scholarly journals Biological Planning of Radiation Dose Based on In Vivo Dosimetry for Postoperative Vaginal-Cuff HDR Interventional Radiotherapy (Brachytherapy)

Biomedicines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1629
Author(s):  
Tamer Soror ◽  
Ramin Chafii ◽  
Valentina Lancellotta ◽  
Luca Tagliaferri ◽  
György Kovács
Keyword(s):  
Early Stage ◽  
Treated Group ◽  
In Vivo Dosimetry ◽  
Vaginal Cuff ◽  
Dose Fraction ◽  
Group A ◽  
Group B ◽  
Fractionation Schedules

(1) Background: Postoperative vaginal-cuff HDR interventional radiotherapy (brachytherapy) is a standard treatment in early-stage endometrial cancer. This study reports the effect of in vivo dosimetry-based biological planning for two different fractionation schedules on the treatment-related toxicities. (2) Methods: 121 patients were treated. Group A (82) received 21 Gy in three fractions. Group B (39) received 20 Gy in four fractions. The dose was prescribed at a 5 mm depth or to the applicator surface according to the distance between the applicator and the rectum. In vivo dosimetry measured the dose of the rectum and/or urinary bladder. With a high measured dose, the dose prescription was changed from a 5 mm depth to the applicator surface. (3) Results: The median age was 66 years with 58.8 months mean follow-up. The dose prescription was changed in 20.7% of group A and in 41% of group B. Most toxicities were grade 1–2. Acute urinary toxicities were significantly higher in group A. The rates of acute and late urinary toxicities were significantly higher with a mean bladder dose/fraction of >2.5 Gy and a total bladder dose of >7.5 Gy. One patient had a vaginal recurrence. (4) Conclusions: Both schedules have excellent local control and acceptable rates of toxicities. Using in vivo dosimetry-based biological planning yielded an acceptable dose to the bladder and rectum.

A Comparative Study of Amalaki Choorna along with Madhu and Vata Twak Kashaya Yoni Pichu Dharana in the Management of Shweta Pradara

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Renuka M. Tenahalli
Keyword(s):  
Vitamin C ◽  
Early Stage ◽  
Pathological Condition ◽  
Before And After ◽  
Group A ◽  
Phosphorus Iron ◽  
Group B ◽  
Busy Schedule ◽  
Iron And Calcium

Shweta Pradara (Leucorrhoea) is the disease which is characterized by vaginal white discharge. Vaginal white discharge this symptom is present in both physiological and pathological condition, when it becomes pathological it disturbs routine life style of the woman. Most of the women in the early stage will not express the symptoms because of hesitation and their busy schedule. If it is not treated it may leads to chronic diseases like PID (Garbhashaya Shotha etc.) Charaka mentioned Amalaki Choorna along with Madhu and Vata Twak Kashaya Yoni Pichu Dharana. This treatment is used in Shweta Pradara shown positive results, hence a study was under taken to assess its clinical efficacy. 30 diagnosed patients of Shweta Pradara were randomly selected, allocated in three groups. Group A and Group B received Amalaki Choorna with Madhu and Vata Twak Kashaya Yoni Pichu Dharana respectively and Group C received Amalaki Choorna with Madhu followed by Vata Twak Kashaya Yoni Pichu Dharana for 15 days. The patients were assessed for the severity of the symptoms subjectively and objectively before and after the treatment and at the end of the follow up. Data from each group were statistically analyzed and were compared. No side effects were noted and it may be considered as an effective alternative medicine in Shweta Pradara (leucorrhea). Amalaki is rich in natural source of vitamin C and contains phosphorus, iron and calcium. Honey contains carbohydrate, vitamin C, phosphorus iron and calcium. All together these help to increase Hb% and immunity. Vata Twak Kashaya contains tannin which helps to maintain normal pH of the vagina.

scholarly journals In VivoTherapeutic Efficacy of Chloroquine Alone or in Combination with Primaquine against Vivax Malaria in Kolkata, West Bengal, India, and Polymorphism inpvmdr1andpvcrt-oGenes

2012 ◽  
Vol 57 (3) ◽  
pp. 1246-1251 ◽  
Author(s):  
Swagata Ganguly ◽  
Pabitra Saha ◽  
Subhasish K. Guha ◽  
Sonali Das ◽  
Dilip K. Bera ◽  
...  
Keyword(s):  
Clinical Trial Registry ◽  
Content Type ◽  
Sequencing Method ◽  
Life Threatening ◽  
Group A ◽  
Mutation Pattern ◽  
Group B ◽  
Parasitological Response

ABSTRACTPlasmodium vivaxmalaria, though benign, has now become a matter of concern due to recent reports of life-threatening severity and development of parasite resistance to different antimalarial drugs. The magnitude of the problem is still undetermined. The present study was undertaken to determine thein vivoefficacy of chloroquine (CQ) and chloroquine plus primaquine inP. vivaxmalaria in Kolkata and polymorphisms in thepvmdr1andpvcrt-ogenes. A total of 250 patients withP. vivaxmonoinfection were recruited and randomized into two groups, A and B; treated with chloroquine and chloroquine plus primaquine, respectively; and followed up for 42 days according to the WHO protocol of 2009. Data were analyzed using per-protocol analyses. We assessed polymorphisms of thepvmdr1 and pvcrt-ogenes by a DNA-sequencing method. Out of the 250 patients recruited, 204 completed a 42-day follow-up period, 101 in group A and 103 in group B. In group A, the non-PCR-corrected efficacy of CQ was 99% (95% confidence interval [CI], 0.944 to 1.00), and in group B, all cases were classified as adequate clinical and parasitological response (ACPR). Day 3 positivity was observed in 11 (5.3%) cases. No specific mutation pattern was recorded in thepvcrt-ogene. Eight nonsynonymous mutations were found in thepvmdr1gene, three of which were new. The Y976F mutation was not detected in any isolate. Chloroquine, either alone or in combination with primaquine, is still effective againstP. vivaxmalaria in the study area. (The study protocol was registered in CTRI [Clinical Trial Registry-India] of the Indian council of Medical Research under registration no. CTRI/2011/09/002031.)

Thyroid stimulating antibody: an index of thyroid stimulation in Graves' disease?

1987 ◽  
Vol 116 (1) ◽  
pp. 7-12 ◽  
Author(s):  
L. Baldet ◽  
A. M. Madec ◽  
C. Papachristou ◽  
A. Stefanutti ◽  
C. Jaffiol
Keyword(s):  
Rank Test ◽  
Graves Disease ◽  
Initial Value ◽  
Absolute Value ◽  
Standard Ml ◽  
Group A ◽  
The Absolute ◽  
Group B

Abstract. Early (20 min) thyroid radio-iodine uptake (ERU) and thyroid-stimulating antibodies (TSab) were determined in 27 untreated unselected patients with Graves' disease at the time of diagnosis. In 21 subjects the same tests were further performed in parallel during combined carbimazole-L-T3 therapy (mean duration of follow-up: 10.8 ± 5.8 months; mean ± sd). TSab was determined by a cAMP-human thyrocyte culture stimulation assay and expressed in μl-equivalent of a TSab standard/ml (μl-eq/ml). Before treatment, ERU, ranging from 15 to 54% of the injected dose (normal ≤ 8% dose) correlated with serum T3 (r: 0.54; P < 0.01); TSab, ranging from 6 to 85 μl-eq/ml was detected in 21/27 patients. There was a significant correlation between ERU and TSab (Spearman rank test: r: 0.57; P < 0.01). During the first months of treatment, 5 of the 21 patients sequentially studied had undetectable TSab levels throughout the study and in these patients ERU decreased by 57% of its initial value; the remaining 16 subjects were divided into two groups according to ERU changes: in group A (9 patients), initial ERU decreased by 50% or more or the absolute value became less than 20% of the dose and TSab decreased from 10.9 ± 4.8 ISP-μl-eq/ml to 5.3 ± 1.6 μl-eq/ml (P < 0.01); in group B (7 patients), the fall of ERU was less than 50% or the absolute value remained greater than 20% of the dose and TSab values remained unchanged. Furthermore, the values of ERU and TSab serially obtained during treatment varied in parallel in the 9 patients of group A, whereas in group B, TSab and ERU evolutions were discordant. These two patterns of TSab and ERU changes could not be related to any clinical or biological findings. We conclude that 1) ERU is more closely related to thyroid overstimulation than TSab in untreated patients with Graves' disease, but that there is a significant relationship between ERU and TSab values; 2) during antithyroid therapy, the TSab decrement was significantly greater in patients in whom initial ERU decreased by 50% or more or the absolute value became less than 20% of the dose than in patients with persistent high ERU levels; 3) the follow-up of these patients during antithyroid-L-T3 treatment showed two patterns of changes for ERU and TSab, parallel in some patients, discordant in others, suggesting an heterogeneity in the in vivo TSab effect from one patient to another.

scholarly journals COMPARISON OF PATCHING DURATION ON AMBLYOPIC CHILDREN IN CMH MUZAFFARABAD

2019 ◽  
Vol 33 (1) ◽  
Author(s):  
Sidra Malik ◽  
Iqra Zaib ◽  
Omer Farooq ◽  
Kanwal Hanif
Keyword(s):  
Visual Acuity ◽  
Randomized Control Trial ◽  
Early Stage ◽  
Personal Information ◽  
Factors Affecting ◽  
Group A ◽  
The Mean ◽  
Randomized Control ◽  
Group B

Objective: To Compare the efficacy of 2 different patching regimens in amblyopic children and highlight the factors affecting compliance. Materials & Methods: The randomized control trial was conducted in Eye OPD SKBZ Hospital Muzaffarabad from September 2017- March 2018. Analysis was limited to children 4 to 16 years of age with unilateral amblyopia. Personal information, visual acuity with and without correction, Cycloplegic refraction & subjective refraction was noted. Children with amblyopic eye acuity of 20/40 to 20/200 (mean 0.56 log MAR, approximately 20/63) and inter ocular acuity difference of 2 or more lines were specified to get either 2 hours (Group A) or 6 hours (Group B) of daily patching, combined with 1 hour of near visual activities per day. Follow up period was 2 weeks, 4 weeks and 3 months. Results:     Out of 72 children 44(61.1%) were males and 28(38.9%) were females. The mean age was 10.25 ± 0.67 years.  Mean visual acuity was 20/63(+0.5 log Mar) in both groups. In group A, 66.7 % and in group B 83.3% of patients showed improvement. The mean difference of BCVA was 2.77 ± 1.28 SD and 3.41±3.16 SD in group ‘A’ and group ‘B’ respectively. Group A and B showed improvement of 3.0 and 2.0 lines respectively. Both groups showed a poor compliance of 11.2 %. Conclusion: 2 hours of patching along with 1 hour of near activity is sufficient to treat amblyopia as compared to 6 hours of patching. Firstly, screening should be done to diagnose amblyopia at early stage. Secondly compliance is found to be a single most important factor to improve outcomes.

Recurrence and survival after robotic-assisted radical hysterectomy (RRH) for early-stage cervical cancer (CC): Experience may matter.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 5535-5535 ◽  
Author(s):  
Christine K. Fitzsimmons ◽  
Amanda J. Stephens ◽  
Jessica A. Kennard ◽  
Madhavi Manyam ◽  
Julie W. Pepe ◽  
...  
Keyword(s):  
Learning Curve ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Phase Iii ◽  
Inclusion Criteria ◽  
Free Survival ◽  
Uterine Manipulator ◽  
Group A ◽  
Group B

5535 Background: The phase III LACC Trial found that minimally invasive surgery (MIS) / radical hysterectomy was inferior to open radical hysterectomy (ORH) with reduced disease-free survival (86% v 96.5%) and a higher disease-specific death rate (DSDR) (4.4% v 0.6%). We evaluated our experience with attention to the learning curve. Methods: Patients (pts) with early-stage CC (4/2007-12/2017) who underwent RRH with a uterine manipulator were evaluated in a contemporaneously maintained database. First 10 learning curve cases per surgeon (Group A) were compared to all subsequent cases (Group B). Inclusion criteria mirrored the LACC trial: > one-year follow-up, adenocarcinoma, adenosquamous, or squamous carcinoma, stage IA2 or IB1 using FIGO 2014 guidelines, and pathologic tumor size (TS) of 4 cm or less. Atypical histologies and lesions > 4 cm were excluded. Study parameters assessed included recurrence free survival (RFS), DSDR, and pattern of recurrence. Results: 144 RRH pts were identified and 90 met inclusion criteria with mean age of 45.6±14.3 years. Exclusions included stage 1A1 without LVSI (n = 13), atypical histology (n = 10), lost to follow-up (n = 13), and occult stage 1B2 (n = 18). 40 pts met Group A and 50 met Group B criteria. Median follow-up was 61±34.3 months (A = 71.5, B = 52.5). The 5-year RFS was 92% (95 CI ±4%) and the DSDR 5.5% (n = 5). There were 7 (7.8%) recurrences with median time to recurrence of 12±8.3 mos. Recurrence in Group A (n = 6, 15%) exceeded Group B (n = 1, 2%), p= 0.025. DSDR was 10% Group A v 2% B ( p= 0.184). The 4.5 yr RFS was 84.8% (95 CI ±7%) in Group A v 98% (95 CI ±3%) in Group B. There were no differences in risk factors for recurrence between A & B (TS > 2 cm, LN (+), adjuvant therapy (AT), and LVSI p> 0.05), except (+) vaginal margin status (A = 10% v B = 0%, p= 0.034). Three recurrences involved carcinomatosis, which may be insufflation related. All recurrent cases had TS > 2 cm and 5 received AT. Conclusions: In this study, recurrence of disease in early-stage CC clustered in the first 10 cases per surgeon and occurred in TS > 2 cm. This data suggests a possible learning curve effect and argues against a uterine manipulator cause. Carcinomatosis may be insufflation related, unique to MIS, and deserves further study.

scholarly journals Early Stages Non-Traumatic Avascular Necrosis of Femoral Head Treated by Core Decompression With and Without Platelets Rich Plasma Injection: A Comparative Study

2021 ◽  
Author(s):  
Ghadeer H. Majeed ◽  
Mohammed Sh Al-Edanni ◽  
Luay Jasim Abbood ◽  
Sadik A Al-Mukhtar
Keyword(s):  
Comparative Study ◽  
Avascular Necrosis ◽  
Hip Joint ◽  
Early Stage ◽  
Platelet Rich Plasma ◽  
Core Decompression ◽  
Harris Hip Score ◽  
Group A ◽  
Group B

Core decompression is one of the commonest used techniques in the handling of osteonecrosis of the pre-collapsed head of the femur. Core decompression had succeeded in preserving the hip joint and delaying the requisite for total hip replacement, but it had failed in the induction of osteogenesis in the necrotic area, thus augmenting core decompression with biological agents to induce osteogenic activity. To assess the effects of platelet-rich plasma in non-traumatic avascular necrosis of the hip joint (early stage) after core decompression. Interventional comparative study for twenty-four patients (32 hip joints) with AVN of the head of the femur was involved in this prospective study, and they were separated into two groups of 16 hips, group (A) treated by core decompression and PRP injection and group (B) treated by core decompression alone. There was a significant statistical difference in Harris Hip Score and Visual Analogue of the two groups at six months follow up (P<0.05), but this difference was insignificant statistically at 12 months follow up. The radiological success was better in the group (A) as compared to group (B) (13 of 16 versus 10 of 16 hips). The addition of PRP to core decompression for pre-distorted stages of the head of the femur had resulted in improved pain alleviation and functional results and had slowed the disease progression in the one year of follow up.

scholarly journals A comparative study between results of different modalities of management of cervical intraepithelial neoplasia I

2021 ◽  
Vol 53 (1-2) ◽  
pp. 8-12
Author(s):  
Eti Saha ◽  
Fouzia Begum ◽  
Zannatul Ferdous Jesmin ◽  
Muckti Kaniz Fatema
Keyword(s):  
Early Stage ◽  
Expectant Management ◽  
High Rate ◽  
Treatment Modalities ◽  
P Value ◽  
Stage Of Development ◽  
Group A ◽  
Group B ◽  
Cold Coagulation

Background: Carcinoma cervix is a preventable disease. It runs a long preinvasive stage, such as Normal - CIN I - CIN II - CIN III - Cancer cervix. It can be prevented at early stage of development with proper diagnosis, treatment & follow up. A major portion of CIN I spontaneously regress but some need treatment. Obiective: The purpose of this study was to determine the frequency of abnormal colposcopic findings during the 1 year follow up period in patients of CIN I treated with cold coagulation, LEEP and expectant management. Materials and Methods: This retrospective study was conducted in colposcopic centre of Khulna medical college hospital, Khulna, Bangladesh from January 2018 to December 2019. After confirmation of CIN I, ladies were arranged in three groups according to their treatment modalities - Expectant management (group A), Cold coagulation (group B) & LEEP (group C). They were reexamined with colposcopy after 6 months, or after one year of first visit. Persistence or reappearance of CIN was assayed & correlation between colposcopic results during follow up of different groups was analysed. Results: Total 195 ladies were diagnosed colposcopically as CIN I. Of them 75 women were confirmed by histological examination. Among 75 ladies, 25 ladies received no treatment, grouped as group A. Forty ladies treated with cold coagulation falls in group B, whereas 10 ladies who treated with LEEP were grouped as group C. Distribution of age, parity, monthly income, education, marital age, age at first delivery was similar in different group. During follow up persistence of disease were found in 2(13.3%) ladies who did not receive any form of treatment, 3(10.7%) who were treated with cold coagulation (p value 0.333) and 1(12.5%) lady who received treatment with LEEP (p value 0.667), were not significant. Conclusion: Colposcopic surveillance without treatment appears reasonable in treating CIN I because of the high rate of spontaneous regression of CIN 1, but adherence to the follow up should be emphasized to the patients during the follow up visits. Bang Med J Khulna 2020: 53 : 8-12

Absorbable suture material in carotid surgery

VASA ◽  
2015 ◽  
Vol 44 (6) ◽  
pp. 451-457 ◽  
Author(s):  
Vincenzo Gasbarro ◽  
Luca Traina ◽  
Francesco Mascoli ◽  
Vincenzo Coscia ◽  
Gianluca Buffone ◽  
...  
Keyword(s):  
Suture Material ◽  
Absorbable Suture ◽  
Paediatric Surgery ◽  
Carotid Surgery ◽  
Suture Materials ◽  
Absorbable Suture Material ◽  
Absorbable Sutures ◽  
Group A ◽  
Group B

Abstract. Background: Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery. Patients and methods: In an 11 year period, 1126 patients (659 male [58.5 %], 467 female [41.5 %], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered. Results: A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5 % and 2.0 % for group A, respectively, and 11.8 % and 12.9 % for group B, respectively. Conclusions: In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.

Laparoscopic Incisional and Ventral Hernia Repair with Absorbable Tacks in a Long Term Follow-up: A Retrospective Control Study

2019 ◽  
Vol 14 (2) ◽  
pp. 141-146
Author(s):  
Simone Zanella ◽  
Enrico Lauro ◽  
Francesco Franceschi ◽  
Francesco Buccelletti ◽  
Annalisa Potenza ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
The Elderly ◽  
Long Term Follow Up ◽  
Group A ◽  
Group B ◽  
Absorbable Tacks

Background: Laparoscopic Incisional and Ventral Hernia Repair (LIVHR) is a safe and worldwide accepted procedure performed using absorbable tacks. The aim of the study was to evaluate recurrence rate in a long term follow-up and whether the results of laparoscopic IVH repair in the elderly (≥65 years old) are different with respect to results obtained in younger patients. Methods: One hundred and twenty-nine consecutive patients (74 women and 55 men, median age 67 years, range = 30-87 years) with ventral (N = 42, 32.5%) or post incisional (N = 87, 67.5%) hernia were enrolled in the study. Patients were divided into two groups according to their age: group A (N = 55, 42.6%) aged <65 years and group B (N = 74, 57.4%) aged ≥65 years. Results: The mean operative time was not significantly different between groups (66.7 ± 37 vs. 74 ± 48.4 min, p = 0.4). To the end of 2016, seven recurrences had occurred (group A = 3, group B = 4, p = 1). Complications occurred in 8 (16%) patients in group A and 21 (28.3%) patients in group B. Conclusion: In conclusion, our results confirm that the use of absorbable tacks does not increase recurrence frequency and laparoscopic incisional and ventral repair is a safety procedure also in elderly patients.

A Study on Frozen Shoulder and its clinical management through Nasaapana and Nasya

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Praveenkumar H. Bagali ◽  
A. S. Prashanth
Keyword(s):  
Medical Science ◽  
Frozen Shoulder ◽  
Signs And Symptoms ◽  
Treatment Modalities ◽  
Animal Kingdom ◽  
Shoulder Joints ◽  
Group A ◽  
Group B

The unique position of man as a master mechanic of the animal kingdom is because of skilled movements of his hands and when this shoulder joints get obstructed, we call it as Apabahuka (Frozen shoulder), we do not find satisfactory management in modern medical science. Various effective treatment modalities have been mentioned which reverse the pathogenesis, Shodhana is advised initially followed by Shamana therapies. In the present study 30 patients were selected incidentally and placed randomly into two groups A and B, with 15 subjects in each group. Group A received Amapachana with Panchakola Churna, Jambeera Pinda Sweda and Nasya Karma. Group B received Amapachana with Panchakola Churna, Jambeera pinda Sweda and Nasaapana. In both the groups two months follow up was done. Both groups showed significant improvement in the signs and symptoms of Apabahuka as well as the activities of daily livings, thereby improving the quality of life of the patients. Nasya Karma and Nasaapana provided highly significant results in all the symptoms of Apabahuka. In the present study as per the clinical data, Nasaapana is found to be more effective than Nasya Karma.

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