Decoding the influence of the immune system and immunotherapy targets on carcinomas: A hidden prism in oral cancer therapy.

In recent decades, understanding tumorigenesis and the complex interaction between the host and the immune system has been the pillar for significant advances in anticancer therapy. Conventional anticancer therapy (e.g., cut, burn, and cytotoxic drugs) involves multiple targeting of tumor cells. However, the tumor tissue microenvironment can present a dysregulated, stimulating, or subverted immune response which, in turn, reveals pro-tumor activities favoring tumor expansion and progression. Recently, new potential targets have been identified based on immunomodulatory therapies, which are crafted to re-establish the host anti-tumoral immune response. Clinicians should fully understand the intricate interactions between carcinogens, the tumor milieu, the immune system, and traditional anticancer therapies in order to progress and to overcome the refractory/recurrent challenges and morbidity of the disease. Thus, in this article, we highlight the complex milieu of the oral cancer immune response, pointing out potential therapeutic immunotargets for oral squamous cell carcinomas. The impact of traditional anticancer therapy on the immune system is also outlined.

Are Local Anesthesia Vials Similar to Champagne: Do they Lose their Potency Once Opened?: An In vitro study.

BACKGROUND AND OBJECTIVES: Epinephrine is volatile and unstable on exposure to air. Addition of sodium metabisulfite as an antioxidant has been effective, but there are no clear-cut consensus on its efficiency in retarding the oxidation that sets in once the anesthetic vials are kept open with a needle in situ. There is a paucity of scientific data regarding the risks of reuse of anesthetic vials following the use of cartridges, a common practice in western countries. It is our endeavor to shed light on the constant change in pH, drug deterioration, and instability that sets in an anesthetic vial with a needle in situ. METHODS: Twenty sets of identical local anesthetic vials (lidocaine 2% with 1:80,000 adrenaline) were collected. The samples were divided into four individual groups followed by a segregation of 5 subsamples at varying time intervals from each individual group. pH was measured using pH meter. RESULTS: Change in the pH of the solution was noted as days progressed in open local anesthetic vials when compared to closed vials. However, the decreased pH remained constant following a brief time interval after complete conversion of sulfite to sulfate. CONCLUSIONS: Local anesthetic vials with needle pricked in for a longer duration can alter the pH, concentration of the vasoconstrictor and deteriorate the properties of local anesthetic solution. This can manifest clinically as delayed onset of action, increased burning sensation, and pain on administration.