Browsing by Author "Holmes, Haly"
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Item An in-vitro study of antifungal activity of gymnemic acid(University of the Western Cape, 2017) Asmyou, Sana Alhadi; Holmes, HalyCandida species are frequently isolated from oral mucosal surfaces of healthy individuals and is the most common genus responsible for up to 75% of all candidal infections. The most common problems associated management of oral candidiasis are antifungal drug resistance and side effects Natural medicine is an emerging field and is being explored to overcome drug resistance and to reduce side effects. Gymnemagenin (will be known as Gymnemic acid; GA) is a purified extract from Gymnema sylvestre, a slow growing, perennial, medicinal plant found in Central and Western India, Tropical Africa and Australia is regarded as one of the plants with potent antimicrobial and antifungal activity.Item The antimicrobial efficacy of three chlorhexidine mouth rinses: an in-vitro analysis(University of the Western Cape, 2014) Abdalrahman, Basheer Mohamed; Holmes, Haly; Peck, M. Thabit; Basson, NicholasDifferent chlorhexidine (CHX) preparations and formulations are available in local markets. Some preparations contain anti-discoloration systems (ADS), additional antimicrobials like cetylpyridinium chloride (CPC), or alcohol. The aim of this study was to compare the antimicrobial efficacies of 3 different CHX preparations (Corsodyl®, Curasept® and GUM® Paroex®)Item Determining an average distance from the external mandibular cortex to the inferior alveolar canal using cone beam computed tomography (CBCT) imaging: An aid to harvesting mandibular ramus autogenous grafts.(South African Dental Association, 2016) Padayachee, S.; Holmes, Haly; Parker, M.E.OBJECTIVES: To provide average measurements relating the external mandibular cortex (EMC) to the inferior alveolar canal (IAC) using CBCT. METHODS: 100 CBCT images from UWC Dental hospital patient database were analysed using CBCT software (NewtomVGi Image works Corps) to produce coronal slices at four defined points along the IAC. Each point was measured from the IAC to the outer aspect of the mandibular buccal cortex and to the alveolar ridge crest (edentulous mandibles) or buccal cortical plate crest (dentate mandibles). The paired t-test was used to analyse right and left side measurements in order to test for differences in right and left side means. RESULTS: A mean width of 5.891mm (±1.09) from the IAC to the EMC in the horizontal plane and a mean height of 13.068mm (±2.963) from IAC to the alveolar crest or buccal cortical plate was demonstrated. Mean height was lower in edentulous mandibles (11.142mm in females; 13.490mm in males) than in dentate mandibles (12.916mm in females; 14.102 in males). There was no significant difference in width values. Height values were greater in males (14.102mm) than in females (12.916mm), being marginally significant (p-value of 0.00948:p<0.05). CONCLUSIONS: These measurements are clinically applicable when harvesting mandibular autogenous block grafts.Item The effect of cigarette smoking on whole stimulated salivary flow rate and pH(University of the Western Cape, 2016) Gadour, Noha; Holmes, HalyIntroduction: Saliva is a significant biological fluid involved in the maintenance of good oral health. Cigarette smoking exerts detrimental effects on oral health and has been shown to affect saliva, but with no consensus regarding its effect on the quantity (flow rate) and quality (pH) of the saliva. Aim: To assess the effect of cigarette smoking on the flow rate and pH of whole stimulated saliva. Method: A case control study was conducted using patients who presented at the UWC Oral Health Centre patient sifting/waiting area. The patients who agreed to participate were assessed for inclusion into the study until the sample size was (n=60), stratified by smoking (n=30) and non-smoking (n=30). Stimulated saliva samples were collected in specimen jars by asking patients to chew a sterilized rubber band for 5 minutes and spit the contents into the specimen jar provided at 1 minute intervals. The specimens were transported to the laboratory within 30 minutes to measure the salivary quantity and pH. Results: No statistically significant difference in the salivary flow rates was found between smokers and non smokers (p=0.5273). Smokers showed a statistically significant decrease in their pH compared to non smokers (p=0.028). Conclusion: Cigarette smoking reduces the salivary pH, thereby producing an acidic environment.Item The effect of percentage combination of probiotics and chlorhexidine on C. albicans(University of the Western Cape, 2019) Ahmed, Sara Ali Mohamed; Holmes, HalyBackground: Candida is a normal commensal of the oral cavity; these microorganisms can be isolated in 20% to 80% of healthy individuals. Oral candidiasis (OC) is the most common fungal infection related to the oral cavity caused by the most common opportunistic fungus (C. albicans). The management of oral candidiasis involves removal or reduction of predisposing factors together with the administration of an antimitotic agent either in topical or systemic form with or without chlorhexidine (CHX). The increasing number of people who are immunosuppressed and the development of antimicrobial resistance, has necessitated there is a need to explore others treatment to fight this infectious disease. This led to the exploration and use of beneficial microorganisms (probiotics) as an alternative prophylactic & therapeutic mode of treatment against Candida infections. Aim: To evaluate the effect of percentage combination of chlorhexidine (CHX) and probiotics on (PB) C. albicans growth. Method: The study was conducted in the Department of Oral Medicine and Periodontology and the Oral and Dental Research Laboratory (ODRL) at the Faculty of Dentistry, University of the Western Cape, Tygerberg campus. This in-vitro laboratory study was based on the established principle of spread plate technique followed by colony counting on selective media and non-selective media. Chlorhexidine (CHX) and probiotics (PB) were combined at different concentrations (XCHXyPB) (percentage combination), the added sum of which equals to 100 % (the percentage is achieved by multiplication of volumes (V*V)), to evaluate their effect on C. albicans. The treatments were incubated at 37°C for 30 minutes and 24 hours. Serial dilution was carried out on a micro-titer plate based on McFarland standards. A fixed volume (100 μL) of the solution was transferred into plates (selective and non-selective media). Deionized water served as a control (negative). Results: 100 μL CHX with 0 μL PB (100 CHX 0 PB) had a mean value of (0) at both 30 minutes and 24 hours. While 25 μL CHX with 75 μL PB (25 CHX 75 PB) the mean value (9.4) at 30 minutes and (9.5) at 24 hours. 0 μL CHX with 100 μL PB (0 CHX 100 PB) the mean value was (9.6) at 30 minutes while at 24 hours the mean value was (9.9). The control (0 CHX 0 PB) showed at 30 minutes and at 24 hours slightly similar reading (mean) as for the 0 μL CHX with 100 μL PB (0 CHX 100 PB). The largest difference was between the control (0 μL CHX with 0 μL PB) (0 CHX 0 PB) versus 100 μL of CHX with 0 μL PB (100 CHX 0 PB) (9.692), p <0.001. The smallest difference was between control (0 μL CHX with 0 μL PB) (0 CHX 0 PB) versus 0 μL CHX with 100 μL PB (0 CHX 100 PB). Conclusion: Chlorhexidine (CHX) and probiotics (PB) could be used at different combination concentration, provided that the CHX ratio is lower than the PB. Depending on the combination used, the number of colonies were slightly different. CHX (100 CHX) showed the lowest number of colonies (zero), while probiotics (0 CHX 100 PB) showed the highest number of colonies. Combination 25 CHX 75 PB showed reduction in CFU/mL. This means that CHX destroyed the organism which have already been established in literature, in comparison to probiotics which reduces the number of organisms (strain specific effect). These two effects are required when treating Candida infection, the treatment goal when treating Candida infection is to eradicate the organism but not completely, because if we completely eradicate the organism it will cause an unbalance in the normal flora of the oral cavity. Therefore, it is recommended that probiotics be administered to patients after being treated with CHX to avoid an imbalance in the normal flora. . Should these combinations be used simultaneously or subsequently is a question that requires further elucidation by research.Item In vitro antimicrobial comparison of three commercially available chlorhexidine-based oral rinses(South African Dental Association, 2016) Abdalrahman, Basheer Mohamed; Holmes, Haly; Peck, Mogammad T.; Basson, NicolaasINTRODUCTION: Commercially available chlorhexidine (CHX) formulations differ in their CHX concentrations (0.2% and 0.12%) as well as in various additives including alcohol, antimicrobials such as cetylpyridinium chloride and antidiscolouration chemicals such as ascorbic acid and sodium metabisulphite. AIMS AND OBJECTIVES: To compare in vitro the antimicrobial efficacies of three different CHX preparations (Corsodyl ®, Curasept® and GUM® Paroex®) using 0.2% and 0.12% CHX concentrations as controls METHODS: A disk diffusion test was performed using pure cultures of the organisms Streptococcus mutans and Candida albicans, and mixed cultures (facultative and strict anaerobes) prepared from oral rinse samples of 14 study participants. The means and standard deviations of the diameters of inhibition zones were calculated. RESULTS: A statistically significant difference (p value = 0.0001) was found only in Candida albicans cultures between the mean inhibition zones of the CHX preparation disks. Pure CHX preparations and Corsodyl® showed higher antifungal efficacy than Curasept® and GUM® Paroex Conclusion: Both CHX preparations (0.12% and 0.2%) and the 0.2% CHX preparation containing alcohol (Corsodyl®) have more potent antifungal properties against C. albicans than alcohol-free 0.12% CHX preparations such as Curasept® and GUM® Paroex®.Item Nanoparticle antifungal therapy for resolution of oropharyngeal candidiasis: Systematic review and meta-analysis(University of the Western Cape, 2022) Saleem, Ahmed Omar Abbasher; Holmes, HalyOral candidiasis is an opportunistic infection caused by Candida Species that generally affects Immunocompromised individuals and Denture wearers. The side effects associated with the use of anti-fungal medicaments are increased and the therapeutic effectiveness is decreased. Nonetheless, the increase in resistance to conventional anti-fungal medicaments and the limitation of available antifungals make it difficult to manage the disease.Item Oral medicine case book 47: oral neurofibroma(South African Dental Association (SADA), 2013) Stander, Suzette; Dreyer, Wynand P.; Holmes, Haly; Jeftha, Anthea; Afrogheh, AmirA 29-year-old male patient presented at the Oral Medicine Clinic with the complaint of slow-growing growths on his tongue, causing discomfort. Extra-oral examination revealed several painless soft tissue nodules on his face (Figure 1 and 2), trunk (Figure 3), back (Figure 4) and arms. The patient reported that the lesions had appeared during childhood and had since increased in size and number. He was unaware of any family history of the disease. Intra-oral examination showed two soft tissue nodules on the midline of the dorsal surface of the tongue, 3,5cm and 0,5 cm in diameter respectively (Figure 5).Item Oral medicine case book 49: plasmablastic lymphoma(South African Dental Association (SADA), 2013) Stander, Suzette; Holmes, Haly; Dreyer, Wynand P.; Afrogheh, Amir; Mohamed, Nadja; Hille, Jos; Osman, NuraanA 25-year-old male patient presented at the Oral Medicine Clinic with a painful bleeding lesion on the palate causing him discomfort during speech, mastication, and sleep. The lesion started approximately five months earlier as a small growth that gradually increased in size. The patient was rather vague about his medical history and habits but he did reveal that he smoked two cigarettes per day as well as using cocaine, a habit for which he was receiving therapy, for drug-induced hallucinations, at a local psychiatric hospital. He was not aware of any other medical conditions or allergies. The extraoral examination revealed nothing of note, however, on intraoral examination a large and firm pedunculated exophytic soft tissue mass was seen on the hard palate. It covered a large portion of the hard palate extending from the back of the upper incisors posteriorly onto the anterior part of the soft palate and into the right vestibule. It extended laterally to the gingival margins of all the teeth in the first quadrant, resulting in an appearance of gingival hyperplasia. The growth had an erythematous appearance with surface patches of necrosis and other areas that easily bled on touch (Figure 1).Item Oral medicine case book 55: ondontogenic myxoma(South African Dental Association (SADA), 2013) Holmes, Haly; Mulder, Sune; Dreyer, Wynand P; Fakir, E; Roberts, T; Wainright, HA 20-year old female was referred from her local community health clinic to the Oral Medicine Clinic at Groote Schuur Hospital for a swelling that started out as a small and painless lesion. She had attended the local clinic approximately two months earlier when the growth increased in size, her teeth loosened and the lesion became symptomatic. At that time, her upper left molar teeth were extracted but, despite this, the lesion continued to enlarge.Item Oral Medicine Case Book 56: Oral Manifestations of aplastic anaemia(South African Dental Association, 2014) Padayachee, S.; Holmes, Haly; Dreyer, Wynand P.A 22-year old female patient was referred to the Oral Medicine Clinic from the Haematology Ward at Groote Schuur Hospital for evaluation of a painful oral ulcer, which had been present for three weeks. The patient reported that, six weeks ago, she had sought treatment from her own dentist for painful and bleeding gingivae. The dentist performed a scale and polish and prescribed a combination of amoxicillin and metronidazole, at normal adult doses, for seven days. The gingival bleeding had not resolved by the time she presented for her recall visit, two weeks later. The patient also reported the presence of 'small, purple spots' on her lower limbs and trunk.Item Oral Medicine Case Book 57: Orofacial granulomatosis(SADA, 2014) Mulder-Van Staden, Sune; Holmes, Haly; Dreyer, Wynand P.; Afrogheh, AmirA 17-year old female presented at the Oral Medicine Clinic with the complaint of persistent swelling of the upper lip and anterior attached gingiva, causing her discomfort when eating and talking. The swelling started approximately ten months earlier. At the time she was seen by her physician who prescribed an antibiotic that gave mild symptomatic relief, but no clinical resolution. She was also seen by an oral hygienist on three occasions with no improvement of the gingival swelling. The patient also reported that she had been diagnosed with depression and type 2 diabetes approximately two years ago and was currently using Citalopram (a selective serotonin reuptake inhibitor) and Glucophage (metformin hydrochloride, an anti-hyperglycemic drug). Extra-oral examination revealed a firm, swollen and superficially cracked upper lip with a red granular appearance. No enlarged cervical lymph nodes could be palpated. Intra-orally, the anterior maxillary and mandibular gingivae were hyperplastic and erythematous, with a granular surface (Figures 1, 2 and 3). The differential diagnosis included contact allergy and granulomatous disease, including mycobacterial infection.Item Oral medicine case book 74: marijuana-induced Oral Leukoplakia(South African Dental Association, 2017) Temilola, Dada; Holmes, Haly; Mulder Van Staden, Sune; Afrogheh, AmirA 55-year-old male presented at the Oral Medicine Clinic of the University of the Western Cape, Oral Health Centre, Tygerberg Campus, for the evaluation of a persistent white patch on his right edentulous mandibular ridge. He had been referred from the Prosthodontics Clinic where he was seen for complete denture rehabilitation. The patient had no significant medical history and informed us that he had been smoking marijuana five times a day for more than twenty years and consumed alcohol occassionally. He had never worn a dental prosthesis and did not use tobacco in any form.Item Oral medicine case book 76: Methotrexate induced mucosal erosions and ulcerations(South African Dental Association, 2017) Negi, M.; Mulder Van Staden, Sune; Holmes, Haly; Nel, L.A 71-year-old male was referred from his general practitioner to the Oral Medicine Clinic at the University of the Western Cape, Oral Health Centre, Tygerberg campus, on account of a six-week history of recurrent oral ulceration.Item Oral supplemental interventions for the 6 management of recurrent aphthous stomatitis (ras) – A systematic review and meta-analysis(University of the Western Cape, 2022) Mirza, Waqas; Holmes, HalyRecurrent aphthous stomatitis (RAS) is described as a painful, recurrent oral mucosal ulcerative condition in otherwise healthy individuals. Treatment objectives include pain relief/reduction, prevention of secondary infection, promoting healing and reducing recurrence. Conventional treatment modalities include topical or systemic corticosteroids, analgesics and antiseptic mouth rinses. Recent evidence suggests a therapeutic role for oral supplementation in the management of RAS.Item Periodontitis and cardiovascular disease(South African Dental Association (SADA), 2013) Jeftha, Anthea; Holmes, HalyPeriodontal medicine has been studied and reviewed extensively since its introduction to the dental fraternity. The association of periodontal disease with and its effects on the cardiovascular system are amongst the many topics explored. A summary of the research into these associations and the possible mechanisms of any relationship is presented. Although a link between these two chronic inflammatory diseases is evident, the very heterogeneity of the relevant studies has not provided evidence sufficient to support an actual causal relationship. More stringent epidemiologic and intervention studies are required.Item Salivary creatinine as a diagnostic tool for evaluating patients with chronic kidney disease(The University of the Western Cape, 2017) Temilola, Dada Oluwaseyi; Holmes, HalyBACKGROUND Preliminary studies have shown the potential use of saliva in the diagnosis of chronic kidney disease (CKD). For saliva to completely replace serum as a diagnostic and monitoring tool for CKD, studies must be done to determine its effectiveness as a substitute in diagnosing chronic kidney disease, at each stage of the disease. Aim: The aim of the study was to evaluate the role of saliva as a safe and non-invasive alternative to serum, for creatinine estimation, in all stages of chronic kidney disease. METHOD A cross sectional study was conducted at the Renal Unit of Tygerberg Hospital, on 230 patients at all stages of CKD. Informed consent was obtained; thereafter saliva and serum samples were collected for creatinine analysis. Correlation between serum and salivary creatinine was determined using Spearman's correlation test. Receiver Operating Characteristics (ROC) analysis was used to determine the diagnostic ability of salivary creatinine and a cut-off value for sensitivity and specificity of salivary creatinine to diagnose CKD with GFR < 60ml/min was obtained. RESULTS Serum creatinine values ranged from 46?mol/L to 1581?mol/L with a median value of 134?mol/L. Salivary creatinine values ranged from 3?mol/L to 400?mol/L with a median of 11?mol/L. Spearman's correlation analysis showed a strong positive correlation (r = 0.82) between serum and salivary creatinine values for all CKD stages. Linear regression analysis of serum and salivary creatinine for CKD patients was significant in all CKD stages, except for stage 1. Area under the curve for salivary creatinine was 0.839. A cut-off value of 8.50?mol/L showed a sensitivity of 78.3% and specificity of 74.0% at eGFR < 60ml/min, for classifying patients as having CKD.