Aim: Globally, India accounts for the highest number of oral cancer cases. The survival rates are about 30% lower than those in developing countries. The main reason for these dismal figures is the late presentation of patients. In order to downstage oral cancer in such a scenario, screening and diagnosis at an early stage is warranted. A pragmatic approach is needed for an oral cancer screening program, hence a mobile health (mHealth) approach was used. In this approach, health workers were empowered with mobile phones with decision-based algorithm. Risk stratification of tobacco habit enables us to identify lesions associated with particular habits. Materials and methods:A specific cohort of factory employees who predominantly had pure tobacco chewing habit was chosen to examine the effect of pure tobacco on oral mucosa. One thousand three hundred and fifty-seven subjects were screened in two phases. In the first phase, habits and oral lesions were identified and photographed. The photographs were remotely diagnosed by an oral medicine specialist and those subjects requiring biopsy were recalled for phase II. Cytology and biopsy were performed in phase II.
Background and objectives Autogenous bone grafting is the gold standard procedure for various maxillofacial defects which needs surgical correction and anterior iliac crest is the most common site of harvest. Immediate postoperative pain at the harvested site is a major morbidity associated with it. The aim of the study was to assess the immediate postoperative pain control at the iliac crest graft harvested site by placing an epidural catheter in the incision wound and continuously infiltrating bupivacaine 0.25% at regular intervals. Materials and methods Twenty patients requiring autogenous bone grafting for large maxillofacial defects were chosen for the study. They were divided randomly into two groups of ten each. Group 1 patients were placed with epidural catheter in the incision wound at iliac crest harvested site and group 2 patients did not receive epidural catheter. Continuous infiltration of long acting amide local anesthetic (Bupivacaine) was given to group 1 patients on the postoperative day. Both group 1 & group 2 patients received parenteral analgesic Diclofenac sodium 75mg intramuscularly. Pain at the iliac crest and maxillofacial area was assessed by VAS scale. Also the time of ambulation of the patient was noted. These variables were compared statistically. Results The observed findings were statistically analyzed. Group 1 patients showed significant pain relief at the graft harvested site as compared to group 2 patients. Also the patients in group 1 were ambulated early as compared to group 2 patients. Interpretation and conclusion It was concluded that by placing epidural catheter at the incision wound and continuously infiltrating with bupivacaine 0.25% at iliac crest harvested site at regular intervals effectively controls the immediate acute pain postoperatively and the patient can be ambulated and brought back to normal routine early.
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