Knowledge and awareness of orthopaedic surgeons about radiation hazards in operation theatres

<p class="abstract"><strong>Background:</strong> Due to increase in geriatric orthopaedic patients minimally invasive soft tissue and orthopaedic surgeries are gaining. But such procedures have increased the surgeon’s dependence on fluoroscopy which has exposed them to ever increasing dosage of ionising radiations (both direct and scattered).</p><p class="abstract"><strong>Methods:</strong> The study was carried out among medical professionals attending annual north zone conference of orthopaedics using a pre-designed questionnaire on a non-probability sample of 200 orthopedicians. Questionnaires contained 11 MCQs.<strong></strong></p><p class="abstract"><strong>Results:</strong> 62% of the surgeons believed that hands receive maximum amount of C-arm radiations followed by thyroid (25%). 9% of surgeons have answered eyes and 4% say gonads. 31% of surgeons believe that 100 mSv is allowable annual effective whole-body dose of radiation. 15% believe it to be 500 msv. Majority (37%) of the surgeons had no idea on the allowable annual effective whole-body dose of radiation. 30% of surgeons believe that allowable annual effective dose of radiation for hands is 50 msv. Further 23% of the surgeons believe it to be 100 msv. 50% have no idea about this.</p><p class="abstract"><strong>Conclusions:</strong> All orthopaedic residents and surgeons should have more information and knowledge about ionising radiation. Special courses and workshops can be arranged at local, regional and national levels in this regard.</p><p class="abstract"> </p>

Radioprotective natural products as alternative complements in oncological radiotherapy

Humans when exposed to harmful ionising radiations suffer from various pathophysiological disorders including cancer. Radiotherapy is a treatment where these cancerous cells within a tumor are targeted and killed by means of high energy waves. This therapy is very expensive and involves highly sophisticated instruments. In addition to this, most synthetic radioprotectors including Amifostine have been found to possess toxicity. This led researchers to develop a novel, economically viable, and efficient therapeutic alternative to radiation therapy. The last two decades have observed a major shift towards investigating natural products as radioprotectors, as these are immensely effective in terms of their potential bioequivalence relative to many of the established synthetic compounds available. Taking into account the limitations of radiation therapy, an approach ‘Integrative Oncology’ that involves a combination of both traditional and conventional medical treatment are used nowadays to treat patients suffering from cancer and associated mental and psychological disorders.

The challenges of radioiodine treatment for incontinent paediatric patients with complex care needs

Objectives: A thyrotoxic paediatric patient with incontinence, autism and Down’s syndrome was referred for radioiodine therapy. Here, the risk assessment methodology and measures taken to deliver a legally compliant treatment that was acceptable to the family are described. Methods: Prior risk assessment indicated that the most active incontinence waste would require decay storage until it could be transported for disposal. The Health and Safety Executive (HSE) indicated that school staff would be occupationally exposed under the Ionising Radiations Regulations (2017) based on the patient’s retained activity. To avoid the need for HSE Registration, it was advised that the patient’s return to school may need to be delayed slightly. Post-treatment, confirmatory waste and patient dose rate measurements were made to refine the advised timescales. Results: Domestic waste disposal resumed at 28 days. The patient recommenced schooling a few days after school their reopened after the summer break. The school underwent HSE Notification. Conclusion: Careful planning allowed us to provide a safe, compliant treatment regarding waste management and occupational exposure. Advances in knowledge: Incontinent 131I outpatient treatments require detailed, patient specific waste management. The HSE considered school staff as occupationally exposed by the patient well after normal social restrictions had ended.

Solid papillary thyroid carcinoma with Hashimoto’s thyroiditis: description of a further case with challenging cytological features

Solid papillary thyroid carcinoma (SV-PTC) is a rare variant which is mainly observed in young patients with a history of exposure to ionising radiations. Neoplasms belonging to such category generally carry RET-PTC (REarranged during Transfection- Papillary Thyroid Carcinoma) fusions and seem to have a slightly worse prognosis with respect to classical and follicular variants of papillary thyroid carcinoma (PTC), though consistent prognostic and survival data are scarce. SV-PTC should be differentiated from trabecular-insular poorly differentiated thyroid carcinomas, which occur in a different age group and carry a dismal prognosis. These latter tumours do not show the typical nuclear features of PTC and show tumour necrosis with an high mitotic activity. In this report a further case of SV-PTC is described which was associated to Hashimoto’s thyroiditis, a finding never described in the cytological literature up to now for SV-PTC; this association created further differential diagnostic problems. The neoplasm displayed RET-PTC1 fusion.

Gamma Radiation Induced Intestinal Proteomic Modulation in Mice: A Two Dimensional Electrophoretic Analysis

<p>Exposure to high doses of radiation causes serious injuries in gastrointestinal tract, by affecting biomolecules of the tissue. To demonstrate the modulation of intestinal proteome by ionising radiations, we analysed changes in protein expression in 9 Gy irradiated C57BL/6 mice at 24 h and 72 h by using two dimensional electrophoresis technique. A total of 19 protein spots with statistical significance (fold change&gt;1.5 and P&lt;0.05) were found to be differentially expressed. Of these 07 spots were identified by MALDI-TOF MS and peptide mass fingerprinting techniques which matched with the known proteins documented in the online database. These proteins belong to biological-functional categories like cytoskeleton system, molecular chaperones, DNA damage response, and stress response. These identified radiation induced proteins can help in understanding the mechanisms behind the intestinal injuries and thus can become potential targets for therapeutics and also aid in drug development.</p>