Oral manifestation of post cancer therapy

Oral cancer has become serious health issues. It is owing to a variety of factors including poor hygiene, tobacco usage, chewing tobacco, smoking, and others. Along with surgery and chemotherapy, the most common treatments include radiation therapy and chemotherapy. Patients with cancer may experience oral toxic effects as a result of antineoplastic therapy such as radiotherapy and chemotherapy. A variety of factors influence radiation, including the oral mucosa's fast cell turnover rate, the richness and complexity of the oral microbiota, and soft tissue stress during normal mouth function. The present literature review is for awareness regarding the main oral manifestation secondary to post cancer therapy.

EFFECT OF ORAL TOBACCO ON VITAL DATA

Chewing Tobacco is a global public Health hazard. oral and nasal smokeless products have been used in many countries for centuries. Smokeless tobacco use has been associated with oral cancer and leukoplakia at the site of application of tobacco . .Nicotine is cardio active , changes in heart rate, temperature respiratory rate blood pressure were observed . At present cross-sectional study was done between September 2020 to February 2021 on apparently healthy individuals of age group 20 to 40 years who have the habit of tobacco chewing for more than 2 years. Oral use of smokeless tobacco is widely prevalent in India. On chewing tobacco in any form, nicotine is released into bloodstream which in turn has effect on sympathetic nervous system Hence the present study was conducted to study the effect of oral tobacco on heart rate , respiratory rate , blood pressure and temperature

Epidemiological snapshot of carcinoma lung at a tertiary cancer centre of Bihar, India

Background: According to the GLOBOCAN 2020 report, the estimated incidence of lung cancer in India was 72,510 in all ages and both sexes. In incidence, lung cancer ranked fourth overall among the various types of cancer. To study epidemiological profile in terms of clinical presentation, stage, risk factors and factors associated with late stage presentations at a newly established tertiary cancer care hospital BiharMethods: This was a retrospective-prospective analysis of collected data of histopathologically proven lung cancer cases in the Outpatients department (OPD) of Department of Radiotherapy, All India Institute of Medical Sciences (AIIMS), Patna over a period of 2.5 years from March 2018 to October 2020.Results: There were 140 patients, with a median age of 56 years, 59.28% (n=83) were smokers, 37.14% (n=52) used chewing tobacco, 24.28% (n=34) worked on earthen stoves and 15% (n=21) had passive smoking exposure. The male-to-female ratio was 1.64:1. Non-small cell lung carcinoma comprised 87.85% (n=123), stage IV presentation in 76.42% (n=107) cases with the most common site of metastases being bone (35.51%, 38 patients). IHC was performed on 64 patients (45.71%) of total 140 patients of which 51 patients were of adenocarcinoma histology. 35.29% (n=18) were EGFR positive and 28.57% (n=4) tested ALK positive. 4 patients tested for ROS-1 were negative. 32.14% (n=45) cases were treated empirically for Tuberculosis on the finding of chest X-ray only.Conclusions: Majority of the patients were males in advanced stage. Bone is the most common site of metastases. Long empirical treatments lead to late presentations.

Mutational signatures among young-onset testicular cancers

Background Incidence of testicular cancer is highest among young adults and has been increasing dramatically for men born since 1945. This study aimed to elucidate the factors driving this trend by investigating differences in mutational signatures by age of onset. Methods We retrieved somatic variant and clinical data pertaining to 135 testicular tumors from The Cancer Genome Atlas. We compared mutational load, prevalence of specific mutated genes, mutation types, and mutational signatures between age of onset groups (< 30 years, 30–39 years, ≥ 40 years) after adjusting for subtype. A recursively partitioned mixture model was utilized to characterize combinations of signatures among the young-onset cases. Results Mutational load was significantly higher among older-onset tumors (p < 0.05). There were no highly prevalent driver mutations among young-onset tumors. Mutated genes and types of nucleotide mutations were not significantly different by age group (p > 0.05). Signatures 1, 8 and 29 were more common among young-onset tumors, while signatures 11 and 16 had higher prevalence among older-onset tumors (p < 0.05). Among young-onset tumors, clustering of signatures resulted in four distinct tumor classes. Conclusions Signature contributions differ by age with signatures 1, 8 and 29 were more common among younger-onset tumors. While these signatures are connected with endogenous deamination of 5-methylcytosine, late replication errors and chewing tobacco, respectively, additional research is needed to further elucidate the etiology of young-onset testicular cancer. Large studies of mutational signatures among young-onset patients are required to understand epidemiologic trends as well as inform targeted prevention and treatment strategies.

Understanding etiology of chromosome 21 nondisjunction from gene × environment models

Maternal risk factors and their interactions with each other that associate chromosome 21 nondisjunction are intriguing and need incisive study to be resolved. We determined recombination profile of nondisjoined chromosome 21 and maternal genotypes for four selected polymorphic variants from the folate regulators genes stratifying the women according to the origin of segregation error and age at conception. We conducted association study for genotype and maternal addiction to smokeless chewing tobacco, usually chopped tobacco leaves or paste of tobacco leaves with the incidence of Down syndrome birth. Additionally, we designed various logistic regression models to explore the effects of maternal genotype, maternal habit of smokeless chewing tobacco, maternal age at conception and all possible interactions among them on chromosome 21 nondisjunction. We found folate regulator gene mutations are associated with maternal meiosis II error. Regression models revealed smokeless chewing tobacco and folate polymorphic/mutant risk genotype interact with each other to increase the risk of reduced and single peri-centromeric recombination events on chromosome 21 that nondisjoined at meiosis II in the oocytes and the effect is maternal age independent. We inferred maternal folate polymorphic/mutant risk genotypes and habit of smokeless chewing tobacco interact with each other and increase the risk of meiosis II error in oocytes in maternal age-independent manner.

Assessment of Knowledge, Awareness and Attitude towards Oral Precancer and Cancer among Narikuravar Population in Pondicherry State

Objective Literature revealed that oral health status and awareness about oral hygiene measures of Narikuravar tribes were very poor. There was also an increased prevalence of tobacco usage among this population. Considering this, incidence and prevalence of oral precancerous and cancerous lesions are expected to be high in this population. Surprisingly, the literature search revealed a lack of data on the awareness, knowledge, and prevalence of oral cancer and precancer in this group. The primary objective of this survey is to assess knowledge, awareness and attitude toward oral precancer and cancer among the Narikuravar tribal population in Pondicherry state. Materials and Methods This questionnaire survey is a part of the Model for Oral Cancer Eradication project conducted among the Narikuravar population in Pondicherry, which is funded by Indian Council of Medical Research (ICMR). A total of 153 participants were recruited for the survey. A prevalidated questionnaire was used for the survey. Results The results indicated that 47% of the participants were aware of what is oral precancer and cancer. As much as 62% knew that chewing tobacco causes oral cancer and 44% thought that the growth of tissue in the mouth could be a sign of oral cancer. Almost 100% did not think that the presence of a red lesion, white lesion, or limitation of mouth opening could be signs of cancer or precancer. Only 16% thought that oral cancer is preventable. Conclusion Awareness about oral cancer and precancer is inadequate among the Narikuravar population of Pondicherry. Majority of the population is not aware of the risks, signs, or treatment options of oral precancer and cancer. The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) identified the people’s knowledge gaps, and improving awareness is one of the strategies of the program.

Population attributable risk for multimorbidity among adult women in India: Do smoking tobacco, chewing tobacco and consuming alcohol make a difference?

Background The present study aims to estimate the prevalence and correlates of multimorbidity among women aged 15–49 years in India. Additionally, the population attributable risk for multi-morbidity in reference to those women who smoke tobacco, chew tobacco, and consume alcohol is estimated. Methods The data was derived from the National Family Health Survey which was conducted in 2015–16. The effective sample size for the present paper 699,686 women aged 15–49 years in India. Descriptive statistics along with bivariate analysis were used to do the preliminary analysis. Additionally, binary logistic regression analysis was used to fulfil the objectives. Results About 1.6% of women had multimorbidity in India. The prevalence of multimorbidity was high among women from southern region of India. Women who smoke tobacco, chew tobacco and consume alcohol had 87% [AOR: 1.87CI: 1.65, 2.10], 18% [AOR: 1.18; CI: 1.10, 1.26] and 18% [AOR: 1.18; CI: 1.04, 1.33] significantly higher likelihood to suffer from multi-morbidity than their counterparts respectively. Population Attributable Risk for women who smoke tobacco was 1.2% (p<0.001), chew tobacco was 0.2% (p<0.001) and it was 0.2% (p<0.001) among women who consumed alcohol. Conclusion The findings indicate the important role of lifestyle and behavioural factors such as smoking and chewing tobacco and consuming alcohol in the prevalence of multimorbidity among adult Indian women. The subgroups identified as at increased risk in the present study can be targeted while making policies and health decisions and appropriate comorbidity management can be implemented.

A systematic review of proteomic biomarkers in oral squamous cell cancer

Background Head and neck squamous cell cancer (HNSCC) is the most common cancer associated with chewing tobacco, in the world. As this is divided in to sites and subsites, it does not make it to top 10 cancers. The most common subsite is the oral cancer. At the time of diagnosis, more than 50% of patients with oral squamous cell cancers (OSCC) had advanced disease, indicating the lack of availability of early detection and risk assessment biomarkers. The new protein biomarker development and discovery will aid in early diagnosis and treatment which lead to targeted treatment and ultimately a good prognosis. Methods This systematic review was performed as per PRISMA guidelines. All relevant studies assessing characteristics of oral cancer and proteomics were considered for analysis. Only human studies published in English were included, and abstracts, incomplete articles, and cell line or animal studies were excluded. Results A total of 308 articles were found, of which 112 were found to be relevant after exclusion. The present review focuses on techniques of cancer proteomics and discovery of biomarkers using these techniques. The signature of protein expression may be used to predict drug response and clinical course of disease and could be used to individualize therapy with such knowledge. Conclusions Prospective use of these markers in the clinical setting will enable early detection, prediction of response to treatment, improvement in treatment selection, and early detection of tumor recurrence for disease monitoring. However, most of these markers for OSCC are yet to be validated.

Association of Health Status and Nicotine Consumption with SARS-CoV-2 positivity rates

Background Much of what is known about COVID-19 risk factors comes from patients with serious symptoms who test positive. While risk factors for hospitalization or death include chronic conditions and smoking; less is known about how health status or nicotine consumption is associated with risk of SARS-CoV-2 infection among individuals who do not present clinically. Methods Two community-based population samples (including individuals randomly and nonrandomly selected for statewide testing, n = 8214) underwent SARS-CoV-2 testing in nonclinical settings. Each participant was tested for current (viral PCR) and past (antibody) infection in either April or June of 2020. Before testing, participants provided demographic information and self-reported health status and nicotine and tobacco behaviors (smoking, chewing, vaping/e-cigarettes). Using descriptive statistics and a bivariate logistic regression model, we examined the association between health status and use of tobacco or nicotine with SARS-CoV-2 positivity on either PCR or antibody tests. Results Compared to people with self-identified “excellent” or very good health status, those reporting “good” or “fair” health status had a higher risk of past or current infections. Positive smoking status was inversely associated with SARS-CoV-2 infection. Chewing tobacco was associated with infection and the use of vaping/e-cigarettes was not associated with infection. Conclusions In a statewide, community-based population drawn for SARS-CoV-2 testing, we find that overall health status was associated with infection rates. Unlike in studies of COVID-19 patients, smoking status was inversely associated with SARS-CoV-2 positivity. More research is needed to further understand the nature of this relationship.

Investigating the Prevalence of Substance Abuse Among Students of Medical Science Universities in the Eighth Macro-region of Iran

Background: The growing trend of substance abuse among students is a serious threat for the health of young adults. Using Network Scale-up (NSU) method Objectives: The present study was designed to indirectly estimate the prevalence of substance abuse among students of medical science universities in the eighth macro-region of Iran to attract government attention to this problem. Methods: This cross-sectional study was performed on 3,900 students from medical science universities in the eighth macro-region of Iran (2300 from Kerman and 1600 from Sistan and Baluchestan provinces) in 2019. The sample size of each university was determined using a multistage non-random sampling approach. The participants were asked to introduce their academic close friends who did high-risk behaviors during last year. Results: Out of 3,900 participants, 1,872 (48%) were males and 2,028 (52%) were females. Students from all academic degrees contributed to this study. The prevalence of alcohol, marijuana, hemp, chewing tobacco, tramadol, methylphenidate, and opium abuse were 20.6% (95% CI: 19.3 - 21.9), 13.5% (CI: 12.4 - 14.5), 4.1% (CI: 3.5 - 4.7), 6.3% (CI: 5.5 - 7.1), 3.1% (CI: 2.6 - 3.7), 6.5% (CI: 5.7 - 7.3), and 4.0% (CI: 3.1 - 4.9), respectively. Also, the prevalence of substance abuse was higher among male students than females. Conclusions: Male students are more at risk for substance abuse. The rates of alcohol and marijuana consumption were higher among students. Training programs are recommended to increase awareness level of young people and the society about disadvantages of these behaviors.