Medical Journey and beyond

28/03/2026

PUBLISHED :- Original Research Article

Title : Targeting glioblastoma through chromatin remodeling: epigenetic insights into actionable molecular pathways.

*Corresponding author: Tshetiz Dahal

DOI: https;//doi;10.18231/j.sajhp.57585.1774594650

© 2026 The Author(s), Published by Innovative Publications.

Journal : Southeast Asian Journal of Case Report and Review ISSN (Online): 2319-1090. Publisher: IP Innovative Publication

Volume : 2026;9(1): Pages : 10-20

Link : https://sajhp.com/archive/volume/9/issue/1/article/26489/pdf

Journal homepage: https://www.sajcrr.com/

ABSTRACT :

Background: Glioblastoma is the most common and highly aggressive primary brain tumor in adults, characterized by rapid progression and dismal patient
survival. Its profound intratumoral heterogeneity, driven predominantly by epigenetic dysregulation, presents major challenges to effective therapeutic
development. Understanding the chromatin remodeling programs that distinguish glioblastoma stem cells (GSCs) from normal neural stem cells (NSCs) is essential for identifying actionable molecular vulnerabilities.

Materials and Methods: To investigate epigenetically driven regulatory mechanisms underlying glioblastoma pathogenesis, we employed SYNGN, a specialised syngeneic experimental framework enabling direct comparison between GSCs and NSCs derived from expanded potential stem cells (EPSCs). This platform allowed high-resolution profiling of chromatin architecture, transcriptional programs, and signaling pathway alterations unique to GSC populations.

Results: Our analysis revealed that chromatin remodeling profoundly influences the transcriptional landscape of glioblastoma stem cells, regulating key
oncogenic genes and signaling cascades responsible for tumor initiation, maintenance, and progression. Comparative profiling between GSCs and NSCs
identified distinct epigenetically modulated pathways that are selectively activated in malignant cells. Notably, we discovered previously unrecognised, patient-specific epigenetically regulated therapeutic targets, including SMOX and GABBR2, which exhibit strong potential as precision drug targets in glioblastoma.

Conclusion: This study highlights the pivotal role of epigenetic modulation in shaping the transcriptional and functional identity of glioblastoma stem cells.
By leveraging the SYNGN framework, we uncover novel, patient-specific vulnerabilities—most prominently SMOX and GABBR2—that hold promise for
targeted therapeutic development. These findings underscore the importance of chromatin remodeling–based analyses in understanding glioblastoma biology
and advancing personalised treatment strategies for this highly lethal malignancy.

Citation : Dahal T. Targeting glioblastoma through
chromatin remodeling: epigenetic insights into actionable molecular pathways. South Asian J Health Prof. 2026;9(1):10-20.

© 2026 Southeast Asian Journal of Case Report and Review

ډاکټر شیتیز دهل Medical Journey and beyond Indian Medical Association - Sikkim State Branch. Olcias Live Conferences fans Lugansk State Medical University , Ukraine

28/03/2026

PUBLISHED :- Original Research Article

Title : Decr2 within tumor cells modulates ferroptosis and shapes immunotherapy
response

*Corresponding author: Tshetiz Dahal
Co Authors : Subarna Rizal, Wajahat Nazir, Anupam Raj Nepal

DOI: https;//doi;10.18231/j.sajhp.67983.1774595926

© 2026 The Author(s), Published by Innovative Publications.

Journal : Southeast Asian Journal of Case Report and Review ISSN (Online): 2319-1090. Publisher: IP Innovative Publication

Volume : 2026;9(1): Pages : 21-33

Link : https://sajhp.com/archive/volume/9/issue/1/article/26490/pdf

Journal homepage: https://www.sajcrr.com/

ABSTRACT :

Background: Immune checkpoint inhibitors (ICIs) have transformed cancer therapy; however, durable responses are achieved only in a subset of patients.
Identifying molecular determinants of resistance is essential to improving the effectiveness of immunotherapy.

Objective: To identify genes that regulate tumor cell sensitivity to immune checkpoint blockade and to elucidate their mechanistic role in immune-mediated
tumor killing and clinical outcomes.

Materials and Methods: A genome-wide CRISPR knockout screen was performed to uncover genes involved in resistance to immunotherapy. Functional
validation assays were conducted to assess the impact of gene loss on CD8⁺ T cell–mediated cytotoxicity and in vivo response to anti-PD-L1 therapy. Biochemical analyses evaluated ferroptosis pathways and lipid profiles, particularly polyunsaturated ether phospholipids (PUFA-ePLs). RNA sequencing
datasets from melanoma patients treated with anti-PD-1 therapy were analyzed to correlate gene expression or deletion status with clinical outcomes.

Results: The CRISPR screen identified Decr2, encoding peroxisomal 2,4-dienoyl-CoA reductase, as a key regulator of immunotherapy sensitivity. Decr2 loss
significantly impaired CD8⁺ T cell–mediated tumor cell killing and reduced the therapeutic efficacy of anti-PD-L1 in vivo. Mechanistically, Decr2 suppression
diminished ferroptosis, accompanied by decreased PUFA-ePL abundance. Clinical transcriptomic analysis demonstrated that higher Decr2 expression
correlated with improved responses to anti-PD-1 therapy in melanoma patients, whereas genomic deletion of Decr2 was associated with inferior outcomes.

Conclusion: Decr2 is a critical regulator of immune-driven tumor cell death, primarily by promoting ferroptosis through modulation of PUFA-ePL levels. Its
loss confers resistance to ICIs, while elevated expression predicts better clinical outcomes. These findings position Decr2 as a promising biomarker and
potential therapeutic target to enhance immunotherapy efficacy.

Citation : Dahal T, Rizal S, Nazir W, Nepal AR. Decr2
within tumor cells modulates ferroptosis and shapes immunotherapy response. South Asian J Health Prof. 2026;9(1):21-33

© 2026 Southeast Asian Journal of Case Report and Review

Olcias Live Conferences ډاکټر شیتیز دهل Indian Medical Association - Sikkim State Branch. fans

27/03/2026

Case Presentation : Extrapulmonary Tuberculosis (TB) Mimicking Meigs’ Syndrome

A 34-year-old Indian woman presented with a four-week history of constant epigastric discomfort, progressive abdominal distension, and exertional shortness of breath associated with a dry cough. She denied weight loss, anorexia, or fever but reported fatigue. Her menstrual cycles were regular, and she had no significant past medical history. Before admission, she was treated in primary care with a proton pump inhibitor (omeprazole) and subsequently Helicobacter pylori eradication therapy for the above symptoms, without improvement. At this stage, she was further investigated for other causes of the above symptoms, which revealed a markedly elevated CA-125 (369 U/mL), prompting further investigations (Table 1).

On admission, she was otherwise hemodynamically stable except for tachycardia. Examination revealed reduced air entry at the left lung base and a distended abdomen with epigastric tenderness. Laboratory investigations demonstrated a mild microcytic anemia (hemoglobin 108 g/L, mean corpuscular volume 77 fL) and raised C-reactive protein (48 mg/L), while other tumor markers were within normal limits. Chest radiography showed a large left pleural effusion (Figure 1). An abdominal ultrasound confirmed gross ascites. Cross-sectional imaging (computed tomography (CT) chest/abdomen/pelvis and MRI pelvis) demonstrated a large pleural effusion, extensive ascites, peritoneal thickening, and bilateral adnexal changes with a complex left ovarian cyst (Figures 2-4).

In view of the raised CA-125 and these findings, the initial differential diagnoses included peritoneal carcinomatosis or Meigs’ syndrome. The case was discussed at the gynecology multidisciplinary meeting, which advised tissue diagnosis. The patient was referred to the respiratory team as well and subsequently underwent medical thoracoscopy for tissue diagnosis and symptomatic relief, draining 2.6 L of hemorrhagic fluid. Cytological examination of pleural and ascitic fluid revealed a lymphocytic predominance without malignant cells.

description continued from image 4 onwards :

© 2026_dr_tshetiz_dahal

11/01/2026

PUBLISHED :- Research Article

Title : Diabetes mellitus: Clinical characteristics, glycemic outcomes, and insights from recent therapeutic trials - research study.

Authors : Suyash Saurabh, Tshetiz Dahal

Journal : Southeast Asian Journal of Health Professional

https;//doi;10.18231/j.sajhp.45553.1767956308

© 2025 The Author(s), Published by Innovative Publications.

22/08/2025

link to join the conference :

https://meet.google.com/nhw-wtvz-qre

07/08/2025

Patient Testimonial on Cancer Research & Treatment by Dr. Tshetiz Dahal

My Name is Matt Ode – A Journey Through Cancer, Resilience, and Giving Back

At the age of 24, I was diagnosed with Stage 3C Testicular Cancer. By 25, I was placed in a two-week non-induced coma after doctors discovered an 11 cm tumor in my small intestine. I underwent five grueling rounds of BEP chemotherapy, followed by a 10-hour surgery to remove the tumor.

What came next was an unimaginable series of complications—my body shut down, leading to complete kidney and liver failure. I fell into a two-week coma, spent 40 of my 53 hospital days in the ICU, and went into cardiac arrest just one week after waking up—resulting in another week-long coma. Over the course of this journey, I underwent four additional surgeries, the last of which left me with an open abdominal wound. I had to learn to walk again and rebuild every part of my life, dropping from a 185 lb personal trainer to just 110 lbs within 8 months.

I’m honored to now be collaborating with Dr. Tshetiz Dahal, whose pioneering work in cancer research and treatment is bringing new hope to the fight against cancer. Today, I am cancer-free. I’ve regained my strength, my weight, and my purpose. I’ve turned my experience into a mission to help others—survivors, patients, and caregivers—find healing and direction through their own battles.

Dr. Dahal’s dedication to advancing therapies and improving outcomes for patients is both inspiring and essential. His involvement further strengthens our community’s commitment to not just surviving—but thriving.

“As someone who has been through the darkest depths of cancer, I can say with full conviction that hope is often found in the hands of those who refuse to give up on us. For me, that hope came through the groundbreaking research and compassionate care of Dr. Tshetiz Dahal.

Dr. Dahal’s approach to cancer treatment goes beyond medicine—it’s rooted in deep humanity, relentless innovation, and a fierce commitment to saving lives. His cutting-edge work in cancer research didn’t just treat my condition; it reignited my belief that a cure is not a dream, but a future that’s being built today.

Thanks to his guidance and the therapies pioneered through his research, I not only survived—I found strength I never knew I had. Every day I wake up, I’m reminded that I’m living proof of what can happen when brilliant science meets unwavering compassion.

Dr. Dahal, thank you for being a beacon of hope in a world that so desperately needs it. Your work is changing lives—and I’m honored to be one of them.”

Let’s continue to uplift, rebuild, and find meaning beyond the battle.

— Matt Ode

07/08/2025

https://youtu.be/_X2zYD_OYio?si=wtS-B077v2Bk82hq

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Join Dr. Dahal in this enlightening video as he uncovers the latest breakthroughs in cancer research that could revolutionize treatment and patient care! Dis...

14/07/2025

COMING SOON : FIRST EDITION

Book : Textbook of Oncology and Hematology

Autbored By : Dr. Tshetiz Dahal

ISBN: 978-93-343-4518-6

ORCID ID : 0000 0002 4042 7768

01/07/2025

Wishing a very Happy Doctor’s Day to the ones who heal with their hearts and treat with their wisdom. To all the doctors who work selflessly to keep us healthy, we salute you. Happy Doctor’s Day ...

Doctor’s Day is a special day dedicated to honoring doctors and medical professionals for their tireless service, dedication, and commitment to saving lives and improving public health.

In India, Doctor’s Day is celebrated on July 1st every year in memory of Dr. Bidhan Chandra Roy, a renowned physician and the second Chief Minister of West Bengal, who was born and died on the same date (1st July). He was also awarded the Bharat Ratna for his exceptional contributions to medicine and society.

🩺 Significance of Doctor’s Day
1. Acknowledging Sacrifices – Doctors often work long hours under stressful conditions and make personal sacrifices to care for patients.
2. Celebrating Medical Progress – It is a reminder of the critical role that medicine and healthcare play in society.
3. Building Trust – It strengthens the bond between patients and healthcare providers, promoting respect and trust.
4. Inspiring Future Generations – It encourages young people to consider careers in medicine and healthcare.

On this Doctor’s Day, take a moment to thank the doctors in your life and take a step towards your own health by scheduling your annual full body checkup. Staying informed about your health is one of the best gifts you can give yourself—and it makes your doctor’s job a lot easier ...

28/06/2025

Medical Case Report on a Heart Attack (Myocardial Infarction):

Case Report: Acute Myocardial Infarction in a 54-Year-Old Male

Patient Information:
• Age/Sex: 54-year-old male
• Medical History: Hypertension for 5 years, smoker (1 pack/day for 30 years), sedentary lifestyle
• Family History: Father died of myocardial infarction at age 60
• Presenting Complaint: Sudden onset of severe, crushing chest pain radiating to the left arm and jaw, lasting more than 30 minutes
• Associated Symptoms: Nausea, profuse sweating, shortness of breath

Clinical Findings:
• Vitals on Admission:
• BP: 90/60 mmHg
• HR: 110 bpm
• RR: 24/min
• SpO₂: 92% on room air
• ECG: ST-segment elevation in leads II, III, and aVF (suggestive of inferior wall MI)
• Cardiac Enzymes:
• Troponin I: Elevated
• CK-MB: Elevated

Diagnosis:

ST-Elevation Myocardial Infarction (STEMI) – Inferior Wall

Management and Treatment:
• Immediate administration of:
• Aspirin 300 mg and clopidogrel 600 mg orally
• Sublingual nitroglycerin
• Intravenous morphine for pain relief
• Patient was transferred for primary percutaneous coronary intervention (PCI) within 90 minutes
• Coronary Angiography: 100% occlusion of right coronary artery
• Treatment: Balloon angioplasty followed by stent placement
• Post-Procedure Medications: Dual antiplatelet therapy, beta-blockers, statins, ACE inhibitors, lifestyle counseling

Outcome and Follow-Up:
• Patient was stabilized and discharged after 5 days
• At 1-month follow-up: No recurrence of chest pain, improved exercise tolerance, adherence to medications and lifestyle changes
• Cardiac rehabilitation advised

Discussion:

This case highlights a classic presentation of acute myocardial infarction and underscores the importance of rapid diagnosis and timely intervention. Risk factors such as smoking, hypertension, and family history were strongly contributory. The use of primary PCI significantly improved the patient’s outcome, reinforcing current guidelines.

28/06/2025

🎗️Case Report :

1. Spontaneous Coronary Artery Dissection (SCAD) in a Young Woman
• Summary: A 35-year-old woman with no cardiac risk factors presented with acute chest pain. ECG showed ST-elevation MI. Angiography revealed SCAD.
• Learning Point: SCAD is an important differential for MI in young women without atherosclerosis.

25/06/2025

This CT scan belongs to a 73-year-old woman in whom doctors discovered a 30-year-old calcified fetus.

Known medically as a lithopedion, this rare condition occurs when a fetus dies during pregnancy and is not expelled from the body. Instead, the body responds by surrounding the remains with calcium deposits, effectively preserving the fetus in a calcified form. This usually happens when fetal death occurs during the second trimester and the body does not recognize or respond to the loss, allowing the fetus to remain in the abdominal cavity undetected for years.