Medical Bulletin 19/ March/ 2024

According to a research published in the Journal of Molecular Medicine, consumption of tobacco and alcohol has been linked to rising cases of head and neck cancers (HNC) accounting for a 35-times higher risk.

When tobacco is smoked or chewed, it exposes the cells in the mouth, throat, and other parts of the head and neck to harmful chemicals. These chemicals can damage the DNA in cells, leading to mutations that can eventually result in cancerous growth. Similarly, alcohol consumption can irritate the cells in the mouth and throat, making them more susceptible to carcinogens. Additionally, alcohol can interfere with the body's ability to metabolize and eliminate these carcinogens, further increasing the risk of cancer.

In two case-control studies, researchers investigated the link between tobacco/alcohol consumption and head and neck cancer risk. The first study, conducted at the ENT Department of the University hospitals of Heidelberg and Giessen included 200 male patients with head and neck squamous cell cancer and 800 matched control subjects. Results showed that 4.5% of patients never smoked compared to 29.5% of controls. Patients had roughly double the tobacco and alcohol consumption of controls, with the highest consumption seen in oropharyngeal cancer patients. Tobacco and alcohol increased cancer risk in a dose-dependent manner and were independent risk factors. Heavy smokers (> 60 pack-years) had a relative risk of 23.4 (adjusted for alcohol).

In the second study conducted at the University of Heidelberg's ENT Department, 164 males with laryngeal squamous cell carcinoma and 656 matched controls were examined. Results showed that 4.2% of cases never smoked, contrasting with 28.5% of controls. Risk of laryngeal cancer increased with tobacco consumption, peaking at 9.1 (adjusted for alcohol) for consumption exceeding 50 tobacco-years (TY).

The findings concluded that the consumption of tobacco and alcohol lead to cellular damage, DNA mutations, and impaired cellular functions, all of which contribute to an increased risk of developing cancer in the head and neck area.

Reference: H. Maier, A. Dietz, U. Gewelke, W. D. Heller & H. Weidauer; Journal: Molecular Medicine; DOI: https://doi.org/10.1007/BF00184668

Early detection crucial for effective treatment of endometriosis, finds study

According to experts, early detection is crucial for boosting treatment for endometriosis which are often dismissed as painful periods.

Endometriosis is a condition where tissue similar to the lining inside the uterus (endometrium) grows outside of it. This tissue can be found on the ovaries, fallopian tubes, outer surface of the uterus, and other organs within the pelvis. During the menstrual cycle, this tissue thickens, breaks down, and bleeds. However, because it has no way to exit the body like menstrual blood, it becomes trapped. This can lead to inflammation, scar tissue formation, and severe pain.

Although there is currently no known way to prevent endometriosis, early diagnosis, and management can help slow down "the natural progression of the disease and reduce the long-term burden of its symptoms, including possibly the risk of central nervous system pain sensitisation", as per the World Health Organization.

"The symptoms of endometriosis can vary from person to person and may not correlate with the severity of endometriosis. Most women with endometriosis tend to have painful periods which may be attributed to the normal menstrual cramps and diagnosis is often delayed," said Gayathri D Kamath, Senior Consultant, Obstetrics & Gynecology, Fortis Hospitals, Bannerghatta Road, Bangalore.

“Excessive pain during menstruation (dysmenorrhea), painful intercourse (dyspareunia), chronic pelvic pain, severe backache, or constant painful urge to defecate during and around periods are some of the red flags. In addition, difficulty getting pregnant (infertility) can also be associated with endometriosis.” said Gayathri.

Therefore, recognizing the significance of early clinical diagnosis is crucial in the evolving paradigm of endometriosis management. Consistently adopting a standardized approach to both diagnosis and treatment is essential to enhance patient care and improve outcomes.

Reference: IANS

Can turmeric boost beneficial bacteria in the gut?

Researchers from University of Western Sao Paulo (UNOESTE) and Sao Paulo State University have found that Lactobacillus bacteria, a common probiotic found in foods such as yoghurt was about 25% more prominent in mice treated with curcumin solution.

The findings were published in the International Journal of Pharmaceutics.

Curcumin, a compound found in turmeric, has been shown, in certain studies, to have antimicrobial properties, particularly against harmful bacteria in the gut. By inhibiting the growth of these harmful bacteria, curcumin may create a more favourable environment for the growth and proliferation of beneficial bacteria in the gut. Additionally, curcumin has anti-inflammatory properties, which can help reduce inflammation in the gut and support a healthier microbial balance.

While curcumin has gained prominence in treatments to combat inflammatory intestinal disorders, its bioavailability -- amount reaching the site of physiological activity -- is low when administered orally and even lower in patients with inflammatory conditions such as Crohn's disease, ulcerative colitis and others.

"The research comprised two stages. The first entailed producing a nanoemulsion to deliver the curcumin. In the second, we evaluated its stability, morphology and physicochemical properties," said Lizziane Eller, a professor at University of Western Sao Paulo and the last author of the study.

For the study, researchers induced intestinal inflammation in mice using the drug indomethacin followed by administering curcumin nano-emulsion orally for 14 days.

By analysing intestinal inflammation at the end of this period, the team found that after the drug caused damage, the nanoemulsion changed the gut microbiota of mice by enhancing the presence of beneficial bacteria along with "effectively" improving the bioavailability of curcumin.

"The nanoemulsion didn't lead to a significant improvement in the intestinal inflammation but the relative abundance of Lactobacillus bacteria was about 25 per cent higher in the mice treated with curcumin nanoemulsion than in the control group," said Eller.

The findings highlighted the importance of developing novel formulations to enhance the efficacy of curcumin in preventing and treating inflammatory bowel disease, given that the compound has proved as a valid alternative to existing treatments which are expensive and produce significant side effects.

Reference: Journal: International Journal of Pharmaceutics.