American Journal of Medicine and Medical Sciences 2019, 9(10): 393-395
DOI: 10.5923/j.ajmms.20190910.08
Efficacy of Treatment of Acute Herpetic Stomatitis.
Clinical and Immunological Parameters of Oral Cavity in
Children
Iroda Makhsumova
*
, Sayyora Makhsumova, Malika Mukhamedova,
Kholmatova Zarnigor, Matkulieva Sevara
Preventive Dentistry Department, Tashkent State Dental Institute, Tashkent, Uzbekistan
Abstract
Currently, one of the most frequent diseases in children is a herpetic infection, which is explained not only by
the prevalence of herpes simplex virus (HSV), but also by the peculiarities of the development of the immune system in a
developing child's div. Questions of the general status of herpetic stomatitis in children is important. The purpose of the
study was to study the immunological parameters of the oral cavity in children with acute herpetic stomatitis in the dynamics
before and after treatment with Kyzyl May. In 62 children with acute herpetic stomatitis who applied to the department of
pediatric therapeutic dentistry at TSDI, clinical and immunological studies were conducted. Based on the obtained clinical
and immunological data, the high efficacy of Kyzyl May is effective in the treatment of acute herpetic stomatitis.
Keywords
AHS, Immunology, Lysozyme, Secretory immunoglobulin A, Phagocytic activity of neutrophils
A third of the world's population is affected by a herpetic
infection, over half of these patients suffer several attacks of
infection over the course of a year, often with manifestations
in the oral cavity. It has been established that the infection of
children with the herpes simplex virus aged from 6 months to
5 years is 60%, and by the age of 15 it is already 90% [1,2].
Every year, the incidence of children with acute (primary)
herpetic stomatitis increases.
Acute herpetic stomatitis in children is an infectious viral
disease caused by primary contact with the herpes simplex
virus, characterized by inflammation of the oral mucosa with
the manifestation of vesicular rash, fever and decreased
immunity [3,4].
The structure of the oral mucosa in children in early
childhood and the activity of local tissue immunity are of
great importance in the development of herpes infection.
1. Objective
To study the immunological studies of the oral cavity in
children with acute herpetic stomatitis to identify indicators
of local oral immunity before and after treatment.
* Corresponding author:
imahsumova@inbox.ru (Iroda Makhsumova)
Published online at http://journal.sapub.org/ajmms
Copyright
©
2019
The Author(s).
Published
by
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&
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This work is licensed under the Creative Commons Attribution International
License (CC BY). http://creativecommons.org/licenses/by/4.0/
2. Materials and Methods
We examined 62 children from 8 months to 3 years with
acute herpetic stomatitis of moderate severity, who applied
to the department Pediatric Therapeutic Dentistry, Tashkent
State Dental Institute.
All children were divided into 2 groups:
1
st
group: 30 - children with acute herpetic stomatitis of
moderate severity with 0.25% oksolin ointment against the
background of general treatment.
2
nd
group: 32 - children with acute herpetic stomatitis of
moderate severity who, against the background of general
treatment, used the drug "Kyzyl May" (polyphytic oil).
Polyphitic oil "Kyzyl May" is an oily extract of medicinal
plants, which has antiviral, anti-inflammatory, pain-relieving
and anti-bacterial action.
AHS proceeds with hyperemia, edema on the mucous
membrane of the oral cavity appear erosion and ulcers,
which are covered with white fur. Lesions are from 2-3 to 7-8
mm. Favorite localization of aft on the mucous tongue, lips
and transitional folds. The mucous membranes that are free
from erosion are edematous and hyperemic, the tongue is
coated with a white-gray bloom, a putrid odor from the
mouth, an increase in salivation is noted. Submandibular,
mental and cervical lymph nodes are enlarged.
The complex treatment included general and local
treatment. General treatment used the drug "Acyclovir"
tablets in an age dosage. In the 1st group: local treatment was
394
Iroda Makhsumova
et al.
: Efficacy of Treatment of Acute Herpetic Stomatitis.
Clinical and Immunological Parameters of Oral Cavity in Children
started with antiseptic treatment of the oral cavity with
Furacilin solution 1: 5000 and application of OXOLIN
0.25% ointment.
2nd group: antiseptic treatment of the oral cavity with
Furacillin 1: 5000 and application with Kyzyl May.
3. Research Results
Immunological studies were performed in all patients:
quantitative determination of local oral protection factors
such as the level of secretory immunoglobulin A, phagocytic
activity of neutrophils and the level of lysozyme in the oral
fluid. To determine the phagocytic activity of neutrophils in
the oral fluid, the collection and processing of saliva was
carried out in a modification Antonov A.V. (1996). To do
this, the selected oral fluid was cleaned, washed, buffered
solution and centrifuged at 1000 rpm for 10 minutes: the
non-settling liquid was drained, and 0.5 ml of physiological
saline was added to the sediment.
To 0.2 ml of the obtained suspension in a test tube, 0.1 ml
of latex suspension (5x108 in 1 ml) with a diameter of 0.8
mm was added. The mixture was incubated in a humid
chamber for 30 minutes at 37 °C. Subsequently from this
mixture smears were prepared by the type of blood smear
stained according to Romanovsky Giemsa. Not less than 100
neutrophils were counted with and without latex in each
preparation, the phagocytosis index was determined, i.e. %
of phagocytic leukocytes was counted.
The activity of lysozyme in the oral fluid was determined
by us using the method proposed by Aliev Sh.R. (2016),
which included the use of sterile paper discs. For this
purpose, oral fluid was collected on an empty stomach into
sterile tubes, then paper discs were taken with tweezers
(similar to antibiotic) and thoroughly soaked in oral fluid.
After that, these discs were placed on the surface of nutrient
agar (Mueller Hinton medium) in Petri dishes planted with a
lawn daily culture) were incubated in a thermostat at 37 ° C,
the lysozyme activity in the oral liquid was determined by
the diffusion method in agar.
Determination of class A immunoglobulin titer of
secretory fraction (s IgA). The method is based on the
Mancini method, which is based on measuring the diameter
of the precipitation ring formed when oral fluid is introduced
into the wells cut in an agar layer in which monospecific
antisera are pre-dispersed. Under standard experimental
conditions, the diameter of the precipitation ring is directly
proportional to the concentration of immunoglobulin.
The first group of patients on the 4th-5th day showed a
decrease in bleeding of the gums, epithelialization occurred
on the 4th day after treatment. Aphthae epithelialized
more slowly, lymph nodes decreased, hyperemia, edema
disappeared, epithelization of the affected areas began,
gingival papillae took the correct configuration for 5-6 days.
Full recovery occurred on the 7-8th day. Patients of the 2nd
group who used the drug "Kyzyl May" on the 2nd day freely
opened their mouth and took food, as the oil contains licorice
root, which has analgesic properties. On the 3rd day after
treatment, epithelialization began, the gingival margin
became pink, the amount of saliva released decreased, the
duration of treatment was shorter by 2 days. It should be
noted that there were no allergic reactions to the drug.
Table 1.
Immunological indicators during the height of the disease and
after treatment
Immunological
indicators
Norm
Before
treatment
N=62
After treatment
1
st
group
N=30
2
nd
group
N=32
Secretory
immunoglobulin
A, g\l
2,0
1,45±0,15
1,65±0,1
1,90±0,1
Phagocytic
activity of
neutrophils, %
55,3
48,5±2,1
51,58±1,5*
53,5±2,1*
the level of
lysozyme, mg\ml
18,0
16,5±0,3
15,4±0,4
19,2±0,5*
Note: * - significant difference of the indicator in relation to “Before treatment”
by the Student's criterion at the level of p <0.05.
4. Conclusions
Thus, in our studies, it can be concluded that in children
with acute herpetic stomatitis in the oral cavity, an
immunodeficiency state develops, which further aggravates
the clinical course of the disease. On the basis of the obtained
clinical and immunological data, it is possible to conclude
that Kyzyl May is highly effective in treating acute herpetic
stomatitis. The data obtained allow us to recommend this
drug not only in the treatment of acute herpetic stomatitis,
but also in the development of various pathological changes
in the oral mucosa, in which there are inflammatory changes.
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