European Journal of Molecular & Clinical Medicine

Background: Childhood cancer survivors may face growth impairment due to late effects of childhood cancer therapies. Present study was aimed to study the impact of various modalities of treatment on growth of children with malignancy.
Material and Methods: Present study was Prospective observational hospital-based study, conducted in children between age group 1-18 years, diagnosed with Haematological malignancy or any solid tumour and are on treatment/follow-up in Pediatric hematoncology unit, at least on 4 occasions (4-6 months apart).
Results: Out of 45 children, 30 (66.7%) were boys, mean age of the children enrolled was 5.4 ± 3.684 years. 29 (64.4%) had Leukaemia, 31 (68.8%) received only chemotherapy, 12 (26.6%) received surgery and chemotherapy, 10 received radiotherapy and chemotherapy (22.2%) and 8 (17.8%) of them received all 3 modes of treatment. Among 29 children with leukaemia, there was significant weight gain as well as increase in height at each follow up compared to baseline.  There was no statistically significant gain in weight or height in children with lymphoma at all 3 follow ups. In children with solid organ tumor significant weight gain is observed at each follow up compared with baseline weight which was taken at initiation of chemotherapy. Significant gain in height & weight at each follow up was observed among all 31 children who received only chemotherapy, there was gain in weight & height observed in all children who received both chemotherapy and underwent surgery.  No significant weight gain but a significant gain in height in all 13 children who received both chemotherapy and radiotherapy.
Conclusion: Weight is more affected in children who received radiotherapy along with chemotherapy and in children who received all 3 modes of treatment that is chemotherapy, radiotherapy and underwent surgery for excision of tumour when compared with children who received chemotherapy alone

Background: Cardiovascular disease in patients with breast cancer undergoing chemotherapy is of major growing concern. The commonly  used  chemotherapeutic  regimen have cardiotoxic effects  including  doxorubicin, trastuzumab and  other agents .these  have  acute  effects  on  cardiac  function and  longterm effects  on cardiac  remodelling  and  function. There have been a few studies on this regard, Hence we  aimed  to investigate  the  early  effects  of chemotherapy  on cardiac  function  in addition to association  of N –terminal  pro-brain  natriuretic  peptide and  echocardiagraphic indices.
Methods: This is a prospective, single-center study including 100 patients who received a breast cancer diagnosis in the Government Royapettah Hospital between July 2021 and April 2022 before beginning chemotherapy. Before beginning chemotherapy (baseline -T1), the day following the conclusion of the second cycle (T2), and the day following the conclusion of the fourth cycle (T3), 2D echocardiography was performed on all patients enrolled.
Results: It showed that the mean age of the subjects was 44.2 ± 8.80 years. Out of all the subjects, 40% had breast cancer of right side and 60% had breast cancer of left side. Thirty percent subjects had diabetes and 40% had hypertension. Maximum subjects had undergone surgery (70%). The chemotherapy regimen followed in most of the subjects was ACP- regimen in 70% subjects, followed by 20% having CMF- regimen and 10% having TCH-regimen. It was seen that out of all the variables, only TAPSE, and S’–TV have significant difference at T1, T2 and T3. In our study 20 % had LV systolic dysfunction, 20% had LV diastolic dysfunction and 30% had RV systolic dysfunction which correlate with NT pro BNP values.
Conclusion: Tissue Doppler echocardiography is currently used and is sufficient for providing chemotherapy patients with effective cardiac care in places with limited resources. Our study also enlighten that Echo should performed at T1 and T3 stage for all chemotherapy patients with focus on RV function as it is the earlier marker for cardiotoxicity. Future molecular mechanisms will facilitate the use of medications that operate on certain molecular targets to treat cardiotoxicity

Background: Cancer has become highly prevalent in developing countries, and Africa is not far from it. The treatment of these cancers increases the risk of infertility in women. This review aims to understand the effects of different types of cancer treatments on the fertility in women.
Method: PRISMA guidelines were followed for scrutinizing the articles. Original research articles were searched and obtained from online databases including Pub Med, Pub Med Central, Springer, Nature, Web of Sciences, Semantic Scholar, Medline, Science Direct, Directory of Open Access Journals, Google Scholar, Research Gate, EMBASE, National Center for Biotechnological Information etc. After removing irrelevant, duplicated, and less correlated articles from the total of 1671 obtained articles, 19 studies were included in the systematic analysis.
Results: Among The 19 Studies Included, 14 Were Retrospective. Based On The Systematic Analysis Performed, Overall Fertility Deficits Were Observed In Female Survivors Of Cancers. Sex, Age At Diagnosis, Pre-Diagnosis Parenthood, And Diagnostic Period All Had An Effect On Fertility After Cancer Treatment. Treatment with alkylating agents, second line therapy, and age>35 years also influence the chances of pregnancy. Pre-term delivery was also found to be linked to cancer-related therapy. The probability of having a first live birth among cancer survivors was low. The site of cancer and age at the onset of cancer were independent predictors of a reduced probability of giving birth after diagnosis. Pelvic radiation was found to be more damaging than abdominal or supradiaphragmatic radiation.
Conclusion: The present review suggests that future measures should be taken to include an assessment of women’s desire for future fertility and also provide fertility preservation options. Fertility preservation strategies for cancer-affected women in their reproductive years. Long-term fertility data on cancer survivors in South Africa are needed. Counseling tools and guidelines for referral to onco-fertility specialists should be developed for newly diagnosed young patients.

Aim: The aim of the present study to evaluate the oncologic prognoses of people with nonurothelial bladder cancer.
Material and methods: This prospective observational study was carried out after being given the all-clear by the protocol review committee and the institutional ethics committee. Twenty-two adults were included in the study because they all had histologically confirmed NUBCs.
Results: Twenty-two people who had NUBCs participated in this study. Adenocarcinoma was found in 12 of them, whereas Squamous Cell Carcinoma was in 5, small cell carcinoma in 3, and inflammatory myofibroblastic cancer in 2. The patients' median age at presentation was 53.55 years, and 19 of them (86.36%) presented with hematuria as their primary complaint. Two people reported soreness in the lower urinary tract. The majority of patients were diagnosed at T3, and just one had advanced cancer.
Conclusion: Rare uveo-uveal biliary cancer (NUBC) exhibits several histological variants. We conclude that NUBC is a very aggressive disease with a poor prognosis since it is often diagnosed late in the course of the disease. The courses of therapy vary. To improve long-term survival rates, we need a concerted effort from institutions all around the world to shed light on the biology of these cancers and evaluate current treatment methods

To figure out how well pre-operative (neo-adjuvant) chemo-radiotherapy works for patients with
locally advanced rectal cancer by looking at the rates of radiation enteritis after both preoperative
and post-operative treatment. Follow-up continues until November 2019. The research
required appropriate biochemistry, pathology, radiography, and medical/surgical management.
Since June 2019, outpatients are assessed. Rectal cancer research studied age, sex, diagnosis
delay, mortality, treatment options, death causes, surgical complications, and hospital stay.
Typical, pre-validated, semi-structured case record proformas recorded the data. CBC,
biochemical profile, serological sample, upright abdominal X-ray, CT scan, transrectal, pelvic, or
abdominal ultrasound. After staging, patients received chemotherapy (625 mg/m2 capecitabine
orally in 4 doses) and radiation (50.4 Gy in 28 parts) and were reevaluated for surgery after 4
weeks. The majority of cases had adenocarcinomas in the middle and lower rectum. 17.5% of
neo-adjuvant patients developed radiation enteritis. To make neoadjuvant treatment standard,
more experience, competence, and patients are needed.

Aim: The aim of this study to evaluate the microflora in the post-chemotherapy patients of oral cancer.
Methods: The present study was conducted in the Department of Dentistry Ananta Institute of Medical Sciences and Research Centre, Tehsil Nathdwara, Distt. Rajsamand, Rajasthan, India, from July 2020 to June 2021. We enrolled 24 patients (15 men and 9 women, aged 20–55years) with solid malignancy that had no previous adjuvant radiotherapy or recent antimicrobial or antiviral treatment. Sampling was done at the same time of day, approximately 2 h after breakfast. Microorganisms were identified by standard procedures as well as the production of a set of metabolic enzymes (as tested with Rapid ID 32A and Rapid ID32 Strep). With regard to bacterial counts, the results were expressed in MCF, equivalent to 1.5 × 108 cells/ml.
Results: Oral mucositis, according to WHO scores, involving nonkeratinized sites developed in 8 patients (33.33%) in the test group: 7 with Grade 1 and 1 with Grade 2. No ulcerations on the keratinized mucosa were scored. No mucositis developed in the control group. 12 patients (50%) who developed plaque that consisted predominantly of saprophytic Gram-positive cocci (Streptococcus spp., Leuconostoc spp., Granulicatella spp., and Gemella spp.). The other 12 patients (50%) developed periodontal pathogens (F. nucleatum, P. gingivalis, Actinobacillus spp., and P. micros). Actinobacillus spp. was the least frequently found periodontal pathogen in the test group (8.33%), while F. nucleatum was the most frequently found (16.67%). No significant differences were found in bacterial changes between t0, t1, and t2 in the test group. In the control group, the bacterial count remained unchanged during the observation period. At t0, t1, and t2, differences in qualitative and quantitative variations between the two groups were not significant.
Conclusion: No changes occur in microflora in dental plaque in cancer patients within 7 days from the first course of chemotherapy. No correlations between oral mucositis and specific microorganisms were assessed

Aim: To analyse the post-operative wound complications in patients getting neoadjuvant
chemotherapy in respect to those patients who underwent surgery without any neoadjuvant
chemotherapy.
Material and method: The present prospective observational study was conducted in
GMCH AMRITSAR Punjab.It consisted of 50 female patients admitted with breast
carcinomadivided into group of 25 each, one group that received neoadjuvant
chemotherapy and the other group which underwent surgery first.
Results: The mean age of the patients was 50.16±11.57 years. no significant difference was
observed in age, wound complications, healing time between the two groups. Flap necrosis
was seen in 4% cases and 12% cases in group 1(primary surgery) and 2(NACT)
respectively. Seroma was seen in 16% and 8% cases in group 1 and 2 respectively. 12%
cases of group 1 and 20% cases of group 2 presented with wound infection. Patients with
DM presented with more complication in both the groups. The difference between both the
groups was significant which shows that diabetic patient without NACT have more risk of
developing wound complications than with NACT.No significant difference was observed
between the mean of healing time in both the groups .
Conclusion:In conclusion, our study revealed that a factor, like diabetes mellitus was
associated with an increased risk of wound complications for patients undergoing
mastectomy. However, neoadjuvant chemotherapy was not associated with an increased
risk of wound complications.

Immune thrombocytopenia or ITP is an autoimmune disorder in which the body creates autoantibodies against its thrombocytes or platelets that are destroyed, resulting in purpura or minor bleeding spots under the surface. It is most often found in cancer patients and is of growing concern.While the main causes of thrombocytopenia in cancer pat ients are chemotherapy and radiation, other aetiologies should also be considered in patients suffering
 from this debilitating disease. Thrombocytopenia causes a variety of complications in the treatment of cancer patients and therefore pharmacists need to be familiar with epidemiology, pathophysiology, risk factors, diagnostic methods, and emerging therapeutic options for chronic immune thrombocytopenia to help oncologists identify and implement realistic treatment measures for chronic immune thrombocytopenia patients undergoing cancer treatment.The objective of this review is to provide a brief overview of chronic immune thrombocytopenia and various strategies for the clinical management of the disease.

Aim: To analyse the post-operative wound complications in patients getting neoadjuvant
chemotherapy in respect to those patients who underwent surgery without any neoadjuvant
chemotherapy.
Material and method: The present prospective observational study was conducted in
GMCH AMRITSAR Punjab.It consisted of 50 female patients admitted with breast
carcinomadivided into group of 25 each, one group that received neoadjuvant
chemotherapy and the other group which underwent surgery first.
Results: The mean age of the patients was 50.16±11.57 years. no significant difference was
observed in age, wound complications, healing time between the two groups. Flap necrosis
was seen in 4% cases and 12% cases in group 1(primary surgery) and 2(NACT)
respectively. Seroma was seen in 16% and 8% cases in group 1 and 2 respectively. 12%
cases of group 1 and 20% cases of group 2 presented with wound infection. Patients with
DM presented with more complication in both the groups. The difference between both the
groups was significant which shows that diabetic patient without NACT have more risk of
developing wound complications than with NACT.No significant difference was observed
between the mean of healing time in both the groups .

Background: Reproductive cancer is an important health problem since it leads to mortality and morbidity of women in all over the world. Aim: evaluate effect of improving Nurses' practices on women’s satisfaction diagnosed with Reproductive Cancer undergoing Chemotherapy. Setting: The study was conducted at Nasser institute hospital (at oncology department outpatient & inpatient department). Study design: a quasi experimental design was utilized. Sample: All nurses (40) who were working in the pre mentioned study setting during the time of the study and convenient sample,80 women with reproductive cancer Tools: Tool 1 self- administered structured questionnaire sheet, Tool 2 observational checklist, and Tool 3 Women's satisfaction questionnaire sheets. Results: showed statistically significant improvement in nurses’ practical skills related to chemotherapy administration immediately post intervention and after three month follow up phase and increase Women's satisfaction level toward care provided by nurses, study confirmed statistically a highly significant positive relation between nurses' practice and Women's satisfaction post guidelines intervention. Conclusion: nursing guideline had positive effect on nurses' practices regarding chemotherapy which had direct effect on women’s satisfaction with nursing care they received. Recommendation: Refreshing courses pre-service and in-services training programs to enhance nurse’s practical skills at oncology units. Further research is recommended to identify factors that effect on nurse’s knowledge and their practice related to oncology patient receiving chemotherapy.

Epithelial ovarian malignant growth is ordinarily analyzed at a propelled stage. The better current class of chemotherapy treatments result in the high frequency of full reductions, however, the repetition rate is also higher. The infection eventually is a cycle of free moments and repetitive scenes in most cases. Distinctive focused on treatment draws near and natural medications, as of now being worked on, bring the guarantee of transforming ovarian malignant growth into a sensible ceaseless ailment. In this survey, we examine the present standard in the treatment for ovarian malignancy, significant late examinations on the new variations of regular treatments, and new remedial methodologies, as of late endorsed as well as in clinical preliminaries. The following also have an opponent in angiogenic drugs, polyADP-ribose polymerase (PARP), developmental factor flagging inhibitors or folate receptor inhibitors. They also address the cost-effectiveness of certain new treatments and the question of best option for personalized therapy.

AIM: This study aims to find out about life-saving advances in skin cancer treatment.
INTRODUCTION: Skin malignant diseases are those that emerge from the skin. They are due to the development of abnormal cells that can invade and spread to different parts of the body there are three types of skin cancer- basal cell carcinoma, squamous cell carcinoma and melanomas. Hereditary factors strongly influence the risk factor of skin disease and malignant growth. Basal cell malignant growth develops gradually and can harm the tissue around it, however, it does not spread to distant areas or result in death. Squamous cell skin disease is bound to spread. Melanomas are the most aggressive. Although hereditary variables may have the least impact on skin management growth, most skin cancers are caused due to exposure to UV radiation.
MATERIALS AND METHODS: Review of various scientific literature was done in preparation of the manuscript. Several databases were searched for relevant articles from pub med and Google scholar. Databases of individual journals were searched for keywords such as skin cancer, sunlight on skin cancer, treatment, advances, prevention etc. The exclusion criteria were case reports, review and studies in other languages.
CONCLUSION: From the review, we can know about many recent advances for the cure of cancer. Personalised vaccines, cell therapy, gene editing and micro-treatment are newer technologies for treating cancer. In future cancer can also become a curable disease.

Aim: We aimed to investigate the action mechanism of Zhengyuan capsule (a registered proprietary Chinese medicine) against chemotherapy-related fatigue (CRF). Methods: BALB/c-nu nude mice model with human lung adenocarcinoma A549 xenografts was constructed by injection of A549 cell suspension. The xenografted mice were randomly divided into model, cisplatin and cisplatin+Zhengyuan groups (n = 20 each). The cisplatin group was given an intraperitoneal injection of 5 mg/kg cisplatin every 3 days for 21 days. The cisplatin+Zhengyuan group was given an intragastric administration of cisplatin and 25 mg/kg Zhengyuan capsule each day for 21 days. Normal control and model groups were administrated with equal amount of saline. Forced swimming assay, tail suspension test, open field test, hepatic glycogen assay, blood analysis, and bone marrow smear was performed. Results: The cisplatin group developed CRF after receiving chemotherapy. When compared with cisplatin group, the cisplatin+Zhengyuan group exhibited longer exhaustive swimming time (p

Chemotherapy remains one of the principal modes of treatment for cancer patients. Despite advances in anticancer agents for multiple cancers, development of resistance to classical chemotherapeutic drugs and targeted drugs continues to be a major challenge. Drug resistance which can be either intrinsic or acquired, leads to treatment failure and tumor progression. Drug resistance occurs because of mechanisms that are associated with individual cancer cells or through mechanisms that relate to the microenvironment within tumors. Multiple molecular determinants of intrinsic and acquired resistance including genetic, epigenetic factors, as well as other factors which act at the genomic or cellular level have been identified. This review provides a conspectus on some of the recent discoveries on mechanisms of anticancer drug resistance and the possible ways to revert resistance and thereby improve cancer therapy.