High temperature setup for measurement of Hall coefficient and electrical conductivity of thermoelectric materials.

An experimental setup has been developed for the simultaneous measurement of the Hall coefficient (RH) and electrical conductivity (σ) of thermoelectric (TE) specimens in the temperature range of 300-700 K. The van der Pauw geometry is utilized for the RH and σ measurements. The sample holder geometry has been designed for diverse TE specimen dimensions and easy sample mounting. A special feature of the holder geometry is that the same sample can be used for other relevant thermoelectric measurements such as the Seebeck coefficient and thermal diffusivity. This minimizes measurement errors associated with compositional or doping inhomogeneities. In the absence of high temperature standard reference materials for Hall coefficient measurements, silicon samples with different doping concentrations have been used to verify the accuracy of the instrument. Additionally, the electrical conductivity data have been validated by measurements on the same samples in a calibrated setup. Repeat measurements indicate a maximum standard deviation of ±3% and ±0.5% for the RH and σ data in the studied temperature range. Furthermore, comparisons with the calibrated setup indicate deviations within ±3% for the σ data. The suitability of the measurement setup for TE specimens has been demonstrated using measurements on n-type (Mg2Sn) and p-type (Mg3Sb2) specimens with carrier concentrations in the range of 1019-1020 cm-3.

Do rainfed production systems have lower environmental impact over irrigated production systems?: On -farm mitigation strategies.

The intensive agriculture practices improved the crop productivity but escalated energy inputs (EI) and carbon foot print (CF) which contributes to global warming. Hence designing productive, profitable crop management practices under different production systems with low environmental impact (EI and CF) is the need of the hour. To identify the practices, quantification of baseline emissions and the major sources of emissions are required. Indian agriculture has diversified crops and production systems but there is dearth of information on both EI and CF of these production systems and crops. Hence the present study was an attempt to find hot spots and identify suitable strategies with high productivity, energy use efficiency (EUE) and carbon use efficiency (CUE). Energy and carbon balance of castor, cotton, chickpea, groundnut, maize, rice (both rainfed and irrigated), wheat, sugarcane (only irrigated), pigeon pea, soybean, sorghum, pearl millet (only rainfed) in different production systems was assessed. Field specific data on different crop management practices as well as grain and biomass yields were considered. Rainfed production systems had lower EI and CF than irrigated system. The nonrenewable sources of energy like fertilizer (64 %), irrigation (78 %), diesel fuel (75 %) and electricity (67 %) are the major source of energy input. Rainfed crops recorded higher CUE over irrigated condition. Adoption of technologies like efficient irrigation strategies (micro irrigation), enhancing fertilizer use efficiency (site specific nutrient management or slow release fertilizer), conservation agriculture (conservation or reduced tillage) rice cultivation methods (SRI or Direct seeded rice) were the mitigation strategies. These results will help policy makers and stake holders in adoption of suitable strategies for sustainable intensification.

Noise survey of neonatal intensive care unit at a government tertiary-care centre.

BACKGROUND: With technological advancement, Neonatal Intensive Care Units (NICU) have become noisier than ever. Studies have shown the detrimental effects of increasing noise in NICU on growing pre-term and sick neonates. The present study aimed to survey the amount of noise in one of the NICU blocks of a government tertiary care centre and explore ways to control it when dealing with these sick babies. METHODS: A detailed noise survey was carried out, for February 2023, in one of the two blocks of NICU in a government tertiary-care centre. The noise measurements were performed using two "Sound Ear 3" noise meters. The analyses were done in Leq (equivalent continuous sound levels) A-weighted decibels (dBA). RESULTS: The extracted data analysis revealed that the NICU block was exposed to a mean Leq of 67.78 dBA noise with a maximum of 89.0 dBA. There was a significant difference between the values noted in devices at different locations and across different periods. There were certain instances (57 and 42 for two devices) when there were sudden spikes in the noise levels beyond 80 dBA. It was also seen that noise was more than 65 dBA most of the time (72% and 66% for the two devices). CONCLUSION: The noise survey carried out over one month revealed a considerable amount of noise in the NICU of a government tertiary-care centre. The study also explored ways such as environmental modification, human behavior modification, awareness programs, and neonatal-centered modifications to reduce the noise and lower its detrimental effects on the growth of neonates.

Plan quality score to evaluate the dwell time deviation restricted inverse planning by simulated annealing and graphically optimized treatment plans for template based interstitial brachytherapy.

PURPOSE: To evaluate the impact of dwell time deviation constraint (DTDC) on the quality of IPSA-optimized treatment plans in comparison with graphical plans using plan quality scores (PQS). MATERIAL AND METHODS: Seventy optimized plans (graphical & IPSA with different DTDC values) of ten cervical cancer patients were generated. Various DVH parameters like D90, V100, V150, V200, V300 were compared to evaluate the impact of DTDC on target coverage and high dose regions inside target for different plans. Similarly, for the OAR dose, values of D2cc were compared. Various planning parameters like CI, COIN, DHI, DNR, ODI, EI and gain factor (GF) for different OARs were calculated. Based on these indices a plan quality score (PQS) was formulated and calculated. PQS values were used to see the impact of DTDC on plan quality of IPSA in comparison with dosimetric quality of graphical plan. RESULTS: We have found that target coverage is similar for IPSA and graphically optimized treatment plans. However, dose homogeneity was improved in IPSA compared to graphical optimization whereas conformality was better in graphically optimized plans. OAR dose was less in IPSA plans. High-dose regions inside the target were also reduced in IPSA comparatively. However, IPSA plans optimized with various values of DTDC did not necessarily reduce high-dose regions beyond 0.6. Plan quality scores (PQS) were 6.31, 6.31, 6.34, and 6.17 for the graphically optimized plan, IPSA with DTDC values of 0.0, 0.4, and 1.0 respectively. CONCLUSION: We found that IPSA is dosimetrically advantageous over graphical optimization. IPSA with a DTDC value of 0.4 improved overall plan quality. However, DTDC value beyond 0.6 produces dosimetrically sub-optimal plans hence the use of DTDC should be very selective and limited.

Lunar lenses - Acquired lens colobomas.

Acquired lens colobomas secondary to ocular surgeries are scarcely described in the literature. We describe two cases of acquired lens coloboma in two infants with glaucoma who underwent ocular surgery. The coloboma in the first case was likely because of direct trauma to the lens zonules during an optical iridectomy with a vitrectomy cutter, resulting in localized loss of zonules and consequently localized lens coloboma. The coloboma in the second case was noticed during examination under anesthesia after scleral buckling and cryopexy for retinal detachment. The cause for coloboma development in this case could be disruption of the lens zonules because of stretching of the globe after scleral buckle surgery or because of injury to zonules during scleral buckling and the cryopexy procedure.

Tumor necrosis factor alpha and palmitate simulate bovine fatty liver disease in vitro when using abattoir-derived primary bovine hepatocytes isolated by a novel nonperfusion method.

Hepatic lipidosis (i.e., fatty liver) is a common periparturient disease in high-producing dairy cattle affecting nearly 50% of cows to some degree and costing an estimated 60 million dollars annually. Large animal studies are costly, labor intensive, and are not well suited to mechanistic studies. Traditionally, mechanistic studies employ in vitro methodologies, utilizing established cell lines or primary cell culture methods. However, with dairy cattle, established hepatic cell lines do not exist, and methods for primary cell culture studies typically involve complicated procedures that often utilize very young animals (typically bull calves). Several previously published papers have used abattoir-derived tissues as a source of primary cells; however, a simple method utilizing simple culture media has yet to be presented. In addition, we sought to develop a way to replicate the syndrome of fatty liver disease "in a dish" using adult cattle that should more closely represent the physiology of the periparturient dairy cow. Herein we present a non-perfusion-based method that results in robust growth and proliferation of abattoir-derived bovine hepatocytes that demonstrate lipid loading, elevated lactate dehydrogenase leakage, and cytotoxicity as demonstrated by elevated caspase 3/7 expression consistent with in vivo physiology of the periparturient dairy cow with fatty liver disease.

Post-trabeculectomy early bleb localization mimicking a 'ring of steel'.

A 54-year-old-man underwent trabeculectomy with mitomycin-C (0.02%). At 4-week follow-up, there was an elevated, well-circumscribed bleb with raised intra-ocular pressure (IOP) of 32-mmHg, with a classic "ring of steel" appearance, typically seen in a tenon's cyst. A sub-tenon needle revision re-established aqueous flow. Two weeks later, the IOP was 8-mmHg without any anti-glaucoma medications. A diffuse well formed bleb was noted. Careful ocular examination helps to identify early post-operative localized bleb that may appear like a "ring of steel" but can be managed by needling, unlike a tenon's cyst, which would require more extensive intervention.

Anaerobes in cardiac infections: A decade experience from the tertiary care center.

PURPOSE: Anaerobic infections are common yet life-threatening. They are being recovered from all sites of the body, including the cardiovascular system. This study was aimed to determine the retrospective analysis on the isolation of anaerobes in cardiovascular samples received for a decade-long duration. It helps in knowing the frequency of isolation of anaerobic causes of cardiovascular infection. METHODS: All cardiovascular samples from the department of Cardio-thoracic vascular surgery from January 2010 to December 2020 were studied. RESULTS: Of 601 samples received, predominant samples were vegetations and valvular tissues of 258, followed by 98 samples of pericardial tissues, 92 samples of embolus, 90 samples of blood and post-operative collections, and 63 excised aneurysms and vascular grafts. Of the total, 15 samples grew anaerobes where Clostridium species were the predominant isolates. Clostridioides difficile was isolated in 2 samples. CONCLUSIONS: Anaerobes in cardiovascular samples are uncommon yet form a significant cause of morbidity and mortality. Most infections are from the contiguous spread, penetrating trauma, and hematogenous causing endocarditis or valvular infections. These conditions and samples form the seat of infectious focus and clinical suspicion towards the anaerobic cause of these conditions, especially in conventional routine culture-negative samples. Timely diagnosis of anaerobic infections plays a vital role in the good prognostic outcome of patients undergoing cardiothoracic and vascular surgery.

Exogenous hydrogen sulphide alleviates copper stress impacts in Artemisia annua L.: Growth, antioxidant metabolism, glandular trichome development and artemisinin biosynthesis.

A supply of plant micronutrients (some of which are metals) is necessary to regulate many plant processes; their excess, however, can have detrimental consequences and can hamper plant growth, physiology and metabolism. Artemisia annua is an important crop plant used in the treatment of malaria. In this investigation, the physio-biochemical mechanisms involved in exogenous hydrogen sulphide-mediated (H2 S) alleviation of copper (Cu) stress in A. annua were assessed.. Two different levels of Cu (20, 40 mg·kg-1 ), one H2 S treatment (200 µm) and their combinations were introduced while one set of plants was retained as control. Results showed that the presence of excess Cu in the soil reduced growth and biomass, photosynthetic parameters, chlorophyll content and fluorescence, gas exchange parameters and induced antioxidant enzyme activity. Copper stress enhanced the production of thiobarbituric acid reactive substances (TBARS) and increased Cu content in both roots and shoots of affected plants. Exogenous application of H2 S restored the physio-biochemical characteristics of Cu-treated A. annua plants by reducing lipid peroxidation and enhancing the activity of antioxidant enzymes in Cu-stressed plants as compared with the controls. Hydrogen sulphide also reduced the Cu content in different plant parts, increased photosynthetic efficiency, trichome density, average area of trichomes and artemisinin content. Therefore, our results provide a comprehensive assessment of the defensive role of H2 S in Cu-stressed A. annua.

Testing CPT symmetry in ortho-positronium decays with positronium annihilation tomography.

Charged lepton system symmetry under combined charge, parity, and time-reversal transformation (CPT) remains scarcely tested. Despite stringent quantum-electrodynamic limits, discrepancies in predictions for the electron-positron bound state (positronium atom) motivate further investigation, including fundamental symmetry tests. While CPT noninvariance effects could be manifested in non-vanishing angular correlations between final-state photons and spin of annihilating positronium, measurements were previously limited by knowledge of the latter. Here, we demonstrate tomographic reconstruction techniques applied to three-photon annihilations of ortho-positronium atoms to estimate their spin polarisation without magnetic field or polarised positronium source. We use a plastic-scintillator-based positron-emission-tomography scanner to record ortho-positronium (o-Ps) annihilations with single-event estimation of o-Ps spin and determine the complete spectrum of an angular correlation operator sensitive to CPT-violating effects. We find no violation at the precision level of 10-4, with an over threefold improvement on the previous measurement.

In silico guided design of non-covalent inhibitors of DprE1: synthesis and biological evaluation.

DprE1 is a potential target of resistant tuberculosis (TB), especially multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB. 2-benzoxazolinone is a closely related bioisostere of some scaffolds such as benzoxazoles, benzimidazole, benzothiazolinone, and benzothiazoles that have been previously explored against DprE1. Thus, a ligand-based quantitative pharmacophore model (AHRR.8) of DprE1 was developed and this pharmacophore model was utilized in activity profiling of some 2-benzoxazolinones from an in-house database using virtual screening. Obtained hits were subject to molecular docking, molecular dynamics (MD), and MM/GBSA calculations, which resulted in benzoyl-substituted derivatives of 2-benzoxazolinone showing strong interactions with the key amino acid residues in the active site of DprE1. Based on in silico results, the top five hits were duly synthesized and evaluated against the XDR-TB strain. This study is an initial effort to explore 2-benzoxazolinones against XDR-TB, which can be submitted further to lead optimization for refining the results.

Estimation and comparison of integral dose to target and organs at risk in three-dimensional computed tomography image-based treatment planning of carcinoma uterine cervix with two high-dose-rate brachytherapy sources: 60Co and 192Ir.

BACKGROUND: Iridium-192 (192Ir) has been a widely accepted radioisotope for high-dose-rate (HDR) brachytherapy. Recently, Cobalt-60 (60Co) radioisotope with a longer half-life (5.26 years) has been gaining popularity due to economic and logistical reasons as compared with the traditional 192Ir. AIM: This study aimed to evaluate and compare the integral dose (ID) to the target and organs at risk (OARs) with two HDR brachytherapy sources in brachytherapy treatment of carcinoma uterine cervix to find appropriate HDR radioisotopes for clinical benefit. MATERIALS AND METHODS: This is a retrospective analysis of 52 computed tomography image-based brachytherapy plans of 52 patients who have received intracavitary treatment with 192Ir HDR source. For each patient plan, one additional set of plan was created using 60Co source in place of 192Ir source keeping the same dwell position, and again dose was optimized. The volume and mean dose for target, OARs, and volume structures of 400%, 200%, 150%, 100%, and 50% were recorded for the estimation and comparison of ID. RESULTS: The mean ID to high-risk clinical target volume was significantly higher by 5.84% in 60Co plan than that in 192Ir plan. For OARs, the mean ID to the rectum was significantly higher by 2.60% in 60Co plan as compared to 192Ir plan, whereas for bladder and sigmoid colon, it was lower in 60Co plan than that in 192Ir plan. The mean ID of central dose volume structures of 400%, 200%, 150%, 100%, and 50% was higher by 12.97%, 9.77%, 8.16%, 6.10%, and 3.22%, respectively, in 60Co plan than that of 192Ir plan. CONCLUSION: The results of our study concluded that 192Ir HDR radioisotope should be preferred for intracavitary brachytherapy due to its ideal physical characteristics for better clinical outcomes.

Myocardial performance index in term appropriate and small for gestational age neonates - a cross sectional study.

BACKGROUND: It is known that small for gestational age (SGA) babies may be at an increased risk of cardiovascular diseases during adulthood. There is paucity of literature regarding comparative cardiac functions of SGA and appropriate for gestational age (AGA) babies in neonatal period. The present study was conceived to compare the cardiac function of term small and appropriate for gestational age (AGA) babies through a relatively novel echocardiographic index in early neonatal period. OBJECTIVES: To compare values of myocardial performance index (MPI) index (MPI = IVCT + IVRT/ET) at 48-72 hours of age among AGA and SGA babies. METHODS: Morphological and anthropometric assessment of serially born term babies was done at time of birth to recruit hundred each of AGA and SGA babies. Tissue Doppler Imaging (TDI) was done between 48-72 hours for each enrolled baby to assess both right and left ventricle MPI in each group. RESULTS: Mean±SD values for right ventricular MPI in AGA and SGA groups were 0.268 + 0.007 and 0.30 + 0.026 respectively (p < 0.001). Mean±SD values for left ventricular MPI in AGA and SGA groups were 0.25 + 0.012 and 0.30 + 0.017 respectively (p < 0.001). There was significant negative correlation between MPI values for either ventricles and the birth weight (spearmen's rho of -0.66) (p < 0.001). Mean±SD values for LVET in AGA and SGA group were 0.304 + 0.026 and 0.266 + 0.032 respectively (p < 0.001). CONCLUSION: MPI had a higher absolute value in the SGA babies as compared to AGA babies. These observations point towards suboptimal cardiac performance among SGA babies as compared to AGA babies on the basis of myocardial performance index.

Assessment of Genetic Polymorphisms in the Rewa Population of Central India Using Y-Chromosomal STR Markers.

The aim of the study was to analyze unrelated samples from the Rewa male population of Central India by targeting Y-short tandem repeats (STR) and then compare the results to previously published Y-STR haplotype data. Materials and Methods: A total of 181 unrelated male subjects from the Rewa population were genotyped for seventeen Y-STRs (DYS19, DYS389I, DYS389II, DYS390, DYS391, DYS392, DYS393, DYS385a/b, DYS437, DYS438, DYS439, DYS448, DYS456, DYS458, DYS635, and Y-GATA-H4) by using an AmpFlSTR® Yfiler™ multiplex kit (Thermo Fisher Scientific, USA). The allele frequencies and forensic parameters were evaluated. Results: A total of 111 distinct Y-STR alleles with corresponding frequencies ranging from 0.006 to 0.829 were identified. The gene diversity values ranged from 0.3092 at DYS437 to 0.8188 at DYS385b. The studied population showed a high level of haplotype diversity (0.9985) and discrimination capacity (0.927). A haplotype analysis was also conducted. Among the 181 unrelated male samples, 165 haplotypes and 153 unique haplotypes were found. Additionally, Rst (genetic distance) values were calculated using the analysis of molecular variance (AMOVA) for the studied population and for other 18 populations described in the literature. The Rst provides a convenient parameter for estimating the level of genetic differentiation from the microsatellite data. Based on these Rst values and using the multidimensional scaling plot, a neighbor-joining tree was constructed. Conclusion: The high values of haplotype diversity and discrimination capacity indicate a great potential for distinguishing between male individuals in the studied population. The present population data are expected to find their use in forensic caseworks and population genetics.

Myths, facts and scope of spinal cord tolerance dose revision in Intensity modulated SIB treatment of locally advanced head and neck cancer: A dosimetrical and radiobiological demonstration.

PURPOSE: To explore the possibility of revising the spinal cord tolerance dose in Simultaneously Integrated Boost (SIB) intensity modulated treatment plan of locally advanced head and neck (H&N) cancer and assessment of achieved planning gain due to the revision. In SIB regimen, the Organ at Risk (OARs) tolerance dose is equally distributed throughout the treatment. Clinicians have usually considered the spinal cord tolerance to be the same as in conventional technique. However, in SIB fractionation regimen with intensity modulation treatment, the spinal cord may receive a physical dose of 45Gy, with much lesser dose per fraction than 2Gy per fraction. So when the dose of spinal cord is distributed throughout the treatment, the tolerance dose limit of physical dose can be considered higher than the usual conventional dose limits. In this study, an attempt has been made to explore the possibilities of dose escalation and treatment planning benefits while exploiting this "Window of Opportunity (WoO)" of increase in spinal cord and Planning Risk Volume (PRV) spinal cord tolerance dose. MATERIAL AND METHODS: A total of 12 patients CT data set along with approved structure set of H&N cancer used for treatment planning in. Three independent SIB VMAT plans named as SPC, SPR and SPDE were generated for the 12 patients. First plan (SPC) was generated by considering standard spinal cord tissue constraint of maximum dose of 45Gy and PRV spinal cord maximum dose 50Gy as per QUANTEC summary and second plan (SPR) was generated considering spinal cord tissue constraint of maximum dose 52.50Gy and PRV spinal cord maximum dose 56.35Gy while optimization and dose calculation. The objectives for rest of the Organ at Risk (OAR) were kept same in both the plans during optimization and dose calculation. The SPC plan was copied for creation of third plan (SPDE) in which dose was escalated by increasing dose per fraction for target volumes such that dose to spinal cord reached a maximum dose of 52.50Gy and PRV spinal cord maximum dose of 56.35Gy. In this plan there have been changes to only dose per fraction, however dose optimization and dose calculation have not been performed. Radiobiological parameters TCP and NTCP were also calculated by using indigenously developed software. RESULTS: Considering the increase of spinal cord tolerance dose as "window of opportunity", a sufficient escalation in physical dose, Biological Effective Dose (BED) and Tumor Control Probability (TCP) was observed for all target volumes with acceptable level of NTCP values. CONCLUSION: Sufficient dose escalation and increased in TCP for target volumes or effective planning benefits can be achieved by revising the spinal cord tolerance dose in intensity modulated SIB treatment of locally advanced H&N cancers.

In silico guided designing of 4-(1H-benzo[d]imidazol-2-yl)phenol-based mutual-prodrugs of NSAIDs: synthesis and biological evaluation.

The free COOH group of conventional NSAIDs is a structural feature for non-selective cyclooxygenase (COX) inhibition and the molecular cause of their gastrointestinal (GI) toxicity. In this context, an in house database of synthesizable ester prodrugs of some well-known NSAIDs was developed by combining their -COOH group with -OH of a newly identified antioxidant 4-(1H-benzo[d]imidazol-2-yl)phenol (BZ). The antioxidant potential of BZ was unveiled through in silico PASS prediction and in vitro/in vivo evaluation. The in house database of NSAIDs-BZ prodrugs was first subjected to screening with our previously reported pharmacophore models of hCES1 (AAHRR.430) and hCES2 (AHHR.21) for determining hydrolytic susceptibility. Biotransformation behaviour of screened prodrugs was then assessed by using QM/MM and sterimol parameterization, followed by ADMET calculations to predict the drug likeness. On the basis of in silico results, five prodrugs were duly synthesized and the best three were subject to the in vivo evaluation for their anti-inflammatory, analgesic, antioxidant activities, and ulcerogenic index. Among these prodrugs, BN2 and BN5 displayed better anti-inflammatory and analgesics potential in comparison to their parent drugs. All the prodrugs were found to be gastro sparing in the rat model and significantly improved the levels of oxidative stress biomarkers in both blood plasma as well as gastric homogenate.

Ultrasound-guided radiofrequency ablation for treatment of Morton's neuroma: initial experience.

AIM: To assess the efficacy and safety of ultrasound-guided radiofrequency ablation (RFA) for treatment of symptomatic Morton's neuroma. MATERIALS AND METHODS: Patients with symptomatic Morton's neuroma of the foot were referred for treatment with RFA, prior to consideration for surgery. All neuromas were proven by ultrasound imaging and had a trial of conservative management including orthotic support and/or steroid injections. Ultrasound-guided RFA was performed as an outpatient procedure under local anaesthetic. Patients were followed up at 8 weeks and 8 months. Outcomes were assessed with a visual analogue scale (VAS) score, Manchester-Oxford Foot and Ankle Questionnaire, overall patient satisfaction, and complications. RESULTS: Twenty-two neuromas were treated with RFA under ultrasound guidance. The VAS score at 8 weeks was significantly lower than the VAS score pre-procedure (p<0.001, Wilcoxon signed ranks test) and the VAS score at 8 months was significantly lower than the VAS score at 8 weeks (p=0.008, Wilcoxon signed ranks test). At 8 months, 89% of treated patients were satisfied with the procedure outcome. No significant adverse effects were recorded. CONCLUSION: Ultrasound-guided RFA is safe, with excellent initial results in treatment of symptomatic Morton's neuroma. Further studies on long-term outcomes and comparison to other management options will be required to establish its role in management of symptomatic Morton's neuroma.

Well-differentiated Squamous Cell Carcinoma Arising in Syringocystadenoma Papilliferum.

Syringocystadenoma papilliferum (SCAP) is a hamartoma of apocrine sweat gland origin, occurring predominantly in children, in the head and neck region. SCAP can arise or coexist with both benign and malignant tumors. We report herein an extremely rare case of squamous cell carcinoma (SCC) arising in SCAP growth located in unusual supragluteal region in an elderly Indian male. A wide surgical excision of the growth was performed which upon histopathological examination revealed the confirmatory diagnosis. SCC arising in SCAP is unusual, and only two histologically confirmed cases have been previously reported in the literature. This case report emphasizes about extremely rare malignant transformation of SCAP, which should be kept in mind while evaluating a suspicious skin lesion.

Interfraction physical dose variations in high-dose-rate brachytherapy for carcinoma cervix based on computed tomography image dataset to find the compatibility of the first fraction plan to treat successive fractions.

CONTEXT: Due to limited resources and/or affordability by majority of the patients, many centers in low- and middle-income countries are still not able to adapt three-dimensional image-based brachytherapy planning in their routine practice. AIM: The aim of the study was to see the feasibility of using computed tomography (CT)-based plan of the first fraction to treat successive fractions of intracavitary brachytherapy based on the estimation of the physical dosimetric differences between successive applications. MATERIALS AND METHODS: CT image-based brachytherapy plans of 38 patients who received three insertions of intracavitary application with high-dose-rate brachytherapy have been analyzed. Revised plans for the second and third insertions were generated by adapting dwell time and dwell position of the first insertion plan. The dose to point "A" and maximum doses to 2, 1, and 0.1 cc volumes of the rectum and bladder have been used for dosimetric comparison. RESULTS: The statistical differences of mean point "A" doses were observed insignificant except between original and revised plans for the second insertions. The dosimetric differences between consecutive original and revised plans for the bladder and rectum have not shown any significance except minimum dose to 0.1 cc volume of the rectum for the third insertions. CONCLUSIONS: Dosimetric deviation for tumor and organs at risk is within acceptable limit while using CT image-based brachytherapy plan of the first fraction for treating successive fractions.