Journal of Integrative Oncology

Wilms’ tumor (WT) is an embryonic tumor of kidney that belongs to paediatric age group. The etiopathology is highly complex due to interaction between genetic
and epigenetic factors. The genetic heterogeneity of methylene tetrahydrofolate reductase (MTHFR) gene polymorphism increase “risk factor” of the disease.
The present study has been designed to identify new gene variants single nucleotide polymorphism (SNP) of MTHFR using Sanger’s sequencing and decode the
nucleotide sequences into corresponding amino acids to understand the translational events. Further, allele refractive mutation system with polymerase chain
reaction (ARMS- PCR) was also used to confirm mutations (frequency) in the cases of WT and compare with age matched controls. Present findings reveal
that genetic heterozygosity was observed in 20% cases of WT by substitution of nucleotide cytosine in to thymidine (C→T) followed by change of amino acid
alanine is replaced by valine due to missense mutation. DNA sequencing data varies in different cases of WT that includes - first case shows four new SNPs -1)
nucleotide cytosine is substitute by thymidine (C→T) followed by change in amino acid alanine is replaced by valine, 2) thymidine change into adenine (T→A)
results in isoleucine→asparagine, 3) cytosine is substitute by adenine (C→A) results in isoleucine →asparagine, and 4) thymidine is substitute by cytosine
(T→C), where phenylalanine →serine. Similarly, Second and third case of WT again showing the missense mutation, where the nucleotide cytosine is substitute
by thymidine (C→T) followed by alanine→valine and thymidine into adenine (T→A) followed by change in isoleucine→asparagine, respectively. Based on
bioinformatics analysis, the 3D structure predicted that the mutation in MTHFR gene modulate the functional activity of ligand binding sites either with protein or
methotrexate. Collective findings of PCR and DNA sequencing suggests that these new gene variants which has not been reported earlier might have interfere
in folate - metabolism during DNA methylation and increase genetic susceptibility and “risk factor” in WT cases.

The opioid crisis affects people with cancer who depend on opioids to help them relieve their pain. It can be caused by cancer, by its treatment or by a combination of factors. While some pain lasts for a relatively short period and recovers on its own, cancer or its treatment may also lead to long-lasting, chronic pain. Opioid medications are an important component of the treatment of many forms of unreliable cancer pain.

Non pharmacological treatments are valuable adjuncts to the treatment modalities for patients with cancer pain. Variety can be used to minimize pain and concomitant mood disturbance and improve quality of life. Physicians may feel relatively uninformed about the approaches used and scientific support for cancer patients. This article discusses a variety of non-pharmacological and complementary and alternative approaches widely used in patients with cancer pain. It focuses on those with scientific support or encouraging preliminary evidence, with the intention of familiarizing physicians with therapies that may supplement routine oncological treatment. Pain is a multi-faceted condition involving biological , psychological and social effects. The incidence of pain in cancer patients has been reported to be between 46% and 79% during cancer care and 65% for those with advanced disease. Etiological causes for cancer pain include disease progression, treatment strategies for stopping cancer (e.g. surgery, chemotherapy, or radiotherapy), inactivity musculoskeletal pain, and cancer-related infections that cause neuropathic pain. A mixture of pharmacological and non-pharmacological treatment approaches for cancer pain is the standard of care as set out in the latest recommendations of the World Health Organization (WHO).

Background: The principal aim of health service providers in the field of breast cancer is to detect and treat lesions at an appropriate time. Therefore, identification of barriers to screening can be very helpful. The present study aimed to systematically review the qualitative studies for extracting and reporting the barriers of screening for breast cancer from the women’s perspective. Materials and Methods: In this systematic review; Pubmed, Google Scholar, Ovid Scopus, Cochrane Library, Iranmedex, and SID were searched using the keywords: screening barriers, cancer, qualitative studies, breast and their Persian equivalents, and the needed data were extracted and analyzed using an extraction table. To assess the quality of the studies, the Critical Appraisal Skills Program me (CASP) tool was used. Results: From 2,134 related articles that were found, 21 articles were eventually included in the study. The most important barriers from the point of view of 1,084 women were lack of knowledge, access barriers (financial, geographical, cultural), fear (of results and pain), performance of service providers, women's beliefs, procrastination of screening, embarrassment, long wait for getting an appointment, language problems, and previous negative experiences. Articles' assessment score was 68.9. Conclusions: Increasing women's knowledge, reducing the costs of screening services, cultural promotion for screening, presenting less painful methods, changing beliefs of health service providers, provision of privacy for giving service, decreasing the waiting time, and providing high quality services in a respectful manner can be effective ways to increase breast cancer screening.

Sonography of the Gastro-Intestinal Tract can reveal intra-mural tumours, Intra-mural haematoma, Lesions of Ampulla of Vater like benign & infiltrating mass lesions. Neoplastic lesion is usually a segment involvement, & shows irregularly thickened, hypoechoic & aperistaltic wall with loss of normal layering pattern. It is usually a solitary stricture & has eccentric irregular luminal narrowing. It shows loss of normal Gut Signature. Enlargement of the involved segment seen. Shouldering effect at the ends of stricture is most common feature. Enlarged lymphnodes around may be seen. Primary arising from wall itself & secondary are invasion from peri-Ampullary malignancy or distant metastasis. All these cases are compared & proved with gold standards like surgery & endoscopy. Some extra efforts taken during all routine or emergent ultrasonography examinations can be an effective non-invasive method to diagnose primarily hitherto unsuspected benign & malignant Gastro-Intestinal Tract lesions, so should be the investigation of choice.