Published date: Sep 26 2019

Journal Title: Sudan Journal of Medical Sciences

Issue title: Sudan JMS: Volume 14 (2019), Issue No. 3

Pages: 152–161

DOI: 10.18502/sjms.v14i3.5215

Abdel Azim Alsanousi1. Omdurman Islamic University, Faculty of Medicine and Health sciences, Biochemistry Department, Omdurman,Sudan

Abdel Raouf Ahmed2. Omdurman Islamic University, Faculty of Sciences and Technology

GadAllah Modawemdurman Islamic University, Faculty of Medicine and Health sciences, Biochemistry Department, Omdurman,Sudan

Background: Oral cancer in Sudan has high incidence rate due to the use of Toombak , a home- made smokeless tobacco, rich in tobacco specific nitrosamines .There have been calls for continuous monitoring on toombak users to discover very early the carcinogenic changes to avoid mortality, and  morbidity.

Objective: The purpose of this study was to assess technically, and financially affordable  methodologies, that are  reliable, reproducible,  sensitive, specific and cost effective valid  for use  in  mass  screening  amongst  the  high  risk  groups. (The toombak  users).The present study was done to evaluate the levels of copper, zinc and magnesium in serum of toombak dippers.  

Materials and Methods: The levels of copper, zinc, and magnesium were estimated in the serum of 150 toombak dippers . The values were compared with 50 normal age matched, healthy control subjects and 50 patients with oral squamous cell carcinoma, using Atomic absorption spectrophotometry.

 Results: There was significant difference of the mean serum copper, zinc, and magnesium levels of toombak  dippers when compared to the normal controls. In oral cancer patients there was significant difference in the copper, zinc, and magnesium levels. Copper level was found increased gradually starting from control through toombak dippers to oral squamous cell carcinoma patients , while the level of zinc and magnesium was found decreased in the same sequence.

Conclusion: Serum may be used as a potential diagnostic tool, which can be efficiently employed  to evaluate the copper, zinc and magnesium  levels in Sudanese snuff dippers for population based  mass screening .Serum trace elements levels could be used as potential  diagnostic markers for early changes caused by toombak dipping.

Keywords: Atomic absorption spectrophotometry, copper,  magnesiumm , zinc,  oral squamous cell carcinoma, tobacco specific nitrosamines,  serum , toombak.

[1] Hanspal S, Pushaparja S, Sreelatha SV, Madvikha P. analysis of salivary antioxidant levels in different clinical staging and histological grading of OSCC:noninvasive technique in dentistry. J clin diagn Res.2014 Aug (8) zc08-zc11.

[2] Boyle P, Levin B. World Cancer Report 2008. Lyon: International Agency for Research on Cancer; 2008. p. 22-3, 330-6.

[3] Osman T.A, Satti A, Boe OE, Yang YH, Ibrahim SO, Sulieman AM. pattern of malignant tumors registerd at a referral and maxillofacial hospital in sudan during 2006 and 2007. J of cancer res and ther. 2010.vol 6 issu 4 (473-477).

[4] Idris AM, Nair J, Ohshima H, Friesen M, Brouet I, Faustman EM, Bartsch H. Unusually high levels of carcinogenic tobacco-specific nitrosamines in Sudan snuff (toombak). Carcinogenesis. 1991 Jun;12(6):1115-8.

[5] Idris AM, Ahmed HM, Mukhtar BI, Gadir AF, el-Beshir EI. Descriptive epidemiology of oral neoplasms in Sudan 1970-1985 and the role of toombak. Int J Cancer. 1995 Apr 10;61(2):155-8.

[6] Hussain G A, Rayan M. (2007). Impact of Toombak dipping in etiology of oral cancer: gender exclusive hazard in the Sudan. journal of cancer research & therapeutic: vol 3:2:127-130.

[7] Murphy S, Carmella SG, Idris AM, Hoffmann D. Uptake and metabolism of carcinogenic levels of tobacco-specific nitrosamines by Sudanese snuff dippers. Cancer Epidemiol Biomarkers Prev. 1994 Jul-Aug;3(5):423-8.

[8] Nawal AL, Tahie BA, Omar E, Altayeb, Asiha A A.. Analysis of tobacco-specific nitrosamines in the common smokeless tobacco afzal in Oman. Sultan Qabos university med J.2016; 20:26.

[9] Idris A M, ProkoPczyk B, Hoffmann D. Toombak a major risk factor of cancer of the oral cavity in Sudan.Prev med.1994 Nov; 23(6):823-10.

[10] Brunnemman KD, Procopczykb, Djordjevitic MV, Hoffmann D.formation and analysis of tobacco specific nitrosamines.Crit Rev toxicol.1996;26(2):121-37.

[11] Mustafa H, Fuatozkan, Mohmed F, Mustafa C, Hamet S K. Effects of smokeless tobacco use on carotid media thickness. Med sci monit. 2013. 19; 859-864.

[12] Andersen RA, Burton HR, Fleming PD, Hamilton- Kemp TR. Effect of storage conditions on nitrosated, acylated, and oxidized pyridine alkaloid derivatives in smokeless tobacco products. Cancer Res. 1989 Nov 1;49(21):5895-900.

[13] Prokopczyk B, Wum, Cox J E, Hofman D. Bioavailability of tobacco specific Nitrosamines to the snuff dippers carcinogenesis. 1992 May 13; (5): 863- 6.\

[14] Idris A M, Nair J, Ohshima H, Friesen M, Broue I, Faustman E M, Bartsch H.. Unusually high levels of carcinogenic tobacco-specific nitrosamines in Sudan snuff.carcinogenesis. 1991.Jun; 12(6)11 12-8.

[15] Hussain G A. Aetiology of oral cancer in the Sudan. J oral Maxillofac Res. 2013 Apr-Jun; 4(2) c 3.

[16] Nair J, Ohsima H, Nair UJ, Bartsch H. Endogenous formation of nitrosamines and oxidative DNA damaging agents in tobacco users crit rev toxicol 1996 26; (2):149-61.

[17] Anderson S.M. (2015). Medical imaging of oral and oropharyngeal cancer. Radiol Tecnol Nov-Dec 87 (2):187-206.

[18] Hamad HM.. Cancer iniative in Sudan. Annals of oncology. Supplement. 2006; 81 Vol 11.

[19] Acho A, Reusga M, Rodriguez M, Pancorbo M, Aguirre J. Application of the oral scrape (exfoliative) cytology in oral cancer and precancer. Med oral patl oral cir buccal. 2005; 2:95-102.

[20] Epstein J, Bookley C, Milner A, Emerton S, Vander M, Len E. The utility of toluidine blue application as diagnostic aid in pts previously treated for upper oropharyngeal carcinoma. Oral surg oral Med oral patho oral radial Endact.1997; 83:537-47.

[21] DU GF., Lic Z., Chenx M., Xiao Q., Cao Z. (2007). Rose Bengal staining in detection of precancerous and malignant lesions with colorimetric evaluation a pilot study. Int J Cancer;120: 1950 – 63.

[22] Watanabe A, Taniguchi M, Tsujie H, Hosokawa M, Fujita M, Sasaki S. Clinical impact of iodine staining for diagnosis of carcinoma in situ in the floor of mouth, and decision of adequate surgical margin. Auris Nasus Larynx. 2012;39:193–7.

[23] Rosenberg D, Cretin S.use of meta analysis to evaluate Tolinium in oral cancer screening Oral surgery Oral Medcine Oral Pathology.1989; 67]: 621-7

[24] Pollack RL, Kravitz E. Nutrition in Oral Health and Disease. Philadelphia: Lea and Febiger; 1985.

[25] Weinstock N., Uhlemann M. Automated determination of copper in undiluted serum by atomic absorption spectroscopy. Clinical chemistry (1981). 27, 1438.

[26] Butrimovitz G. B., Purdy WC. The determination of zinc in blood plasma by atomic absorption spectrometry. Anal Chim. Acta 94, 63 (1977).

[27] Amino J. S. “clinical chemistry” principles, and procedure 3