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BACKGROUND AND AIMS: One of the priorities in public health policy for the control of Cutaneous Leishmaniasis (CL) is to investigate associations between disease distribution, socio-demographical and environmental risk factors, so that rational prevention and control strategies can be developed. Assessment of baseline awareness of the disease amongst the endemic population would be one of the first steps in this direction. This study aims to provide qualitative information on lay perceptions of CL in an endemic area in Saudi Arabia. We also attempted to correlate these perceptions with associated socio-demographical backgrounds. METHODS: This was a cross-sectional descriptive survey carried out in Al-Hassa, located in the Eastern Province of Saudi Arabia. The study included 1824 participants, age ranging from 15 to 63 years (mean 35.86±9.54 years). RESULTS: Over 76% of the studied population recognized the infectious nature of CL. There was also good awareness regarding the clinical features of CL, but the awareness regarding the vector, transmission, risk factors and preventive methods were very poor. Our study demonstrated a significantly higher knowledge score correlated with regard to male gender, higher family income, age and a previous history of CL. CONCLUSION: In our study we found low awareness for important epidemiological aspects like transmission of the disease, risk factors and prevention. Our study provides a baseline to understand and correct deficits in the perceptions and knowledge regarding CL in Saudi Arabia and would provide a template to design interventions.
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Concienciación , Enfermedades Endémicas , Leishmaniasis Cutánea/psicología , Opinión Pública , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Leishmaniasis Cutánea/epidemiología , Masculino , Persona de Mediana Edad , Proyectos Piloto , Factores de Riesgo , Arabia Saudita/epidemiología , Adulto JovenRESUMEN
The aim of this study was to evaluate the significance of performing patient specification quality assurance for patients diagnosed with glioblastoma multiforme treated with intensity modulated radiation therapy. The study evaluated ten intensity modulated radiation therapy treatment plans using 10 MV beams, a total dose of 60 Gy (2 Gy/fraction, five fractions a week for a total of six weeks treatment). For the quality assurance protocol we used a two-dimensional ionization-chamber array (2D-ARRAY). The results showed a very good agreement between the measured dose and the pretreatment planned dose. All the plans passed >95% gamma criterion with pixels within 5% dose difference and 3 mm distance to agreement. We concluded that using the 2D-ARRAY ion chamber for intensity modulated radiation therapy is an important step for intensity modulated radiation therapy treatment plans, and this study has shown that our treatment planning for intensity modulated radiation therapy is accurately done.
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Neoplasias Encefálicas/radioterapia , Glioblastoma/radioterapia , Radioterapia de Intensidad Modulada/métodos , Humanos , Garantía de la Calidad de Atención de SaludRESUMEN
Worldwide, thyroid cancer accounts for some 10% of total cancer incidence, most markedly for females. Thyroid cancer radiotherapy, typically using 131I (T1/2 8.02 days; ß- max energy 606 keV, branching ratio 89.9%), is widely adopted as an adjunct to surgery or to treat inoperable cancer and hyperthyroidism. With staff potentially receiving significant doses during source preparation and administration, radiation protection and safety assessment are required in ensuring practice complies with international guidelines. The present study, concerning a total of 206 patient radioiodine therapies carried out at King Faisal Specialist Hospital and Research Center over a 6-month period, seeks to evaluate patient and occupational exposures during hospitalization, measuring ambient doses and estimating radiation risk. Using calibrated survey meters, patient exposure dose-rate estimates were obtained at a distance of 30-, 100- and 300 cm from the neck region of each patient. Occupational and ambient doses were measured using calibrated thermoluminescent dosimeters. The mean and range of administered activity (AA, in MBq) for the thyroid cancer and hyperthyroidism treatment groups were 4244 ± 2021 (1669-8066), 1507.9 ± 324.1 (977.9-1836.9), respectively. The mean annual occupational doses were 1.2 mSv, that for ambient doses outside of the isolation room corridors were found to be 0.2 mSv, while ambient doses at the nursing station were below the lower limit of detection. Exposures to staff from patients being treated for thyroid cancer were less compared to hyperthyroidism patients. With a well-defined protocol, also complying with international safety requirements, occupational exposures were found to be relatively high, greater than most reported in previous studies.
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Radioisótopos de Yodo/efectos adversos , Radioisótopos de Yodo/uso terapéutico , Exposición Profesional/análisis , Neoplasias de la Tiroides/radioterapia , Adulto , Anciano , Femenino , Personal de Salud , Humanos , Hipertiroidismo/radioterapia , Radioisótopos de Yodo/administración & dosificación , Masculino , Persona de Mediana Edad , Exposición Profesional/efectos adversos , Protección Radiológica , Arabia Saudita , Dosimetría Termoluminiscente/métodos , Adulto JovenRESUMEN
This study has sought to evaluate patient exposures during the course of particular diagnostic positron emission tomography and computed tomography (PET/CT) techniques. A total of 73 patients were examined using two types of radiopharmaceutical: 18F-fluorocholine (FCH, 48 patients) and 68Ga-prostate-specific membrane antigen (PSMA, 25 patients). The mean and range of administered activity (AA) in MBq, and effective dose (mSv) for FCH were 314.4 ± 61.6 (462.5-216.8) and 5.9 ± 1.2 (8.8-4.11), respectively. Quoted in the same set of units, the mean and range of AA and effective dose for 68Ga-PSMA were 179.3 ± 92.3 (603.1-115.1) and 17.9 ± 9.2 (60.3-11.5). Patient effective doses from 18F-FCH being a factor of two greater than the dose resulting from 68Ga-PSMA PET/CT procedures. CT accounts for some 84 and 23% for 18F-FCH and 68Ga-PSMA procedures, accordingly CT acquisition parameter optimization is recommended. Patient doses have been found to be slightly greater than previous studies.
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Neoplasias de la Próstata , Exposición a la Radiación , Colina/análogos & derivados , Isótopos de Galio , Radioisótopos de Galio , Humanos , Masculino , Tomografía Computarizada por Tomografía de Emisión de Positrones , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/radioterapiaRESUMEN
Medical exposure of the general population due to radiological investigations is the foremost source of all artificial ionising radiation. Here, we focus on a particular diagnostic radiological procedure, as only limited data are published with regard to radiation measurements during urethrograpic imaging. Specifically, this work seeks to estimate patient and occupational effective doses during urethrographic procedures at three radiology hospitals. Both staff and patient X-ray exposure levels were calculated in terms of entrance surface air kerma (ESAK), obtained by means of lithium fluoride thermoluminescent dosimeters (TLD-100(LiF:Mg:Cu.P)) for 243 urethrographic examinations. Patient radiation effective doses per procedure were estimated using conversion factors obtained from the use of Public Health England computer software. In units of mGy, the median and range of ESAK per examination were found to be 10.8 (3.6-26.2), 7.0 (0.2-32.3), and 24.3 (9.0-32.0) in Hospitals A, B, and C, respectively. The overall mean and range of staff doses (in µGy) were found to be 310 (4.0-1750) per procedure. With the exception of hospital C, the present evaluations of radiation dose have been found to be similar to those of previously published research. The wide range of patient and staff doses illustrate the need for radiation dose optimisation.
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The objective of this study is to estimate the annual effective dose for cardiologists and nurses by measuring Hp(10) and Hp(0.07) during cardiac catheterization procedures. A total of 16 staffs members were working in interventional cardiology during 1 year at a tertiary hospital. The occupational dose was measured using calibrated thermo-luminescent dosemeters (TLD-100, LiF:Mg,Ti). The overall mean and range of the annual Hp(10) and Hp(0.07) (mSv) for cardiologists were 3.7 (0.13-14.5) and 3.2 (0.21-14.7), respectively. Cardiologists were frequently exposed to higher doses compared with nurses and technologists. The exposure showed wide variations, which depend on occupation and workload. Staff is adhered to radiation protection guidelines regarding shielding the trunk, thyroid shield, thus appropriately protected. Lens dose measurement is recommended to ensure that dose limit is not exceeded.
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Cristalino , Exposición Profesional , Exposición a la Radiación , Cateterismo Cardíaco , Humanos , Exposición Profesional/análisis , Dosis de Radiación , Exposición a la Radiación/análisis , Arabia SauditaRESUMEN
Lutetium-177 (DOTATATE) (177Lu; T1/2 6.7 days), a labelled ß- and Auger-electron emitter, is widely used in treatment of neuroendocrine tumours. During performance of the procedure, staff and other patients can potentially receive significant doses in interception of the gamma emissions [113 keV (6.4%) and 208 keV (11%)] that are associated with the particle decays. While radiation protection and safety assessment are required in seeking to ensure practices comply with international guidelines, only limited published studies are available. The objectives of present study are to evaluate patient and occupational exposures, measuring ambient doses and estimating the radiation risk. The results, obtained from studies carried out in Riyadh over an 11 month period, at King Faisal Specialist Hospital and Research Center, concerned a total of 33 177Lu therapy patients. Patient exposures were estimated using a calibrated Victoreen 451P survey meter (Fluke Biomedical), for separations of 30 cm, 100 cm and 300 cm, also behind a bed shield that was used during hospitalization of the therapy patients. Occupational and ambient doses were also measured through use of calibrated thermoluminescent dosimeters and an automatic TLD reader (Harshaw 6600). The mean and range of administered activity (in MBq)) was 7115.2 ± 917.2 (4329-7955). The ambient dose at corridors outside of therapy isolation rooms was 1.2 mSv over the 11 month period, that at the nursing station was below the limit of detection and annual occupational doses were below the annual dose limit of 20 mSv. Special concern needs to be paid to comforters (carers) and family members during the early stage of radioisotope administration.
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Neoplasias Meníngeas/radioterapia , Meningioma/radioterapia , Exposición Profesional , Octreótido/análogos & derivados , Compuestos Organometálicos/uso terapéutico , Humanos , Medicina Nuclear , Octreótido/administración & dosificación , Octreótido/uso terapéutico , Compuestos Organometálicos/administración & dosificación , Medicina de Precisión , Dosificación RadioterapéuticaRESUMEN
The aims of the present work were to quantify radiation doses arises from patients' exposure in mammographic X-ray imaging procedures and to estimate the radiation induced cancer risk. Sixty patients were evaluated using a calibrated digital mammography unit at King Khaled Hospital and Prince Sultan Center, Alkharj, Saudi Arabia. The average patient age (years) was 44.4⯱â¯10 (26-69). The average and range of exposure parameters were 29.1⯱â¯1.9 (24.0-33.0) and 78.4⯱â¯17.5 (28.0-173.0) for X-ray tube potential (kVp) and current multiplied by the exposure time (s) (mAs), respectively. The MGD (mGy) per single projection for craniocaudal (CC), Medio lateral oblique (MLO) and lateromedial (LM) was 1.02⯱â¯0.2 (0.4-1.8), 1.1⯱â¯0.3 (0.5-1.8), 1.1⯱â¯0.3 (0.5-1.9) per procedure, in that order. The average cancer risk per projection is 177 per million procedures. The cancer risk is significant during multiple image acquisition. The study revealed that 80% of the procedures with normal findings. However, precise justification is required especially for young patients.
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With associated cure rates in excess of 90%, targeted 131I radioactive iodine therapy has clearly improved thyroid cancer survival. Thus said, potential radiation risks to staff represent a particular concern, current study seeking to determine the radiation exposure of staff from 131I patients during hospitalization, also estimating accumulated dose and related risk to staff during preparation of the radioactive iodine. In present study made over the three-month period 1st February to 1st May 2017, a total of 69 patient treatments were investigated (comprising a cohort of 46 females and 23 males), this being a patient treatment load typically reflective of the workload at the particular centre for such treatments. The patients were administered sodium iodide 131I, retained in capsules containing activities ranging from 370 to 5550 MBq at the time of calibration, radioiodine activity depends on many factors such as gender, clinical indication, body mass index and age. The staff radiation dose arising from each patient treatment was measured on three consecutive days subsequent to capsule administration. In units of µSv, the mean and dose-rates range at distances from the patients of 5â¯cm, 1â¯m and 2â¯m were 209⯱â¯73 (165-294), 6.8⯱â¯2 (5.3-9.5) and 0.9⯱â¯0.3 (0.7-1.2). The annual dose (also measured in units of µSv), based on annual records of doses, for medical physicists, technologists and nurses were 604, 680 and 1000 µSv respectively. In regard to current practice and workload, staff exposures were all found to be below the annual dose limit for radiation workers.
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Radioisótopos de Yodo/efectos adversos , Exposición Profesional/efectos adversos , Exposición a la Radiación/efectos adversos , Radiofármacos/efectos adversos , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dosis de Radiación , Monitoreo de Radiación/instrumentación , Neoplasias de la Tiroides/radioterapia , Adulto JovenRESUMEN
The urinary 'steroid profile' in doping control analysis is a powerful tool aimed at detecting intra-individual deviations related to the abuse of endogenous steroids. Factors altering the steroid profile include, among others, the excessive fluid intake leading to low endogenous steroids concentrations compared to an individual's normal values. Cases report the use of hyperhydration by athletes as a masking method during anti-doping urine sample collection. Seven healthy physically active non-smoking Caucasian males were examined for a 72-hour period using water and a commercial sports drink as hyperhydration agents (20 mL/kg body weight). Urine samples were collected and analyzed according to World Anti-Doping Agency (WADA) technical documents. Although, significant differences were observed on the endogenous steroid concentrations under the studied hyperhydration conditions, specific gravity adjustment based on a reference value of 1.020 can eliminate the dilution induced effect. Adjustment methods based on creatinine and urinary flow rate were also examined; however, specific gravity was the optimum method in terms of effectiveness to adjust concentrations close to the baseline steroid profile and practicability. No significant effect on the urinary steroid ratios was observed with variability values within 30% of the mean for the majority of data. Furthermore, no masking on the detection ability of endogenous steroids was observed due to hyperhydration. It can be concluded that any deviation on the endogenous steroid concentrations due to excessive fluid intake can be compensated by the specific gravity adjustment and therefore, hyperhydration is not effective as a masking method on the detection of the abuse of endogenous steroids.
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Atletas , Doping en los Deportes/métodos , Ingestión de Líquidos/fisiología , Esteroides/orina , Adulto , Algoritmos , Bebidas , Voluntarios Sanos , Humanos , Indicadores y Reactivos , Masculino , Estándares de Referencia , Gravedad Específica , Detección de Abuso de Sustancias/métodos , Adulto JovenRESUMEN
Computed tomography angiography (CTA) has become the most valuable imaging modality for the diagnosis of blood vessel diseases; however, patients are exposed to high radiation doses and the probability of cancer and other biological effects is increased. The objectives of this study were to measure the patient radiation dose during a CTA procedure and to estimate the radiation dose and biological effects. The study was conducted in two radiology departments equipped with 64-slice CT machines (Aquilion) calibrated according to international protocols. A total of 152 patients underwent brain, lower limb, chest, abdomen, and pelvis examinations. The effective radiation dose was estimated using ImPACT scan software. Cancer and biological risks were estimated using the International Commission on Radiological Protection (ICRP) conversion factors. The mean patient dose value per procedure (dose length product [DLP], mGy·cm) for all examinations was 437.8 ± 166, 568.8 ± 194, 516.0 ± 228, 581.8 ± 175, and 1082.9 ± 290 for the lower limbs, pelvis, abdomen, chest, and cerebral, respectively. The lens of the eye, uterus, and ovaries received high radiation doses compared to thyroid and testis. The overall patient risk per CTA procedure ranged between 15 and 36 cancer risks per 1 million procedures. Patient risk from CTA procedures is high during neck and abdomen procedures. Special concern should be provided to the lens of the eye and thyroid during brain CTA procedures. Patient dose reduction is an important consideration; thus, staff should optimize the radiation dose during CTA procedures.
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Hydatidosis constitutes a major public health problem in kingdom of Saudi Arabia. The variability on susceptibility to hydatidosis has been related to the HLA system. So this study aimed to identifying the possible association between the class-II HLA-DRB1 alleles with the occurrence of hydatidosis and the clinical course in Saudi patients using Micro SSP HLA-DRB1 kits. Since HLA-disease associations might vary in relation to gender, so this study aims also to determining the HLA-DRB1 alleles- hydatidosis association in relation to gender. The results proved that HLA-DR16 and HLA-DR7 alleles were the suitable markers of susceptibility association while HLA-DR1 and HLA-DR10 alleles might confer protection against hydatidosis. All the previous susceptible and resistance associations were statistically significant. Also, the majority of the female patients (81.8%) had HLA-DR14 compared to 9.1% of female controls while 50% of the male patients had HLA-DR7 compared to 4.5% of male controls. These results were statistically associated and this is the first study that found an association between certain HLA-DRB 1 alleles and the occurrence of human hydatidosis in relation to gender. Also, significant relations were detected between HLA-DR16 and hepatic and single cyst, HLA-DR7 and lung cyst, HLA-DR14 and combined cysts. Also, no statistical significance was found between other cystic characteristics and any one of the susceptible HLA-DRBs. On conclusion beside the role HLA-DRB 1 on the susceptibility or the resistance to hydatidosis disease occurrence among Saudi population also it may have an important role in the prevalence of the disease in relation to gender.