Title: Case Report: Tribal Habits and Rural Anaesthetist

Authors: Lalhmingmawia, Vanlalhmangaihi Hmar, Lalramengi

 DOI: https://dx.doi.org/10.18535/jmscr/v7i9.111

Abstract

  

The habit of chewing betel nut is very common in North eastern part of India especially among the tribal population. Several additives have been added to a betel nut (like lime and betel leaf) making the betel quid. Deleterious effects of chewing betel nut on oral soft tissues are published many times in dental and otolaryngology literatures. Areca – induced lichenoid lesions mainly on buccal mucosa or tongue are reported at quid retaining sites. In chronic chewers, a condition known as betel chewers mucosa, a discoloured area with encrusted change, is often found where the quid particles are retained. These areas result in oral leukoplakia and submucous fibrosis.4 Apart from chewing betel nut, tobacco chewing (smokeless tobacco) is very common among the same population. Robert O Green Jr DDS et al  described 4 distinct lesions associated with smokeless tobacco – erythroplakic lesions of oral mucosa, gingival or periodontal inflammation, combination of oral and periodontal inflammation and cervical erosion of teeth.1

References

  1. Robert O Green Jr ODS et al. Oral tissue alterations associated with the use of smokeless tobacco by teenagers: Part I. Clinical findings. Oral Surgery, Oral Medicine, Oral Pathology Vol 56 (3), sept 1983, pages 275-284
  2. Meena Cherian et al. Building and retaining the neglected anesthesia health work force: is it crucial for health systems strengthening through primary health care?  Bulletin of the WHO 2010;88, pages 637-639
  3. Rajesh Veeramachaneni et al. Awareness about anaesthesia in India: a survey in southern India. Indian journal of research in Medical Sciences 2016 Feb:4(2) pages 499-508
  4. CR Trivedy et al The oral health consequences of chewing areca nut. Addiction biology 2002, 7(1) pages 115-128
  5. F Mashhadiabbas et al. Correlation of vascularisation and inflammation with severity of oral leukoplakia. Iranian journal of Pathology 2017,12(3), pages 225
  6. Eipe N .The chewing of betel quid and oral submucous fibrosis and anesthesia. Anesthesia and Analgesia: April 2005 Vol 100 (4) pages 1210-1213.
  7. PL Narendra et al. Betel quid chewing habits and difficult intubation: a case report and critical appraisal of evidence for practice. Anaesthesia Essays and Researches 2015 Jan – April (1) 105-108
  8. Surajit Giri. Challenges of anesthesia and regional anesthesia practices in rural center: Journal of anaesthesia and critical care case reports. Vol 3(2) May-August 2017, pages 3-4
  9. Habib et al. Can’t ventilate, can’t intubate in a patient with tracheal stenosis. Anaesthesia, Pain and Intensive Care Vol 17(3) Sep-Dec,2013.

Corresponding Author

Vanlalhmangaihi Hmar

Anaesthetist, District Hospital, Champhai, Mizoram, India Pin 796321