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   Table of Contents - Current issue
Coverpage
January-March 2020
Volume 4 | Issue 1
Page Nos. 1-82

Online since Tuesday, March 17, 2020

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EDITORIAL  

The effectiveness of cold atmospheric plasma by inhaling anesthetic mask or through bronchoscopy against COVID-19 Highly accessed article p. 1
Jalaledin Ghanavi, Poopak Farnia, Hamidreza Ghomi
DOI:10.4103/bbrj.bbrj_27_20  
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REVIEW ARTICLES Top

Cesarean section delivery and the autism spectrum disorder: Risk and consequences in Bangladesh p. 3
Rashed Noor, Syeda Muntaka Maniha, Masuma Afrin Taniya
DOI:10.4103/bbrj.bbrj_134_19  
Long-term health problems such as an elevated rate of developing obesity and asthma; and most importantly the neurodevelopmental problem of the children born by cesarean section delivery is very likely which in turn may lead to autism or attention deficit disorder. The survival and proliferation of the infant gut microbiota in relation to the mode of delivery is noteworthy because of its ultimate impact on the psychological and neurological behavior of the children. Studies so far conducted on the detrimental long-term outcomes linked with the cesarean delivery, a great deal of evidences have been found about the gut bacterial composition acquired by the infants. The early life dysbacteriosis or the imbalance of the resident microflora may hamper the protective immunity accompanied with inflammatory diseases which is also coupled with the neurological malfunction leading to autism spectra. Therefore, the intentional delivery through the C-section needs to be reduced which is unfortunately a very common case in the underdeveloped and developing countries with lack of such technical information among the huge population. Current review focused on the impact of alteration of the infant gut microorganisms (caused by the cesarean delivery) leading to the autism spectrum disorder; and concentrated on the dissemination of such knowledge in the mass community from the public health perspective.
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Rheumatoid arthritis identification using epistasis analysis through computational models p. 8
R Manavalan, S Priya
DOI:10.4103/bbrj.bbrj_147_19  
Rheumatoid arthritis (RA) is an autoimmune disorder that damages joints irreversibly. Many RA illnesses were also related to complex genetic characteristics and genetic interactions as well. Genome-wide association studies (GWASs) analyzing the fundamental RA-related genetic factors over the past two decades. Nonlinear interaction recognition, also known as epistasis identification, plays a crucial part in identifying RA's genetic causes. GWAS recognizes all single nucleotide polymorphisms (SNPs) genetic variants and the interactions between SNPs to identify RA susceptibility. Manual evaluation and interactions of many SNPs were too complicated for physicians. The main objective of this study is to explore various techniques of statistical, machine learning, optimization, so far applied to identify epistasis effect related to arthritis. The challenges behind the computational model and the experimental outcome of various methods were also focused.
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Asthma and aspergillosis: Which One causes another p. 16
Roaa Noori Ali, Ali Abdul Hussein S. Al-Janabi
DOI:10.4103/bbrj.bbrj_149_19  
The respiratory system of the human body is always under exposure to a great number of fungal spores every day. Asexual spores of Aspergillus are the most frequent type occurring in various environments. Inhalation of these spores can lead to various undesirable effects in the airway. Infection in the form of aspergillosis is one type of harmful effect of inhaled spores, especially in immunocompromised patients, while sensitization is a second type after long-term exposure to Aspergillus spores. In some cases, sensitization can develop into a various types of allergic diseases such as asthma. Otherwise, aspergillosis can be initiated in many asthmatic patients, which make asthma a predisposing factor for aspergillosis. In conclusions: Asthma and aspergillosis have shared responsibility to form each other in reversible relationship.
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ORIGINAL ARTICLES Top

Cartridge-based nucleic acid amplification test (Xpert Mycobacterium tuberculosis/Rifampicin Assay): An essential molecular diagnostic test for early diagnosis and initiation of treatment in childhood tuberculous meningitis and primary multidrug-resistant cases p. 21
Prasanta Kumar Das, Somtirtha B Ganguly, Bodhisatya Mandal
DOI:10.4103/bbrj.bbrj_107_19  
Background: Tuberculosis (TB) still remains the major public health threat in India. Early diagnosis, so as to initiate early treatment is a priority as any delay, may complicate the prognosis further leading to the failure of an effective control. India accounts for 6% incidence of pediatric TB cases in a population that has 40% as estimated latent TB cases. Pediatric samples were considered as the key population in the study. TB remains the most common cause of childhood meningitis in high burden countries. India accounted for the highest number of TB deaths among children in the year 2015, followed by Nigeria and China. Of which, tuberculous meningitis (TBM) stands to be the most common cause of morbidity. Extrapulmonary TB accounts for 25% of the total TB cases reported among which the most severe form being TBM. Although severe and difficult to diagnose due to lack of specific tests to get confirmed, cartridge-based nucleic acid amplification test (CBNAAT) is the only solution for microbiological confirmation of the disease for early treatment initiation and reduction of morbidity and mortality. Previously, due to lower case detection rates owing to inadequate diagnostic facilities of higher analytical sensitivity, the mortality and morbidity continued to be in the higher range, and empirical treatment modality was the mainstay till the CBNAATs came into existence. The increase in the case detection for tuberculous meningitis at a manageable stage of the disease would help in decreasing the mortality rates. The study explores the increased case detection rates among pediatric population suffering from tuberculous meningitis from referral units to Intermediate Reference Laboratory (IRL), Kolkata. Cerebrospinal fluid (CSF) from the pediatric patients has not been very difficult procedure though invasive, especially in the pediatric age group, and can be practiced at peripheral unit having CBNAAT facility. Methods: CSF from pediatric patients showing obvious clinical signs of meningitis was collected from tertiary unit linked to IRL, Kolkata, and tested on CBNAAT by Xpert Mycobacterium tuberculosis/ rifampicin (RIF) (Cepheid) along with all the pulmonary and extrapulmonary samples based on the manufacturer's instruction. The data were captured in the Inbuilt software of the GeneXpert MTB/RIF (Xpert) and Genotype MTBDRplus (DRplus) (Cepheid , USA) of the cartridge based nucleic acid amplification test machines automatically during the tests and exported to the Microsoft Excel sheets for further analysis. A defined study design against each and every objective was setup to analyze the effective detection of tuberculous meningitis case and their resistance to RIF along with the other pulmonary and extrapulmonary samples. Results and Conclusions: The study concluded the confirmation of tuberculous meningitis cases by the help of CBNAAT. The detection of microbiologically confirmed TB by these specimens sent from the referral unit linked with IRL, Kolkata, for pulmonary and extrapulmonary cases along with tuberculous meningitis cases is significant and facilitates the early initiation of treatment for TB and more so to those who are newly detected as multidrug-resistant TB especially below the 6 months of age. About 5% prevalence and around 4.9% incidence are an alarming situation in the TB control scenario of West Bengal. The positive case detection among the CSF samples was found to be more in the 0.6–1-year group followed by the age group of 1–5 years. The percentage positivity of CSF is recorded as 2.38%, and the percentage of RIF resistance among positive cases from CSF was found to be 13.79% (n = 28).
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In vitro antibacterial traits of the commonly used food preservatives and spices in their crude forms p. 26
Syeda Muntaka Maniha, Tahsin Tabassum, Tasmin Tabassum, Nafisa Tabassum, Rashed Noor
DOI:10.4103/bbrj.bbrj_132_19  
Introduction: Preservatives or chemical additives are frequently used in various food items with the principal objective of preventing the food spoilage caused by adulteration, chemical changes, and due to microbial contamination. The current study attempted to detect the in vitro antibacterial activities of the crude forms of common food additives/preservatives. Methods: A total of seven locally available samples (four preservatives and three different spices) were collected from the super shops within Bashundhara Area, Dhaka. The antibacterial traits of the collected samples were examined by the Kirby–Bauer (agar well diffusion) method. The test bacterial strains used in this study were Escherichia coli, Salmonella species, Staphylococcus aureus, Pseudomonas aeruginosa, and Pseudomonas fluorescens. Results: Except the crude granular spices (turmeric powder, chili powder, and the tasting salt), the other three food additive samples (tomato sauce, honey, and vinegar) were found to be nearly effective in eliminating the bacterial growth, while soy sauce did not exhibit notable antibacterial activity. Conclusion: The investigation showed that the liquid food additives were effectively capable of abolishing bacterial growth whereas the crude samples didn't impart the anti-bacterial activity.
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Tuberculosis and liver fluke infection: An expressional analysis for common antioxidative pathway p. 31
Rujittika Mungmunpuntipantip, Viroj Wiwanitkit
DOI:10.4103/bbrj.bbrj_113_19  
Background: Tuberculosis is a common medical problem seen in several areas of the world including Indochina. The concurrence of tuberculosis with other tropical infections is possible. For those infections, the role of oxidative pathway system is widely proposed. Here, the authors study on the common antioxidative pathway of tuberculosis and liver fluke infection. Materials and Methods: This work is a bioinformatic expressional analysis. A common pathway analysis with interrelationship identification is done to on expressional antioxidative pathways of tuberculosis and liver fluke infection. Results: The common pathway can be identified with the linkage node at glutathione. Each infection contributes to increased susceptibility to each other. Conclusion: Based on the identified common antioxidative pathway, the concurrent management of both diseases at the endemic area of both liver fluke and tuberculosis infections is needed.
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Mononuclear cell evaluation: A correlation study between manual and analyzer-based estimation p. 34
Rehan Ahmed, Prosenjit Ganguli, UD Gupta, YK Jaiswal, Velu Nair, Satyaranjan Das, Ajay Sharma, Sana Khan, Rekha Singh Ganguli
DOI:10.4103/bbrj.bbrj_133_19  
Background: Bone marrow transplantation (BMT) is being routinely done at the Army Hospital for the past 15 years. Our experience with Stem Cell Transplantation and clinical trial on stem cell efficacy, our Centre had brought out the issue of trial deviates (<2 × 108 mononuclear cells [MNCs]) based on low yield of MNCs. PubMed search did not reveal any comparative data of analyzers versus manual counts. Thus, we decided to investigate the cause for the discrepancy calculated on 3-part and 5-part analyzers and manual estimation. This study has institutional relevance for hospitals involved in hematopoietic stem cell transplantation, therapy, and research. Introduction: MNCs are widely being used as a morphologic analog of precursor cells in hematopoietic stem cell transplantation and BMT units. The aim of the present study was, therefore, to evaluate the validity of the automated blood cell counter with gold standard of a manual count. Methods: The samples of peripheral blood (n = 80) and bone marrow (n = 80) were included in the study. Informed consent was obtained, and approval was taken from the IEC (Institutional Ethics Committee), Army Hospital Research and Referral, New Delhi, India. Results: Evaluation of MNC with 5-part hematology analyzer and gold standard manual count shows the correlation in the group of total leukocyte count samples: <4000, 4000–12,000, and 12,000–20,000 with no significant difference and >20,000 showing significant difference. Conclusion: The good correlation of 5-part hematology analyzer with manual gold standard method of MNC count is indicating equivalent performance. MNC can be performed by 5-part with nonsignificant difference and can be used as good as manual count.
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Association between metabolic syndrome and Helicobacter pylori infection: A myth or a fact? A cross-sectional study p. 41
Varun J Shetty, HL Kishan Prasad, Aashish Sharma Konamme, K Jayapraskash Shetty, Ganaraj Kulamarva
DOI:10.4103/bbrj.bbrj_139_19  
Aim: To determine the association between Helicobacter pylori and metabolic syndrome. Methods: This study comprised 31 study subjects whose biopsies were positive for H. pylori. Fasting plasma glucose (FPG), body mass index, serum triglycerides, serum high-density lipoprotein (HDL), and blood pressure were estimated in this group. Abnormalities in at least three of the five parameters were considered to be metabolic syndrome. Results: The results showed a significant association between H. pylori and metabolic syndrome, based on P = 0.007 (<0.05) in the Chi-square test. There was also an insignificant correlation between sex and metabolic syndrome (P = 0.576). A large percentage of the study group had high FPG (67.74%), low serum HDL (77.42%), and hypertension (87.10%). 78.2% of the study group had metabolic syndrome. Conclusion: The present study suggests that H. pylori gastritis is significantly associated with metabolic syndrome. It is recommended to do further research using a larger sample size to explore the relationship between Metabolic syndrome and H. pylori infection. The H. pylori eradication can be used as a tool in the prevention and treatment of metabolic syndrome.
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The correlation between total immunoglobulin-E levels and interleukin-13 gene polymorphism in asthmatic children treated with inhaled corticosteroids or montelukast p. 45
Saad Hashim Abood, Aqeel Mahdi Hussein, Mohanad Mohsin Ahmed, Haidar Abdul Amir Najim Abood
DOI:10.4103/bbrj.bbrj_146_19  
Background: The aim of this research was to study the possible correlation between single-nucleotide polymorphism of interleukin (IL)-13-1112 C/T with specific parameters in asthmatic children (total serum immunoglobulin-E [TSIgE] levels and asthma severity) treated with montelukast or inhaled corticosteroid. Methods: The study included one hundred asthmatic patients attending Karbala Teaching Hospital for children and similar numbers of healthy unrelated age-matched controls from the same locality of Iraq. TSIgE levels were determined by ELISA technique. DNA was extracted and processed by the allele-specific polymerase chain reaction technique for characterization of genetic variants of IL-13-1112 C/T gene polymorphisms. Results: Iraqi children with asthma showed a lower frequency of the IL-13-1112 CC genotype (13% vs. 16%) for control cases with a higher frequency of the heterozygous IL-13-1112 CT genotype (78% vs. 75%). IL-13-1112 showed significantly negative association with asthma in the dominant, codominant, and overdominant models of inheritance. On the other hand, comparing genotypes of subgroups related to gender, asthma severity, and asthma control showed a nonsignificant difference (P > 0.05). Homozygous wild types of IL-13-1112 TT might be considered protective to Iraqi asthma children. Conclusion: The IL-13 gene may be associated with the level of control in treated asthmatic patients. There is no correlation between TSIgE and the SNP.
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Effects of contact-stress on wear behavior of zirconia-reinforced lithium silicate glass-ceramic p. 51
Efe Cetin Yilmaz, Recep Sadeler
DOI:10.4103/bbrj.bbrj_148_19  
Background: The purpose of the present study was to investigate effects of contact-stress on direct-contact wear behavior of zirconia reinforced lithium silicate glass-ceramic; in vitro off-axis sliding contact chewing simulation. Methods: In this study, 12 mm diameter X 2 mm thickness in size of lithium disilicate, Vita Suprinity; zirconia-reinforced lithium silicate was used. The test specimens were subjected to 100.000 mechanical loading, 3000 thermal cycles, 1.2 Hz wear frequency, 30° angle 0.7 mm lower jaw movement and different size Al2O3 antagonist material in artificial saliva. The average wear volume loss of the test specimens was obtained after wear test procedure using non-contact 3D profilometer. Furthermore, micro-structure analyzes of the wear surfaces of the test specimens were performed using scanning electron microscopy (SEM) and atomic force microscopy (AFM). Results: As a result of this study, ceramic material showed better abrasion resistance with increasing contact surface of abrasive material. Conclusion: However, microstructure analysis has shown that micro cracks occur on the wear surfaces both wear test procedures. These micro cracks may have occurred under the wear surface of the ceramic material.
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Antidermatophyte activity of syzygium aromaticum, petroselinum crispum, and tetrapleura tetraptera p. 55
Roger Ducos Youmsi Fokouo, Patrick Valere Tsouh Fokou, Cedric Derick Jiatsa Mbouna, Fabrice Fekam Boyom
DOI:10.4103/bbrj.bbrj_150_19  
Introduction: The increasing incidence of dermatophytoses in the world and the side effects of the drugs used encouraged the search of alternative drugs. Hence, the objective of this work was to determine antidermatophyte activity of Syzygium aromaticum seed, Petroselinum crispum leaves, and Tetrapleura tetraptera fruits. Methods: The extracts were prepared by maceration of plant materials into 70% ethanol and methanol. The phytochemical screening was carried out on the extracts. The antidermatophyte assay was performed by the agar dilution method. Results: The results showed that the extraction yields ranged from 9.83% to 32.96%. The phytochemical screening revealed the presence of phenol, glucosides, anthraquinones, and tannins in all extracts. The 70% ethanolic and methanolic extracts of S. aromaticum showed significant inhibition following the preliminary screening. The methanolic extract of S. aromaticum portrayed the best activity with MIC ranging from 0.3125 to 0.625 mg/ml. Conclusions: These results show that the methanolic extract of S. aromaticum seed is promising in the treatment of dermatophytosis, as an alternative in the development of a new therapy.
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The utility of urinary dipstick in the diagnosis of urinary tract infection in children p. 61
Zuhair Mahdi Al-Musawi, Qahtan Mohammed Ali Al-Obaidy, Zaynab Hazim Husein
DOI:10.4103/bbrj.bbrj_151_19  
Background: Urinary tract infection (UTI) is frequent in children and may have significant adverse effects, especially for young children. Objective: The objective was to assess the sensitivity and specificity of pyuria, leukocyte esterase, and nitrite test in the diagnosis of UTI and whether they can be used as an alternative to the conventional culture, which is expensive and needs more time for the result to be obtained. Methods: This is a cross-sectional study in which 143 patients were prospectively studied in Kerbela teaching hospital for children, who were suspected to have UTI and did not receive antibiotics for at least a week. Urine samples were collected using urine catheter for children who are not toilet trained and midstream urine for older children. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were measured for nitrite, leukocyte esterase, and pyuria. Results: There was a highly significant association between the positive results of urine dipstick (nitrite test and leukocyte esterase test) and microscopic (examination for pyuria) and the positive results of urine culture (P < 0.001). There were no significant differences between dipstick (nitrate test and leukocyte esterase) and pyuria at sensitivity, specificity, PPVs, and NPVs (P = 0.514, 0.706, 0.232, and 0.414, respectively). Conclusions: The dipstick tests had no significantly different results compared with examination for pyuria and urine culture in the detection of UTIs. Escherichia coli is the most common isolated organism, and it is sensitive mainly to third-generation cephalosporin and amikacin.
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To study the isolation and identification of fungi from oral cancer after radiotherapy p. 65
Vibha Khatri, Harish Kumar, Veer Bahadur Singh, Gautam Kumar Meghwanshi
DOI:10.4103/bbrj.bbrj_166_19  
Background: Cancer, known medically as a malignant neoplasm, is a broad group of diseases involving unregulated cell growth. In oral cavity infection, the oral microflora may be subsequently replaced by potentially pathogenic microorganisms such as candela species (from 72% to 92%). Hence, because of a weakened line of defense in oral cancer patients, the present prospective cohort study was carried out with the aim of isolation and identification of fungal colonization from oral cavity from radiotherapy. Radiotherapy and both radio-chemotheray treated patients. Methods: The proposed study was carried out on clinical samples in the Department of Microbiology in S. P. Medical College, Bikaner, Rajasthan. Isolates from clinical samples were collected from Acharya Tulsi Regional Cancer Hospital, Bikaner, Rajasthan. Samples of the lesion from the tongue and mouth were obtained with a sterile cotton swab. The sample was cultured on Sabouraud's dextrose agar and typical yeast colonies were determined after 72 h. After, staining isolates were subjected to biochemical identification. Results: A total of fifty isolates were taken for the study. Out of these fifty isolates, 45 (90%) were male, whereas 5 (10%) were female. In this study, about 90% of oral and pharyngeal cancer in men and around 10% in women can be estimated. Out of fifty, the highest isolates obtained were Candida albicans (15, 30%), followed by Candida glabrata (11, 22%) and Candida tropicalis (8, 16%), and the lowest number was of Candida krusei (6, 12%). In this purposed study, out of fifty patients, C. albicans can be isolated in 15 patients that is a higher value. Conclusion: C. albicans is the most commonly implicated organism in the mouth after radiotherapy and radio chemotherapy. It is clear that C. albicans is the most commonly found fungi to cause secondary infection.
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Protective effect of lycopene against tamoxifen-induced hepatotoxicity in albino rats p. 69
Elias Adikwu, Nelson Clemente Ebinyo, Ozeke Benalayefa
DOI:10.4103/bbrj.bbrj_3_20  
Background: Tamoxifen citrate (TAM) is a drug of choice for the treatment of hormone-dependent breast cancer, but its use has been associated with frequent hepatotoxicity. Aim: This study evaluated the protective effect of lycopene (LYP) against hepatotoxicity induced by TAM in albino rats. Methods: Adult female albino rats (200–250 g) were divided into eight groups of n = 5. Group 1 (control) received normal saline (0.2mL) intraperitoneally (i.p.), daily for 7 days. Groups 2–4 were treated daily with LYP (10 mg/kg, 20 mg/kg, and 40 mg/kg) (i.p.) for 7 days, respectively. Group 5 was treated daily with TAM (45 mg/kg) i.p. for 7 days. Groups 6–8 were supplemented daily with LYP (10 mg/kg, 20 mg/kg, and 40 mg/kg) before treatment with TAM (45 mg/kg) i.p. for 7 days, respectively. At the end of treatment, the rats were anesthetized and blood samples were collected and assessed for serum markers of liver function. Liver samples were harvested for histology and biochemical assessments. Results: Significant (P < 0.001) elevations in serum and liver aminotransferases, lactate dehydrogenase, gamma glutamyl transferase, alkaline phosphatase, total bilirubin, and conjugated bilirubin levels were observed in TAM-treated rats when compared to control. Furthermore, significant (P < 0.001) elevations in liver malondialdehyde levels with significant (P < 0.001) decreases in glutathione peroxidase, superoxide dismutase, glutathione, and catalase levels were observed in TAM-treated rats when compared to control. Vascular congestion with necrotic materials and lipoid necrosis were observed in TAM-treated rats. However, TAM-induced hepatotoxicity was significantly attenuated in a dose-dependent fashion in rats supplemented with LYP 10 mg/kg (P < 0.05), 20 mg/kg (P < 0.01), and 40 mg/kg (P < 0.001) when compared to TAM. Conclusion: LYP may have clinical application in hepatotoxicity caused by tamoxifen.
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In vitro antiproliferative activity of cold atmospheric plasma on small-cell lung carcinoma p. 76
Mina Amini, Jalaledin Ghanavi, Poopak Farnia, Morteza Karimi, Hamidreza Ghomi
DOI:10.4103/bbrj.bbrj_25_20  
Background: Cold plasma is shown to inhibit the cancer cell growth. Manipulation of different plasma parameters might have influence on the production of major reactive species which leads to killing of the cancer cells. Antiproliferative activity of cold atmospheric pressure plasma jet was investigated on small-cell lung carcinoma BHY cell line (squamous cell carcinoma) under different in vitro conditions. Methods: A homemade plasma jet was designed and created using pure helium gas. To identify the species created by the plasma jet, optical emission spectroscopy (OES) was employed. Next, the effect of plasma jet was examined on lung cancer cell survival by MTT assay and the effects of main parameters were evaluated on plasma performance. In this favor, various treatment times including 60, 90, 120, 180, and 300 s in combination with different voltages of 5, 11, and 14 kV were investigated, and the results were analyzed at 2, 24, and 48 h after exposure to plasma. Results: Predominant species of OES spectra were O, OH, N2+, and N2. Results of MTT assay indicated a dramatic reduction in cell viabilities in both dose- and time-dependent manners, and more than 75% of cancer cells were died after 48 h at 180 s of plasma treatment. Conclusion: The homemade plasma jet can chiefly contribute to the production of reactive oxygen and nitrogen species (reactive oxygen species and reactive nitrogen species) and can induce apoptosis in small-cell lung carcinoma BHY cell line.
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LETTER TO EDITOR Top

Surveillance 2019 novel coronavirus (COVID-19) spreading: Is a terrifying pandemic outbreak is soon? p. 81
Falah Hasan Obayes AL-Khikani
DOI:10.4103/bbrj.bbrj_16_20  
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