healthy

While most people are familiar with high blood pressure and diabetes, not many have heard about oral cancer and its devastating effects. 

About 640,000 cases are diagnosed every year worldwide and only about 50 percent of these patients will still be alive five years’ later. These grim statistics are testament to the fact that the disease is often discovered too late. 

The five-year survival rate for early-stage oral cancer is more promising, however, at 80 to 90 percent. But, in the case of late-stage cancer, these rates go down to 20 to 30 percent. Unfortunately, most cases of oral cancer may start as a small red or white patch in the mouth, which patients do not notice. It can take only two or three months for early-stage oral cancer to progress to a late stage, when it invades the tissues and becomes an ulcer or swelling, sometimes spreading to the neck. 

Heavy smoking and alcohol consumption are the main risk factors in the West, though in this part of the world, habits such as chewing betel nut, which contains nicotine, are also a major cause of the 
disease. 

There are many oral screening methods, one of which is the Velscope, which was used for a mouth-cancer awareness campaign in Singapore. Velscope uses a special filter to detect alterations in the fluorescence of oral mucosal tissues and has been reported to be a useful way to detect early carcinogenic changes. 

This is principally due to ignorance, and a study in India has validated that early detection could reduce late-stage oral cancer and directly improve survival rates. With some modifications to the study, we devised a system of oral self-examination so that patients could examine their own mouths more adequately and on a regular basis, and then report to a doctor or dentist if there was a suspicion of something wrong. This method consists of ten quick steps that a patient can easily use on a daily basis to look carefully into the mouth to detect early oral cancer; it functions in the same way as women conducting self-examination of their breasts for the early detection of breast cancer. 

Another condition, though not deadly, and one that is common among young people is the problem of wisdom teeth. These teeth typically appear in people aged between 18 to 21 years old and being the last to erupt, there is often a lack of space, which results in them growing abnormally. 

The gums overlying these partially buried teeth can become infected, and cause a painful condition called pericoronitis. This is when most patients will present themselves to the clinic. 

Most impacted wisdom teeth can be removed surgically in ten minutes by an experienced oral and maxillofacial surgeon. 

For the fearful and anxious patient, the use of intravenous sedation can alleviate the problem. “Horror stories” of the dentist taking an hour or more to yank out a wisdom tooth are usually due to an incorrect assessment of the case by an inexperienced surgeon. Difficult cases are best managed under general anesthesia and at our clinic, where a cone-beam CT scan is used to aid the planning of the surgery, especially in those cases where the inferior dental nerve is near the apices of the wisdom teeth. 

More serious complications, such as numbness of the lips and tongue, can occur if the surgeon is inexperienced and damages these nerves. Cone-beam CT scans constitute the latest technology, and are very useful for planning implant surgery as well as other surgical procedures, as it allows the surgeon to visualize the precise anatomy of the problem

Nearly 3 out of 4 US children and young adults consume at least some caffeine, mostly from soda, tea and coffee. The rate didn't budge much over a decade, although soda use declined and energy drinks became an increasingly common source, a government analysis finds.

Although even most preschoolers consume some caffeine-containing products, their average was the amount found in half a can of soda, and overall caffeine intake declined in children up to age 11 during the decade.

The analysis is the first to examine recent national trends in caffeine intake among children and young adults and comes amid a US Food and Drug Administration investigation into the safety of caffeine-containing foods and drinks, especially for children and teens. In an online announcement about the investigation, the FDA notes that caffeine is found in a variety of foods, gum and even some jelly beans and marshmallows.

The probe is partly in response to reports about hospitalizations and even several deaths after consuming highly caffeinated drinks or energy shots. The drinks have not been proven to be a cause in those cases.

The new analysis, by researchers at the Centers for Disease Control and Prevention, shows that at least through 2010, energy drinks were an uncommon source of caffeine for most US youth.

The results were published online Monday in the journal Pediatrics.

The American Academy of Pediatrics recommends against caffeine consumption for children and teens because of potentially harmful effects from the mild stimulant, including increases in heart rate and blood pressure, and worsening anxiety in those with anxiety disorders.

Dr. Stephen Daniels, chairman of the academy's nutrition committee, said caffeine has no nutritional value and there's no good data on what might be a safe amount for kids.

Evidence that even very young children may regularly consume caffeine products raises concerns about possible long-term health effects, so parents should try to limit their kids' intake, said Daniels, head of pediatrics at the University of Colorado's medical school.

Soda was the most common source of caffeine throughout the study for older children and teens; for those up to age 5, it was the second most common after tea. Soda intake declined for all ages as many schools stopped selling sugary soft drinks because of obesity concerns.

The American Beverage Association, whose members include makers of soft drinks and energy drinks, maintains that caffeine has been safely added to drinks as a flavor enhancer for more than 100 years.

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Bacteria resistant to antibiotics have now spread to every part of the world and might lead to a future where minor infections could kill, according to a report published Wednesday by the World Health Organization.

In its first global survey of the resistance problem, WHO said it found very high rates of drug-resistant E. coli bacteria, which causes problems including meningitis and infections of the skin, blood and the kidneys. The agency noted there are many countries where treatment for the bug is useless in more than half of patients.

WHO's report also found worrying rates of resistance in other bacteria, including common causes of pneumonia and gonorrhea.

Unless there is urgent action, "the world is headed for a post-antibiotic era in which common infections and minor injuries which have been treatable for decades can once again kill," Dr. Keiji Fukuda, one of the agency's assistant director-generals, warned in a release.

WHO acknowledged it couldn't assess the validity of the data provided by countries and that many had no information on antibiotic resistance available.

Health experts have long warned about the dangers of drug resistance, particularly in diseases such as tuberculosis, malaria and flu. In a report by Britain's Chief Medical Officer last year, Dr. Sally Davies described resistance as a "ticking time bomb" and said it was as big a threat as terrorism.

In 1928, Alexander Fleming's discovery of penicillin revolutionized medicine by giving doctors the first effective treatment for a wide variety of infections. Despite the introduction of numerous other antibiotics since then, there have been no new classes of the drugs discovered for more than 30 years.

"We see horrendous rates of antibiotic resistance wherever we look...including children admitted to nutritional centers in Niger and people in our surgical and trauma units in Syria," said Dr. Jennifer Cohn, a medical director at Doctors Without Borders, in a statement. She said countries needed to improve their monitoring of antibiotic resistance. "Otherwise, our actions are just a shot in the dark."

WHO said people should use antibiotics only when prescribed by a doctor, that they should complete the full prescription and never share antibiotics with others or use leftover prescriptions. (*****)