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Oriental journal of medicine and natural sciencesBog'liq 3. Yakubova,Dusmurodova|
ORIENTAL JOURNAL OF MEDICINE AND NATURAL SCIENCES
“Innovative World” Scientific Research Support Center www.inno-world.uz
arresting viral replication. Notably, a study comparing topical antiviral therapy,
aPDT, and aPDT combined with topical antiviral therapy revealed that the
combined approach significantly improved pain scores, HSV-1 quantification, and
pro-inflammatory cytokine levels.
Honey, used as an adjunct treatment, demonstrated benefits in combination
with ACV, significantly improving pain, eating and drinking ability, and reducing
the need for painkillers compared to ACV alone. Honey's anti-inflammatory,
antibacterial, and wound healing properties contribute to these effects. However,
the cariogenic nature of honey should be considered, and the long-term
consequences of its use in children require further evaluation.
In conclusion, while ACV remains a key therapeutic agent for PHGS, the
identified studies emphasize the need for more research on effective and well-
tolerated treatments, considering the challenges in prompt diagnosis and the
potential complications associated with delayed intervention.
As previously mentioned, alleviating symptoms, particularly pain, is a primary
objective of PHGS therapy. Bardellini et al. compared the efficacy of non-alcoholic
chlorhexidine rinses alone and in combination with hyaluronic acid gel or
Mucosyte® [19]. While all therapies demonstrated effectiveness, a significant
improvement in pain scoring and lesion severity was observed with the
combination of non-alcoholic chlorhexidine rinses and Mucosyte®. Mucosyte® is
a solution composed of verbascoside, polyvinylpyrrolidone, and sodium
hyaluronate with reparative action, forming a protective film on the oral mucosa.
Faden reported the use of a mixture of maalox and diphenhydramine, although
lacking scientific evidence on its benefits [18]. Concerns were raised about the
dose, method, and frequency of administration, considering the potential risks of
sedation in infants with diphenhydramine ingestion and the association of
viscous lidocaine ingestion with seizures. Surprisingly, ACV was relatively
infrequently used in Faden's report [18].
This systematic review has certain limitations. Firstly, the lack of a
standardized research protocol in the included studies hinders the comparison of
results. The heterogeneity of outcomes among studies further limits comparisons.
Secondly, caution in interpreting results is advised due to methodological
limitations, incomplete data in one study (study 3), and the potential for bias in
outcomes assessment. Thirdly, the clinical applicability of findings is limited to
treating symptoms secondary to PHGS. Most proposed treatments consist of
empiric regimens of symptomatic drugs, which are ineffective against viral
replication. Regarding ACV-based therapy, commonly used as the primary drug
for PHGS treatment, current evidence on its therapeutic benefits is limited, with
only one out of the five included studies providing weak evidence of its
effectiveness. Standardizing protocols through well-structured randomized
clinical trials (RCTs) is crucial for ensuring consistency in PHGS therapy, reducing
treatment variability, and achieving better outcomes. However, the rapid onset
and remission of the disease pose challenges for conducting RCTs, as the
diagnostic delay of approximately 72 hours decreases the effectiveness of
antiviral drugs.
In conclusion, despite the high global prevalence of PHGS, the absence of
consensus on therapeutic management underscores existing evidence gaps. The
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