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"An ulcer is an area of discontinuity of an epithelial surface. Ulceration is the commonest oral soft tissue disorders and vary greatly in term of etiology signs and symptoms, prognosis and treatment. Abnormalities of immune system can cause oral mucosal ulceration. The purpose of this paper is to discuss the management of some of the more common oral ulcer associated with immunologic disorders. Because the natural history and treatment varies with the diagnosis, the practitioner should became familiar with the clinical aspects of the various type of ulcerations so that appropriate treatment can be instituted."

"The oral mucosa is the target of a number of infectious processes caused by a range of organism. Viruses is one of the organism which is considered in oral mucosa damage. Recently, the main viruses causing oral mucosal infections are the large herpes group. This article discuss herpes simplex virus and varicella zoster virus that cause herpetic stomatitis and gherpes zoster with particular attention to the typical oral manifestations current treatment options. Dentists should recognice the clinical appearances of the diseases, so the appropriate therapy can be done."

"In menopausal women, there are physiological changes as a consequence of the decrease in the secretion of oestrogen and ovary function that produce oestrogen. Numerous metabolic, psychological and physical changes have been associated with this event. In this paper we described oral discomfort in menopausal women. Dentist should know about oral discomfort in menopause including oral dryness, burning sensation, altered taste perception and ulceration, because this symptoms could become a reason for menopausal women to see a dentist. In the management of oral discomfort in menopausal women dentist should collaborate with gynecologist."

"Pendahuluan. Infeksi HIV perinatal di anak adalah salah satu masalah kesehatan di Indonesia. Dengan bertambahnya ketersediaan obat antiretroviral, angka kelangsungan hidup pasien HIV mengalami perkembangan. Implikasi dari hal ini adalah pentingnya mengetahui dampak HIV terhadap kognitif pada anak yang telah diberikan terapi antiretroviral tersebut, karena penurunan kecerdasaan diketahui sebagai salah satu manifestasi dari HIV stadium berat. Penelitian ini bertujuan untuk mengetahui hubungan antara tingkat CD4+ awal dan tingkat kecerdasan pada anak HIV yang telah memperoleh terapi antiretroviral.Metode. Penelitian ini menggunakan metode cross sectional dan melibatkan anak-anak dengan infeksi HIV melalui transmisi perinatal yang berusia 5.5-18 tahun. Pasien yang terlibat dalam penelitian telah melakukan pengobatan dengan ART sekurang-kurangnya 6 bulan sebelum penelitian. Data subjek, yaitu termasuk data tingkat CD4+ awal pasien, diambil dari case record form dan rekam medis pasien dan dilakukan pada periode Juli-Agustus 2016 di RSUPN Cipto Mangunkusumo. Pengukuran fungsi kognitif dilakukan menggunakan metode CIDD (Cross- Cultural Intellectual Test or Device). Hasil data akan digambarkan dalam tabel. Peneliti mencari hubungan CD4+ dan tingkat kecerdasan subjek dengan menggunakan uji uni-variat non parametric test for independent samples of Mann-Whitney dan simple correlation test. Uji multi-variat linear regression digunakan untuk mengevaluasi faktor risiko dalam fungsi kognitif anak dengan HIV.Hasil. Jumlah subjek yang terlibat dalam studi ini adalah 76 subjek. Subjek merupakan mayoritas perempuan dengan rata-rata usia 10 tahun, dimana sebagian besar merupakan berusia dibawah 12 tahun. 80.3% subjek dilahirkan spontan dan 83% subjek diberi ASI. Angka prevalensi comorbidities adalah sebagai berikut, malnutrisi (77%), TB (66%), dan diare persisten (55%). Mayoritas subjek diberi diagnosis dengan stadium klinis WHO 4, dan HIV-associated immunodeficiency status berat berdasarkan nilai CD4+ awal. Nilai tengah dari hasil uji kognitif CIDD adalah 17. Hasil dari test korelasi mengungkapkan hubungan positif yang sangat lemah (r = 0.005) dengan uji univariat yang menunjukkan hubungan yang tidak signifikan (p-value > 0.05) antara tingkat CD4+ dan tingkat kecerdasan. Sedangkan, dalam analisa faktor risiko ditemukan bahwa umur subjek memiliiki hubungan signifikan terhadap tingkat kecerdasaan (p-value < 0.05).Kesimpulan. Rendahnya tingkat CD4+ awal tidak menentukkan rendahnya tingkat kecerdasan pada anak terinfeksi HIV perinatal yang telah memperoleh terapi anitretroviral. Ditemukan bahwa faktor risiko yang memiliki hubungan dengan kognitif adalah umur pasien. Penelitian lebih lanjut untuk mengevaluasi mengenai kognitif terhadap remaja dengan infeksi HIV perinatal dapat dilakukan untuk mengetahui efek jangka panjang HIV terhadap fungsi kognitif.

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Preliminary. Perinatal HIV infection in children is one of the health problems in Indonesia. With the increase in the availability of antiretroviral drugs, the survival rate of HIV patients has progressed. The implication of this is the importance of knowing the cognitive impact of HIV on children who have been given such antiretroviral therapy, because the decrease in intelligence is known as one of the manifestations of severe stage HIV. This study aims to determine the relationship between baseline CD4 + levels and intelligence levels in HIV children who have received antiretroviral therapy.

Method. This study used a cross sectional method and involved children with HIV infection through perinatal transmission aged 5.5-18 years. Patients involved in the study had been taking treatment with ART at least 6 months before the study. Subject data, including patient baseline CD4 + data, were taken from the patient's case record form and medical record and were carried out in the July-August 2016 period at Cipto Mangunkusumo General Hospital. Cognitive function measurements were performed using the CIDD (Cross-Cultural Intellectual Test or Device) method. The results of the data will be illustrated in the table. Researchers are looking for CD4 + relationship and the level of intelligence of the subjects using the non-parametric non-parametric test for independent samples of Mann-Whitney and simple correlation test. The linear regression multi-variate test was used to evaluate risk factors in cognitive functioning of children with HIV. Results. The number of subjects involved in this study was 76 subjects. Subjects constituted the majority of women with an average age of 10 years, with the majority being under 12 year. 80.3% of subjects were born spontaneously and 83% of subjects were breastfed. The prevalence rates for comorbidities are as follows, malnutrition (77%), TB (66%), and persistent diarrhea (55%). The majority of subjects were given a diagnosis with WHO clinical stage 4, and severe HIV-associated immunodeficiency status based on baseline CD4 + values. The mean value of the CIDD cognitive test results was 17. The results of the correlation test revealed a very weak positive relationship (r = 0.005) with a univariate test that showed an insignificant relationship (p-value> 0.05) between CD4 + level and intelligence level. Meanwhile, in the analysis of risk factors it was found that the age of the subjects had a significant relationship to the level of intelligence (p-value <0.05). Conclusion. The low initial CD4 + level does not determine the low level of intelligence in children infected with perinatal HIV who have received antitretroviral therapy. It was found that the risk factor that has a relationship with cognitive is the patients age. Further research to evaluate the cognitive of adolescents with perinatal HIV infection can be done to determine the long-term effects of HIV on cognitive function."

"Stomatitis Aphtous Rekuren (SAR) merupakan kondisi inflamasi kronis yang terjadi pada mukosa mulut yang ditandai dengan terbentuknya ulser. Patch mukoadhesif dapat ditujukan untuk melindungi ulser dari lingkungan mulut dan meningkatkan efektivitas terapi RAS dengan memperpanjang durasi perlekatan. Kurkumin merupakan senyawa yang memiliki aktivitas antiinflamasi sedangkan brazilin memiliki aktivitas antimikroba yang keduanya dapat digunakan untuk terapi RAS. Oleh sebab itu, tujuan penelitian ini adalah membuat dan mengevaluasi patch mukoadhesif dari ekstrak kayu secang dan kurkumin untuk terapi RAS. Patch mukoadhesif dibuat dengan teknik solvent casting dengan menggunakan polikarbofil dan etil selulosa sebagai polimer. Bahan padat dilarutkan dengan etanol lalu ditambahkan plasticizer kemudian dituang ke dalam cawan petri. Patch dibuat dengan 3 formulasi kurkumin-ekstrak kayu secang yang berbeda, yaitu 1:1 (F1), 3:1 (F2), dan 1:3 (F3). Patch yang terbentuk dievaluasi sifat fisiko-mekanik serta profil pelepasannya. Patch memiliki bobot yang seragam dengan ketebalan kurang dari 0,1 mm. Nilai kekuatan tarik sekitar 10,0 N/cm2, kekuatan mukoadhesif berkisar 6,7 sampai 7,5 N/cm2 dan mampu melekat hingga 2 jam. Dalam waktu 2 jam, brazilin telah terdisolusi sebanyak 100,58 % (F1) hingga 104,75% (F3) sedangkan kurkumin terdisolusi sebanyak 97,15% (F3) hingga 101,64% (F1). Secara keseluruhan, patch dapat dibuat dan memiliki karakteristik fisiko-mekanik dan profil pelepasan obat yang baik.

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Recurrent Aphtous Stomatitis (RAS) is a chronic inflammatory disease of the oral mucosa characterized by the formation of ulcers. Mucoadhesive patch is designed to protect the ulcers from the oral environment and increase the effectiveness of RAS therapy by prolonging the duration of attachment. Curcumin is compound that have antiinflammatory activity while brazilin have antimicrobial activity, both of which can be used for RAS therapy. For those reasons, this study aimed to produce and evaluate mukoadhesive patch containing sappanwood extract and curcumin for RAS therapy. Mucoadhesive patch were prepared by solving casting method using polycarbophil and ethyl cellulose as polymers. The patch were made in 3 formulations with different concentration of curcumin and sappanwodd extract, namely 1:1 (F1), 3:1 (F2), and 1:3 (F3). Mucoadhesive patch were evaluated of physicomechanical properties and dissolution profile. The patch of all formulations have a uniform weight with a thickness of less than 0,1 mm. The tensile strength of the patch were around 10,0 N/cm2 and mucoadhesive strength were in range of 6,7 to 7,5 N/cm2 and was able to adhere for up to 2 hours. Within 2 hours, the release of brazilin reached 100,58 % (F1) to 104,75% (F3) while the release of curcumin was 97,15% (F3) to 101,64% (F1). In conclusion, the patch has been produced with good physicomechanical properties and drug release profile."

"Penelitian ini bertujuan mengetahui manifestasi oral, status kesehatan rongga mulut HIV anak dan hubungannya dengan status supresi imun di RSCM. Penelitian potong-lintang terhadap 70 anak HIV yang diterapi HAART di RSCM pada bulan April dan Mei 2014. Hasilnya, frekuensi manifestasi oral rendah. Yang terbanyak lesi SAR minor ditemukan pada 4 anak. Lebih separuh subyek memiliki tingkat kebersihan mulut baik (53,5%). Nilai rerata deft < 6 tahun, nilai DMFTdeft > 6 tahun lebih dari 1 gigi per individu. Tidak dijumpai hubungan antara manifestasi oral dengan supresi imun pada HIV anak yang mendapat terapi HAART.

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The purpose of this cross-sectional study was to determine oral manifestations, oral health status of HIV in children and their relationships with immune suppression status at RSCM. Seventy children treated with HAART at RSCM in April and May 2014 had low frequency of oral manifestations with RAS minor as the frequent lesions consist of 4 lesions. More than half of children had good oral hygiene (53.5%). The mean score of deft < 6 years, DMFT-deft > 6 years were more than 1 tooth per individual.There is no relationship between oral manifestations with immune suppression status of children treated with HAART. "

"Every drug can produce side effect even when used according to standard or recommended methods of administration. Side effect of drugs can involve every organ and system of the body and are frequently mistaken for signs of underlying disease. Similarly, the mouth and associated structures can be affected by many drugs or chemicals. Good oral health including salivary function is very important in maintaining whole body health.Certain drugs can cause change in the oral cavity. Intrinsic discoloration can occur with the tetracyclines and extrinsic stains are associated with certain metal containing liquids. Gingival hyperplasia can occur with some anticonvulsants, calcium channel blockers, and cyclosporin. Xerostomia are produced by antihypertensives, antipsikosis, antihistamin, antikolinergik and many other drugs. Regarding different parts of the oral system, drug side effects can be categorized to oral mucosa and tongue, periodontal tissue, dental structures, salivary glans, cleft lip and palate, muscular and neurological disorders, taste disturbances, and drug-induced oral infection.The knowledge about drug-induced oral side effects helps dentist and to better diagnose oral disease, administer drugs, improve patien compliance during drug therapy, and many influence a more rational use of drugs."

"Latar Belakang: Mukositis merupakan salah satu efek samping yang timbul akibat kemoterapi. Mukositis menyebabkan timbulnya rasa sakit, ketidaknyamanan, kesulitan berbicara, menelan, makan, minum, kekurangan nutrisi, kelemahan sistemik hingga infeksi. Probiotik mengandung mikroorganisme nonpatogen yang memberikan manfaat bagi kesehatan dan membantu dalam pencegahan inflamasi pada rongga mulut. Beberapa studi telah melaporkan manfaat probiotik bagi kesehatan oral. Tujuan: Menganalisis efek probiotik Lactobacillus casei terhadap keadaan klinis mukosa oral pada anak dengan Leukemia Limfositik Akut yang menjalani kemoterapi sebelum berkumur probiotik L.casei, setelah berkumur L.casei selama 7 hari dan 14 hari. Metode Penelitian: Penelitian dilakukan di RS Kanker Dharmais dan RS Kramat 128. Sebelas pasien yang memenuhi kriteria. Tiga hari setelah pemberian kemoterapi, peneliti memeriksa keadaan klinis rongga mulut menggunakan Oral Assessment Guide (OAG). Pasien kemudian mulai berkumur probiotik L.casei dua kali sehari selama 7 hari dan 14 hari. Skor OAG diperiksa kembali setelah berkumur probiotik L.casei selama 7 hari dan 14 hari. Hasil: Terdapat penurunan skor OAG yang bermakna antara sebelum berkumur dengan setelah berkumur probiotik L.casei selama 7 hari dan 14 hari. Kesimpulan: Probiotik L.casei memberikan efek pada anak dengan leukemia limfositik akut yang menjalani kemoterapi dan dapat menjadi terapi alternatif terhadap mukositis oral.

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Mucositis is one of the side effects induced by chemotherapy. It results in pain, discomfort, difficulties in talking, swallowing, eating, drinking, poor nutrition, systemic weakness and life-threatening infections. Probiotics contain nonpathogenic live microorganisms that give benefit to our health and help in preventing inflammation in the oral cavity. Several studies have reported the use of probiotics for oral health purposes. Objective: To analyze the effect of probiotic Lactobacillus casei to clinical appearance of oral mucosa in children with Acute Lymphocytic Leukemia that underwent the chemotherapy process before gargling, 7 days after gargling, and 14 days after gargling with probiotic. Methods: The study was held in National Cancer Hospital “Dharmais” and Kramat 128 Hospital. Eleven patients were meet the criteria. Three days after the chemotherapy started, the researcher checked the patient’s oral mucosa condition using Oral Assessment Guide (OAG). Then the patient started to gargle the probiotic twice a day for 7 days and the researcher rechecked the score of oral mucositis after 7 days and 14 days. Results: There was a significance decreasing OAG score between before gargling with 7 days and 14 days after gargling L.casei probiotics. Conclusion: L.casei probiotics gave effects in children with acute lymphocytic leukemia during chemotherapy and could be an alternative therapy for oral mucositis."