Objective Availability and accessibility to routine health care services for cancer patients were a cause of concern during the COVID‐19 pandemic, which induced stringent enforcement of lockdown and social distancing in Sri Lanka. Oral cancer patients who have undergone surgery recently encountered problems such as pain, difficulty in swallowing. However, accessing routine treatment and obtaining medication emerged as the most pressing concerns among them. Therefore, we aimed to provide supportive care for affected oral cancer patients. Methods A rapid situational analysis was conducted among 25‐randomly selected oral cancer patients of an ongoing interventional study aimed at improving life situation of oral cancer patients. Results Over‐the‐phone supportive care tailored to the needs of oral cancer patients, provided by a health professional, deemed a simple but helpful intervention. Conclusions Facilitating patients to navigate the health care system to ensure that they can continue in receiving timely treatment was the most critical aspect of the intervention. Interventions tailored to patients’ needs could offer better supportive care for cancer patients in COVID‐19 pandemic scenario.

No abstract

Objective: This paper describes the initiation of distress screening in oral cancer clinics, among patients with oral cancer in Sri Lanka, addressing the service gap of lack of psychosocial oncology services. This involved validation of the Sinhala version of the Distress Thermometer (DT) and Problem List (PL) as an adjustment disorder (AD) screening tool. Methods:The DT and PL were translated into the Sinhala language and crossculturally adopted by the "modified Delphi" technique. The judgment validity was obtained through face, content, and consensual validation. The criterion validation of DT was performed among 95 oral cancer patients from two oro-maxillofacialoncological hospitals in Sri Lanka, against the AD diagnosis of two consultant psychiatrists. Results:The DT and the PL revealed good judgment validity. The optimal cut-off point of DT was 4 with a sensitivity of 91.8% (95% CI = 80.8%-96.8%), specificity of 78.3% (95% CI = 64.4%-87.7%), positive predictive value of 0.81 (95% CI = 0.53%-1.1%) and negative predictive value of 0.90 (95% CI = 0.2%-1.7%). The test re-test reliability of DT was excellent (Kappa coefficient 0.894). The area under the curve was 0.843. The PL demonstrated poor internal consistency in practical problems (KD-20 = 0.4), social problems (KD-20 = 0.3) and spiritual problems (KD-20 = 0.6). Conclusions:The Sinhala version of DT and PL were deemed a valid AD screening tool for patients with oral cancer in Sri Lanka to initiate distress screening in busy oral cancer clinics. However, further validation for the full spectrum of distress is needed, preferably with improvements to PL.

Pregnancy marks a unique milestone in woman’s life cycle enriched with an array of physical, psychological, social and even spiritual needs. In this context, an optimal level of oral health status has become fundamental to overall health and well-being of a pregnant woman. This is evident more than ever before, for preventing exacerbation of poor oral health in pregnancy, possible control of adverse pregnancy outcomes whilst ensuring low risk for early childhood dental caries for the offspring. Nevertheless, pregnancy renders special oral health needs for a woman compounded by changes in dietary habits, oral hygiene practices and hormonal changes thereby increasing the risk of dental caries and periodontitis. The possible link between Periodontitis and adverse outcomes in pregnancy is well known. The pandemic caused by acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compounded by emergence more virulent strains not only indelibly impacted on population, countries, economies and health systems across the globe but exposed vulnerable population groups to pervasive health catastrophes. There is accumulating concerns on periodontitis linking with severe complications of Covid-19 attributed to commonalities of exacerbated inflammatory responses. Moreover, adverse Covid-19 induced maternal and fetal outcomes has garnered attention of researchers based on the previous knowledge indicating adverse outcomes attributed to epidemics of human corona viruses. However, it is not known how maternal oral hygiene status and burden of periodontitis impact on Covid-19 induced adverse outcomes in pregnancy. However, it could be rational to argue that poor oral health of a pregnant woman could elevate her risks for adverse health outcomes. Oral health care in pregnancy has received recognition as an essential element of comprehensive antenatal health care provision. However, the persistent global public health emergency of Covid-19 has profoundly impacted on availability of and accessibility to routine oral health care services. Therefore, accessing routine oral health care services poses serious causes for concern among pregnant women. Against this backdrop, present opinion attempts to explore and expound the potential of preventive oral health care could offer to mitigate the potential risks of Covid-19 induced adverse maternal outcomes embracing the context of Sri Lanka: a developing lower middle-income country.