The Significance of Phytochemicals on Periodontal Health

Periodontal disease is an inflammatory disorder of tooth-supporting tissues that affects almost 90% of the population worldwide. The treatment of periodontal disease involved mechanical therapy, surgery, and administration of antibiotics. The high cost of the treatment and bacterial resistance to certain antibiotics regime has led to the search for the alternative treatment to overcome the disease at less cost and side effects. Natural products had been proven to be an important source in developing modern medicine to promote general health. Herbal plant extracts had been widely used in oral health particularly to prevent bacterial plaque adherence and dental caries. In periodontal disease, several studies and reviews have documented that herbal plant extracts had the potential to prevent and treat periodontitis through their active ingredients associated with antimicrobials, antiinflammatory, and anti-oxidant properties. The sources to obtain the herbs are readily available and economical to produce in the market. Some of the herbs had been marketed for public uses in the form of toothpaste and mouth rinses. This review is an attempt to outline the importance of herbal medicine to provide potential effective and economical medicaments for periodontal disease and its significance for further clinical research in the future.

Еffects of percutaneous electrical stimulation of the spinal cord in combination with mechanotherapy on changes in systemic and regional hemodynamics

Objective: to evaluate changes in systemic and cerebral hemodynamics during percutaneous electrical stimulation of the spinal cord and in combination of electrical stimulation with mechanotherapy. Methodology. The subjects underwent percutaneous electrical stimulation of the spinal cord, the duration of the session was 5 minutes. Mechanotherapy was performed using a treadmill. The subjects performed walking at a power of 25W. for 5 minutes. Hemodynamics was evaluated before and after the electrical stimulation session, as well as before and after the mechanical therapy session on the track in combination with percutaneous electrical stimulation of the spinal cord. To study systemic and regional hemodynamics, a rheograph-polyanalyzer "REAN-POLY" was used. Results. Electrical stimulation of the spinal cord does not lead to significant changes in systemic and cerebral hemodynamics. Percutaneous electrical stimulation of the spinal cord in combination with physical exertion leads to reactive changes in systemic hemodynamics, increased blood filling and venous outflow, against the background of a decrease in peripheral resistance of cerebral vessels. Key words: electrostimulation, percutaneous electrostimulation, mechanotherapy, systemic hemodynamics, regional hemodynamics.

EFFECTIVENESS OF MEDICAL REHABILITATION OF ELDERLY PATIENTS WHO HAVE SUFFERED A MYOCARDIAL INFARCTION

На всех этапах восстановления после инфаркта миокарда (ИМ) увеличение физической активности пациентов пожилого возраста - одна из важных составляющих реабилитационного процесса. Безусловно, на ранних стадиях ИМ определенные ограничения физической активности позволяют уменьшить нагрузку на миокард, снизить его потребности в кислороде и создать условия для скорейшего заживления. В последующем, в зависимости от динамики и показателей работы сердечно-сосудистой системы, пациента пожилого возраста переводят с одной ступениактивностинадругую, оцениваютуровень АД, ЧСС, наличие аритмии, данные электрокардиограммы, данные эхо-КГ показателей, а также индивидуальную переносимость нагрузок. На сегодняшний день для медицинской реабилитации пациентов пожилого возраста, перенесших ИМ, актуальным является применение различных вариантов механотерапии. Представляет интерес применение механотерапии по программе комплекса David Back Concept (силовая тренировка). Он представляет собой комплект из тренажеров для работы над мышцами спины. Настоящий лечебно-диагностический комплекс предназначен для диагностики, лечения и профилактики патологий опорно-двигательной системы, а также для реабилитации пациентов после хирургических вмешательств и травм позвоночника. Для восстановления физического статуса до оптимально достижимого уровня, определяемого возможностями адаптационных механизмов пожилого человека, в программе медицинской реабилитации пациентов пожилого возраста с ИБС и после перенесенного ИМ нами применен программный комплекс David Back Concept и оценено его влияние на гемодинамические показатели. At all stages of recovery after myocardial infarction (MI), the expansion of physical activity of elderly patients is one of the most important components. Of course, certain restrictions can reduce the load on the myocardium, reduce its oxygen needs and create conditions for early healing. Subsequently, depending on the dynamics and indicators of the cardiovascular system, the elderly patient is transferred from one stage of activity to another, the level of blood pressure, the number of heartbeats, the presence of arrhythmia, electrocardiogram data, EchoCG data, as well as individual load tolerance are evaluated. To date, there is a huge selection of optimal options for selecting methods of medical rehabilitation for elderly patients who have suffered a MI, and one of them is mechanotherapy. The mechanical therapy program of the David Back Concept complex - strength training is a set of simulators for working on the back muscles. The medical and diagnostic complex is designed for the diagnosis, treatment and prevention of pathologies of the musculoskeletal system, as well as for the rehabilitation of patients after surgical interventions and spinal injuries. Medical rehabilitation of elderly patients with coronary heart disease and after a MI through mechanotherapy, the program of the David Back Concept complex, provides for the restoration of their physical and social status to an optimally achievable level, determined by the capabilities of adaptive mechanisms.

Efficacy of Herbal Mouthwash with Extracts of Coriandrum Sativum, Mint and Clove in the Treatment of Chronic Gingivitis- A Randomized Controlled Clinical Trial

Introduction: Herbal antiseptic or antibiotic agents are introduced very widely that are effective against plaque microorganisms for the healing of gingival and periodontal tissue. However, none of literature has shown antibacterial effect of coriandrum sativum, clove and mint on the levels of dental plaque when used as a mouthwash. Aim: To assess the efficacy of a newly formulated mouthwash containing Coriandrum sativum, mint and clove to reduce plaque and inflammation to maintain the oral hygiene. Methodology: Twenty systemically healthy patients were randomly allocated to either the test group [G1(coriandrm sativum, mint,clove = 10 patients)] or the control group [G2 (Placebo gel = 10 patients]. Full mouth Gingival Index (GI); Full mouth Plaque Index (PI) was evaluated at baseline and on 14 and 21st day. Result: The mean reduction in PI from 2.28 to 0.85 and 2.13 to 1.21 was noted in the experimental and control groups, respectively. The experimental group (2.21–0.76) comparatively showed better reduction in mean PBI than the control group (2.17–1.29). The results obtained were statistically significant at baseline and 14th and 21st day in all the groups. Remarkable improvement was noted from baseline to 14th and 21st day in all the groups. Conclusion: The encouraging results of our study suggest that the newly formulated mouthwash containing coriandrum Sativum, mint and clove demonstrates anti-inflammatory properties, which may be useful as an adjunctive to mechanical therapy in the prevention and treatment of gingivitis.

Peran Latihan Terapeutik Pada Pasien Wanita 23 Tahun Dengan Lupus Eritematosus Sistemik (LES)

Lupus eritematosus sistemik (LES) merupakan penyakit autoimun yang heterogen yang melibatkan banyak organ dengan gambaran klinis yang beragam. Penyakit ini ditandai oleh produksi antibodi terhadap komponen-komponen inti dan umumnya terjadi pada wanita (rasio 9:1), setelah masa pubertas (pada usia 20-30 tahun) serta dipengaruhi oleh faktor genetika. Pada LES didapatkan keterlibatan kulit dan mukosa, sendi, darah, jantung, paru, ginjal, susunan saraf pusat (SSP) dan sistem imun. Dilaporkan bahwa pada 1000 pasien LES di Eropa yang diikuti selama 10 tahun, manifestasi klinis terbanyak berturut-turut adalah arthritis sebesar 48,1%, ruam malar 31,1%, nefropati 27,9%, fotosensitivitas 22,9%, keterlibatan neurologik 19,4% dan demam 16,6%. Kami melaporkan pasien LES wanita usia 23 tahun dengan arthritis yang mengakibatkan limitasi lingkup gerak sendi (LGS) bahu dan jari tangan sehingga kesulitan dalam melakukan aktivitas sehari-hari (AKS) menggunakan tangan antara lain menggenggam dan memakai pakaian dalam, gangguan pola jalan akibat kekakuan lutut kiri. serta keterbatasan ambulasi (jarak tempuh) akibat nyeri sendi ekstremitas bawah. Pasien diberikan program latihan aerobik dan LGS ekstremitas bawah menggunakan static ergocycle, latihan LGS ekstremitas atas dengan Mechanical Therapy Unit (MTU) serta latihan motorik halus dan latihan AKS. Setelah satu bulan, pasien mengalami perbaikan dalam menggenggam dan memakai pakaian dalam serta dapat berjalan dalam jarak sekitar 100m tetapi pasien masih berjalan jinjit pada kaki kiri akibat kekakuan lutut dan pergelangan kaki kiri.

Laser Therapy in the Treatment of Peri-Implantitis: State-of-the-Art, Literature Review and Meta-Analysis

(1) Background: The treatment of the peri-implantitis is still challenging, and no consensus was found in the literature on which is the best treatment protocol. In recent years, numerous authors have proposed the use of the dental laser as an alternative and effective method for decontaminating the surface of infected implants. Therefore, the aim of this work was to examine the state-of-the-art on the use of lasers in the treatment of peri-implantitis through the literature. (2) Methods: An electronic search was conducted through the PubMed database; we selected and reviewed articles that evaluated the effects of laser irradiation in the treatment of peri-implantitis. (3) Results: The use of lasers seems to provide similar results if compared with conventional mechanical therapy. The included studies were divided into three groups based on the active medium of the laser used for the treatments being tested (Erbium: Yttrium Aluminum Garnet, CO2 and diode laser). (4) Conclusions: The lasers showed positive results, on average, after 6 months of follow-up. Comparative clinical trials conducted with the aim to test the efficiency of laser irradiation, in addition to conventional therapy, indicate that this technique can induce similar results if compared to conventional therapy alone.

Endotherapy for Nonvariceal Upper Gastrointestinal Hemorrhage

Nonvariceal upper gastrointestinal hemorrhage (NVUGIH) is a common GI emergency with significant morbidity and mortality. Triaging cases on the basis of patient-related factors, restrictive blood transfusion strategy, and hemodynamic stabilization are key initial steps for the management of patients with NVUGIH. Endoscopy remains a vital step for both diagnosis and definitive management. Multiple studies and guidelines have now defined the optimum timing for performing the endoscopy after hospitalization, to better the outcome. Conventional methods for achieving endoscopic hemostasis, such as injection therapy, contact, and noncontact thermal therapy, and mechanical therapy, such as through-the-scope clips, have reported to have 76 to 90% efficacy for primary hemostasis. Newer modalities to enhance hemostasis rates have come in vogue. Many of these modalities, such as cap-mounted clips, coagulation forceps, and hemostatic powders have proved to be efficacious in multiple studies. Thus, the newer modalities are recommended not only for management of persistent bleed and recurrent bleed after failed initial hemostasis, using conventional modalities but also now being advocated for primary hemostasis. Failure of endotherapy would warrant radiological or surgical intervention. Some newer tools to optimize endotherapy, such as endoscopic Doppler probes, for determining flow in visible or underlying vessels in ulcer bleed are now being evaluated. This review is focused on the technical aspects and efficacy of various endoscopic modalities, both conventional and new. A synopsis of the various studies describing and comparing the modalities have been outlined. Postendoscopic management including Helicobacter pylori therapy and starting of anticoagulants and antiplatelets have also been outlined.

NOVEL PERIODONTAL POCKET DRUG DELIVERY SYSTEMS FOR THE TREATMENT OF PERIODONTITIS

Periodontitis describes a group of related inflammatory diseases resulting in the destruction of the tissues that support the tooth. This disease results from the growth of diverse microflora (especially anaerobes) in the periodontal pockets and releases various bacterial enzymes, toxins, and stimulation of the body’s immune response. Scaling and Root planning is the basic treatment modality for periodontitis. Mechanical treatment is limited by physical impediments and biochemical considerations. Antimicrobial agents may be used as an adjunct to overcome the limitations of mechanical therapy. Nonsurgical controlled intrapocket delivery of antimicrobials in the treatment of periodontitis has been investigated for the possibility of overcoming the limitations of conventional therapy. Nonsurgical controlled release formulations to deliver antibacterial to the site of periodontal pocket are designed to be of low cost, nontoxic, biocompatible, biodegradable, greater stability, non-immunogenicity, and effective long-term treatment at the site of infection with reduced systemic dosing. A number of polymer based delivery systems like fibers, strips, films, chips, microparticles, nanoparticles, and nanofiber made from a variety of natural and synthetic materials have been successfully tested to deliver a variety of drugs. Periodontal pockets as a drug delivery platform for designing a suitable dental localized dosage form along with its potential advantage and limitations is reviewed here.

Molecular Mechanisms and Current Pharmacotherapy of Peyronie’s Disease: A Review

Peyronie’s disease (PD) is a localized fibrotic lesion of the penis that has adverse effects on men’s health. In this review, we summarized the molecular mechanisms and pharmacotherapies of PD. A literature search was conducted using PubMed and Cochrane Library during 2001–2020. Although no oral or topical medication demonstrated efficacy in monotherapy of PD, several intralesional medications have yielded promising results. Currently, the effective strategy in management of PD should be combined modality therapy, including but not limited to pharmacotherapy, mechanical therapy, and psychotherapy. Meanwhile, basic research is still necessary to facilitate the development of novel and more reliable treatments. In future, more attention should be given simultaneously to epigenetic changes, inflammatory cytokines, the abnormal wound-healing process, and profibrotic and anti-fibrotic factors to provide more options for this refractory disease.