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Baz A, Bakri A, Butcher M, Short B, Ghimire B, Gaur N, Jenkins T, Short RD, Riggio M, Williams C, Ramage G, Brown JL. Staphylococcus aureus strains exhibit heterogenous tolerance to direct cold atmospheric plasma therapy. Biofilm 2023; 5:100123. [PMID: 37138646 PMCID: PMC10149328 DOI: 10.1016/j.bioflm.2023.100123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/04/2023] [Accepted: 04/12/2023] [Indexed: 05/05/2023] Open
Abstract
The global clinical and socioeconomic impact of chronic wounds is substantial. The main difficulty that clinicians face during the treatment of chronic wounds is the risk of infection at the wound site. Infected wounds arise from an accumulation of microbial aggregates in the wound bed, leading to the formation of polymicrobial biofilms that can be largely resistant to antibiotic therapy. Therefore, it is essential for studies to identify novel therapeutics to alleviate biofilm infections. One innovative technique is the use of cold atmospheric plasma (CAP) which has been shown to possess promising antimicrobial and immunomodulatory properties. Here, different clinically relevant biofilm models will be treated with cold atmospheric plasma to assess its efficacy and killing effects. Biofilm viability was assessed using live dead qPCR, and morphological changes associated with CAP evaluated using scanning electron microscopy (SEM). Results indicated that CAP was effective against Candida albicans and Pseudomonas aeruginosa, both as mono-species biofilms and when grown in a triadic model system. CAP also significantly reduced viability in the nosocomial pathogen, Candida auris. Staphylococcus aureus Newman exhibited a level of tolerance to CAP therapy, both when grown alone or in the triadic model when grown alongside C. albicans and P. aeruginosa. However, this degree of tolerance exhibited by S. aureus was strain dependent. At a microscopic level, biofilm treatment led to subtle changes in morphology in the susceptible biofilms, with evidence of cellular deflation and shrinkage. Taken together, these results indicate a promising application of direct CAP therapy in combatting wound and skin-related biofilm infections, although biofilm composition may affect the treatment efficacy.
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Affiliation(s)
- Abdullah Baz
- Oral Sciences Research Group, Glasgow Dental School, School of Medicine, Dentistry & Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, United Kingdom
- Glasgow Biofilm Research Network, 378 Sauchiehall Street, Glasgow, G2 3JZ, United Kingdom
| | - Ahmed Bakri
- Oral Sciences Research Group, Glasgow Dental School, School of Medicine, Dentistry & Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, United Kingdom
- Glasgow Biofilm Research Network, 378 Sauchiehall Street, Glasgow, G2 3JZ, United Kingdom
| | - Mark Butcher
- Oral Sciences Research Group, Glasgow Dental School, School of Medicine, Dentistry & Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, United Kingdom
- Glasgow Biofilm Research Network, 378 Sauchiehall Street, Glasgow, G2 3JZ, United Kingdom
| | - Bryn Short
- Oral Sciences Research Group, Glasgow Dental School, School of Medicine, Dentistry & Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, United Kingdom
- Glasgow Biofilm Research Network, 378 Sauchiehall Street, Glasgow, G2 3JZ, United Kingdom
| | - Bhagirath Ghimire
- Department of Chemistry and Material Science Institute, University of Lancaster, Lancaster, LA1 4YB, United Kingdom
| | - Nishtha Gaur
- Department of Chemistry and Material Science Institute, University of Lancaster, Lancaster, LA1 4YB, United Kingdom
| | - Toby Jenkins
- Department of Chemistry, University of Bath, Bath, BA2 7AY, United Kingdom
| | - Robert D. Short
- Department of Chemistry and Material Science Institute, University of Lancaster, Lancaster, LA1 4YB, United Kingdom
| | - Marcello Riggio
- Oral Sciences Research Group, Glasgow Dental School, School of Medicine, Dentistry & Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, United Kingdom
- Glasgow Biofilm Research Network, 378 Sauchiehall Street, Glasgow, G2 3JZ, United Kingdom
| | - Craig Williams
- Glasgow Biofilm Research Network, 378 Sauchiehall Street, Glasgow, G2 3JZ, United Kingdom
- Microbiology Department, Lancaster Royal Infirmary, University of Lancaster, Lancaster, LA1 4YW, United Kingdom
| | - Gordon Ramage
- Oral Sciences Research Group, Glasgow Dental School, School of Medicine, Dentistry & Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, United Kingdom
- Glasgow Biofilm Research Network, 378 Sauchiehall Street, Glasgow, G2 3JZ, United Kingdom
| | - Jason L. Brown
- Oral Sciences Research Group, Glasgow Dental School, School of Medicine, Dentistry & Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, United Kingdom
- Glasgow Biofilm Research Network, 378 Sauchiehall Street, Glasgow, G2 3JZ, United Kingdom
- Corresponding author. Oral Sciences Research Group, Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, 378 Sauchiehall Street, Glasgow, G2 3JZ, UK.
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Gaur N, Patenall BL, Ghimire B, Thet NT, Gardiner JE, Le Doare KE, Ramage G, Short B, Heylen RA, Williams C, Short RD, Jenkins TA. Cold Atmospheric Plasma-Activated Composite Hydrogel for an Enhanced and On-Demand Delivery of Antimicrobials. ACS Appl Mater Interfaces 2023; 15:19989-19996. [PMID: 37040527 PMCID: PMC10141252 DOI: 10.1021/acsami.3c01208] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
We present the concept of a versatile drug-loaded composite hydrogel that can be activated using an argon-based cold atmospheric plasma (CAP) jet to deliver both a drug and CAP-generated molecules, concomitantly, in a tissue target. To demonstrate this concept, we utilized the antibiotic gentamicin that is encapsulated in sodium polyacrylate (PAA) particles, which are dispersed within a poly(vinyl alcohol) (PVA) hydrogel matrix. The final product is a gentamicin-PAA-PVA composite hydrogel suitable for an on-demand triggered release using CAP. We show that by activating using CAP, we can effectively release gentamicin from the hydrogel and also eradicate the bacteria effectively, both in the planktonic state and within a biofilm. Besides gentamicin, we also successfully demonstrate the applicability of the CAP-activated composite hydrogel loaded with other antimicrobial agents such as cetrimide and silver. This concept of a composite hydrogel is potentially adaptable to a range of therapeutics (such as antimicrobials, anticancer agents, and nanoparticles) and activatable using any dielectric barrier discharge CAP device.
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Affiliation(s)
- Nishtha Gaur
- Department
of Chemistry, Lancaster University, Lancaster LA1 4YB, U.K.
| | | | - Bhagirath Ghimire
- Department
of Chemistry, Lancaster University, Lancaster LA1 4YB, U.K.
| | - Naing T. Thet
- Department
of Chemistry, University of Bath, Bath BA2 7AY, U.K.
| | | | | | - Gordon Ramage
- Glasgow
Dental School, School of Medicine, University
of Glasgow, Glasgow G12 8TA, U.K.
| | - Bryn Short
- Glasgow
Dental School, School of Medicine, University
of Glasgow, Glasgow G12 8TA, U.K.
| | | | - Craig Williams
- Microbiology
Department, Lancaster Royal Infirmary, University
of Lancaster, Lancaster LA1 4YW, U.K.
| | - Robert D. Short
- Department
of Chemistry, Lancaster University, Lancaster LA1 4YB, U.K.
- Department
of Chemistry, The University of Sheffield, Sheffield S3 7HF, U.K.
| | - Toby A. Jenkins
- Department
of Chemistry, University of Bath, Bath BA2 7AY, U.K.
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Koirala M, Shakya BM, Parajuli B, Ghimire B. Myocardial Infarction in Non-obstructive Coronary Arteries (MINOCA) in the Perioperative Period can Epinephrine be Responsible? Kathmandu Univ Med J (KUMJ) 2022; 20:535-537. [PMID: 37795740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Ephedrine, metaraminol, epinephrine and maneuvers like carotid sinus stimulation used during intraoperative period have been postulated to cause temporary spasm of the coronary vessels leading to decrease supply to the myocardium and precipitating myocardial infraction in non-obstructive coronary arteries (MINOCA). As an anaesthesiologists, we should be aware that even a dose as small as 25 mcg epinephrine infiltrated along with local anaesthetic in the subcutaneous plane may be responsible for coronary vessel spasm and thus myocardial infraction in nonobstructive coronary arteries. We report a case of 45 years old female with papillary carcinoma of thyroid who developed features of non-ST elevation myocardial infarction 5 minutes after the subcutaneous infiltration of 5 ml of 2% Xylocaine with 1:200000 Epinephrine. Patient was managed for acute Myocardial Infarction. Coronary angiogram done the next day revealed normal coronary arteries, hence the diagnosis Myocardial infraction in non-obstructive coronary arteries was made.
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Affiliation(s)
- M Koirala
- Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
| | - B M Shakya
- Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
| | - B Parajuli
- Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
| | - B Ghimire
- Department of Cardiothoracic and Vascular Anaesthesiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
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Ainasoja O, Hurskainen M, Ghimire B, Lahtela J, Syrjälä S, Lemström K. Spatial Transcriptomic Analysis of Acute Heart Rejection Model. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Lundin K, Sepponen K, Väyrynen P, Liu X, Yohannes DA, Survila M, Ghimire B, Känsäkoski J, Katayama S, Partanen J, Vuoristo S, Paloviita P, Rahman N, Raivio T, Luiro K, Huhtaniemi I, Varjosalo M, Tuuri T, Tapanainen JS. OUP accepted manuscript. Mol Hum Reprod 2022; 28:6574364. [PMID: 35471239 PMCID: PMC9308958 DOI: 10.1093/molehr/gaac012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 03/11/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Lundin
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - K Sepponen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - P Väyrynen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - X Liu
- Molecular Systems Biology Research Group, Institute of Biotechnology & HiLIFE, University of Helsinki, Helsinki, Finland
- Proteomics Unit, Institute of Biotechnology & HiLIFE, University of Helsinki, Helsinki, Finland
| | - D A Yohannes
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Programs Unit, Translational Immunology & Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland
| | - M Survila
- Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - B Ghimire
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - J Känsäkoski
- Department of Physiology, University of Helsinki, Helsinki, Finland
| | - S Katayama
- Folkhälsan Research Center, Helsinki, Finland
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
- Stem Cells and Metabolism Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - J Partanen
- Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - S Vuoristo
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - P Paloviita
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - N Rahman
- Institute of Biomedicine, University of Turku, Turku, Finland
- Department of Reproduction and Gynecological Endocrinology, Medical University of Bialystok, Bialystok, Poland
| | - T Raivio
- Department of Physiology, University of Helsinki, Helsinki, Finland
- Stem Cells and Metabolism Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- New Children's Hospital, Pediatric Research Center, Helsinki University Hospital, HUH, Helsinki, Finland
| | - K Luiro
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - I Huhtaniemi
- Institute of Biomedicine, University of Turku, Turku, Finland
- Department of Metabolism, Endocrinology and Reproduction, Faculty of Medicine, Hammersmith Campus, Imperial College London, London, UK
| | - M Varjosalo
- Molecular Systems Biology Research Group, Institute of Biotechnology & HiLIFE, University of Helsinki, Helsinki, Finland
- Proteomics Unit, Institute of Biotechnology & HiLIFE, University of Helsinki, Helsinki, Finland
| | - T Tuuri
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - J S Tapanainen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Obstetrics and Gynecology, University Hospital of Oulu, University of Oulu, Medical Research Center Oulu and PEDEGO Research Unit, Oulu, Finland
- Corresponding author. Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, PO Box 140, 00029 Helsinki, Finland. Tel: +358-94711; E-mail:
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Ghimire B, Szili EJ, Patenall BL, Mistry D, Fellows A, Jenkins ATA, Short RD. Cold plasma generation of peracetic acid for antimicrobial applications. Plasma Med 2022. [DOI: 10.1615/plasmamed.2022041515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Uprety A, Kobashi Y, Ozaki A, Shrestha D, Ghimire B, Sedain G, Sigdel S, Higuchi A, Tsubokura M, Singh YP. Displaced Intra-Articular Calcaneal Fractures: Evaluation of Clinical and Radiological Outcome Following Open Reduction and Internal Fixation with Locking Branched Calcaneal Plate. Kathmandu Univ Med J (KUMJ) 2021; 19:29-34. [PMID: 34812154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Background An introduction of the World Health Organization Surgical Safety Checklist (WHO SSC) is essential to promote surgical safety. Objective To obtain country-specific information regarding the checklist in a leading medical institution in Nepal. Method The present research was a cross-sectional study with a survey conducted among healthcare professionals working in the operation theatre at the Tribhuvan University Teaching Hospital (TUTH) in Kathmandu, Nepal. A questionnaire was distributed to 150 healthcare professionals working in the operating theatre. Responses to the questionnaire were analysed descriptively and regression analyses used to identify factors associated with awareness of the checklist. Result In total, 127 healthcare professionals participated in the study, of whom 118 (92.9%) had been aware of the WHO SSC. A substantial proportion of participants (108, 91.5%) were not satisfied with the prevailing practice whereby the checklist was not routinely used during surgery. Lack of appropriate training was the most prevalent barrier to the checklist use (72, 67.9%), followed by unwillingness of staff to use the checklist (54, 50.9%), and lack of experience (42, 39.7%). The mean score on the survey was 6.0 out of 10. Regarding the results of the regression model on survey scores, surgeons had higher scores compared to nurses (unadjusted coefficient 0.80, 95% CI 0.20-1.40). Conclusion Most of the healthcare professionals were aware of the WHO SSC, however multiple barriers to the checklist use were identified. It is important to establish an effective use of WHO SSC in the operation theatre.
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Affiliation(s)
- A Uprety
- Department of Anesthesiology, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Y Kobashi
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima City, Fukushima 960-1295, Japan. Department of Anesthesia, Jyoban Hospital of Tokiwa Foundation. Iwaki City, Fukushima, 972-8322, Japan. Medical Governance Research Institute, Minato-ku, Tokyo, 108-0074, Japan
| | - A Ozaki
- Medical Governance Research Institute, Minato-ku, Tokyo, 108-0074, Japan. Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki City, Fukushima, 972-8322, Japan
| | - D Shrestha
- Department of Neonatology, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - B Ghimire
- Department of GI and General Surgery, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - G Sedain
- Department of Neurosurgery, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - S Sigdel
- Department of Cardiothoracic and Vascular Anesthesiology, Manmohan Cardiothoracic Vascular and Transplant Center, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - A Higuchi
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima City, Fukushima 960-1295, Japan. Medical Governance Research Institute, Minato-ku, Tokyo, 108-0074, Japan
| | - M Tsubokura
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima City, Fukushima 960-1295, Japan. Medical Governance Research Institute, Minato-ku, Tokyo, 108-0074, Japan
| | - Y P Singh
- Department of Gastrointestinal and General Surgery, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
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Ghimire B, Khanal K, Bajracharya A, Koirala M. Ischemic Stroke as a Manifestation of Cholesterol Embolization Syndrome Following Percutaneous Coronary Intervention. Kathmandu Univ Med J (KUMJ) 2021; 19:143-145. [PMID: 34812174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Cholesterol embolization syndrome (CES) is one of the major, yet underdiagnosed cause of morbidity and mortality following invasive coronary interventions. The major risk factors are elderly, male, atherosclerotic disease, anticoagulation and femoral access route. This multisystem disease affects skin, kidney, brain, eye and gastrointestinal tract. Only few cases of cholesterol embolization syndrome manifesting as an ischemic stroke are reported. We present a case of an elderly man, admitted to our ICU after percutaneous coronary intervention (PCI) who developed neurological deficits along with skin changes and renal failure. cholesterol embolization syndrome was suspected based upon the presence of cardiovascular risk factors, invasive cardiovascular intervention and clinical signs. The diagnosis of ischemic stroke made through plain MRI brain, revealed multiple areas of lacunar infarcts. He was treated with intermittent hemodialysis, statins and anti-platelet agents. On follow up, skin lesions and renal functions were improved; but slurring of speech and paresis persisted.
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Affiliation(s)
- B Ghimire
- Nepal Mediciti Hospital, Nakhu, Lalitpur, Nepal
| | - K Khanal
- Nepal Mediciti Hospital, Nakhu, Lalitpur, Nepal
| | | | - M Koirala
- Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
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Adhikari B, Adhikari M, Ghimire B, Adhikari BC, Park G, Choi EH. Cold plasma seed priming modulates growth, redox homeostasis and stress response by inducing reactive species in tomato (Solanum lycopersicum). Free Radic Biol Med 2020; 156:57-69. [PMID: 32561321 DOI: 10.1016/j.freeradbiomed.2020.06.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/28/2020] [Accepted: 06/03/2020] [Indexed: 12/30/2022]
Abstract
Seed germination and vegetative growth are two important plant growing stages that are vulnerable to physical and biological stress. Improvement in crop germination potential and seedling growth rate generally leads to high crop productivity. Cold plasma is a promising technology used to improve seed germination and growth. Structural changes on tomato seed surface exposed with cold air plasma jet for a different time period (1 min, 5 min, 10 min) was examined by SEM. For in-depth study, different physiological parameter such as seed germination and seedling growth, biochemical parameter such as reactive species status, antioxidants and phytohormone, and molecular analysis of various gene expression was also evaluated. Drought stress tolerance potential of cold plasma primed tomato seedling was also examined under 30% PEG stress. Cold plasma seed priming modulates tomato seed coat and improves the germination efficiency. It also induces growth, antioxidants, phytohormone, defense gene expression, and drought stress tolerance potential of tomato seedling. Cold plasma seeds priming augment the reactive species at a molecular level within seedlings, which changes the biochemistry and physiological parameters of plants by inducing different cellular signaling cascades.
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Affiliation(s)
- Bhawana Adhikari
- Plasma Bioscience Research Center, Kwangwoon University, Seoul 01897, South Korea
| | - Manish Adhikari
- Plasma Bioscience Research Center, Kwangwoon University, Seoul 01897, South Korea.
| | - Bhagirath Ghimire
- Department of Electrical and Biological Physics, Plasma Bioscience Research Center, Kwangwoon University, Seoul 01897, South Korea
| | - Bishwa Chandra Adhikari
- Department of Electrical and Biological Physics, Plasma Bioscience Research Center, Kwangwoon University, Seoul 01897, South Korea
| | - Gyungsoon Park
- Department of Electrical and Biological Physics, Plasma Bioscience Research Center, Kwangwoon University, Seoul 01897, South Korea
| | - Eun Ha Choi
- Department of Electrical and Biological Physics, Plasma Bioscience Research Center, Kwangwoon University, Seoul 01897, South Korea.
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Lamichhane P, Adhikari BC, Nguyen LN, Paneru R, Ghimire B, Mumtaz S, Lim JS, Hong YJ, Choi EH. Sustainable nitrogen fixation from synergistic effect of photo-electrochemical water splitting and atmospheric pressure N2 plasma. ACTA ACUST UNITED AC 2020. [DOI: 10.1088/1361-6595/ab7f4d] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Adhikari M, Adhikari B, Ghimire B, Baboota S, Choi EH. Cold Atmospheric Plasma and Silymarin Nanoemulsion Activate Autophagy in Human Melanoma Cells. Int J Mol Sci 2020; 21:ijms21061939. [PMID: 32178401 PMCID: PMC7139470 DOI: 10.3390/ijms21061939] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/10/2020] [Accepted: 03/11/2020] [Indexed: 12/13/2022] Open
Abstract
Background: Autophagy is reported as a survival or death-promoting pathway that is highly debatable in different kinds of cancer. Here, we examined the co-effect of cold atmospheric plasma (CAP) and silymarin nanoemulsion (SN) treatment on G-361 human melanoma cells via autophagy induction. Methods: The temperature and pH of the media, along with the cell number, were evaluated. The intracellular glucose level and PI3K/mTOR and EGFR downstream pathways were assessed. Autophagy-related genes, related transcriptional factors, and autophagy induction were estimated using confocal microscopy, flow cytometry, and ELISA. Results: CAP treatment increased the temperature and pH of the media, while its combination with SN resulted in a decrease in intracellular ATP with the downregulation of PI3K/AKT/mTOR survival and RAS/MEK transcriptional pathways. Co-treatment blocked downstream paths of survival pathways and reduced PI3K (2 times), mTOR (10 times), EGFR (5 times), HRAS (5 times), and MEK (10 times). CAP and SN co-treated treatment modulates transcriptional factor expressions (ZKSCAN3, TFEB, FOXO1, CRTC2, and CREBBP) and specific genes (BECN-1, AMBRA-1, MAP1LC3A, and SQSTM) related to autophagy induction. Conclusion: CAP and SN together activate autophagy in G-361 cells by activating PI3K/mTOR and EGFR pathways, expressing autophagy-related transcription factors and genes.
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Affiliation(s)
- Manish Adhikari
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea; (B.A.); (B.G.)
- Correspondence: (M.A.); (E.H.C.)
| | - Bhawana Adhikari
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea; (B.A.); (B.G.)
| | - Bhagirath Ghimire
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea; (B.A.); (B.G.)
| | - Sanjula Baboota
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, Delhi 110062, India;
| | - Eun Ha Choi
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea; (B.A.); (B.G.)
- Correspondence: (M.A.); (E.H.C.)
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Yadav DK, Adhikari M, Kumar S, Ghimire B, Han I, Kim MH, Choi EH. Cold atmospheric plasma generated reactive species aided inhibitory effects on human melanoma cells: an in vitro and in silico study. Sci Rep 2020; 10:3396. [PMID: 32099012 PMCID: PMC7042335 DOI: 10.1038/s41598-020-60356-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 02/10/2020] [Indexed: 12/23/2022] Open
Abstract
Malignant melanoma is considered to be a heterogeneous disease that arises from altered genes and transformed melanocytes. In this study, special softjet cold atmospheric plasma was used to treat three different human melanoma cells using air and N2 gases to check the anti-melanoma activity. The physical effects by plasma revealed an increase in the temperature with the gradual reduction in pH at 60 sec, 180 sec and 300 sec air and N2 plasma treatment. Cellular toxicity revealed a decreased in cell survival (~50% cell survival using air gas and <~60% cell survival using N2 gas at 60 sec plasma treatment in G-361 cells). Gene analysis by q-PCR revealed that 3 min and 5 min air and N2 plasma treatment activated apoptotic pathways by triggering apoptotic genes in all three melanoma cell lines. The apoptosis was confirmed by DAPI staining and its related pathways were further explored according to protein-protein docking, and their probable activation mechanism was revealed. The pathways highlighted that activation of apoptosis which leads to cellular cascades and hence stimulation ASK1 (docking method) revealed that softjet plasma can be an effective modality for human melanoma treatment.
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Affiliation(s)
- Dharmendra Kumar Yadav
- Gachon Institute of Pharmaceutical Science & Department of Pharmacy, College of Pharmacy, Gachon University, Incheon, Republic of Korea.
| | - Manish Adhikari
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical & Biological Physics, Kwangwoon University, Seoul, Republic of Korea
| | - Surendra Kumar
- Gachon Institute of Pharmaceutical Science & Department of Pharmacy, College of Pharmacy, Gachon University, Incheon, Republic of Korea
| | - Bhagirath Ghimire
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical & Biological Physics, Kwangwoon University, Seoul, Republic of Korea
| | - Ihn Han
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical & Biological Physics, Kwangwoon University, Seoul, Republic of Korea
| | - Mi-Hyun Kim
- Gachon Institute of Pharmaceutical Science & Department of Pharmacy, College of Pharmacy, Gachon University, Incheon, Republic of Korea
| | - Eun-Ha Choi
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical & Biological Physics, Kwangwoon University, Seoul, Republic of Korea.
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Kaushik NK, Ghimire B, Li Y, Adhikari M, Veerana M, Kaushik N, Jha N, Adhikari B, Lee SJ, Masur K, von Woedtke T, Weltmann KD, Choi EH. Biological and medical applications of plasma-activated media, water and solutions. Biol Chem 2019; 400:39-62. [PMID: 30044757 DOI: 10.1515/hsz-2018-0226] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 07/11/2018] [Indexed: 01/28/2023]
Abstract
Non-thermal atmospheric pressure plasma has been proposed as a new tool for various biological and medical applications. Plasma in close proximity to cell culture media or water creates reactive oxygen and nitrogen species containing solutions known as plasma-activated media (PAM) or plasma-activated water (PAW) - the latter even displays acidification. These plasma-treated solutions remain stable for several days with respect to the storage temperature. Recently, PAM and PAW have been widely studied for many biomedical applications. Here, we reviewed promising reports demonstrating plasma-liquid interaction chemistry and the application of PAM or PAW as an anti-cancer, anti-metastatic, antimicrobial, regenerative medicine for blood coagulation and even as a dental treatment agent. We also discuss the role of PAM on cancer initiation cells (spheroids or cancer stem cells), on the epithelial mesenchymal transition (EMT), and when used for metastasis inhibition considering its anticancer effects. The roles of PAW in controlling plant disease, seed decontamination, seed germination and plant growth are also considered in this review. Finally, we emphasize the future prospects of PAM, PAW or plasma-activated solutions in biomedical applications with a discussion of the mechanisms and the stability and safety issues in relation to humans.
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Affiliation(s)
- Nagendra Kumar Kaushik
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics and Department of Plasma-Bio Display, Kwangwoon University, Seoul 01897, Republic of Korea
| | - Bhagirath Ghimire
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics and Department of Plasma-Bio Display, Kwangwoon University, Seoul 01897, Republic of Korea
| | - Ying Li
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics and Department of Plasma-Bio Display, Kwangwoon University, Seoul 01897, Republic of Korea
| | - Manish Adhikari
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics and Department of Plasma-Bio Display, Kwangwoon University, Seoul 01897, Republic of Korea
| | - Mayura Veerana
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics and Department of Plasma-Bio Display, Kwangwoon University, Seoul 01897, Republic of Korea
| | - Neha Kaushik
- Department of Life Science, Hanyang University, Seoul 04763, Republic of Korea
| | - Nayansi Jha
- Graduate School of Clinical Dentistry, Korea University, Seoul 02841, Republic of Korea
| | - Bhawana Adhikari
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics and Department of Plasma-Bio Display, Kwangwoon University, Seoul 01897, Republic of Korea
| | - Su-Jae Lee
- Department of Life Science, Hanyang University, Seoul 04763, Republic of Korea
| | - Kai Masur
- Leibniz Institute for Plasma Science and Technology, D-17489 Greifswald, Germany
| | - Thomas von Woedtke
- Leibniz Institute for Plasma Science and Technology, D-17489 Greifswald, Germany
| | | | - Eun Ha Choi
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics and Department of Plasma-Bio Display, Kwangwoon University, Seoul 01897, Republic of Korea
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Kaushik NK, Kaushik N, Adhikari M, Ghimire B, Linh NN, Mishra YK, Lee SJ, Choi EH. Preventing the Solid Cancer Progression via Release of Anticancer-Cytokines in Co-Culture with Cold Plasma-Stimulated Macrophages. Cancers (Basel) 2019; 11:cancers11060842. [PMID: 31216715 PMCID: PMC6628390 DOI: 10.3390/cancers11060842] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/14/2019] [Accepted: 06/14/2019] [Indexed: 02/06/2023] Open
Abstract
Non-thermal atmospheric pressure plasma sources operated in ambient environments are known to generate a variety of reactive oxygen and nitrogen species which could be applied for various biomedical applications. Herein, we fabricate a micro-dielectric barrier discharge plasma device by using screen-printing technology and apply it for studying immuno-stimulatory effects. We demonstrate a tumor-suppressive role for plasma-stimulated macrophages in metastatic solid cancers that directly elicit proliferation and are responsible for tumor relapse mediated by mesenchymal shift. Using microarray analysis, we observed that cold plasma stimulates and differentiates monocyte cells into macrophages as demonstrated by expression of several cytokine/chemokine markers. Moreover, plasma treatment stimulates the differentiation of pro-inflammatory (M1) macrophages to a greater extent. These stimulated macrophages favor anti-tumorigenic immune responses against metastasis acquisition and cancer stem cell maintenance in solid cancers in vitro. Differentiation of monocytes into anticancer macrophages could improve the efficacy of plasma treatment, especially in modifying pro-tumor inflammatory microenvironment through effecting highly resistant immunosuppressive tumor cells associated with tumor relapse.
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Affiliation(s)
- Nagendra Kumar Kaushik
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea.
| | - Neha Kaushik
- Laboratory of Molecular Biochemistry, Department of Life Science, Hanyang University, Seoul 04763, Korea.
| | - Manish Adhikari
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea.
| | - Bhagirath Ghimire
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea.
| | - Nguyen Nhat Linh
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea.
| | - Yogendra Kumar Mishra
- Functional Nanomaterials, Institute for Materials Science, Kiel University, Kaiserstr. 2, D-24143 Kiel, Germany.
| | - Su-Jae Lee
- Laboratory of Molecular Biochemistry, Department of Life Science, Hanyang University, Seoul 04763, Korea.
| | - Eun Ha Choi
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea.
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Kaushik NK, Kaushik N, Linh NN, Ghimire B, Pengkit A, Sornsakdanuphap J, Lee SJ, Choi EH. Plasma and Nanomaterials: Fabrication and Biomedical Applications. Nanomaterials (Basel) 2019; 9:E98. [PMID: 30646530 PMCID: PMC6358811 DOI: 10.3390/nano9010098] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 12/28/2018] [Accepted: 01/08/2019] [Indexed: 12/20/2022]
Abstract
Application of plasma medicine has been actively explored during last several years. Treating every type of cancer remains a difficult task for medical personnel due to the wide variety of cancer cell selectivity. Research in advanced plasma physics has led to the development of different types of non-thermal plasma devices, such as plasma jets, and dielectric barrier discharges. Non-thermal plasma generates many charged particles and reactive species when brought into contact with biological samples. The main constituents include reactive nitrogen species, reactive oxygen species, and plasma ultra-violets. These species can be applied to synthesize biologically important nanomaterials or can be used with nanomaterials for various kinds of biomedical applications to improve human health. This review reports recent updates on plasma-based synthesis of biologically important nanomaterials and synergy of plasma with nanomaterials for various kind of biological applications.
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Affiliation(s)
- Nagendra Kumar Kaushik
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea.
| | - Neha Kaushik
- Department of Life Science, Hanyang University, Seoul 04763, Korea.
| | - Nguyen Nhat Linh
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea.
| | - Bhagirath Ghimire
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea.
| | - Anchalee Pengkit
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea.
| | - Jirapong Sornsakdanuphap
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea.
| | - Su-Jae Lee
- Department of Life Science, Hanyang University, Seoul 04763, Korea.
| | - Eun Ha Choi
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea.
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Gurung B, Shrestha R, Shrestha S, Singh M, Koirala A, Chataut S, Tuladhar S, Shrestha S, Ghimire B, Shrestha M, Gautam M, Dhakal H. P3.09-09 “Prevalence of Epidermal Growth Factor Receptor Mutation in Non-Small Cell Carcinoma Lungs at a Cancer Center in Nepal”. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ruparel M, Quaife S, Ghimire B, Dickson J, Horst C, Tisi S, Bhowmik A, Navani N, Baldwin D, Duffy S, Waller J, Janes S. P2.11-29 Impact of an Information-Film to Promote Informed Decision-Making in Individuals Taking Part in a Lung Cancer Screening Demonstration Pilot. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Thakur DK, Ghimire B, Singh YP. Trend in Gastric Outlet Obstruction at Patients Attending Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Birat J Health Sci 2017. [DOI: 10.3126/bjhs.v2i2.18531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
IntroductionGastric outlet obstruction (GOO) involves obstruc_on in the antro-pyloric region or bulb of duodenum. Malignancy is common cause of GOO in adults but many patients with GOO have benign causes. Despite the improvement in medical management, about 5% patients with complicated duodenal ulcer disease and 1%-2% with complicated gastric ulcer disease respectively develop this problem.ObjectiveThe purpose of this study was to find the etiologies of GOO, their management options and outcome in Tribhuvan University Teaching Hospital.MethodologyIn this retrospective study, the records of 44 patients admited with diagnosis of GOO from September 2007 to August 2010 in the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal were retrieved. Patients' demography, etiologies of GOO, treatment given and their outcome were analysed.ResultsThirty two patients (73%) were male and 12 (27%) were female with M:F ratio of 2.7:1. The mean age of patients was 57.40 years and duration of symptoms 2.68 months. Carcinoma of stomach, 28 cases (64%) was most common ecology of GOO followed by PUD, 9 (21%), duodenal malignancy,3 (7%), corrosive stricture, 2 (5%), advanced gallbladder carcinoma, 1 (2%) and chronic pancreatis, 1 (2%). Seventeen (39%) patients were treated by gastrojejunostomy, 14 (32%) by subtotal gastrectomy and gastrojejunostomy, 5 (11%) by truncal vagotomy and gastrojejunostomy, 4 (9%) by medical management, 2 (4.5%) by feeding jejunostomy, and 2 (4.5%) were discharged on request. Complications occurred in 7 (16%) patients and mortality in 1 (2%). Twenty three (52%) patients were candidates for chemotherapy either in an adjuvant or palliative seting.ConclusionGastric malignancy was the most common cause of gastric outlet obstruction. Most of the patients in our setup presented with advanced disease and were candidates of palliative treatment only. Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017, Page: 219-221
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Sapkota R, Ghimire B, Lakhey PJ, Ghimire RK, Shrestha UK. Visceral artery aneurysms: an institutional review. J Soc Surg Nepal 2017. [DOI: 10.3126/jssn.v17i2.17140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Methods: It is a retrospective review of prospectively kept data of patients treated for visceral artery aneurysms in Tribhuvan University Teaching Hospital and Manmohan Cardiothoracic Vascular and Transplant Center from 1997 to 2009.Results: Fifteen patients were diagnosed with 16 visceral artery aneurysms. These consisted of 7 splenic (in 6 patients), 4 hepatic, 2 superior mesenteric, 1 gastroduodenal, and 1 renal artery aneurysms. There were 14 symptomatic patients including 4 who presented with rupture. Commonest presenting symptom was pain abdomen (14/15), followed by gastrointestinal bleed (6/15) and mass abdomen (5/15). The diagnosis was made with the help of CECT of abdomen in 13 patients, which was confirmed by conventional angiography in three patients. In two patients with obscure GI bleeding, diagnosis was clinched by conventional angiogram. Eight patients were treated only surgically, with three mortality. Transcatheter embolization alone was used in 5 patients. Two patients were treated with combination of surgical and endovascular therapy. One patient with superior mesenteric artery aneurysm in whom nothing could be done during laparotomy died six months later. Average follow up duration was one year.Conclusion: Splenic artery remains the most commonly afflicted vessel among the visceral artery aneurysms. The VAAs can be treated surgically or with endovascular means with fair success, although the best mode of treatment needs to be individualized.Journal of Society of Surgeons of NepalVol. 17, No. 2, 2014, Page: 3-6
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KC R, Ghimire B, Singh YP. Annular pancreas presenting as gastric outlet obstruction in an adult: a case report. J Soc Surg Nepal 2017. [DOI: 10.3126/jssn.v17i2.17146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Annular pancreas is a rare congenital abnormality which arises in the embryo by persistence of pancreatic tissue in the track which the ventral pancreatic bud follows in its rotation round the duodenum. A 21 years old male was admitted because of a non bilious vomiting and epigastric fullness after intake of food. Diagnosis was confirmed with contrast enhanced CT scan of the abdomen. He successfully underwent laparoscopic gastrojejunostomy with uneventful postoperative recovery. Though rare, annular pancreas should be considered as differential diagnosis in patient presenting as gastric outlet obstruction after excluding common causes.Journal of Society of Surgeons of NepalVol. 17, No. 2, 2014, Page: 35-36
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Ghimire B, Singh YP, Timalsina S. Post operative diagnosis of early gastric cancer in a low risk population and the possibility of risk stratified screening. Kathmandu Univ Med J (KUMJ) 2015; 12:32-7. [PMID: 25219991 DOI: 10.3126/kumj.v12i1.13630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Gastric cancer is the second commonest cause of cancer related mortality worldwide. Though its incidence is more in Eastern Asia, it is increasing in the South Asian subcontinent. The diagnosis of early gastric cancer (EGC) confined to the mucosa or submucosa, is an important concern due to a better outcome at this stage where five year survival rates could increase by 90 percent. Though mass screening is done in few countries, it has not been applied in developing countries like Nepal. Preoperative diagnosis of EGC is rare in Nepal. The aim of this study is to analyze the clinicopathological features of postoperative cases of gastric cancer managed in a tertiary care university hospital of Nepal. METHODS All patients with histological diagnosis of gastric cancer admitted in the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal during the three year period (September 2010 to August 2013) were analyzed retrospectively. RESULTS Ninety two patients with endoscopic diagnosis of gastric cancers were admitted during the past three years. The mean age was 60 years ranging from 28 years to 85 years with the male to female ratio of 2.8:1. Five patients were younger than 40 years and all were in advanced stage. Thirty five percent of the patients belonged to Janajatis (Hill) community though they comprise only 23% of the population and about 65% of them belonged to an area involving 25% of the country. Seventy six cases were operated. Out of 92 patients, 4 patients were diagnosed as early gastric cancer postoperatively. All patients with early gastric cancer were above 50 years with CT Scan abdomen revealing focal thickening without lymphadenopathy. CONCLUSION Over the years, the incidence of gastric cancer is increasing in Nepal. Though 92% are advance gastric cancers, few have been diagnosed and treated early. A screening program in a country like Nepal with diverse ethnicity and difficult terrain might be helpful if it targets high risk people in high risk areas.
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Affiliation(s)
- B Ghimire
- Department of Surgery, Institute of Medicine Tribhuvan University Teaching Hospital Kathmandu, Nepal
| | - Y P Singh
- Department of Surgery, Institute of Medicine Tribhuvan University Teaching Hospital Kathmandu, Nepal
| | - S Timalsina
- Department of Biochemistry, Institute of Medicine Tribhuvan University Teaching Hospital, Kathmandu, Nepal
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Ghimire B, Khan MI, Bibhusal T, Singh Y, Sayami P. Accuracy of triple test score in the diagnosis of palpable breast lump. JNMA J Nepal Med Assoc 2008; 47:189-192. [PMID: 19079392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Breast lump is a very sensitive issue for the patient so a reliable, non invasive and prompt diagnosis helps to lessen the associated anxiety and leads to early definitive treatment. The aim of this study was to evaluate the accuracy of Triple Test Score (TTS) as a clinical tool for the diagnosis of a palpable breast lump. This diagnostic test study was carried out in the Department of Surgery of Tribhuvan University Teaching Hospital. Of the 117 patients admitted with breast diseases from the breast clinic over thirteen months, 87 had breast lump. Fifty patients underwent Triple Test Score ( physical examination, mammography and fine needle aspiration cytology) and were categorized into benign, suspicious and malignant. This was later correlated with the histopathological findings. Nineteen patients with breast lumps interpreted by TTS as benign correlated with the histopathological findings whereas of 31 malignant lumps, 30 turned out to be malignant and one benign. This gives TTS an over all accuracy of 98% with 100% sensitivity, 95.2% specificity and positive predictive value of 96.7%. Carcinoma was seen in 29 (58%) cases in the age group of 35 to 70 years. The mean age at diagnosis of benign and malignant disease was 41.8 and 45.1 years respectively. In conclusion, TTS is an accurate and least invasive diagnostic test based on which definitive treatment can be initiated.
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Affiliation(s)
- B Ghimire
- Department of Surgery, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
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