Oral cancer and bio-nutrition

Conspicuous national and international variations in oral cancer incidence and mortality rates, as well as observations in migrant populations, raise the possibility that diet and nutritional status could be an important aetiologic factor in oral carcinogenesis. Abuse of alcohol and tobacco have serious nutritional implications for the host and generate increased production of reactive free radicals as well as elicit immunosuppression. Maintenance of optimal competence of the immune system is critical for cancer surveillance. Active oxygen species and other reactive free radicals mediate phenotypic and genotypic alterations that lead from mutation to neoplasia. Consequently the most widely used chemopreventive agents against oral cancer [e.g. Vitamin A, E, C and beta carotene] are antioxidants/ free radical scavenger. These antioxidants, both natural and synthetic, neutralize metabolic products, interfere with activation of procarcinogens, prevent binding of carcinogens to DNA, inhibit chromosome aberrations, restrain replication of the transformed cell, suppress actions of cancer promoters, and may even induce regession of precancerous oral lesions such as leukoplakia and erythroplakia. This review article underscores the compounding but important roles of nutritional/dietary factors in the longestablished causal link between abuse of alcohol and tobacco [smoking and smokeless] with oral cancer

Social isolation and induced delusional disorder, folie a trois

Three cases of shared delusional psychosis are described - Mr. H., his sister Miss H and his girlfriend Miss C. They have lived a very closely knit existence, In the same environment for a long time. They have many interests in common and deep and dependent relationships with each other. They share their life experiences, their needs and wishes, particularly their experience of being isolated from the outside world. Mr. H is the dominant partner while Miss H and Miss C are relatively passive and dependent in the relationship. The three of them developed symptoms of delusional psychosis. Mr. H being the first to be affected. Later he transmits those to the other two in the network. The delusional symptoms and the social isolation further reinforced each other until a crisis arose. Mr. H was subsequently admitted to Hospital and the other two people were moved to residential accommodation together. After some months they all improved, but only partially. The Multi-disciplinary team was then faced with the dilemma of their future placement

Multiparameter studies in t-cell acute lymphoblastic leukemia [T-all] in Karachi children

T-ALL is known to be associated with bad prognosis within ALL. Morphology of the ten cases studied showed L2 70% while L1 was 30% indicating the more malignant nature of the disease. Haematological blood parameters showed high haemoglobin and platelets and low numbers of blasts in the marrow indicating better preservation of the marrow and suggesting non-marrow origin of the disease. Acid phosphatase reaction was positive in majority of the blasts. P.A.S. stain was negative in majority of the cases while myeloperoxidase and alpha-napthyl esterase was negative. Sheep red blood cells rosettes were negative in a few cases suggesting that surface marker develop at a later stage than cytochemical enzymes since acid phosphatase was positive in all cases. This study shows continental variation of T-ALL since we report low presentation counts and high frequency of L2 in T-ALL. This further explains the more malignant nature of the disease and explain the poor prognosis of ALL in Karachi Children