Rancang Bangun Sistem Pakar untuk Menentukan Penyakit Mulut dengan Menggunakan Metode Certainty Factor

Dentistry graduates are required to treat patients with various diseases of mouth. A dentist who examined the patient should undertake a careful and thorough examination in order to determine the disease suffered by the patient. It is not always easy for the newly graduated dentists to deal with a wide variety of oral diseases. It is urgently needed a system that is able to facilitate the new dentist in diagnosing diseases of the mouth and how to follow up the disease. Based on the description of the problems, in this work we designed a web-based expert system application. The application is expected to help to overcome the problems of dentists who just completed his studies in diagnosing and following up on the patient\u27s natural disease. The expert system uses the certainty factor method to determine any symptoms experienced by the patient. The diagnosis is expected to produce a report to assist dentists in making a follow-up to the natural disease in the patient and save it into the database system. Based on the test results showed that the application of this expert system has the accuracy of 100% to indicate that the system is able to determine the type of oral disease. The accuracy of the results obtained from 10 test by a dentist

RECURRENT APHTHOUS STOMATITIS RELATED TO PSYCHOLOGICAL STRESS, FOOD ALLERGY AND GERD

Background: Recurrent Aphthous Stomatitis (RAS) is inflammation in oral mucosa characterized by recurrent single or multiple ulcers that usually affected in non keratinized mucosa. Etiology RAS is unknown but psychological stress, allergy, and gastrointestinal disease can be predisposing factors Case Management: A 23rd years old complained recurrent oral ulcer with free ulcer period for 3-5 days. The patient had a history of food allergy, GERD and psychological stress. Intraoral examination showed recurrent multiple ulcers in variation site of the mouth. DASS 42 screening showed high stress and high anxiety. Skin Prick Test showed positive allergy to kapok, beef, chicken, cow milk, white egg, duck egg, shrimp, cob fish, milkfish, chocolate, and peanut. Ulcers treated with nonsteroid antiinflammation Aloe Vera gel and stress management by reading assignment method.Discussion: Psychological stress altered the immune system so oral mucosa prone to inflammation, and make the history of GERD getting worse. Stress causes cortisol secretion that changes the imbalance of proinflammatory and antiinflammatory cytokines. Oral mucosa becomes more susceptible to hypersensitivity. In addition, stress decreased oral and esophageal mucosa resistance to GERDConclusion: RAS triggered by psychological stress, allergy, and GERD. Treatment of RAS is by elimination predisposing factors to prevent recurrence

KARAKTERISASI PROTEIN TAT HIV PEMICU PEMBENTUKAN HIFA CANDIDA ALBICANS SEBAGAI DASAR DESAIN BLOCKER UNTUK MENCEGAH ORAL CANDIDIASIS P ADA INFEKSI HIV

Oral Candidiasis adalah ko-infeksi yang paling sering terjadi pada pasien HIV/AIDS. Patogenesis selalu dikaitkan dengan penurunan sistem imun pasien, namun mekanismenya belum jelas. Candida albieans adalah flora komensal rongga mulut dengan sifat oportunistik. Pembentukan hifa merupakan petanda transfonnasi sifat Candida albicans dari komensal menjadi patogen. Protein transcriptional activator (fat) HIV mampu berikatan dengan reseptor pada dinding Candida albicans dan memicu pembentukan hifa melalui suatu jalur penyandi. Penelitian ini bertujuan menjelaskan peran protein Tat HIV pada patogenesis Oral Candidiasis yang terjadi pada pasien mv / AIDS. Penelitian dilakukan dalam tiga tahap. Tahap pertama dilakukan secara observasional eksploratif, untuk mengkarakterisasi protein Tat HIV dalam plasma dan saliva. Tahap kedua dilakukan isolasi protein pada membran Candida albicans. Tahap ketiga dilakukan secara eksperimental Iaboratorium untuk mengamati interaksi antara protein Tat HIV dan Candida albicans. Selain didapatkan data epidemiologis prevalensi kelainan rongga mulut pada pasien HIV/AIDS, peneiitian ini juga menemukan bahwa protein Tat HIV adalah protein spesifik pada plasma dan saliva pasien terinfeksi HIV dan dapat dideteksi melalui SDS-PAGE dan immunoblotting. Penelitian tahun kedua mendapatkan data prevalensi Oral Candidiasis dan prevalensi Candida spp pada pasien mv/AIDS, serta mengamati peningkatan ekspresi protein Candida albicans pada uji binding dengan protein Tat HIV. Penelitian ini menyimpulkan bahwa protein Tat mv memiliki peran dalam memicu pertumbuhan hifa Candida albicans

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 <0.05) and 0.013 (p<0.05), respectively. There were significant differences between group A' and B' and between B' and C' (p>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

The Role of Mycobacterium Tuberculosis Detection on Oral Mucosa in Diagnosis of Pulmonary Tuberculosis

Background. Tuberculosis is one of the world's health problems, with larger mortality rate than HIV/AIDS. In order to control this disease, a new and inexpensive diagnostic method is needed. Oral samples, such as buccal mucosa epithelium, can be an alternative specimen, other than sputum, in the diagnosis of tuberculosis. Purpose. This study aimed to analyze the presence of Mycobacterium tuberculosis on buccal swabbing of tuberculosis patients. Method. Study was conducted on 18 new pulmonary tuberculosis patients in TB DOTS unit of Dr. Soetomo General Hospital. Each subject was swabbed on the buccal mucosa of the oral cavity for subsequent examination of PCR, AFB, and culture to detect Mycobacterium tuberculosis in the oral cavity. Result. The results showed that Mycobacterium tuberculosis was detected from 2 study subjects (11%) using PCR, whereas in AFB and culture examination methods no Mycobacterium tuberculosis was detected on buccal mucosa of the oral cavity. Conclusion. This study showed that Mycobacterium tuberculosis was detected on buccal mucosa swab of tuberculosis patients based on PCR technique, but this method is less suitable in diagnosis of pulmonary tuberculosis

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

Acid fast bacilli detected in the oral swab sample of a pulmonary tuberculosis patient

Background: Tuberculosis (TB) is an infectious disease that persists as a health problem worldwide. Mycobacterium tuberculosis, as an etiological agent, is transmitted from infected to uninfected individuals via airborne droplet nuclei. Oral health care workers or dental practitioners may be at high risk of TB infection because of their close proximity to infected individuals during treatment procedures. Simple and rapid screening of mycobacterium tuberculosis in the oral cavity is necessary in order to prevent transmission of infection. Purpose: To investigate the presence of acid-fast bacilli in the buccal mucosa of pulmonary TB patients. Methods: Nineteen pulmonary TB patients of both sexes, ranging in age from 19 to 74 years old participated in this study. The diagnosis of tuberculosis was performed by clinical symptom assessment and supporting examination, including acid-fast bacilli on sputum examination. Two buccal mucosa swabs taken from pulmonary TB patients were collected for acid fast bacilli direct smear by Ziehl Neelsen staining. Results: With regard to mycobacterium tuberculosis, acid-fast bacilli presented in 10.5% of the oral buccal mucosa swabs of subjects, whereas in the sputum specimens, bacilli were found in 52.6% of subjects. Conclusion: Acid-fast bacilli can be found in the buccal epithelial mucosa of pulmonary tuberculosis patients, although its presence was very limited

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

Hyperplasia of Wistar rat tongue mucosa due to exposure to cigarette side-stream smoke

Background: Hyperplasia, a condition whereby an increasing number of cells are produced due to their uncontrolled division, represents a common symptom of carcinogenesis. Cancer is a physical manifestation of cell malignancy resulting from abnormal proliferation. Globally, oral cancer currently constitutes the sixth largest lethal form of the condition. The most common etiology of oral cancer is tobacco of which cigarettes are the most popular related product. The health risks associated with cigarette smoke not only affect active smokers but also individuals who ingest it passively. Sidestream smoke comes from the lighted end of a burning tobacco product such as a cigarette, pipe or cigar and contains nicotine and many harmful cancer-causing chemicals. Inhaling sidestream smoke increases the risk of lung and other types of cancer. Purpose: The purpose of this study was to understand how sidestream cigarette smoke initiates precancerous changes, in this case hyperplasia, in the oral mucosa epithelium of Wistar rats. Methods: The subjects were divided into three groups, a 4-week treatment group (P1), an 8-week treatment group (P2), and a control group (K), each consisting of ten subjects. The subjects were exposed to a daily two-cigarette dose of smoke. The experiment used a post-test only control group design. All samples were sacrificed during the fourth and eighth weeks. Haematoxylin-eosin staining was performed on the tongues of the Wistar rats to establish the presence of hyperplasia. Data was analyzed using a one-way ANOVA test. Results: After the Wistar rats had been exposed to cigarette smoke, an increased degree of epithelial cell proliferation (hyperplasia) showed a significant difference with a p-value <0.05 during the eighth week. Conclusion: Exposure to cigarette sidestream smoke induces increased epithelial cell proliferation (hyperplasia) in Wistar rats

Correlation Linear Gingival Erythema, Candida Infection and CD4+ Counts in HIV/AIDS Patients at UPIPI RSUD Dr. Soetomo Surabaya, East Java, Indonesia

East Java has been 2nd highest province with HIV/AIDS cases in Indonesia on 2013. Oral manifestations are among the earliest and most important indicator of HIV infection progression. Linear Gingival Erythema (LGE) is the one of seven oral manifestation which associated with HIV Infection. Clinical feature of LGE is a distinctive fiery red band along the margin of the gingiva. The etiology and pathogenesis of LGE are still questionable, but a candidal infection and decreased of CD4+ counts has been suggested. The aim of this study was to investigate LGE with its correlation with Candida infection and decreased level of CD4+ in HIV/AIDS patient. This study was an analytical observational research with cross-sectional and total sampling method. The samples consisted of 88 HIV/AIDS patients treated in UPIPI RSUD Dr. Soetomo Surabaya from July-August 2014 were recruited for Candida microbial screening on LGE lesion. Clinical specimens including oral swabs were collected. Diagnosed of LGE by clinical appearance, the oral cavity of research subjects examined by oral medicine specialist. CD4+ counts obtained from patient's medical record. 88 HIV/AIDS patients were examined, there were 7 cases (5,83%) LGE, 7 from 7 gingival margin found Oral Candidiasis (OC) (100%). LGE was found to be significantly correlated to OC and decreased CD4+ counts < 200 cells/mm3 (p<0.05). LGE related to candida infection and decreased CD4+ counts in HIV/AIDS patients