyl acetate, methanol, chloroform, acetone and isopropyl alcohol as the solvents. The crystals were monitored with Thin Layer Chromatography (TLC) on a Kiesel gel 254 GF plate (e. Merck) using the developing system of hexane: ethyl acetate: formic acid (1:1:0.1) mixture and a UV light spot viewer with 366 wavelength emissions. Purification test with TLC two directions using hexane: ethyl acetate: formic acid (1:1:0.1) mixture as the eluents for the first development, continued with the second development using chloroform: methanol: acetate acid (9:0.5:0.5) mixture. The Retention Factor (Rf) value for the spot was measured. Results: Chromatogram showed only 1 spot with Rf value 0.88. Conclusion: There is one pure (active) isolate in red pomegranate seeds ethanolic extract

Infeksi virus herpes simplex tipe 1 yang tereaktivasi oleh paparan sinar matahari

Virus herpes simplex tipe 1 termasuk ke dalam famili Herpesviridae dan subfamili Alphaherpesvirus dengan manusia sebagai reservoir alami virus herpes. Virus herpes simplex tipe 1 bermanifestasi pada oral dan perioral. Setelah terjadi infeksi primer, subkeluarga alphaherpesvirinae akan laten pada saraf ganglia dan dapat reaktivasi. Terjadinya reaktivasi alpha herpesvirinae salah satunya dikarenakan paparan sinar matahari. Laporan kasus ini memaparkan tentang infeksi virus herpes simplex tipe 1 yang tereaktivasi oleh paparan sinar matahari. Pasien laki-laki berusia 37 tahun berobat ke Poliklinik Ilmu Penyakit Mulut RSUP dr. Hasan Sadikin Bandung didiagnosa intraoral herpes rekuren dan kandidiasis pseudomembran akut. Pasien mengeluhkan sudah 1 bulan ini terdapat banyak sariawan pada lidah, gusi dan tenggorokan terasa nyeri sehingga sulit untuk makan dan minum dan lama kelamaan timbul warna putih pada lidah. Ada riwayat demam pada awal terjadi sariawan, riwayat alergi disangkal, pernah sariawan sebelumnya tetapi tidak separah seperti saat ini serta bekerja di kebun dalam satu bulan terakhir. Sudah berobat ke beberapa dokter gigi tetapi tidak ada perbaikan. Penanganan yang dilakukan meliputi, anamnesis, pemeriksaan ekstra oral danintral oral, pemeriksaan laboratorium imunoserologi dan mikrobiologi, tatalaksana farmakologi dan non farmakologi. Pasien menunjukkan perbaikan yang signifikan dalam pengobatan 3 minggu. Artikel ini memaparkan paparan sinarmatahari dapat menyebabkan reaktivasi infeksi virus herpes simplex tipe 1

Herbal Medicines as Adjunctive Therapy for Oral Squamous Cell Carcinoma Management: a Case Report: Obat Herbal sebagai Terapi Tambahan untuk Manajemen Karsinoma Sel Skuamosa Oral: Laporan Kasus

Oral Squamous Cell Carcinoma (OSCC) is the most frequent oral cancer. The management for OSCC are surgery, chemotherapy, and radiotherapy. Chemotherapy and radiotherapy have high toxicity and side effects, therefore effort are needed to reduce them. Several studies show that herbal medicines have anticancer effects with lower toxicity and side effects. The objective is to discuss about management of OSCC using chemotherapy and anticancer herbal medicines as adjunctive therapy.  A 59-year-old man came to the oral medicine clinic complaining a painful ulcer on the right tongue since 8 months ago. The ulcer had been enlarged in the last 3 months and the tongue was difficult to be moved. He used pain relievers and aloe vera gel but there was no improvement. He smoked one pack a day since 40 years ago. Intraoral showed an irregular indurated endophytic mass with an ulcer on the right lateral of the tongue. An incisional biopsy was performed and the histopathological diagnosis was poorly differentiated OSCC. The patient was referred to the oncology department and advised for chemotherapy 6 cycles per 3 weeks. He also used herbal medicines containing Panax ginseng radix, Panax pseudoginseng radix, Ophiopogonis japonicus, Ganoderma lucidum, Ligusticum wallichii rhizoma, and Atractylodes macrocephala rhizoma. The content of these herbal medicines have anticancer and immunomodulatory effects. After the second cycle of chemotherapy, there was a significant improvement. OSCC management with chemotherapy combined with anticancer herbal medicines can increase the success of therapy and reduce the side effects of chemotherapy

A REVIEW: ZINC AS AN ANTIVIRUS ALTERNATIVE TREATMENT FOR HERPES SIMPLEX VIRUS INFECTION

This study aimed to review zinc's effectiveness as an antivirus in treating herpes simplex virus infection. The authors use international journals published from 2000-2022, and use search engines such as Google Scholar, PubMed, and Science Direct with the keywords "zinc and herpes simplex virus". The herpes simplex virus that often causes symptoms in humans are HSV type 1 and type 2. The lesions appear as vesicles which then rupture into ulcers. Zinc is one of the most abundant nutrients or metals in the human body besides iron. Studies about the effects of zinc on HSV have shown that it has the function of inhibiting the viral life cycle. HSV attaches to the host cells to replicate and synthesize new viral proteins. Zinc can inhibit this process by depositing on the surface of the virion and inactivating the enzymatic function which is required for the attachment to the host cell, disrupting the surface glycoprotein of the viral membrane so it could not adhere and carry out the next life cycle, it can also inhibit the function of DNA polymerase that works for viral replication in the host cell. This article showed that zinc has effectiveness as an antivirus against the herpes simplex virus, therefore, patients infected with HSV can be treated with zinc as an alternative to an antivirus drug

The Challenge of Accurate Diagnosis of Oral Lichenoid Lesions in Diabetic Patient: A Case Report

Mercury in  amalgam restoration is one of allergen-induced oral lichenoid lesions which resemble oral lichen planus clinically and histopathologically. Thus, an accurate clinical diagnosis is frequently challenging for clinicians, and it is further complicated because similar oral lesions in oral lichenoid lesions can occur as a manifestation of oral lichenoid drug reactions. This case report illustrates the difficulty of an accurate diagnosis of oral lichenoid lesions due to amalgam restorations in type II diabetes mellitus patient. A 59-year-old male patient presented with a 12-month history of oral ulceration and white striations on left lateral tongue, bilateral distribution of white non scrapable plaque-like lesion mixed together with erosion on buccal mucosa adjacent to amalgam restorations on 37 and 47. The patient’s history for any associated skin lesions was negative. The patient had type II diabetes mellitus with inconsistent intake of oral  hypoglycemic drugs, and  atopy history of house dust mite and shrimp. We initially diagnosed the case as oral lichen planus. Systemic and topical corticosteroids were instituted, but after a month follow-up, all lesions still showed slight improvement. The final diagnosis of oral lichenoid lesions due to amalgam restorations was made following a positive patch test for amalgam. All lesions were gradually resolved in 3-month follow-up after the causative teeth being extracted. Patch test is useful to differentiate between oral lichenoid lesions and oral lichen planus. The treatment of oral lichenoid lesions due to amalgam restorations is simply removal or replacing the offending materials

Efek Penggunaan Produk Perawatan Gigi Dan Mulut Yang Dijual Bebas (Otc) Pada Mukosa Oral

Over-the-Counter (OTC) drug is a drug which is sold freely in the market and can be purchased without a prescription. Special markings on the packaging and etiquette of OTC drug is a green circle with a black edge.  Over-TheCounter (OTC) Dental Care Products are dental care products sold directly to consumer without a prescription from the dentist. Nowadays, there has been a significant increase in the number of OTC products in the market for oral health such as mouth washes, breath fresheners, tooth whitening, tooth paste, denture cleaners etc. To find out the effect of inappropriate use of OTC dental care products on the oral  mucosa. Many OTC dental products are freely  sold, make easier for people to obtain the desired products without visiting the dentist. Besides those advantage, they may also cause undesirable effects due to the inappropriate use and indications which could actually risk the oral health of patients. Side effects that may occur in the oral cavity including altered taste, tooth staining, burning sensation, gingival irritation, desquamation, erosion, numbness and dryness of the oral mucosa. Discontinuing the use of   these products usually will recover the oral mucosa conditions. The inappropriate use and indications of OTC dental care products could cause unwanted side effects

MANAGEMENT OF BURNING MOUTH SYNDROME: A LITERATURE REVIEW

Background: Burning mouth syndrome (BMS) is a chronic idiopathic oral dysaesthesia that presents as a burning sensation in the oral cavity usually without any specific oral lesions or laboratory findings. Burning sensations may appear on the buccal mucosa, hard and soft palate, tongue and lips. BMS appears to be more prevalent in postmenopausal women. The term menopause is often used for a condition in which the permanent cessation of the primary function of the ovaries in humans that occurs especially in middle-aged women. Available evidence suggested that BMS is a multifactorial disorder with physiological basis. Pathophysiology of BMS remains unclear. The etiopathogenesis in most patients who complain of burning sensations have interactions with several factors such as local, systemic, and/ or psychogenic factors. The aim of this literature review was to assess and evaluate the management of BMS comprehensively.Discussion: The therapy of BMS including hormone replacement therapy,systemically therapy, such as antidepressants, clonazepam and topical medication (clonidine and capsaicin) and reassurance as the stress management.Conclusion: Proper management of the BMS involves the combination of pharmacologic treatment and psychotherapy, as well as reassurance is an important thin

VIRUS AS A CAUSE OF SALIVARY GLAND DISEASES

Background: Enlargement in the extraoral region with the absence of abnormal dental and periodontal structures are sometimes seen in dental practice, sometimes followed by xerostomia. Enlargement of the acute nonsuppurative salivary glands has been associated with several types of viruses. The purpose of this paper is to review salivary gland diseases associated with non-HIV and HIV viral infections. Discussion: Non-HIV viruses which were detected in the salivary glands including Paramyxovirus, cytomegalovirus (CMV), Hepatitis C virus (HCV), human papilloma viruses (HPV), Epstein-Barr virus (EBV), human herpes simplex virus (HHSV-8), and coxsackie virus. HIV-associated salivary gland disease typically presents with xerostomia and/or intraglandular lymph nodes, and diffuse infiltrative lymphocytosis syndrome (DILS). The most common viral infection conditions in salivary gland disorders are mumps and HIV. Enlargement and inflammation of the glandular structures will affects the control of salivary secretion by nerves. Parasympathetic nerves block conducted signals to the salivary glands, so the salivary flow is decreased. Conclusion: There is association between viral infection and diseases of the salivary gland. By knowing sequelae viruses on the salivary gland, dentists are expected to understand the clinical condition and therapeutic that should be given to the patients