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The aggressive tumour known as oral cancer can metastasize, produce a high fatality rate, and infect nearby tissue. Surgery, chemotherapy, and radiation therapy, for example, are common treatment options that, when used in clinical settings, have both minimal drawbacks and major side effects. Currently, oral therapeutic medication delivery using targeted drug administration is proving to be effective. In recent years, an effective alternative therapy known as “nanomedicine,” or using nanoplatforms to deliver drugs for the treatment of cancer, has evolved. Thanks to the use of nanoplatforms, drug delivery to the tumour site can be done precisely and with minimal drug degradation in the body. As a result, the drug's toxicity is diminished, its concentration at the tumour site is elevated, and its distribution to other organs is kept to minimum. We present a contemporary review of the development medication delivery targeted for the treatment of oral cancer in this article different oral delivery systems, including as cyclodextrins, liposomes, hydrogel-based forms, and nanolipids are highlighted and explored. Biomimetic systems, such as therapeutic vitamins, proteins, exosomes, and virus-like particles, with a focus on cancer treatment, are also described. The study concludes with a brief analysis of future applications for nanoplatforms in the treatment of oral cancer
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The camps have been organized for rural cervical cancer screening in the villages of Lucknow which offer valuable platform for the detection of infertility in young women and their cytological examination. The cervical cytology has been studied in the cases of infertility to find out if there is any increase in abnormal cytology and compare them with those obtained in fertile women (controls).Since its inception in May 2013, the camps organized were 186 in number and 5682 women attended these camps. Primary infertility was found in 182 and the secondary infertility in 31 women. The incidence of Squamous intraepithelial lesions of cervix (SIL) was found to be 14.8% in women suffering from primary infertility and 16.1% in the secondary infertility cases and was comparable with SIL rate of 17.4% in the controls. Persistent vaginal infections caused by the poor personal genital hygiene practiced by the rural women may be the reason for a high SIL rate in the fertile women. The SIL rate was seen high in the younger women upto 30 years with pain in lower abdomen and erosion cervix in the primary infertility cases while the high SIL rate was seen in 21- 30 years age groups with parity 2 in secondary infertility cases with no SIL seen with symptoms and clinical lesions. Mostly young women upto 30 years of age complained of infertility and showed high SIL rate. These women were referred to the Hospital of Era Medical College, Lucknow for further investigation and treatment.
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Background: Gallbladder cancer (GBC) is the most frequent biliary tract cancer, with high morbidity and poor prognosis, and shows early metastasis and invasiveness. No reliable biomarkers are available for detection of GBC progression. Aim: To investigate the immunohistochemical expression of Oct-4 and CD133 in malignant and nonneoplastic lesions of gallbladder and to analyze the clinical significance of the expressions related to clinicopathological parameters. Settings and Design: This is a prospective case control study, conducted in medical college background. Materials and Methods: A total of 103 cases of gallbladder were grouped into malignant lesions (n = 48) and nonneoplastic lesions (simple epithelial hyperplasia; n = 35 and chronic cholecystitis; n = 20). All tissue samples were evaluated for expression of Oct-4 and CD133 using immunohistochemistry in an effort to elucidate the correlation between their expressions with clinicopathological parameters. Statistical Analysis: The final score was calculated by multiplying the intensity to the percentage of positive cells. The scores ?2 were considered as positive. Results: Significant positive correlation of higher expression levels of Oct-4 and CD133 were observed in malignant as compared to nonneoplastic lesions of gallbladder (P < 0.0001). High expression of Oct-4 and CD133 were significantly associated with tumor grading (Oct-4, P = 0.04; CD133, P = 0.02), staging (Oct-4, P = 0.03; CD133, P = 0.02), and liver metastasis (Oct-4, P = 0.01; CD133, P = 0.007). Significantly reduced survival was observed with high expression of Oct-4 (P = 0.002). No significant correction was observed between CD 133 and survival. Conclusion: This study revealed that high expression level of Oct-4 may provide a new insight for the prognosis of the disease in terms of clinical staging and grade.
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Synovial Sarcoma is a soft tissue neoplasm having incidence 6%- 10%.Malignant cells in synovial fluid aspiration is extremely rare. Only 5%cases have been reported to have joint cavity involvement. We report a case of synovial fluid malignant effusion of knee joint in a 35 year old male who presented with a left popliteal fossa swelling. Synovial fluid aspiration revealed tumor cell clusters with anaplastic morphology .Subsequent biopsy showed spindle cell tumor consistent with synovial sarcoma. This is a rare presentation of synovial sarcoma with the presence of malignant cells in synovial fluid
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DNA is double helical macromolecule which carries all the genetic information and it is usually found enveloped inside a nucleus. The DNA helix relaxes and supercoils itself frequently in order to derive information from the genes during processes like transcription, condensation, replication and recombination, which require mutable or immutable alterations to cause the separation of the two DNA strands. Due to problems caused by the helical structure of DNA, these topoisomerase enzymes perform the required DNA uncoiling. Their role in cell cycle is also significant as their mutation leads to failure of anaphase separation (1, 2). In the present review, the important roles of DNA topoisomerases and their inevitable role in cell growth and cell cycle are discussed viz. how they function in cell proliferation and what are the results when different inhibitors are added to the cells, affecting cell cycle at various checkpoints .
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Context: In India, lung carcinoma is the fifth-most common tumor and second-most common tumor in the males as per the Indian Council of Medical Research registry of 2002. It has been seen that ALDH1 expression in non-small cell lung cancer (NSCLC) and the presence of marker was linked to a more tumorigenic potential in the in vivo assessment and shorter disease-free survival in NSCLC patients with platinum treatment. Aims: Hence, our objective was to detect association of cancer stem cell (CSC) marker aldehyde dehydrogenase 1 (ALDH1) with clinicopathological profile in lung carcinoma patients. Settings and Design: This is a Pilot study. Subjects and Methods: It was a Pilot study where biopsies from 55 fresh previously untreated lung cancer patients visiting the Pulmonary Medicine Department of Era's Lucknow Medical College and Hospital Lucknow and King George's Medical University were taken for 18 months November 2014–April 2016, after taking proper informed consent from them. Paraffin blocks were taken and stained by hematoxylin and eosin (Sigma) to make the histopathological diagnosis and immunohistochemistry was done for detection of CSC marker ALDH1 (Daco). Statistical Analysis Used: The statistical analysis was done using Statistical Package for Social Sciences Version 15.0 Statistical Analysis Software. The values were represented in number (%) and mean ± standard deviation. Results: Expression of stem cell marker ALDH1 with the staging of the tumor was observed in 62.5% of Stage I, 80% of Stage II, 94.1% of Stage III, and 100% of Stage IV cases. Statistically, there was a significant association between ALDH1expression and stage of disease (P < 0.001). Diagnostic efficacy of ALDH1 expression in the detection of any positive clinical stage, it was found to be 88.6% sensitive and 90.9% specific. Conclusions: Strong ALDH1 expression correlates with higher stage of lung carcinoma making it a prognostic marker needing in-depth study.
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Cervical carcinoma is one of the most common and dreaded diseases of women, and in India, it accounts for 16 per cent of total cervical cancer cases occurring globally. The situation is more alarming in the rural areas where the majority of women are illiterate and ignorant about the hazards of cervical cancer. Different screening strategies such as rural cancer registries and camp approach for cancer detection have been found useful in minimizing the problem of cervical cancer in the villages. Various screening techniques such as visual inspection with acetic acid, visual inspection with Lugol's iodine, visual inspection with magnification devices-magnavisualizer, Pap smear and HPV-DNA testing have been suggested and tried under low-resource settings of our country, and cervical cytology screening has been found effective in reducing incidence of the disease. In the present review, feasibility of different screening methods has been assessed to find out the most suitable mode applicable at the rural level. Single lifetime screening particularly of high-risk women along with analysis of cost-effective tumour markers such as Argyrophilic nucleolar organizer regions (AgNOR) counts to discriminate high-risk dysplasia cases appears to be an appropriate approach in fighting against cervical cancer.
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Lung cancer is regarded as one of the most common cancers in the world with a worldwide occurrence of approximately 1.8 million cases and an estimated mortality of 1.6 million in 2012 alone.1 In the United States, there are approximately 2,25,000 new cases of lung cancer with over 1,60,000 deaths annually. Lung cancer is a very serious problem of the Indian subcontinent, especially in the lower socioeconomic subgroups. In India lung carcinoma is the 5th most common tumor and 2nd most common tumor in the males as per the ICMR [Indian Council Of Medical Research] registry of 2002.It accounts for 6.9% of new cancer cases detected each year.3 The importance of study of stem cells and cancer stem cells lays in CSC acting as prognostic and therapeutic markers. It is a known fact that there are innate stem cells present in the lining of the bronchial epithelium, at the carina and alveolar lining which help in regeneration of lungs post injury , however there are present similar cells which post driver mutations are christened CSC and help in cancer survival, growth and chemo resistance. CSC also known as “cancer stem-like cells” (CSLCs), or “tumor-initiating cells” (TICs) are heterogeneous cell population comprising of a small subpopulation of cancer cells with the property of self-renewal and differentiation. CSCs are thought to be responsible for cancer initiation, progression, metastasis, recurrence, and drug resistance.Important CSC under study in lung are, CD 133, ALDH 1, CD 44,ABCG2 etc.
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Oral cancer is one of the leading cause of cancer in India, new diagnostic modalities for early diagnosis and treatment will increase the survival of the patients. The present study was carried out with an aim to evaluate salivary levels of EGFR in oral cancer and pre-cancer as tumor marker. For this purpose an observational case-control study was carried out in which a total of 72 subjects were enrolled.Of these 24 (33.3%) were patients of premalignant oral lesions and 24 (33.3%) were patients of malignant oral lesions& 24 (33.3%) subjects were normal healthy controls. Demographic information and clinical data was obtained, estimation for EGFR was performed in saliva. In premalignant cases, buccal mucosa was the most common site involved (87.50%) whereas in malignant cases tongue was the most common site involved (n=10;41.67%). Mean salivary EGFR levels were higher in malignant cases (0.23±0.17 pg/ml) and low in controls (0.10±0.19 pg/ml). Mean EGFR levels in premalignant cases were 0.12±0.22 pg/ml. statistically, this difference was not significant (p=0.052). Statistically, no significant difference in mean EGFR levels among different TNM stages could be seen (p=0.145). EGFR levels showed a potential to discriminate between malignant and premalignanat cases but this difference was statistical insignificant due to lower sample size.
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Lung cancer is a leading cause of cancer related death worldwide. It is increasing at a very fast rate in both men and women. Some significant mutations occurring at molecular level in lung adenocarcinoma, like ALK, EGFR, KRAS, MET, and, ALK (anaplastic lymphoma kinase) gene mutations for an ALK encoded transmembrane receptor tyrosine kinase domain and subsequently participating in the progression of Non-Small Cell Lung Adenocarcinoma (NSCLC). Some fusion partner genes involved in this process are EML-4, KLC1, KIF5B and TFG. The ALK-EML-4 rearrangement is the second most common oncogenic mutation in the nonsmall cell lung adenocarcinoma. There is 3-7% ALK mutation occurring in early or never-smokers in accompanying NSCLC. The NSCLC with ALK gene mutation generally do not have EGFR or KRAS gene mutation which are also molecular markers, which get mutated in cancer. For the detection of ALK mutation in NSCLC, different types of techniques like Fluorescence in situ Hybridization (FISH), Immunohistochemistry (IHC) and Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) are being used. On the basis of sensitivity and specificity, FISH is gold standard in detecting the mutation when compared with other methodologies like IHC and RT- PCR. However in the Indian setting, FISH is more expensive and hence not available everywhere. In this review the efficacy of these different techniques in detecting ALK mutation and the detailed interpretation of results obtained with FISH has been discussed. For the treatment of ALK/MET mutated NSCLC patients an orally administered drug, crizotinib drug (tyrosine kinase inhibitor) has been approved by Food and Drug Administration (FDA) of United States. Highly sensitive and specific techniques are used for the detection of ALK gene mutation in NSCLC patients which have to be given for crizotinib treatment.
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Chordoma are slow growing, locally destructive tumors derived from remnants of notochord. They occur mostly along axial skeleton that is basiocciput and sacrococcygeal area. are biphasic malignant neoplasm possessing elements of both chordoma and cartilaginous tissue, an entity which has better prognosis than classical Chordoma. The tumor is likely to recur and hence diagnostically important for appropriate management. Histopathologically, tumor showed chords or nests of cells with partly vacuolated cytoplasm (physaliferous cells) embedded in a myxoid matrix and extensive cartilage formation with degenerative calcification was seen. Immunohistochemically, tumor was positive for Cytokeratin and EMA and negative for S-100 except for Cartilaginous areas which were S-100 positive. We report a case of Chondroid chordoma in a 50 year male presented with intermittent radiating pain in both leg and backache for 1 year. MRI lumbosacral showing the tumor in posterior elements if L S vertebra. Chondroid chordoma is a distinct entity to be 5 2 discriminated from typical type of Chordoma because of its better prognosis. MRI cannot differentiate between Chondroid chordoma and typical chordoma. Awareness of this rare tumor will avoid misdiagnosis and improve the prognosis. Awide surgical excision coupled with adjuvant radiation is the best treatment in the present case.
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Electrical charge is an indicator of the cellular state of health. In cells, the cell membrane is a leaky dielectric. Capacitors are composed of two conducting sheets separated by a thin layer of insulating material known as a dielectric. Cells contain several forms of biological capacitors, which consist of an insulating material (the membrane) covered on both sides by collection of charged dissolved minerals, which serve the function similar to a conducting metal plate. This means that any condition, illness or change in dietary intake that affects the composition of the cell membranes and their associated minerals can affect and alter cellular capacitance. Healthy cells have a higher whole cell and cytoplasm conductivity and higher membrane capacitance than the malignant cells. The electric charge of cell membranes of mammals is negative at physiological pH. It is well-known that surface of cancer and tumor cells carry negative charge in excess to that of normal cells which is responsible for their increased mobility and invasiveness. The high negative surface charge on malignant cells and trophoblasts may mediate the lack of immune rejection of these cells. Thus, neutralizing or removing the tumor cell negative charge may allow negatively charged lymphocytes to approach and destroy them and thereby, the viability and survival of the cancer cells may be affected at least in vitro. The present study serves to - test this hypothesis on invasive human breast carcinoma cell line MDA-MB-231 (ER ) using specially designed and constructed combination of circuits. Preliminary results showed that out of the 8 designed circuits, sets 1, 2 and 7 were able to produce significant growth inhibition of MDA cells in vitro. The application of electrostatic field through specially designed circuits is unique and has never been reported previously. Our long-term goal is to develop a minimally invasive device that will selectively target and destroy both metastatic and non-metastatic cancer cells in humans. Better understanding of effect of decreasing surface charge density of tumor cells may lead to device effective treatment strategy of human tumors in future.
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Walthard cell rests are benign cluster of epithelial cells found in connective tissue of fallopian tubes and also seen in the mesovarium, mesosalpinx and ovarian hilus. It was proposed that Walthard cell rests may be a source of Brenner's tumor or primary urothelial cell carcinoma because of similar histogenetic origin of their cells. Here we report a case which not only during gross examination showed peculiar peritubal glistening tiny nodules but also demonstrated attention grabbing clusters of cell on histopathology, mimicking ? A tumor. A diagnosis of Walthard cell rest was made. One should always consider a differential diagnosis as Brenner's tumor (primary) or serosal implant from gynaecological, genitourinary or other tumors before making a confirmatory diagnosis of Walthard cell rest.
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To assess pain in cases of cancer cervix and to evaluate the response to pain management according to WHO step ladder pattern in cases of cancer cervix, total 209 carcinoma cervix diagnosed and admitted case were recruited in the study. Baseline pain score was measured for each patient. For mild to moderate pain (VAS ≤ 7) , step 1 analgesic, NSAID, diclofenac sodium (50 mg TDS) was prescribed. Pain scores were reevaluated after 48 hrs and change of score was recorded. If pain persisted (same score), worsened (score increased) or score decreased but with a VAS score of > 4 , case was considered as non responder and patient was switched to step 2 analgesic. Step 2 was also applied directly to patients presenting with severe pain ( VAS >7) at the time of recruitment. Drugs used in step 2 was oral tramadol (50 mg QID ) along with Diclofenac ( 50 mg TDS) . VAS Score was reevaluated after 48 hrs. If score still remained above 4; adjuvant analgesics (Amitryptiline 25-75 mg OD, Prednisolone 5mg BD – 10 mg/day) were added to step 2. Step 2 non responders were treated with step3 protocol. In step 3, tab morphine (10 mg BD upto maximum 30 mg BD) was given after stopping all other drugs . After 48 hrs, scores were re evaluated; if scores remained >4; adjuvant analgesics ( Amitryptiline 25-75 mg OD, Prednisolone 5mg BD – 10 mg/day ) were added. After 48 hrs if still pain scores did not decrease to <4, case was declared as failure . The WHO algorithm was followed as per the response of the patients. Outcome showed decrease in pain score using Visual Analogue Scale Score. 209 patients were enrolled in the study. 60 patients had no pain at baseline. Out of 149 patients with pain, 44.9 % (67) patients achieved complete pain relief at step 1. Out of the remaining 82 patients , 5 were lost to follow up. 49.3 % (38) achieved complete relief at step 2 . Only 39 patients did not reach score of zero after step 2 but 35 (89.7%) out of them achieved complete relief after step 3. Out of 142 patients ( excluding lost to follow up ), 2 cases were declared as failure. Among these failure cases, one of them had metastasis of femur and symphysis pubis; bisphosphonates were started. Other patients had bladder and bowel involvement diagnosed on repeat cystoscopy. This WHO guideline implementation study supports use of algorithm in decision making for cancer pain management. Following the same we were able to achieve effective pain relief in 96% of our patients with failure rate of only 4%. It further helped to reduce patient’s agony and improved the quality of life.