By By Shaimaa Moustafa Mahdye Eldieghdye lecturer at Biological - - PowerPoint PPT Presentation

By By

Shaimaa Moustafa Mahdye Eldieghdye

lecturer at Biological Application Dep. Atomic Energy Authority

1- Problem*diabetes*ضرمءادلاىركسلا

2- Complications of diabetesلكاشملاةجتانلانعةباصلباىركسلاب 3- Treatments of diabetic wound which being used and its side effects تاجلبعلاهمدختسملاايلاحاهراثاوةيبناجلا 4-Our new treatment (plasma)جلبعلاحرتقملامادختسابامزلببلا 5-Wound healing using plasmaجئاتنلايتلامتاهقيقحتمادختسابامزلببلا

separated from blood cells Reabsorption Over 80% of the filtrate is reabsorbed to blood. This ensures that useful materials such as glucose & amino acids are returned to the blood Secretion This includes active secretion of substances to eliminate toxins and responsible for electrolyte balance

• Diabetes is the most common endocrine diseases

with a prevalence of more than 8 million people in Egypt.

• The most common types ( type 1 & 2)
• ىركسلا ءادلا ضرم

Main causes of diabetes complications

Complications of Diabetes

• 1- Nephropathy toxicity
• 2-Eye damage
• 3-Delaying wound healing
• 4- Cardiovascular diseases
• ىركسلاب ةباصلبا نع ةجتانلا لكاشملا

Wound healing

➢Protects the individual from infection & dehydration ➢Critical to the survival ➢ It has specific phases which include

• حورجلا مائتلإ

حورجلا مائتلا لحارم

• so from the onset of the wound…
• patients need wound care sooner than
• Definitive care at or before 4 weeks with the introduction
• f advanced therapy to treat the wound Is very important.

✓Access to care:

Wounds Have a Golden *Hour*

DFUs)

Complications of Diabetic Foot Ulcers

• DFUs that persist more than 4 weeks have 5-

fold higher risk of infection.1Development of an infection in a foot ulcer increases the risk for hospitalization 55.7 times and the risk for amputation 155 times. ا ل رت و ح

• “

Diabetes Neuropathy Infection

Amputation

Foot Ulcer

Amputations are a serious predictor

• f death…

Controlling impaired wound healing

حورلا ما تلا مدع مكحتلا

Prevention & continuing control

• f impaired wound healing are

important, Various methods have been suggested to reduce impaired wound healing,

Usage Side effects

but

What if ?

1-No harming tissue or causing pain? و ملا 2-Wound healing with low cost ? ت ل ا 3-Disinfect wounds without antibiotics?م ت و ا ا م و ح 4- Enhance healing at short time ?مائتلا ل ا و مم 5- Enhance healing without side effects ?مائتلا و را ا

اج

So, New methods were needed

plasma The forth state of matter

Plasma

What is a Plasma?

• 4th State of Matter

The forth state of matter why called plasma

It is like the plasma of blood in its majority of components

Plasma components

Main types of plasma according to plasma temp.

• Non-thermal plasma (Cold) – used safely at room

temperature & atmospheric pressure.

• Thermal –plasma are obtained when electron and gas

temperature are equal and with very high power and have bad effects.

1- No harming tissue or causing pain

Biomedical Significance of non-thermal plasma including the following:-

Blood coagulation

includes accelerating of blood coagulation

Sterilization

includes antimicrobial effect against numerous of microorganisms include (Bactria, Fungi and virus)

Vascularization

By ROS & NO from Non-thermal plasma jet

1- Test whether atmospheric non-thermal plasma could have a positive role in promotion and /or acceleration of healing process in diabetic albino rats and Why?. ةباصملا ناذرجلا ىف حورجلا مائتلا نم ليجعتلا ىلع هردقلا اهل ةثافنلا امزلببلا له اذاملو ىركسلاءادب 2- Assess the adverse effects of non-thermal plasma treatment

• n

some biochemical and hematological parameters in albino rat. ءادب هباصملا ناذرجلا ىف ةيويحلا فئاظولا ىلع ةيبناج راثا اهل ةثافنلا امزلببلا له ىركسلا

The present study aimed to fulfill two main goals, :

❖ Kidney diseases are common health problem worldwide. ❖ There are different types of kidney diseases:

Plasma jet device

Animal model

Atmospheric non-thermal plasma jet source (ANPJ): ANPJ device was designed by ANPJ team work (plasma and nuclear fusion department of Nuclear Research Centre, Atomic Energy Authority- Inshas) with cost about (3150 LE).

2-Low costs

Active species generated from plasma jet

2 - Set up the best conditions for ANPJ topical treatment of diabetic wounds in rats.

• The feed Gas was air
• Flow rate 12 L/min.
• 2 cm distance from the outer electrode.
• Plasma dose was (0.17 J/cm2) meanwhile, the

destructive dose over(135J/cm2 )

Animals 40 male albino rats were used in this study. The animals were housed as 1 rat per cage under standard laboratory conditions.

3- Induction of Type 2 Diabetes:

• Type

2 diabetes was induced in rats by intraperitoneal injection

• f

freshly prepared stretozotocin (STZ) (60 mg / kg) 15 minutes after intraperitoneal administration of 140 mg / kg nicotinamide.

• Three days following STZ injection, animals

with blood glucose level above 250 mg/dL were used for the study.

Experimental design 40 male albino rats were shaved & divided into the following groups

Group(1):

normal

Group(2):without

treatment (wounded and without any treatment)

Group (3): Diabetic

rats treated by plasma dose (0.17 J/cm2) 3 day /weak for 21 days. .

Group (4):

Diabetic rats treated with antibiotic (2 g) 3day \ weak for 21 days.

Wound Surgery: After confirming the induction

• f

diabetes, 10 animals per group were used to create wounds. About 250 mm2 full thickness open excision wound was made on the back of the rat.

• 35

Measured Parameters Topical effects

Rate of hair Growth Homeostasis, Sterilizations and percent

• f wound

healing

Systemic effects VEGF, Protein S,C Fibrinogen and total Antioxidant capacity Side effects

CBC, PT, PTT Kidney, Liver functions and T3 Mortality&Behavior

• Plasma exposure for

5 sec. Hemostasis

Fungi growth normal G1

no any growth of bacteria

• Fungi and Bactria

growth

Without any treatment group G2

• No growth of

both fungi and bacteria

• Plasma

treated group G3

Growth of both fungi and bacteria

Antibiotic treated group G4

3-Sterilization Without antibiotic

Day (0) without treatment plasma treatment

• Antibiotic

treatment

G4 G3 G2 Fus. plasma +ve

Day(0)

Day (5) without treatment plasma treatment

• Antibiotic

treatment

G4 G3 G2 Fus. plasma +ve

Day(5)

• 25%
• 9 %
• 70%

Day (10) without treatment plasma treatment

• Antibiotic

treatment

G4 G3 G2 Fus. plasma +ve

Day(10)

• 97%
• 50%
• 60%

Day (15) without treatment plasma treatment

• Antibiotic

treatment

G4 G3 G2 Fus. plasma +ve

Day(15)

4-Healing at Short time

• 67%
• 99.8%
• 80%

Day(21) without treatment plasma treatment

• Antibiotic

treatment

G4 G3 G2 fuside plasma +ve

Day(21)

normal Without treat. Plasma treat. Antibiotic treat.

0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 G1 G2 G3 G4

level of VEGF Groups

VEGF level in all groups

G1 G2 G3 G4 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 G1 G2 G3 G4 level of TAC Groups

Total antioxidant capacity in all groups

G1 G2 G3 G4

20 40 60 80 100 120 140 160 180 200

Protein S Protein C

Protein( S &C ) percent "%"

Level of Protein S and C in studied groups

G1 G2 G3 G6

400 410 420 430 440 450 460 470 480 490 G1 G2 G3 G4

Fibrongen level Groups

Fibrinogen level in all groups

G1 G2 G3 G4

normal Without treat. Plasma treat. Antibiotic treat.

2 4 6 8 10 12 14 16

HB % RBc WBC Paramters levels

Hematlogical paramters in all studied groups

G1 G2 G3 G6

400 410 420 430 440 450 460 470 480 490 G1 G2 G3 G4

• Plt. level

Groups

• Plt. level in all groups

G1 G2 G3 G4

normal Without treat. Plasma treat. Antibiotic treat.

.

5 10 15 20 25

PT PTT PT & PTT time " Sec."

PT & PTT time in studied groups

G1 G2 G3 G6

normal Without treat. Plasma treat. Antibiotic treat.

normal Without treat. Plasma treat. Antibiotic treat.

0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 G1 G2 G3 G4 urea conc.Axis Title Groups

urea conc. in all groups

G1 G2 G3 G4 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 G1 G2 G3 G4

• creat. conc in all groups Axis Title

Groups

• Creat. conc in all groupsChart Title

G1 G2 G3 G4

1 2 3 4 5 6 7 8 9

T.Protein Albumin A\G Ratio Total bil. Paramters levels

Liver functions in all studied groups

G1 G2 G3 G6

10 20 30 40 50 60 70

ALT AST Paramters levels

Liver enzymes activity in all studied groups

G1 G2 G3 G6

normal Without treat. Plasma treat. Antibiotic treat.

5-Healing without side effects

0.5 1 1.5 2 2.5 3 G1 G2 G3 G4

T3 level Groups

Total T3 hormone in all groups

G1 G2 G3 G4

normal Without treat. Plasma treat. Antibiotic treat.

100 200 300 400 500 600

• Glu. D(0)
• Glu. D(21)

Glucose level " mg\ dl "

Paramters

Glucose level in all studied groups

G1 G2 G3 G6

normal Without treat. Plasma treat. Antibiotic treat.

• D

i a b e t e

Results of this study

Air Diabetic male rat 250 mm2 excision wound

4 minutes Results of (Fathollah et al., 2016) 10 minutes

• Diabetic male rat

12 mm2 excision wound pure helium (He)

In non- thermal plasma treatment

3- Healing at Short time 1- No harming tissue or causing pain 4-Sterilization Without antibiotic 2-Low costs 5-Healing without side effects

❖ Further research efforts should be directed towards the

useful effects of non-thermal plasma in treatments of different human wounds.

❖ Moreover, future studies are required to evaluate the

properties of non-thermal plasma on different biomedical application