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Editorial Board Prof. Satheesan Balasubramanian

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Prof. Keechilat Pavithran Department of Medicaloncology and Hematology, Amrita Institute of Medical Sciences P.O. AIMS Ponekkara Cochin, India.

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Dr. Chinmay Kumar Panda Dept. of Oncogene Regulation Chittaranjan National Cancer Institute, Kolkata, India.

Dr. Dillip Kumar Parida Head, Department of Oncology, Maw Diang Diang, Shillong, Meghalaya, India.

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Dr. B.R. Ambedkar Institute-Rotary Cancer Hospital, AIIMS Department of Medical Oncology, India.

Dr. Fayaz Ahmad Malik

Dr. Krishna P. Gupta

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Dr. Arun Chaturvedi

Carcinogenesis Labratory,Indian Institute of Toxicology Research,M.G.Marg, Lucknow, India.

Dr. D.K. Vijaykumar

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Prof. & Head, Dept. of Surgical Oncology Amrita Institute of Medical Sciences & Research CentrePonekkara P.O., Cochin Kerala, India.

Prof. Suresh Babu

Dr. Gouri Shankar Bhattacharyya

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HOD, Medical Oncology & Clinical Hematology, FORTIS Hospitals, E.M Byepass and AMRI Hospitals, Dhakuria, Kolkata, India.

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Research & Reviews: Journal of Oncology and Hematology

Contents

1. Alarming Increments of Tobacco and Related Substance Use among College and University Students in Ethiopia: Review Aman Mehari Abraha

2. Arsenic as a Cause of Cancer Gidey Gebremeskel, Haile Mulata, Rezene Abraha

3. Adjuvant Treatment in Carcinoma of Endometrium: Where Do We Stand? Beena Kunheri, Vijayakumar DK, Anand RK

4. Chemotherapy: Side Effect and Management Harvinder Kaur

5. Multiple Intestinal and Mesentrical Lymphangiomas in a 16 Year Old Male: A Case Report Garima Verma, Taruna Choudhary, Purnima Baheti, Ramesh Purohit, Vijay Verma

Research & Reviews: Journal of Oncology and Hematology

ISSN: 2319-3387(online) Volume 5, Issue 3 www.stmjournals.com

Alarming Increments of Tobacco and Related Substance Use among College and University Students in Ethiopia: Review Aman Mehari Abraha* Department of Medical Biochemistry and Molecular Biology, Institute of Biomedical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia Abstract The use of substances such as tobacco, alcohol, khat, and other substances has become one of the rising public health and socioeconomic problems worldwide. Onset of smoking and alcohol drinking during early adulthood is a well-documented and significant public health risk factor and is linked to a high risk of chronic diseases at older age. Tobacco is leading cause of death, illness and impoverishment worldwide. The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing nearly six million people a year. Substance misuse/abuse is a growing problem in Ethiopia, as in many developing countries. Alcohol and khat are the most frequent substances of abuse. Studies indicate that substance use among Ethiopian adolescents is considerably rising. Of the young segment of the Ethiopian population, college and university students are at the highest risk of substance use. Tobacco causes several types of cancers and systemic diseases at large the lung cancer and cardiovascular diseases. In Ethiopian universities and colleges, a critical intervention is needed either pre-university or at university stay period of the students. Pre-university training that encompasses a detailed medical aspects and social problems of smoking might have long-term contribution, as the student will be also expertise after they graduate and come back to the community. Keywords: Tobacco, alcohol, chat, university students

INTRODUCTION

Tobacco products are made entirely or partly of leaf of tobacco as raw material, which are intended to be smoked, sucked, chewed or snuffed. Nicotine is the main psychoactive substance present in tobacco, targeting in the central nervous system, the nicotinic acetylcholine receptors (nAChR). The main effects of nicotine associated with smoking are nAChR upregulation, nAChR desensitization and modulation of the dopaminergic system [1]. Nicotine has a very similar chemical structure to the neurotransmitter acetylcholine. Due to the similarity in structure, nicotine is able to bind to receptors and activate cholinergic receptors, just as acetylcholine normally could. When acetylcholine binds to these receptors, it is thought to stimulate brain functions and help muscle control. It plays a large role in brain process speed. The structural similarity of nicotine allows it to activate these receptors much as acetylcholine

can. Tobacco use is one of the main risk factors for a number of chronic diseases, including cancer, lung diseases, and cardiovascular diseases. Despite this, it is common throughout the world. A number of countries have legislation restricting tobacco advertising, and regulating who can buy and use tobacco products, and where people can smoke in Ethiopia smoking is mostly allied with khat chewing and alcohol consumption. Khat is a plant with amphetamine like characteristics with effects including insomnia, euphoria, decreased fatigue and suppressed appetite when chewed [2]. Frequent and chronic khat use has been associated with various consequences. These include substance dependency [3], early sexual debut [4] unprotected sex [5] mental health issues [6, 7] and with various social, cognitive and financial problems [8â&#x20AC;&#x201C;10]. Ethiopia is one of several countries in Africa and the Middle East where khat chewing is common. A national

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Research & Reviews: Journal of Oncology and Hematology ISSN: 2319-3387(online) Volume 5, Issue 3 www.stmjournals.com

Arsenic as a Cause of Cancer Gidey Gebremeskel*, Haile Mulata, Rezene Abraha Department of Medical Biochemistry, College of Health Sciences, Mekelle University, Mekelle, Ethiopia

Abstract Inorganic Arsenic (iAs) is a pervasive and ubiquitous environmental toxin that has created world-wide human health problems. Populations exposed to high concentrations of arseniccontaminated drinking water suffer serious health consequences ranging from acute toxicities to development of malignancies, including alarming cancer incidence and death rates. Epidemiologic studies have shown a relationship between chronic arsenic exposure and disease of the skin, lung, urinary bladder, and conceivably liver, kidney, and prostate in people. Inorganic arsenic, a recorded human cancer-causing agent, is biotransformed through consecutive expansion of methyl gatherings, procured from S-adenosylmethionine (SAM). This is to imply that; arsenic is methylated in the body by substituting lessening of pentavalent arsenic to trivalent and expansion of a methyl bunch from SAM. The end metabolites are methylarsonic acid (MMA) and dimethylarsinic acid (DMA). Absorbed arsenate (AsV) is decently quickly diminished in blood to AsIII which infers expanded lethality. Digestion system of arsenic produces an assortment of genotoxic and cytotoxic species, harming DNA specifically and in a roundabout way, through the era of receptive oxidative species and enlistment of DNA adducts, strand breaks and cross connections, and hindrance of the DNA repair prepare itself. Since SAM is the methyl group donor utilized by DNA methyltransferases to keep up typical epigenetic designs in every single human cell, arsenic is additionally hypothesized to influence upkeep of ordinary DNA methylation designs, chromatin structure, and genomic stability. This review article is important in pinpointing the natural procedures fundamental the growth advancing components of arsenic digestion system, identified with DNA harm and repairs, in this way to make consciousness of it in the universal group. Keywords: Inorganic arsenic, oxidative stress, carcinogenesis, cancer

INTRODUCTION

Arsenic is a colourless, odourless, tasteless, nonirritating gas that causes a fast and novel decimation of red blood cells and may bring about kidney disappointment, which is consistently lethal without legitimate treatment. Because of its physical qualities (no colour, no odour, and no test), arsenic presentation is regularly unnoticed, particularly when ingested through drinking water. The World Health Organization and the U.S. Environmental Protection Agency have recommended a threshold of 10 Îźg/L for inorganic arsenic concentration in drinking water [1]. Arsenic is readily absorbed from the gastrointestinal tract and lungs and is widely distributed in most tissues of the organisms. Great concentrations are deposited in the liver, kidney, lungs and skin. There are various conceivable methods of activity of arsenic

carcinogenesis: chromosomal variations from the norm, oxidative stress, altered DNA repair, altered DNA methylation patterns, Altered growth factors, abnormal cell expansion, advancement/movement, gene amplification, and suppression of p53 [2].

SOURCES AND OCCURRENCE OF ARSENIC IN THE ENVIRONMENT

Arsenic occurs in few amounts in all stone, soil, water and air. It is available in more than 200 mineral species, the most widely recognized of which is arsenopyrite [3]. Inorganic arsenic of land origin is found in groundwater utilized as drinking-water [4]. Natural arsenic compounds, for example, arsenobetaine, arsenocholine, tetramethylarsonium salts, arsenosugars and arsenic containing lipids are predominantly found in marine living beings albeit some of

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Research & Reviews: Journal of Oncology and Hematology

ISSN: 2319-3387(online) Volume 5, Issue 3 www.stmjournals.com

Adjuvant Treatment in Carcinoma of Endometrium: Where Do We Stand? Beena Kunheri1, Vijayakumar DK2,*, Anand RK3

Department of Radiation Oncology, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidhyapeedham, Coimbatore, Tamil Nadu, India 2 Department of Gynaecological Oncology, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidhyapeedham, Coimbatore, Tamil Nadu, India 3 Department of Radiotherapy, Medical College, Trivandrum, Kerala, India

Abstract Endometrial cancer is one of the most common gynecological malignancy worldwide. Though there are a large number of completed prospective and retrospective studies, adjuvant treatment remains poorly defined, mainly due to the heterogeneity in selection criteria, different treatment approaches and low recurrence rates in good risk early stage disease. This article comprehensively covers the different risk stratification approaches and the current concepts and evidences in tailoring of adjuvant treatment in carcinoma of the endometrium. Keywords: Endometrial cancer, malignancy, endometrium treatment

INTRODUCTION

Malignancies of the uterine corpus is the second most common gynecological malignancy worldwide [1]. Endometrial cancer accounts for 90% of this uterine corpus malignancy. In India, the incidence is 2.3/100,000 [1]. More than 70% of the patients are diagnosed with early stage disease because of early onset of symptoms leading to excellent cure rates [2]. But stage alone is not a good prognosticator and certain clinicopathological and molecular markers have been proposed to further predict the survival. Depending on these factors, endometrial cancers can be divided into two typesâ&#x20AC;&#x201D;type 1 and type 2 tumors [3]. Type 1 is endometroid histology, occurs in younger individuals and is associated with prior estrogen exposure, Microsatellite instability (MSI), Phosphatase and tensin homolog (PTEN) gene silencing, altered PI3K pathway; whereas type 2 is usually serous, clear cell histology, occurs in older age group and is associated with TP53 mutation. Type 2 has an aggressive course and usually presents at an advanced stage. Surgery remains the primary modality and there is great variation between centers in deciding when to give adjuvant pelvic radiotherapy (RT) or vaginal

brachytherapy (VBT). The role of adjuvant chemotherapy and its sequencing with RT in high risk cases is an area of ongoing research. This overview discusses the role of adjuvant treatment in carcinoma endometrium with current evidence and recommendations.

RISK STRATIFICATION

Carcinoma endometrium is primarily a surgically staged and treated disease. Now the accepted surgery is total abdominal hysterectomy and bilateral salpingooophorectomy with comprehensive surgical staging with pelvic and para-aortic lymphadenectomy. Importance of comprehensive surgical staging is that, much of the information required for risk stratification and decision of subsequent therapy could reliably be obtained only after comprehensive staging. Hence, even though randomized trials (MRC, ASTEC) failed to prove a survival benefit, comprehensive surgical staging with lymph node sampling is well accepted. The role of lymphadenectomy in low risk endometrial cancer is still controversial and practices vary widely. As per the largest retrospective study based on SEER data of

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Research & Reviews: Journal of Oncology and Hematology ISSN: 2319-3387(online) Volume 5, Issue 3 www.stmjournals.com

Chemotherapy: Side Effect and Management Harvinder Kaur* Academic Coordinator, Department of Continuing Nursing Education, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India Abstract Cytotoxic drugs are therapeutic agents intended for but not constrained to, the treatment of cancer. These drugs are kenned to be highly toxic to cells, mainly through their action on cell reproduction. Cytotoxic drugs are increasingly being utilized in a variety of health care settings, laboratories and veterinary clinics for the treatment of cancer and other medical conditions such as rheumatoid arthritis, multiple sclerosis are autoimmune disorders. Cytotoxic drugs are toxic compounds and are kenned to have carcinogenic, mutagenic and/or teratogenic potential. With direct contact, they may cause vexation to the skin, ocular perceivers, and mucous membranes, and ulceration dictates that the exposure of health care personnel to these drugs should be minimized. Concurrently, the requisite for maintenance of aseptic conditions must withal be gratified. Keywords: Cytotoxic drugs, carcinogenic, mutagenic, ulceration, toxic compounds

INTRODUCTION

Chemotherapy is the treatment of cancer with an antineoplastic drug or with a coalescence of such drugs in a standardized treatment regimen. Most commonly, chemotherapy acts by killing cell that divide rapidly, which is of the main properties of most cancer cells. This betokens that is withal harms cells that divide rapidly under mundane circumstances: cells in the bone marrow, digestive tract and hair follicles. This results in the most mundane side effects of chemotherapy: myelosuppression (decremented engenderment of blood cells, hence withal immunosuppressant), mucositis (inflammation of the lining of the digestive tract), and alopecia (hair loss) [1].

REVIEW OF LITERATURE Type of Chemotherapy There are various ways chemotherapy may be used:  Combination Chemotherapy: Administration of two or more chemotherapeutic agents in the treatment of cancer. The drugs differ in their mechanism and side effects. The biggest advantage is minimising the changes of resistance developing to any one agent, allowing each medication to enhance the action of the other or act synergistically with it, e.g. MOPP regimen for Hodgkin’s disease [2].  Adjuvant Therapy: A course of chemotherapy used in conjunction with another



treatment modality like surgery and radiotherapy. Can be used when there is little evidence of caner present, but there is risk of recurrence. This can help reduce chances of developing resistance if the tumour does develop. It is also useful in killing any cancerous cells which have spread to other parts of the body. Neo-adjuvant Chemotherapy: Administration of chemotherapy to shrink the tumor prior surgical removal of the tumor, thereby rendering local therapy (surgery or radiotherapy) less destructive or more effective. Primary Therapy: The treatment of patients with localized cancer for which there is an alternative but less than completely effective treatment. Induction Chemotherapy: The drug therapy is given as the primary treatment for patients with cancer for which no alternative treatment exists. Palliative Chemotherapy: Palliative chemotherapy is given without curative intent, but simply to decrease tumor load and increase life expectancy. For these regimens, a better toxicity profile is generally expected.

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Research & Reviews: Journal of Oncology and Hematology ISSN: 2319-3387(online) Volume 5, Issue 3 www.stmjournals.com

Multiple Intestinal and Mesentrical Lymphangiomas in a 16-year-old Male: A Case Report Garima Verma1,*, Taruna Choudhary2, Purnima Baheti3, Ramesh Purohit4, Vijay Verma5 1,2

Department of Pathology, Dr. S.N. Medical College, Jodhpur, Rajasthan, India Department of Surgery, Dr. S.N. Medical College, Jodhpur, Rajasthan, India 3,4 R.P. Diagnostic Center, Jodhpur, Rajasthan, India

Abstract Lymphangiomas are rare benign tumor of lymphatic vasculature. These usually occur in skin and soft tissues ofhead, neck and axillary region. Very rarely these affect gastrointestinal tract. Here, we present a case of lymphangiomatos is in a 16 year old male who was presented with acute abdomen. Exploratory laparo to my done and multi-lobulated mass in the intestinal wall and mesentry found. Segment of ileum, caecum and part of colon was resected and ileo ascending anastomos is done. The tissue specimen was sent for histopathological examination. Microscopic picture was consistent with multiple lymphangiomas involving the intestine and mesentry which should be considered the cause of acute abdomen in this case. The optimal treatment is radical intestinal resection since incomplete resection may lead to recurrence. Keywords: Lymphangiomas, honey comb, hygroma

INTRODUCTION

Lymphatic vessels are present in every part of the body except the central nervous system (brain and spinal cord), which has its own specialized system. The main functions of the lymphatic system are to maintain fluid balance, to defend the body against disease by producing lymphocytes, andto absorb fats and fat soluble vitamins from the small intestine and transport them to the blood, bypassing the liver. A single mass of lymph vessels or cyst is known as a lymphangioma. Lymphangiomatos is descibes cases where a lymphangioma is not present in a single localised mass, but in a widespread or multifocal manner. The name lymphangiomatosis comes from the words 'lymph-' (describing the lymphatic system), 'angio-' (meaning relating to vessels), '-oma-' (tumour or cyst), '-tosis' (condition). Other names used for the disease includes generalised lymphangioma, systemic cystic angiomatosis, generalised lymphatic malformation, generalized lymphatic anomaly, diffuse lymphatic malformation among others. A total of 90% of lymphangiomas occur in children under 2 years of age and involve most commonly head and neck region.

Lymphangiomatos is thought to be the result of congenital errors of lymphatic development occurring prior to the 20th week of gestation. It is a condition marked by the presence of cysts that result from an increase both in the size and number of thin-walled lymphatic channels that are abnormally interconnected and dilated. These abnormal masses consist of endothelium lined spaces, which are supported by connective tissue stromata of variable thickness that contain lymphoid tissue, round cells and smooth muscle. Although it is benign, these deranged lymphatics tend to invade surrounding tissues and cause problems due to invasion and/or compression of adjacent structures. Abdominal lymphangiomas are rare. These have been reported in every region of the abdomen, though the most reported sites involve the intestines and peritoneum; spleen, kidneys, and liver. Small bowel lymphangiomas occur very rarely in adults. Often there are no symptoms until late in the progression of the disease. When they do occur, symptoms include abdominal pain and/or distension; nausea, vomiting, diarrhea; decreased appetite and malnourishment.

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