Open Access Indonesian Journal of Medical Reviews

Effective Pain Management in a Patient with Colon Cancer: A Case Report of Combined Quadratus Lumborum and Transabdominal Plane Blocks

Tue, 04 Mar 2025 02:25:56 +0000

Cancer-related pain, particularly in cases of advanced colon cancer, presents a significant challenge to healthcare providers. Traditional pain management strategies, including opioids, often prove inadequate or are associated with undesirable side effects. Quadratus lumborum block (QLB) is an emerging regional anesthesia technique offering potential benefits in managing abdominal pain. This case report describes the successful implementation of combined QLB and transabdominal plane (TAP) blocks for effective pain management in a patient with colon cancer. A 53-year-old male patient with a history of colon cancer presented with severe abdominal pain at the site of his stoma radiating to his back. The pain was exacerbated by movement and significantly impacted his quality of life. Despite receiving a multimodal analgesic regimen, including a fentanyl patch and oral medications, his pain remained poorly controlled. After careful consideration, a combined QLB and TAP block was performed using ultrasound guidance. Following the procedure, the patient experienced significant pain relief, with his Numerical Rating Scale (NRS) score decreasing from 7-9 to 1-2 at rest and from 5-6 to 2-3 during movement. He reported no nausea or vomiting and was able to mobilize comfortably. This improvement in pain control facilitated his recovery and enhanced his overall well-being. In conclusion, this case report highlights the potential of combined QLB and TAP blocks as an effective pain management strategy for patients with colon cancer. This approach may offer a valuable alternative or adjunct to traditional methods, particularly in cases where opioid use is limited by side effects or tolerance. Further research is warranted to investigate the long-term efficacy and safety of this technique in a larger patient population.

Averrhoa bilimbi L. Fruit Extract as a Potential Alternative Root Canal Irrigant: An In Vitro Evaluation against Staphylococcus aureus

Daryono, Member Reni Purba, Dinda Rizky Aulia — Thu, 13 Mar 2025 05:18:37 +0000

Staphylococcus aureus is a prevalent bacterium in root canal infections, contributing to treatment failure due to its persistence within dentinal tubules. Conventional root canal irrigants like sodium hypochlorite (NaOCl), while effective, can have cytotoxic effects on host tissues. Averrhoa bilimbi L. fruit, traditionally used for medicinal purposes, has shown promising antibacterial activity. This study aimed to evaluate the in vitro antibacterial effectiveness of A. bilimbi fruit extract against S. aureus and compare it with NaOCl. A. bilimbi fruits were extracted using ethanol. The antibacterial activity of the extract at varying concentrations (70%, 60%, and 50%) was assessed against S. aureus using the disc diffusion method. NaOCl (2.5%) served as the positive control, and dimethyl sulfoxide (DMSO) as the negative control. The diameter of inhibition zones was measured and statistically analyzed using Kruskal-Wallis and Mann-Whitney tests. A. bilimbi fruit extract demonstrated significant antibacterial activity against S. aureus at all tested concentrations. The diameter of inhibition zones increased with higher extract concentrations (70% > 60% > 50%). While NaOCl exhibited the largest inhibition zone, A. bilimbi extract showed comparable efficacy to NaOCl, and significantly greater efficacy than DMSO. A. bilimbi fruit extract exhibits promising antibacterial activity against S. aureus in vitro. Its efficacy, comparable to NaOCl at higher concentrations, suggests its potential as an alternative root canal irrigant. Further studies are warranted to explore its clinical application in endodontic treatment.

Green Tea Mouthwash as an Adjunctive Therapy for Gingivitis Management: A Quasi-Experimental Study

Fri, 07 Mar 2025 01:28:51 +0000

Gingivitis, a prevalent inflammatory condition affecting the gums, is primarily caused by plaque accumulation. Green tea (Camellia sinensis) has demonstrated anti-inflammatory and anti-bacterial properties, suggesting its potential as an adjunctive therapy for gingivitis management. This study aimed to evaluate the effectiveness of green tea mouthwash in reducing gingival inflammation. This study employed a quasi-experimental design to investigate the effects of green tea mouthwash on gingival inflammation. A total of 30 participants with mild to moderate gingivitis were recruited from the GBI Miracle Service Medan church in Medan, Indonesia. The participants were instructed to rinse their mouths with green tea mouthwash twice daily, after breakfast and before bedtime, for a period of one week. The green tea mouthwash was prepared by steeping one tablespoon of dried green tea leaves in 250 ml of hot water for 5 minutes, and then cooled to room temperature before use. Gingival index (GI) scores were assessed at baseline and after one week of intervention, which involves examining each tooth at four sites (mesial, distal, facial, and lingual) and assigning a score of 0 to 3 based on the severity of inflammation. The study found a significant reduction in gingival inflammation after one week of using green tea mouthwash. The mean GI score decreased from 2.04 ± 0.401 at baseline to 0.91 ± 0.364 after the intervention, indicating a shift from moderate to mild inflammation (p < 0.05). This improvement in gingival health can be attributed to the anti-inflammatory and antibacterial properties of green tea, particularly its catechin content, which has been shown to inhibit the growth of oral bacteria and reduce inflammatory responses. In conclusion, the findings of this study provide further evidence supporting the use of green tea mouthwash as an adjunctive therapy for gingivitis management. Its efficacy in reducing gingival inflammation, coupled with its natural and readily available nature, makes it a promising option for improving oral health.

Red Betel Leaf (Piper crocatum) Mouthwash for Effective Plaque Control and Halitosis Prevention: A Pre-Experimental Study

Suci Erawati, Susanto, Muhamad Wandy Arianto — Wed, 12 Mar 2025 01:29:04 +0000

Halitosis, or bad breath, is a prevalent oral health issue primarily caused by volatile sulfur compounds (VSCs) produced by the microbial breakdown of food particles in the oral cavity. The accumulation of dental plaque, a biofilm composed of bacteria and their byproducts, provides a conducive environment for VSC production. Red betel leaf (Piper crocatum) has been traditionally used for its medicinal properties, including its potential benefits for oral health. This study aimed to investigate the effectiveness of red betel leaf mouthwash in controlling plaque and preventing halitosis. A pre-experimental study design with a one-group pretest-posttest approach was employed. Participants were recruited from a high school student council, with a sample size of 20 students. The intervention involved the use of red betel leaf mouthwash over a period of one week. The plaque index was assessed using the Loe and Silness index before and after the intervention. Data were analyzed using the paired T-test to determine the significance of changes in the plaque index. The mean plaque index before using the red betel leaf mouthwash was 2.15 ± 0.676, which decreased significantly to 0.94 ± 0.562 after one week of intervention (p = 0.000; p < 0.05). This indicates a substantial reduction in plaque accumulation following the use of red betel leaf mouthwash. Red betel leaf mouthwash demonstrated significant efficacy in reducing plaque index, suggesting its potential as an effective natural alternative for plaque control and halitosis prevention. Further research with larger sample sizes and control groups is recommended to confirm these findings and explore the long-term effects of red betel leaf mouthwash on oral health.

Knowledge and Attitude Influence on Oral Hygiene Practices among University Dental Students with Fixed Orthodontic Appliances

Davin, Maorina, Stevanus Daniel — Wed, 12 Mar 2025 01:29:18 +0000

Fixed orthodontic appliances can complicate oral hygiene maintenance, increasing the risk of dental caries and periodontal diseases. This study aimed to assess the relationship between knowledge, attitude, and oral hygiene practices among university dental students undergoing fixed orthodontic treatment. A cross-sectional study was conducted among dental students at Universitas Prima Indonesia. Data were collected using a self-administered questionnaire that included questions on oral hygiene knowledge, attitude towards oral health, and oral hygiene practices. Descriptive statistics, Chi-square tests, and logistic regression were used to analyze the data. A total of 40 dental students participated in the study. The majority of the participants (95%) had good knowledge about oral hygiene. A positive correlation was found between knowledge and attitude (p=0.027), indicating that students with better knowledge exhibited more positive attitudes towards oral health. Furthermore, students with good knowledge were more likely to perform proper oral hygiene practices, including brushing twice daily (95%), using interdental brushes (97.5%), and visiting the dentist regularly (52.5%). In conclusion, this study highlights the importance of oral health knowledge and positive attitudes in promoting proper oral hygiene practices among dental students with fixed orthodontic appliances. Educational interventions aimed at improving knowledge and shaping attitudes may be beneficial in enhancing oral hygiene behavior and ensuring successful orthodontic treatment outcomes.

Comparative Analysis of Anesthesia Techniques and Circumcision Methods on Pain Outcomes in Pediatric Mass Circumcision: An Observational Study

Thu, 17 Apr 2025 08:03:17 +0000

Circumcision is a common procedure in Indonesia, often performed in mass settings. The associated pain can lead to significant psychological distress in children. Effective pain management is crucial but often challenging in mass circumcision events. This study aimed to identify determinants of pain intensity, specifically comparing anesthesia techniques and circumcision methods, during pediatric mass circumcision. An observational study was conducted in February 2023 involving 56 male children aged 0-10 years undergoing mass circumcision in Bandung and Cirebon, Indonesia. Data collected included anesthesia technique (needle-free injection [NFI], injection, topical + NFI), anesthetic agent (lidocaine vs. lidocaine/pehacain mix), circumcision method (guillotine with thermocautery vs. modified dorsal slit clamp with electrosurgery), presence of phimosis, and event location. Pain was assessed intraoperatively using age-appropriate scales: Neonatal/Infant Pain Scale (NIPS) for 0-<2 years, Face Legs Activity Cry Consolability (FLACC) scale for 2-7 years, and Visual Analogue Scale (VAS) for >7 years. Bivariate and multivariate linear regression analyses were performed using SPSS 20.0 to identify factors significantly correlated with pain scores. The mean age was 4.07 years (SD ± 2.75), and 78.6% had a history of phimosis. The mean pain score was 2.66 (SD ± 2.5) on relevant scales. Multivariate analysis revealed that both anesthesia technique (p=0.010) and circumcision method (p=0.000) were significantly correlated with pain scores, with a moderate overall correlation (R=0.500). Specifically, the modified clamp method was associated with significantly higher pain scores compared to the guillotine method (B=2.719). Combined topical and NFI anesthesia was associated with lower pain scores compared to other techniques (B=-1.059). In conclusion, anesthesia technique and circumcision method are significant determinants of intraoperative pain during pediatric mass circumcision. Less invasive anesthesia approaches (topical + NFI) combined with methods involving less tissue manipulation and shorter duration (guillotine with thermocautery) were associated with lower pain scores. These findings suggest that careful selection of techniques can significantly improve the pediatric experience in mass circumcision settings.