{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:21:26Z","timestamp":1787772086006,"version":"build-2784847793"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Cleft lip and palate (CLP) patients are prone to Candida infections (oral thrush) mainly due to poor oral hygiene, repetitive surgeries, and orthodontic procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>This study was undertaken to evaluate the antifungal efficacy of limonene against clinical Candida isolates from CLP patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>The antifungal efficacy of limonene was studied alone and in combination with fluconazole (FLC) against six standards, twenty nine FLC sensitive, and three FLC resistant clinical strains using broth dilution, checkerboard microdilution, agar disk diffusion, growth curves, and spot assays.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>This nontoxic monoterpene gave low minimum inhibitory concentration (MIC) values of 300\u2013375 \u00b5g\/mL and 500\u2013520 \u00b5g\/mL for FLC susceptible and FLC resistant strains, respectively. It showed synergistic interaction with FLC in all clinical and standard Candida strains (fractional inhibitory concentration (FIC) index \u22640.5).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Significant chemosensitization of FLC was observed even against resistant clinical isolates. Complete suppression of fungal growth was observed when using combinations. Negligible toxicity, easy availability, and potent antifungal properties suggest that limonene and FLC combinations in appropriate doses can make excellent antifungal mouthwashes during CLP treatment pre and post surgery. Impending in vivo studies are needed to validate the present data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/njms.njms_34_23","type":"journal-article","created":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T11:00:33Z","timestamp":1710932433000},"page":"47-54","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Limonene synergistically augments fluconazole susceptibility in clinical Candida isolates from cleft lip and palate patients"],"prefix":"10.4103","volume":"15","author":[{"given":"Saiema","family":"Ahmedi","sequence":"first","affiliation":[{"name":"Department of Biosciences, Jamia Millia Islamia, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imran","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Biosciences, Jamia Millia Islamia, New Delhi, India"},{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samah","family":"Ghanem","sequence":"additional","affiliation":[{"name":"Botany and Microbiology Department, Faculty of Science, Helwan University, Helwan, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhat","family":"Manzoor","sequence":"additional","affiliation":[{"name":"Department of Biosciences, Jamia Millia Islamia, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,3,19]]},"reference":[{"key":"R1-20240908","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1016\/j.resmic.2017.02.005","article-title":"Candida and its dual lifestyle as a commensal and a pathogen","volume":"168","author":"Cauchie","year":"2017","journal-title":"Res. Microbiol"},{"key":"R2-20240908","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1597\/1545-1569_2000_037_0271_poieti_2.3.co_2","article-title":"Prevalence of intranasal ectopic teeth in children with complete unilateral and bilateral cleft lip and palate","volume":"37","author":"Medeiros","year":"2000","journal-title":"Cleft Palate-Craniofacial J"},{"key":"R3-20240908","doi-asserted-by":"crossref","first-page":"2621","DOI":"10.4103\/jfmpc.jfmpc_472_20","article-title":"Cleft of lip and palate:A review","volume":"9","author":"Vyas","year":"2020","journal-title":"J Fam Med Prim"},{"key":"R4-20240908","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1177\/1055665618776428","article-title":"Microbial profile and dental caries in cleft lip and palate babies between 0 and 3 years old","volume":"56","author":"Durhan","year":"2019","journal-title":"The Cleft Palate-Craniofacial J"},{"key":"R5-20240908","doi-asserted-by":"crossref","first-page":"72","DOI":"10.4103\/njms.njms_127_22","article-title":"Incidence and prevalence of oral candidal colonization in patients with cleft lip and palate","volume":"14","author":"Khan","year":"2023","journal-title":"Natl J Maxillofac Surg"},{"key":"R6-20240908","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.micpath.2018.08.042","article-title":"Candida species biotypes in the oral cavity of infants and children with orofacial clefts under surgical rehabilitation","volume":"124","author":"da Silva","year":"2018","journal-title":"Microb Pathog"},{"key":"R7-20240908","doi-asserted-by":"crossref","first-page":"169","DOI":"10.4103\/njms.NJMS_161_20","article-title":"Evaluating the role of local host factors in the Candida colonization of oral cavity:A review update","volume":"11","author":"Khan","year":"2020","journal-title":"Natl J Maxillofac Surg"},{"key":"R8-20240908","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1177\/10556656211030437","article-title":"Oral colonization and virulence factors of Candida spp. in babies with cleft palate","volume":"59","author":"de Souza","year":"2022","journal-title":"Cleft Palate-Craniofacial J"},{"key":"R9-20240908","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1586\/eci.12.52","article-title":"Occurrence, presentation and treatment of candidemia","volume":"8","author":"Mikulska","year":"2012","journal-title":"Expert Rev Clin Immunol"},{"key":"R10-20240908","doi-asserted-by":"crossref","first-page":"1460243","DOI":"10.1155\/2017\/1460243","article-title":"A comparative study of oral microbiota in infants with complete cleft lip and palate or cleft soft palate","volume":"2017","author":"Machorowska Pieni\u0105\u017cek","year":"2017","journal-title":"BioMed Research Internat"},{"key":"R11-20240908","doi-asserted-by":"crossref","first-page":"237","DOI":"10.2147\/IDR.S118892","article-title":"Fluconazole resistance in Candida species:A current perspective","volume":"10","author":"Berkow","year":"2017","journal-title":"Infect Drug Resist"},{"key":"R12-20240908","first-page":"1934578x0800300728","article-title":"Limonene-a review:Biosynthetic, ecological and pharmacological relevance","volume":"3","author":"Erasto","year":"2008","journal-title":"Nat Prod Commun"},{"key":"R13-20240908","first-page":"565","article-title":"Limonene inhibits Candida albicans growth by inducing apoptosis","volume":"56","author":"Thakre","year":"2018","journal-title":"Med Mycol"},{"key":"R14-20240908","doi-asserted-by":"crossref","first-page":"183","DOI":"10.3390\/jof6030183","article-title":"In vitro and in vivo inhibitory activity of limonene against different isolates of Candida spp","volume":"6","author":"Mu\u00f1oz","year":"2020","journal-title":"J Fungi"},{"key":"R15-20240908","first-page":"100285","article-title":"Limonene inhibits virulence associated traits in Candida albicans:In-vitro and in-silico studies","volume":"2","author":"Ahmedi","year":"2022","journal-title":"Phyto Plus"},{"key":"R16-20240908","doi-asserted-by":"crossref","first-page":"93","DOI":"10.4103\/0377-4929.59192","article-title":"Hichrom Candida agar for identification of Candida species","volume":"53","author":"Baradkar","year":"2010","journal-title":"Indian J Pathol Microbiol"},{"key":"R18-20240908","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1099\/jmm.0.020693-0","article-title":"In vitro synergy of eugenol and methyl eugenol with fluconazole against clinical Candida isolates","volume":"59","author":"Ahmad","year":"2010","journal-title":"J Med Microbiol"},{"key":"R19-20240908","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1128\/CMR.19.2.435-447.2006","article-title":"Interpretive breakpoints for fluconazole and Candida revisited:A blueprint for the future of antifungal susceptibility testing","volume":"19","author":"Pfaller","year":"2006","journal-title":"Clin Microbiol Rev"},{"key":"R20-20240908","first-page":"93","article-title":"What is synergy?","volume":"41","author":"Berenbaum","year":"1989","journal-title":"Pharmacol Rev"},{"key":"R21-20240908","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/jac\/dkg301","article-title":"Synergy, antagonism, and what the chequerboard puts between them","volume":"52","author":"Odds","year":"2003","journal-title":"J Antimicrob Chemother"},{"key":"R22-20240908","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/s10096-005-1281-2","article-title":"Adverse effects of antifungal therapies in invasive fungal infections:Review and meta-analysis","volume":"24","author":"Girois","year":"2005","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"R23-20240908","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1016\/j.joms.2010.02.044","article-title":"Oral candidal colonization in cleft patients as a function of age, gender, surgery, type of cleft, and oral health","volume":"69","author":"Ma'amon","year":"2011","journal-title":"J Oral Maxillofac Surg"}],"container-title":["National Journal of Maxillofacial Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/njms.njms_34_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:28:44Z","timestamp":1787768924000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/njms.njms_34_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/njms.njms_34_23","relation":{},"ISSN":["0975-5950","2229-3418"],"issn-type":[{"value":"0975-5950","type":"print"},{"value":"2229-3418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2023-03-03","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-18","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}