Dry Lips Research Articles

ORAL MANIFESTATIONS OF THE ACUTE MYELOID LEUKEMIA: A CASE REPORT

The oral repercussions of patients with leukemia include the reduction of the production of blood cells that can lead to anemia, neutropenia, and thrombocytopenia. This work aims to report on the oral repercussions and dental management of patients with leukemia. A 42-year-old woman with a recent diagnosis of acute myeloid leukemia during the chemotherapy underwent oral opening limitation, with a complaint of odynophagia and low dietary intake, consuming only liquid consistency food. Lip dryness with erosive areas, an increase of volume in the upper lip, and presence of hyperplasia and ecchymoses in the gingival margin and in the region of hard and soft palate were observed. The patient had leukopenia and thrombocytopenia. Lesions management was performed daily, as well as follow-up to minimize discomfort and avoid secondary infections. After medullary recovery, improvement of the general clinical picture of the patient was remarkable. The oral repercussions of patients with leukemia include the reduction of the production of blood cells that can lead to anemia, neutropenia, and thrombocytopenia. This work aims to report on the oral repercussions and dental management of patients with leukemia. A 42-year-old woman with a recent diagnosis of acute myeloid leukemia during the chemotherapy underwent oral opening limitation, with a complaint of odynophagia and low dietary intake, consuming only liquid consistency food. Lip dryness with erosive areas, an increase of volume in the upper lip, and presence of hyperplasia and ecchymoses in the gingival margin and in the region of hard and soft palate were observed. The patient had leukopenia and thrombocytopenia. Lesions management was performed daily, as well as follow-up to minimize discomfort and avoid secondary infections. After medullary recovery, improvement of the general clinical picture of the patient was remarkable.

PROFILE OF INPATIENTS EVALUATED BY THE DENTAL TEAM IN A HOSPITAL UNIT

Objective: To verify the sociodemographic and clinical characteristics of the inpatients evaluated by the dental team in a university hospital. Study Design: Clinical and demographic data were collected from medical records and oral data from routine exams of inpatients of different specialties. Dental visits are performed weekly at different wards for patients who would be willing to receive oral care. The intraoral examinations were performed at bedside with a frontal light, respecting principles of biosafety and oral semiology. Data were stored in an electronic database for analysis. Results: There were 226 patients included in the analysis. The median age was 54.57 ± 16.4 years, and there were 53.1% males and 87.2% non-whites. Most of the patients presented with kidney disease (53.4%), gastrointestinal problems (27.5%), or diabetes (23.8%). The most common oral conditions were dry lips (60.9%), depapillated tongue (7.9%), candidiasis (4.0%), and leukoplasia (2.6%). Besides oral exams, other oral procedures performed were scalings (18.5%), dental fillings (18.5%), and exodontias (10.3%). Conclusion: This study shows information about the demographic and clinical profile and the oral status of hospitalized patients. Prospective studies should be performed to investigate if oral care may reduce the period of hospitalization and complications of the underlying disease.

ATYPICAL ORAL MANIFESTATION OF VISCERAL LEISHMANIASIS IN HUMAN IMMUNODEFICIENCY VIRUS--INFECTED CHILD

A 7-year-old white boy presented with weight loss, coughing, hepatosplenomegaly, and pancytopenia with 2 months of evolution and a diagnosis of visceral leishmaniasis (VL). The medical pediatrician team referred to a dentistry team reporting “Painful lesions in the oral cavity with feeding impaired.” The mother reported 4 days of evolution, pain for eating, speaking, and tooth brushing. Extra-oral examination showed dry lips and skin. Intra-oral examination revealed multiple ulcers on the right side of the hard palate with erythematous dotting and slight mucosal thickening and a single ulcer on the tongue. The hypothetical diagnoses were herpetic gingivostomatitis and oral manifestation of VL. A biopsy in hard palate was performed. The histopathologic exam revealed vacuolated macrophages and structures compatible with Leishmania within the macrophages. This atypical oral manifestation of VL led to the suspicion of other comorbidities, which confirmed by serologic tests that the patient was positive for HIV.

Lip balm drying promotes virus attachment: Characterization of lip balm coatings and XDLVO modeling

HypothesisDrying-induced decrease in lip balm surface energy enhances virus adhesion due to the emergence of strong hydrophobic colloid-surface interactions. ExperimentsA protocol was developed for preparing lip balm coatings to enable physicochemical characterization and adhesion studies. Surface charge and hydrophobicity of four brands of lip balm (dry and hydrated) and human adenovirus 5 (HAdV5) were measured and used to calculate the extended Derjaguin-Landau-Verwey-Overbeek (XDLVO) energy of interactions between lip balm coatings and HAdV5 as well as four other colloids: HAdV40, MS2 and P22 bacteriophages, and SiO2. Quartz crystal microbalance with dissipation monitoring (QCM-D) tests employed SiO2 colloids, HAdV5 and hydrated lip balms. FindingsDrying of lip balms results in a dramatic decrease of their surface energy (δΔGsws≥ 83.0 mJ/m2) making the surfaces highly hydrophobic. For dry lip balms, the interaction of the balm surface with all five colloids is attractive. For lip balms hydrated in 150 mM NaCl (ionic strength of human saliva), XDLVO calculations predict that hydrophilic colloids (MS2, P22, SiO2) may attach into shallow secondary minima. Due to the relative hydrophobicity of human adenoviruses, primary maxima in XDLVO profiles are low or non-existent making irreversible deposition into primary energy minima possible. Preliminary QCM-D tests with SiO2 colloids and HAdV5 confirm deposition on hydrated lip balms.

Knowledge levels and concerns about oral isotretinoin treatment in the parents of adolescent acne patients.

Oral isotretinoin is frequently used in the treatment of young acne patients. However, knowledge levels and attitudes about this treatment have not been studied in the parents previously. We aimed to investigate the knowledge levels and concerns about oral isotretinoin in the parents of adolescent acne patients. We conducted a cross-sectional study on 136 parents of adolescent patients with moderate to very severe acne vulgaris who answered the questionnaire about oral isotretinoin treatment. Demographic data and acne characteristics were recorded. The parents' knowledge levels and concerns about the treatment process were asked by the questionnaire. Since 32 parents have never heard oral isotretinoin before, they were excluded from the study. Of the remaining 104 parents, 80.8% were female and 19.2% were male. Of the parents, 62.5% had some concerns about oral isotretinoin treatment and 34.6% had no idea whether the drug is suitable for the use of <18 years. 52.9% stated that they think the drug will damage the liver. The most known and worrying side effects were dry lips and vision problems, respectively. The knowledge levels about oral isotretinoin treatment and its side effects were low in the parents of adolescent acne patients, leading to prejudice to the drug.

Proper Counseling and Dispensing of Isotretinoin Capsule Products by Community Pharmacists in UAE: A Simulated Patient Study.

PurposeTo evaluate the pharmacist’s assessment of patient eligibility for safe use of isotretinoin and the quality of pharmacist’s counseling.Patients and MethodsA covert simulated patient (SP) methodology was used in which a trained female researcher, who was 25 years old, played the patient’s role through this cross-sectional study by visiting community pharmacies and requesting isotretinoin capsules through a controlled prescription. A data form was used to collect the information following each pharmacy visit by asking about medical/family history and providing comprehensive counseling about the most common adverse effects, proper use instructions, and the importance of adherence to medication. The pharmacists, who did not initiate counseling, were prompted by the SP.ResultsThe pharmacists in 400 pharmacies who agreed to participate were visited by the SP. Only 7 (2%) pharmacists provided a complete assessment of patient eligibility for using isotretinoin with comprehensive counseling. Most of the pharmacists (84%) provided incomplete assessment as indicated by the overall score. Only 11 (3%) pharmacists asked the six crucial questions for the assessment of patient eligibility. On prompting, only 6 (2%) pharmacists provided complete counseling about the expected adverse effects. The most frequently provided adverse effect was dry skin, specifically dry lips (71.8%). A minority of 108 (27%) pharmacists provided education about the importance of using contraception during isotretinoin therapy. A complete level of counseling was provided by 125 (31.3%) pharmacists regarding the lab tests that the SP needs to undergo during therapy. Female pharmacists were more likely to provide counseling about the pregnancy test (mean=134, p=0.001).ConclusionSuboptimal level of the patient’s assessment was revealed with poor educational counseling by the community pharmacists. New strategies are needed to improve pharmaceutical care services in the UAE.

The efficacy of a highly occlusive formulation for dry lips.

Since skin on the lips has a lower water content in the stratum corneum (SC) and a higher transepidermal water loss (TEWL) value than skin on the cheek, the lips are usually very dry and rough areas. Therefore, a lip balm approach to increase occlusivity of the lips is generally used to reduce water loss. Although there have been reports of an improvement effect on lip roughness by specific care agents, differences in the effects due to the occlusivity of a formulation without a specific care agent have not been reported. The purpose of this study was to clarify the improvement effect on dryness and roughness of the lips by a highly occlusive formulation consisting of a combination of common oil and wax, not by a specific care agent. Twenty Japanese female subjects with normal skin (age range 20-39years; mean 28.1) were enrolled in this study. A 4-week continuous use test was conducted using samples with low and high occlusivity. The degree of lip roughness and wrinkles was scored, the hollow index was assessed using ANTERA 3D images, and values of capacitance and TEWL were measured. The hollow index was significantly correlated with both the appearance roughness score and the wrinkle score. The sample with high occlusivity showed significant improvement in the appearance roughness score, wrinkle score, the hollow index and capacitance of the SC. In a comparison between the groups of samples with different occlusive properties, a significant improvement effect in rough appearance was seen in subjects using the highly occlusive formulation. The hollow index assessed by ANTERA 3D imaging allowed the objective evaluation of the improvement in appearance. In the case of continuous use of the highly occlusive formulation, an improvement of capacitance in the SC, which is most correlated with lip roughness, was obtained after 2 and 4weeks. These results demonstrate for the first time that a highly occlusive formulation is effective in improving the roughness of the lips, and this effect is due to the difference in the occlusive property not by a specific care agent.

Validity Analysis on the Findings of Dehydration in 2 to 24-Month-Old Children With Acute Diarrhea.

The most common cause of diarrheal mortality in children is dehydration. In this study, we aimed to assess the validity (sensitivity and specificity) of history and the clinical and laboratory findings in in the diagnosis of dehydration in children younger than 2 years with acute diarrhea. One hundred twenty-six 2 to 24-month-old children with acute diarrhea, who were admitted to Hacettepe University Ihsan Dogramaci Children's Hospital's Diarrheal Diseases Treatment and Training Unit, were included. The patients were examined on admission for clinical findings of dehydration. Percent weight loss on admission was calculated by using the weight on admission and the weight after the diarrhea resolution and was used as the golden standard for analyzing the validity of clinical and laboratory findings. Compared with the golden standard, dehydration was overestimated in 13% of the cases and underestimated in 7% when using only the World Health Organization criteria. Dehydrated children had higher diarrheal frequency and longer anuria time. Thirst, weakness, sunken fontanelle, sunken eyes, decreased tears, dry mucous membranes, and dry lip were detected in children with 2% or greater of weight loss. The most valid laboratory findings were low serum pH (<7.30), low bicarbonate (<15 mmol/L), and hyperurisemia (>5.8 mg/dL). In multivariate analysis, physical findings, such as thirst, dry mucous membranes, weakness, sunken eyes, hoarse crying, and low pH, were found to be significant for the diagnosis of dehydration. In children with acute diarrhea, diarrheal frequency and last urination time should be asked, thirst, dry mucous membranes, weakness, sunken eyes, and hoarse crying should be examined.

Prevalência, intensidade e desconforto da sede no paciente cirúrgico no pós-operatório imediato

Objetivo: Avaliar a prevalência, a intensidade e o desconforto da sede no período pós-operatório imediato. Método: Estudo epidemiológico, transversal, descritivo, quantitativo, realizado em um hospital universitário do Sul do Brasil, de agosto a setembro de 2012. A amostra foi composta de 386 pacientes em recuperação anestésica de cirurgias eletivas e de urgência. Foi utilizado um questionário semiestruturado composto de dados demográficos, clínicos e variáveis relacionadas à sede. Resultados: A prevalência de sede foi de 78% (303 pacientes), com intensidade média de 6,94 (desvio padrão — DP=2,2) e queixa espontânea de sede em 38,3% dos casos (116 pacientes). Os desconfortos relatados foram: boca seca, procura por água, hipossalivação, garganta seca, lábios ressecados, língua seca e vontade de deglutir. Todos os desconfortos apresentaram correlação de Pearson positiva em relação à presença de sede. Conclusão: A sede no pós-operatório imediato é intensa, prevalente e com sinais periféricos desconfortáveis. Essas evidências fundamentam a necessidade da identificação, da mensuração, da avaliação e do tratamento do sintoma sede de forma intencional neste período

Palliative care assessment of dry mouth: what matters most to patients with advanced disease?

PurposeDry mouth is a highly prevalent and significant symptom in patients with advanced progressive diseases. It is a poorly understood area of research, and currently, there is no standardised outcome measure or assessment tool for dry mouth.MethodsTo assess responses to self-reported dry mouth questions, the impact of dry mouth, methods used to reduce symptoms and relevance of the questionnaire. A cross-sectional multisite study of 135 patients with advanced progressive disease experiencing dry mouth. Participants were located in the inpatient, day care, outpatient or community setting.ResultsThe majority (84.4%) of patients rated their dry mouth as moderate or severe using the verbal rating scale (VRS). Seventy-five percent (74.7%) had a numeric rating scale (NRS) score of 6 or more for dry mouth severity. Patients reported that dry mouth interfered most with talking and was the most important function to assess (median score 6 out of 10) followed by eating (median 5) and taste (median 5). Taking sips of drink was the most common and most effective self-management strategy. Over half of patients (54.6%) also reported impact on swallow and sleep and associated dryness of lips, throat and nasal passages.ConclusionsThis study highlights the severity of dry mouth in advanced disease. Important factors when assessing patients with dry mouth should include the functional impact on day-to-day activities including talking, dysphagia and sleep. Simple considerations for patients include provision of drinks and reviewing medications. This study could be used to develop a standardised assessment tool for dry mouth to use in clinical practice.

Deposition of plant lipids after single application of a lip care product determined by confocal raman spectroscopy, corneometry and transepidermal water-loss.

ObjectiveLip treatment products often incorporate oils and waxes in their formulations, and a desired outcome of their use is to prevent lip dryness and roughness as well as help to repair this condition. The objective of this study was to combine confocal Raman spectroscopy with skin capacitance (corneometry) and transepidermal water loss (closed chamber Aquaflux system) measurements, in the evaluation of the degree of moisturization and lip skin penetration of a fruit wax (Rhus vernicula peel cera) and natural oil‐based (Cocos nucifera fruit oil and Olea europea oil) lip care product, following a single application.MethodsThe study was conducted on a total of 15 healthy female volunteers. Instrumental measurements were performed before and 30 min, 2 h and 6 h after a single application of the product.ResultsLip skin barrier function as well as lip hydration were significantly improved and penetration of olive oil was maintained for at least 6 h post product application. The deposition of the three component lipids (berry fruit wax, coconut oil and olive oil) into the stratum corneum after a single application of the lip care product was maintained and data significant for 2–6 h post product application. Lipid deposition was regarded as a positive long‐lasting skin care (depot‐) effect combined with a profound hydrating effect for about 6 h.ConclusionThe tri‐method approach taken in this study is deemed relevant and valid for measuring lip hydration offering a complimentary assessment of the barrier function of lip skin and interactive effects of cosmetic ingredients.

A series of in vitro and human studies of a novel lip cream formulation for protecting against environmental triggers of recurrent herpes labialis.

PurposeThese studies describe the testing of a novel, daily-use lip cream designed for individuals with lips prone to recurrent herpes labialis (RHL) that protects against environmental triggers.Subjects and methodsIn vitro occlusive and in vitro and in vivo photoprotection analyses, a characterization of normal vs dry lips, and a randomized, evaluator-blinded, clinical trial that assessed the lip cream in healthy subjects with dry lips were conducted. In the clinical trial, subjects applied the lip cream or were untreated and evaluated using transepidermal water loss (TEWL), corneometry, visual assessments of lip dryness, expert photographic evaluations, and subject-rated outcomes.ResultsThe lip cream’s in vitro water vapor transmission rate (84.1 g/(m2 h)) indicated moderate occlusivity. The lip cream, but not placebo or control (water), reduced ultraviolet A (UVA)- and UVB-induced DNA damage, and tumor necrosis factor-α (EpiDermFT) and pros-taglandin E2 release (EpiDermFT and EpiGingival™). The lip cream’s in vivo sun protection factor (SPF) was 12.2 (lower confidence limit, 11.3) and SPF/UVA protection factor ratio was 0.9. The characterization of dry vs normal lips identified differences in moisturization. In the clinical trial, the lip cream significantly decreased TEWL (difference: −7.19 [95% CI: −11.41, −2.98]; P<0.01), increased corneometry (difference: 4.62 [95% CI: 1.05, 8.19]; P<0.05), and reduced visual dryness (difference: −1.48 [95% CI: 2.24, −0.71]; P<0.001) compared to untreated subjects. Significant benefits were also observed on expert photographic assessments of scaling (difference: −0.89 [95% CI: −1.75, −0.03]; P< 0.05), cupping (difference: −1.50 [95% CI: −2.30, −0.70]; P<0.001), and healthy appearance (difference: −1.44 [95% CI: −2.29, −0.58]; P<0.01); differences in overall healthy appearance were not significant (P=0.51). Subject-rated assessments indicated improvements in cracking, dryness, and flaking in the lip cream group but worsening in untreated subjects.ConclusionThese studies indicate that this novel, daily-use lip cream protects against UV radiation, drying, and chapping, which are established environmental RHL triggers.

Nocturnal living beats the heat

![Graphic][1] A sweaty brow, dry lips and unslakeable thirst – we all know what it's like to swelter through a hot summer. While we can ease our discomfort by switching on an air conditioner or visiting an ice cream shop, animals don't have that luxury. They can, however, change their

Prevalence of oral side effects of chemotherapy and its relationship with periodontal risk: a cross sectional study.

To determine the prevalence of professionally reported oral side effects of chemotherapy and the self-reported oral side effects and whether both prevalences could be related to the periodontal risk of the patients. A cross-sectional study with patients undergoing chemotherapy treatment was carried out. Demographic, oral hygiene habits, and cancer-related data were collected while the patient was receiving the chemotherapy infusion. Patient's oral status, measured according to the oral-assessment guide for patients in hospital environments, patient-related outcomes (PROMs), measured by a visual analogue scale, and patient's periodontal risk were analyzed using validated questionnaires. Data was reported in means and standard deviations (SD) in quantitative variables and in counts, prevalence, and 95% confidence intervals (CI) in qualitative variables. ANOVA test and chi-squared tests were used to compare oral side effects among different periodontal risk groups. Three hundred sixty-nine patients were included in the study. The prevalence of professionally reported oral side effects was 86.99% (95% confidence interval CI 83.54%; 90.44%). The prevalence of self-reported oral side effects was 89.70% (95% CI 86.59; 92.82). The most common oral side effects were xerostomia (73.4%), dysgeusia (61.8%), and dry lips (54.2%). More oral alterations were found in patients with worse periodontal risk (p < 0.001). The prevalence of oral side effects (professional or self-reported) is higher than 85% in patients undergoing chemotherapy. This prevalence increases as the risk of developing periodontal disease does.

Oral health status of patients in intensive care unit: a cross-sectional study

Introduction: Patients in intensive care unit (ICU) may present oral alterations as a result of patients’ systemic conditions, the use of medications, intubation or poor oral hygiene. Oral alterations should be detected and treated because they may aggravate patients’ condition. The objective of this study was to evaluate the types and frequencies of clinically detected oral alterations in inpatients of an ICU. Methods: This is a cross-sectional study in which an oral evaluation of patients hospitalized in an ICU of a public hospital was performed. Demographic, social and clinical characteristics were collected from medical records. Oral exams were performed by two trained dentists, with reliability checked by intra-class correlation coefficient, while patients were lying in the hospital bed, using a frontal headlamp, tongue depressor and sterile gauze. All data were recorded in study protocol forms and transferred to a data base for analysis. Results: Thirty-seven patients, with similar distribution between genders, with median age of 62 yearswere evaluated. The most frequent causes for hospitalization were postoperative care (51.35%) and respiratory problems (29.72%). About 90% of the inpatients presented some type of oral alterations during the hospitalization period. The most common clinical alterations were dry lips (86.5%); coated tongue (61.1%); paleness of the oral mucosa (54.1%); oral foci of infection (37.8%) and candidiasis (13.5%). Conclusion: The majority of inpatients of the ICU presented some type of oral alteration, and the most frequent were dry lips and coated tongue. Data observed in this study reinforce the need of the dental team support during the period of hospitalization.

A Survey on the most common side effects of Isotretinoin among A Group of Syrian Patients

Acne vulgaris is considered one of the most important cutaneous conditions affecting people in the society at the ages of adolescence and youth. There are many topical treatments along with systemic treatments that can be used to treat it. Isotretinoin is one of the most popular medications that can be used to treat acne vulgaris. Its use can be accompanied by serious side effects; especially teratogenicity. We aimed of this study to evaluate the most common side effects associated to oral isotretinoin intake among the Syrian society to increase the awareness among young adults. We designed an electronic questionnaire containing 20 questions and directed to patients who are treated with oral isotretinoin; taking in consideration the privacy of the questionnaire. 320 individuals (292 females – 28 males from all Syrian communities answered the questionnaire. Among all participants, 8.4% had taken oral isotretinoin without a medical prescription and 55% (176 of 320) had not done liver function tests before starting the course. We noticed that the most frequent side effect was chapped and dry lips 96.3%, and secondly dermatoxerasia 81.6%. It was surprising that 55.6% of all participants suffered from mood disorders and depression. These results confirm the importance of the survey in shedding light on isotretinoin side effects and increasing the awareness of its possible complications, in addition to educate the patients about the effects of this medication on the mental state along with mood disorders that may be associated to long-term use.

Public knowledge of dehydration and fluid intake practices: variation by participants\u2019 characteristics

BackgroundDehydration results from a decrease in total body water content either due to less intake or more fluid loss. Common symptoms of dehydration are dry mouth/tongue, thirst, headache, and lethargy. The aim of this study was to assess knowledge of dehydration definition, symptoms, causes, prevention, water intake recommendations and water intake practices among people living in Riyadh, Saudi Arabia.MethodsA cross-sectional study using self-reported questionnaire was employed. Participants were invited during their visit to shopping malls. The shopping malls were selected based on geographical location covering east, west, north and southern part of the city. Self-filled questionnaires were distributed to 393 participants, using systematic sampling technique. Variables recorded included demographics, past medical history, knowledge of dehydration definition, symptoms, causes, prevention and daily water intake practices. Descriptive statistics were summarised as mean, standard deviation and proportions. Negative binomial model was used to identify the predictors of water intake. Analyses were performed using SAS version 9.4 (SAS Institute, Cary, NC, USA).ResultsOut of 393 participants, 273(70%) were Saudi, 209(53%) were female, average age was 32.32 ± 8.78 years. Majority 366(93%) had good knowledge of dehydration definition, 332(84%) for dehydration prevention, and 293(74%) of water intake recommendation. Top three recognized dehydration symptoms were: dry lips (87%), thirst (84%), dry tongue (76%) and recognized dehydration causes were: diarrhoea (81%), sweating (68%) and vomiting (62%). The less recognized symptoms were fatigue 176(44.78%), lack of focus 171(43.5%), headache/dizziness 160(40.71%), light headedness 117(29.7%), muscle weakness 98(24.94%), rapid breathing 90(22.9%), and muscle cramps 64(16.28%).The participants had reported an average of 5.39 ± 3.32 water glasses intake per day. The total volume of water intake was significantly different between males n = 184 (3.935 ± 2.10 l) and females n = 209 (3.461 ± 2.59 l) (p = 0.046). The participants’ weight status, intake of juice or tea were the significant predictors of more water intake.ConclusionThe participants displayed good knowledge of dehydration definition, prevention, and water intake recommendation. The participants also displayed good knowledge of the common symptoms, however knowledge was lacking for uncommon symptoms. Moreover, participants had reported adequate water intake, meeting the daily water intake recommendation of ≥3.7 l for men and ≥ 2.7 l for women.

Characteristics of seaweed porridge Sargassum sp. and Eucheuma cottonii as raw materials for lip balm

A lip balm is needed to overcome skin problems such as dry lips, cracked, dark, and wrinkled and premature aging of the lips. A Lip balm that contains antioxidants and bioactive compound is needed to inhibit free radical activity and overcome problems in the lips. Seaweed is a natural material that is quite abundant and has a variety of bioactive compounds, including seaweed Sargassum sp. and E.cottonii. This study aimed to characterize and obtain the best formulas of seaweed Sargassum sp. and E. cottonii combination in producing lip balm preparations, as well as obtaining the best lip balm formulations perceived from antioxidant analysis, pH, and loss on drying. This research consists of two stages of research. First stage research was to characterize and prepare the seaweed raw material, characterize and production of seaweed Sargassum sp. and Eucheuma cottonii porridge. Second stage research was the preparation of lip balm preparations. The results showed that the best ratio of seaweed Sargassum sp. and E. cottonii was found on 1: 1 ratio with IC50 antioxidant value of 576.41 ppm, pH 5.39, and Loss on drying 3.52%. The pH value of the lip balm in corresponds to the SNI and pH of the normal human skin balance. Sargassum sp. and E. cottonii seaweed contain phytochemical compounds such as steroids, triterpenoids, flavonoids, and saponins. The content of phytochemical compounds indicates that Sargassum sp. and E. cottonii potential can be used as raw material in making lip balm.

Cutaneous effects associated with fluconazole in patients treated for coccidioidomycosis.

Fluconazole is the most commonly used antifungal treatment for various forms of coccidioidomycosis. Although we had anecdotally observed a high proportion of patients reporting cutaneous adverse effects associated with fluconazole treatment, this observation was not well described in the medical literature, and we were unsure of the additional effect of the arid desert environment of Arizona. We performed a one-time, voluntary survey of patients with coccidioidomycosis and compared the responses of patients treated with fluconazole with those of untreated patients. From January 1, 2015, to August 22, 2017, 62 fluconazole-treated and 35 untreated patients with coccidioidomycosis provided consent and were enrolled in the study; demographics were similar between the two groups. Among the 62 fluconazole-treated patients, daily dosages ranged from 200 mg to 800 mg. However, most (44/62, 71%) took 400 mg daily, the typical dose for the treatment of coccidioidomycosis. The median fluconazole treatment duration at the time of study participation was 6 months. When compared with untreated patients, those taking fluconazole had more moderate to severe dry lips (74.2% [46/62] vs. 23.5% [8/34]; P < 0.001), dry skin (45.8% [27/59] vs. 22.9% [8/35]; P = 0.03), and alopecia (31.1% [19/61] vs. 11.4% [4/35]; P = 0.004). For the treatment of coccidioidomycosis, patients receiving fluconazole reported significantly more severe cutaneous effects, including dry lips, dry skin, and alopecia, than untreated patients. Our findings identify an association but do not prove causality.

Challenges Faced by Woodwind Players in Malaysia While Fasting During Ramadan: A Case Study.

While numerous studies have investigated associations between Ramadan fasting and sports performance, as well as general health, little is known about the experiences of musicians who play while fasting. This exploratory case study aimed to gain a better understanding of the experiences of tertiary-level woodwind players who practice, rehearse, and perform while fasting. Sixteen undergraduate woodwind players from two Malaysian university music faculties completed an 11-item questionnaire, as well as a 7-day food and playing diary, which formed the basis for a semi-structured interview. Their experiences were compared with previous studies of fasting athletes. Many participants stated that practicing from noon to 3:00 pm was difficult due to feeling thirsty, hungry, tired, and exhausted, with some experiencing a dry mouth and/or lips. By 3:00 to 6:00 pm, some had difficulty focusing and felt tired, dizzy, or lacked energy to practice. Many felt more comfortable playing after breaking the fast or after eating sahur. The majority experienced positive impacts such as increased focus and efficiency while practicing. This study suggests that fasting woodwind players would benefit from practicing in the morning and after sunset, limiting their practice time in the afternoon, not skipping sahur, and ensuring adequate hydration during sunset and sunrise.