Palliative oral care in terminal cancer patients:Integrated review

BACKGROUND Palliative care(PC)aims to improve quality of life in patients and its families against life threatening diseases,through suffering’s prevention and relief.It is the duty of the dental surgeon to possess the knowledge needed to treat a patient with little life span,in order to establish an adequate treatment plan for each situation.AIM To synthesize the published evidence on oral conditions,impact,management and challenges in managing oral conditions among palliative patients.METHODS Articles were selected from PubMed and Scopus electronic platforms,using a research strategy with diverse descriptors related to“palliative care”,“cancer”and“oral health”.The article’s selection was done in two phases.The first one was performed by the main researcher through the reading of the abstracts.In the second phase two researchers selected eligible articles after reading in full those previous selected.Data was tabulated and analyzed,obtaining information about what is found in literature related to this subject and what is necessary to be approached in future researches about PC.RESULTS As results,the total of 15 articles were eligible,being one a qualitative analysis,13(92.8%)clinical trials and one observational study.Of the 15 articles,8(53.4%)involved questionnaires,while the rest involved:one systematic review about oral care in a hospital environment,2 oral exams and oral sample collection,one investigation of terminal patient’s(TP)oral assessment records,2 collection of oral samples and their respective analysis and one treatment of the observed oral complications.CONCLUSION It can be concluded that the oral manifestations in oncologic patients in terminal stage are,oral candidiasis,dry mouth,dysphagia,dysgeusia,oral mucositis and orofacial pain.Determining a protocol for the care of these and other complications of cancer–or cancer therapy–based on scientific evidence with the latest cutting-edge research results is of fundamental importance for the multidisciplinary team that works in the care of patients in PC.To prevent complications and its needed to initial the dentist as early as possible as a multidisciplinary member.It has been suggested palliative care protocol based on the up to date literature available for some frequent oral complications in TP with cancer.Other complications in terminal patients and their treatments still need to have further studying.

Anticandidal Activity of Moroccan Medicinal Plants

The prevalence of oral candidiasis has increased over recent years in patients with the compromised general condition. There are a large number of plant species that have been traditionally used for oral diseases by the Moroccan population. These species could provide a source for discovering new active principles of natural origin against Candida albicans involved in the appearance of candidiasis infections. Information was acquired using the electronic databases Web of Science, Scopus and PubMed. In the first part, this review presents the medicinal plants used by the Moroccan population for the treatment of oral disorders (Toothaches, gingivitis, ulcers, stomatitis, abscesses, ...). The second part describes different studies regarding the antifungal activity of essential oils and organic extracts of some Moroccan species against Candida albicans. Inhibition zone diameter (IZD), Minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) values of essential oils and plant’s extracts were noted. The third part concerns Moroccan plants with the antifungal activity that can be used in medical and agricultural fields. Several species of Moroccan plant proved their effectiveness against Candida albicans and can be used for the treatment of oral candidiasis. Further research should be undertaken in the future to investigate the toxicity of essential oils and plant extracts with antifungal properties for clinical use. This review provided an update on Moroccan plants presenting antifungal activity and especially those active against Candida albicans.

Preparation of fluconazole buccal tablet and influence of formulation expedients on its properties

The aim of present study was to prepare buccal tablets of fluconazole for oral candidiasis.The dosage forms were designed to release the drug above the minimum inhibitory concentration for prolonged period of time so as to reduce the frequency of administration and to overcome the side effects of systemic treatment.The buccal tablets were prepared by using Carbopol 71G and Noveon AA-1 by direct compression method.Microcry stalline cellulose was used as the filler and its effect was also studied.The prepared dosage forms were evaluated for physicochemical properties,in vitro release studies and mucoadhesive properties using sheep buccal mucosa as a model tissue.Tablets containing 50% of polymers(Carbopol & Noveon) were found to be the best with moderate swelling along with favorable bioadhesion force,residence time and in vitro drug release.The in vitro drug release studies revealed that drug released for 8 h,which in turn may reduce dosing frequency and improved patient compliance in oral candidiasis patients.