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.
Objective: The purpose of this study was to determine the difference of bacterial aerosol quantity based on blood agarplate position with and without using chlorhexidine as pre-procedural mouthwash in ultrasonic scaling treatment. Methods:The 16 samples rinsed using chlorhexidine and other 16 samples rinsed using sterile water before ultrasonic scaling treatment was started. Bacterial aerosol was collected using blood agar plate for 10 minutes during ultrasonic scaling treatment and placed at three different positions: chest of patient (P-I), right side of patient-8 o'clock (P-II), left side of patient-4 o'clock (P-III). Results:The Friedman test result showed that p= 0.223 (group I) and p< 0.001 (group II). The p= 0.223 showed that there was no significant difference of bacterial aerosol quantity based on blood agar plate position. Conclusion:Chlorhexidine can be used on bacterial aerosol reduction during ultrasonic scaling treatment.
Oral mucositis (OM) is a life-threatening side effect of chemo-radiotherapy. OM can provide a portal of entry for many microorganisms as coinfections which potentially generate other oral lesions. This case report describes a holistic approach to obtaining the successful treatment of OM with necrotizing ulcerative stomatitis (NUS) and oral candidiasis as coinfections in pediatric acute lymphoblastic leukemia (ALL). A 2-year-8-month-old boy was referred from the Pediatrics Department at Dr. Hasan Sadikin General Hospital with the chief complaint of canker sore and eating difficulty for the past two weeks. He had undergone the twelfth cycle of the last chemotherapy using methotrexate regimen. Extraoral examination revealed anemic conjunctiva, icteric sclera, and dry lips. Well-defined irregular multiple ulcers covered by yellowish to grayish pseudomembranous were found on the upper and lower labial mucosa, right and left buccal mucosa, tongue, palate, and gingiva. Potassium hydroxide (KOH) examination showed fungi in the oral lesions smear. The established diagnosis was OM with NUS and oral candidiasis as coinfections. Debridement was done using chlorine dioxide-zinc and 0.2% chlorhexidine gluconate. We collaborated with the pediatrician who prescribed ceftazidime, meropenem, and fluconazole, and also with parents. The holistic approach is beneficial and important in improving quality of life and supporting the successful treatment of OM with coinfections.
Background Oral frailty is an important geriatric syndrome characterized by decreases in oral function that coincides with declines in cognitive and physical function. Objective: The aim of this case report is to describe the comprehensive management of oral frailty in a medically compromised geriatric patient prior to cardiovascular surgery. Case: A 64-year-old male patient complained of pain in swallowing and sore mouth since two days before. He had multiple systemic diseases, including infective endocarditis, acute kidney injury, type II diabetes mellitus, thrombocytopenia, and electrolyte-fluid imbalance. Extra-oral examination showed lymphadenitis, icteric sclera, and dry-exfoliative lips. Intra-oral examination revealed tongue depapillation, frothy saliva, and dry mucosa with poor oral hygiene. The scraped-off white plaque leaving erythematous area was found on the dorsal and ventral tongue, buccal mucosa, and hard palate. Irregular multiple major ulcers, surrounded by erythema, well-demarcated with yellowish concave base, and covered by thick yellowish-green sputum at the soft palate to the uvula. The diagnosis was exfoliative cheilitis, aphthous-like ulcer, acute pseudomembranous candidiasis, and moderate xerostomia. A D-E-N-T-A-L questionnaire was used to evaluate oral frailty, and the cumulative result was seven. Case Management: The patient was treated with 100% petroleum jelly, 0.12% chlorhexidine digluconate mouthwash, and chlorine dioxide-zinc mouthwash three times a day. The oral lesions showed significant improvement after one week of treatment. Conclusion: Appropriate therapy for oral lesions and eliminating the infection could be considered to minimize the long-term effect of oral frailty. The comprehensive management of oral frailty could be beneficial for improving the quality of life. Keywords: Geriatric, Oral frailty, Oral lesion, Systemic disease
Crop production is of major supports for ever-growing population. As for other crops, wheat cannot escape from weed interference which may result in significant loss of yield. Therefore, the success of agricultural practices depends on pest and diseases management including weeds. Agricultural chemicals such as herbicides has been widely applied to maximize crop yield including wheat. The present study was conducted to determine the appropriate herbicide to control weeds associated with wheat and wheat growth and yield. The experiment was carried out at farmer’s land at Batu Bagiriek, Jorong Galagah, Kenagarian Alahan Panjang, Solok, the Province of West Sumatra from May to September 2015. The experimental sites is located at 1.0729° S, 100.7831° E, 1616 m above sea level with temperature ranging from 20 to 25 °C. Three treatments i.e herbicide metsulfuron-methyl (25 g ai ha-1), herbicide 2,4 dimethylamine (1.5 L ai ha-1), and no weed control treatment were studied. Each treatment was replicated four times in a completely randomized design. Data were analysed with ANOVA and mean separation of Tukey HSD at 5%. Results demonstrate that herbicide 2,4 dimethylamine was best to control broad leaf weeds resulted in the highest yield of wheat grain of 6.14 tonnes/ha. Lawn grass (Axonopus compressus) and goose grass (Eleusine indica) were found to be dominant weeds.
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