Background:
Globally, the sixth most common malignancy is oral cancer, which is predominantly due to consumption of potent, proven carcinogens which includes smoking and smokeless form of tobacco and areca nut. Habits associated oral malignancies are mostly preceded by clinically asymptomatic oral lesions collectively referred under the umbrella term as oral potentially malignant disorders (OPMDs). There is a delayed presentation of oral pre cancer and oral cancer in India, as approximately 50% of patients are diagnosed at last stage since the asymptomatic pre cancer lesions are missed by oral physicians/dentists either due to lack of timely communication and habit counseling, lack of knowledge, or inappropriate attitude, putting all in a nut shell --- sheer lack of empathy and commitment towards patient care and society. Early diagnosis greatly increases patient's chances of survival. Patient awareness is much spoken in literature; however, the flip side of the coin lies within the attitude of the primary care physician. They play a pivotal role in effective communication and timely counseling of patients with OPMDs and should prevent malignant transformation to improve quality of life of patients. Poor compliance to attend for oral cancer screening links to the attitude and ignorance of the primary care physician. Palliative care concepts should be integrated to dentistry especially to oral medicine speciality.
Clinical Significance:
The author believes that the three most important, least explored and challenging palliative care approaches namely, “Communication,” “Counseling,” and “Compassionate care,” should be effectively practiced by a primary care physician, to improve their level of commitment to society and attitude towards patient care which can help in early diagnosis of OPMDs and decreased incidence of oral cancer, thus improving quality of life of patients.
Complex regional pain syndrome (CRPS) is a pathological exaggeration caused by trauma from injections and vaccine administration characterized by severe pain (often burning), hyperesthesia, allodynia, edema, vasomotor changes, decreased range of motion, hyperhidrosis, and trophic changes. It occurs at all ages with female predominance, and the incidence increases until late middle age. Hand and foot involvement is well recognized, and this may spread proximally. Treatment usually requires a multimodal approach, including medications and physical and cognitive therapy. Reports of CRPS after vaccination are rare. The incidence of CRPS post coronavirus disease 2019 (COVID-19) vaccination is not yet reported. This case report describes my experience with deltoid hematoma, tennis elbow, and living with CRPS post COVID-19 vaccine shot, including the psychosocial adaptations I made in my day-to-day life.
Oral cancer is the sixth most common malignancy globally with a wide geographic variation. India is the second largest consumer and third largest producer of tobacco in the world. One-third of the global burden of oral cancer is predominantly attributed to high prevalence of tobacco consumption. The highest incidence and prevalence of oral squamous cell carcinoma is found in the Indian subcontinent particularly in the lower socioeconomic strata, due to an increase in the deleterious habits of potent, proven carcinogens like smoking, chewing tobacco, betel quid and areca-nut. Also, there is a delayed presentation of oral cancer in India, as approximately 50% of patients are diagnosed at stage III or IV. In this article, we report five varied presentations of well differentiated oral squamous cell carcinoma from rural belt of Tamil Nadu. All the cases were reported late to diagnose. Clinical and radiological staging plays a pivotal role to stage an oral malignant patient which aids in guiding him to a proper treatment plan. Early diagnosis along with patient counselling is of vital importance for the prognosis of the patients with oral malignancies. Also, it is an utmost important duty of the health care professionals to create awareness on oral cancer especially in rural areas. For this reason, dentists play a very significant role in the early detection and prevention of oral malignancies.
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