Improving Access to Eye Care in Rural Communities: PocDoc's Web-Based Visual Acuity Screening Tool.

Objective: Visual acuity (VA) testing is crucial for early intervention in cases of visual impairment, especially in rural health care. This study aimed to determine the potential of a web-based VA test (PocDoc) in addressing the unique health care needs of rural areas through the comparison in its effectiveness against the conventional VA test in identifying visual impairment among an Indian rural population. Methods: Prospective comparative study conducted in December 2022 at a tertiary referral eye care center in central India. We evaluated all patients with the PocDoc VA tests using three device types, and the conventional VA test. Bland-Altman plot (BAP) compared PocDoc and conventional VA tests. Fisher's exact tests evaluated associations between categorical parameters. Kruskal-Wallis tests followed by post hoc Dunn's tests identified association between categorical parameters and numerical parameters. Results: We evaluated 428 patients (792 measurements of VA) with mean age 36.7 (±23.3) years. PocDoc resulted in slightly worse VA scores (mean logMAR: 0.345) than conventional (mean logMAR: 0.315). Correlation coefficient between the conventional and PocDoc logMAR VA values was rho = 0.845 and rho2 = 0.7133 (p = 6.617 × 10-215; adjusted p = 2.205 × 10-214). Most data points fell within the interchangeable range of ±0.32 on BAP. Difference between the two methods increased with higher logMAR values, indicating poorer agreement for worse VA scores. Conclusions: Identifying and addressing the unique health care needs of rural populations is critical, including access to appropriate and effective VA testing methods. Validating and improving VA testing methods can ensure early intervention and improve the quality of life for individuals with visual impairment.

Telerehabilitation is as effective as outpatient visits in the management of early osteoarthritis knee and mechanical low backache.

PURPOSE: Teleconsultation services can be used to overcome the barriers imposed by the Covid-19 pandemic in providing basic orthopaedic rehabilitation services. Aim of the study is to compare the effectiveness of rehabilitation provided via outpatient and teleconsultation in patients with mechanical low backache (LBA) and early osteoarthritis (OA) of the knee joint utilizing Patient-Reported Outcome Measures. The satisfaction level of patients receiving teleconsultation will also be assessed. METHODOLOGY: This study was a hospital-based prospective observational study. The study's participants were divided into two groups (Outpatient and Teleconsultation, respectively), and each group was further divided into two subgroups of 100 participants each (Knee-pain subgroup 1; LBA subgroup 2). SF-12 questionnaire, visual analogue scale (VAS) score for pain, and functional outcome scores (KOOS score for knee pain and the modified Oswestry Disability Index-MODI for LBA) were assessed at initial presentation and 6 months follow-up. Participants' satisfaction for teleconsultation service was assessed at final follow-up by 5 points Likert scale (5, very satisfied; 1, very dissatisfied). RESULTS: Mean consultation time was significantly longer in the outpatient group (p < 0.001). No statistically significant difference in the VAS score, KOOS score (58.0 ± 7.6 vs. 57.8 ± 9.2; p = 0.893), and MODI Score (24.7 ± 13.3 vs. 27.4 ± 12.4; p = 0.128) between the corresponding subgroups of the two groups at final follow-up. Eighty-seven percentage of the participants were satisfied (Likert score ≥ 4) with the teleconsultation services. CONCLUSION: Teleconsultation is equally effective to that as face-to-face outpatient consultation in the rehabilitation of patients with early OA knee and mechanical LBA. LEVEL OF STUDY: Level 2, Prospective comparative study.

Orthopaedic surgery and its allied associations on social media: an observational study.

BACKGROUND: The use of social media in orthopaedic surgery and its allied associations has not been studied. There are various associations which are actively engaged in social media platforms to enhance their impact with their users across the globe. We evaluated the social media presence and extent of involvement of orthopaedics journals and their publishing companies, orthopaedics organizations, orthopaedics device firms, and health organizations. MATERIALS AND METHODS: We compiled a global list of orthopaedics journals and publishing companies, orthopaedics organizations, orthopaedics device firms and health organizations affiliated to orthopaedics (USA) through the internet and their reliable online links. All the categories and their contents were screened on various social media networking sites (Facebook, Twitter, and LinkedIn) in terms of their membership, likes, followers and active participation. Comparable variables were selected and compared. RESULTS: Orthopaedics journals corresponding to sports and health were more notable than others on social networking platforms, i.e., British Journal of Sports Medicine and American Journal of Sports Medicine. Medscape, Lancet, and Elsevier being the multispeciality health and information publishing companies have remarkable participation on Facebook, Twitter and LinkedIn. Medtronic has maximum followers on all discussed social networking sites. Mayo Clinic Rochester, Minnesota and Cleveland Clinic, Cleveland, Ohio were more admired than other orthopaedics hospitals on Facebook and Twitter in USA. American Academy of Orthopaedic Surgeons was the most popular society on Facebook and LinkedIn while American Orthopaedics Society for Sports Medicine was most talked about on twitter. CONCLUSIONS: Although the active involvement of orthopaedics journals and their publishers is lower than multispecialty publishing companies but increasing trends were found recently. Orthopaedics organisations and device firms were actively involved on social networking while orthopaedics multispeciality health organizations associated with renowned universities have huge likes or followers. The social networking has the potential to flourish these journals and organisations in the near future as large populations over the globe have been actively participating and growing in their numbers exponentially.

Dissipation kinetics and dietary risk assessment of spiromesifen on major summer vegetables using good agricultural practices.

Dissipation kinetics and dietary risk assessment of spiromesifen is worked out on four summer vegetables, viz. okra, chilli, capsicum and brinjal (eggplant or aubergine) during March-April 2015 at the experimental farm of the Department of Entomology, Dr. Yashwant Singh Parmar University of Horticulture and Forestry Nauni, Solan using good agricultutral practices. Two foliar applications of spiromesifen @ 144.0 g.a.i./ha each were given at 10 days interval with a knapsack sprayer with the first application at the fruit initiation stage. Sample were collected up to 15 days after pesticide application and processed using a modified QuEChERS method, which was validated by doing recovery studies having recovery range and RSD within established guidelines of SANCO. Estimation of spiromesifen residues was conducted on GC-MS. The initial deposits after spraying of spiromesifen on okra, capsicum, chilli and brinjal fruit after 2 h of treatment were 1.327, 0.727, 0.800 and 0.738 mg/kg, respectively. The residues persisted up to 7 days and further dissipated and declined below the limit of quantification of <0.025 mg/kg at 10 days after treatment in all of the crops under investigation. Dissipation of spiromesifen followed first-order kinetics. The spiromesifen residues dissipated to half in 1.6, 1.8, 1.9 and 1.7 days with the suggested safe waiting period of 8.9, 5.2, 6.0 and 7.0 in the respective crops. The hazard quotient was <1 and theoretical maximum dietary intake was less than the maximum permissible intake, which was less than the maximum residue limit in all of the vegetable crops under investigation.

Fibular Strut Arthrodesis for Salvage of Campanacci Grade III Giant Cell Tumor of the Hallucal Proximal Phalanx: A Case Report.

Involvement of toe phalanges by giant cell tumor (GCT) is extremely rare; tumors in these locations tend to be aggressive. Whereas aggressive GCTs of the distal phalanx may be managed successfully by en-bloc resection without reconstruction or amputation, management of these lesions, when they involve the proximal phalanx, can be challenging. We present a Campannaci grade III GCT of the hallucal proximal phalanx in a 14-year old girl that had breached into the dorsal soft tissues and the metatarso-phalangeal joint. Wide local resection of the proximal phalanx along with reconstruction arthrodesis with an autologous, non-vascularized fibular strut graft was performed. There was no recurrence at 3 years of follow-up. The patient had an excellent functional outcome. To the best of our knowledge, this is the first case reporting the outcomes of fibular strut arthrodesis for salvage of GCT of the hallucal proximal phalanx.

Attitude and acceptance of Covid-19 vaccine amongst medical and dental fraternity - a questionnaire survey.

BACKGROUND: The second wave of Novel Coronavirus disease (COVID-19, SARS-CoV-2) is proving more disastrous than the first because of the new mutant stains. Under these circumstances, vaccination is the only effective solution that can save millions of lives across the globe. OBJECTIVES: The present study was conducted to assess the attitude and acceptance/willingness of health care professionals (medical and dental) towards COVID-19 vaccine. MATERIALS AND METHODS: An online questionnaire survey was conducted among medical and dental professionals working in different hospitals of two states of India. A total of 520 subjects constituted the final sample size. A self-constructed questionnaire (divided into 2 parts) containing 12 questions was administered to obtain information from the subjects regarding their attitude and willingness towards COVID 19 vaccine. Statistical analysis was done using chi-square test and multiple liner regression analysis. Odds ratio with 95% CI were also generated. Statistical significance was set at p≤0.05. RESULTS: Majority of the subjects (67% of dental and 73% of medical) had full confidence on the effectiveness of COVID-19 vaccine. Willingness to get vaccinated was shown by 63% of subjects and 65% had positive attitude towards vaccine. Some subjects (45.5% dental and 48.4% medical) showed concern regarding unforeseen effects of the vaccine. Willingness to get vaccinated was 3.45 higher in subjects who were involved in COVID duties. Subjects giving less preference to natural immunity over vaccine showed more willingness (OR: 2.98) towards getting the vaccine. CONCLUSION: The findings of the study showed that acceptance and attitude of subjects regarding COVID 19 vaccine was suboptimal as there were various factors which contributed towards subjects' hesitancy to get vaccinated. There is an utmost need to address various issues regarding vaccine safety to promote high uptake.

Dosimetric impact of contrast-enhanced 4d computed tomography for stereotactic body radiation therapy of hepatocelluar carcinoma.

BACKGROUND: A purpose of the study was to investigate the dosimetric impact of contrast media on dose calculation using average 4D contrast-enhanced computed tomography (4D-CECT) and delayed 4D-CT (d4D-CT) images caused by CT simulation contrast agents for stereotactic body radiation therapy (SBRT) of liver cases. MATERIALS AND METHODS: Fifteen patients of liver SBRT treated using the volumetric modulated arc therapy (VMAT) technique were selected retrospectively. 4D-CECT, and d4D-CT were acquired with the Anzai gating system and GE CT. For all patients, gross target volume (GTV) was contoured on the ten phases after rigid registration of both the contrast and delayed scans and merged to generate internal target volume (ITV) on average CT images. Region of interest (ROI) was drawn on contrast images and then copied to the delayed images after rigid registration of two average CT datasets. The treatment plans were generated for contrast enhanced average CT, delayed average CT and contrast enhanced average CT with electron density of the heart overridden. RESULTS: No significant dosimetric difference was observed in plans parameters (mean HU value of the liver, total monitor units, total control points, degree of modulation and average segment area) except mean HU value of the aorta amongst the three arms. All the OARs were evaluated and resulted in statistically insignificant variation (p > 0.05) using one way ANOVA analysis. CONCLUSIONS: Contrast enhanced 4D-CT is advantageous in accurate delineation of tumors and assessing accurate ITV. The treatment plans generated on average 4D-CECT and average d4D-CT have a clinically insignificant effect on dosimetric parameters.

Efficiency of a novel non-monotonic segmented leaf sequence delivery of Varian MLC for non-split IMRT fields.

AIM: Development of bidirectional non-monotonic segmented leaf sequence (NSLS) MLC delivery technique compatible with Varian MLC for non-split IMRT fields reducing total monitor units (TotalMU) and the number of segments (NS) simultaneously and assessment of its efficiency using a plan scoring index (PSI). MATERIALS AND METHODS: The optimal fluence of IMRT plans of ten patients of lung carcinoma, calculated using Eclipse TPS version 11.0 (Varian Medical Systems, Palo Alto, CA, USA), was used to generate the segmented MLC fields using our newly developed equally spaced (ES) reducing level and NSLS algorithms in MATLAB® version 2011b for 6-10 intensity levels. These MLC fields were imported into the plans with the same field setup and the final dose was recalculated. The results were compared with those of commercially available multiple static segments (MSS) leaf motion calculation (LMC) algorithm and few previously published algorithms. Plan scoring index (PSI) and degree of modulation (DoM) was calculated to compare the quality of different plans for the same patient. RESULTS: The average differences in TotalMU and NS with respect to MSS algorithm are -3.80% and -14.28% for the NSLS algorithm, respectively. The calculated average PSI and DoM is 0.75, 2.51 and 0.91, 2.41 for the MSS and NSLS algorithms, respectively. CONCLUSIONS: IMRT plans generated using the NSLS algorithm resulted in the best PSI, DoM values among all the leaf sequencing algorithms. Our proposed NSLS algorithm allows bidirectional delivery in Varian medical linear accelerator which is not commercially available. NSLS algorithm is efficient in reducing the TotalMU and NS with equivalent plan quality as that of MSS.

Dosimetric comparison of dynamic conformal arc integrated with segment shape optimization and variable dose rate versus volumetric modulated arc therapy for liver SBRT.

PURPOSE: The aim is a dosimetric comparison of dynamic conformal arc integrated with the segment shape optimization and variable dose rate (DCA_SSO_VDR) versus VMAT for liver SBRT and interaction of various treatment plan quality indices with PTV and degree of modulation (DoM) for both techniques. MATERIAL: Twenty-five patients of liver SBRT treated using the VMAT technique were selected. DCA_SSO_VDR treatment plans were also generated for all patients in Monaco TPS using the same objective constraint template and treatment planning parameters as used for the VMAT technique. For comparison purpose, organs at risk (OARs) doses and treatment plans quality indices, such as maximum dose of PTV (Dmax%), mean dose of PTV (Dmean%), maximum dose at 2 cm in any direction from the PTV (D2cm%), total monitor units (MU's), gradient index R50%, degree of modulation (DoM), conformity index (CI), homogeneity index (HI), and healthy tissue mean dose (HTMD), were compared. RESULTS: Significant dosimetric differences were observed in several OARs doses and lowered in VMAT plans. The D2cm%, R50%, CI, HI and HTMD are dosimetrically inferior in DCA_SSO_VDR plans. The higher DoM results in poor dose gradient and better dose gradient for DCA_SSO_VDR and VMAT treatment plans, respectively. CONCLUSIONS: For liver SBRT, DCA_SSO_VDR treatment plans are neither dosimetrically superior nor better alternative to the VMAT delivery technique. A reduction of 69.75% MU was observed in DCA_SSO_VDR treatment plans. For the large size of PTV and high DoM, DCA_SSO_VDR treatment plans result in poorer quality.

Kuntscher's nail removal techniques: an illustrative walk-through its journey.

The use of Kuntscher nail for femur fracture dates back to World War 2. Since then, the technique of intramedullary nailing has evolved and the use of Kuntscher nail has become almost obsolete. The orthopaedic surgeons across the globe are facing a new challenge of removal of these Kuntscher nails due to different indications. Different but scattered English literature has been published describing the experiences and techniques of surgeon with K nail removal. Up till now, no systematic analysis has been performed evaluating the available literature. We have planned a systematic review to evaluate and explore the various indications and techniques of K nail removal.

Assessment of Quality of Life after Hysterectomy using European Quality of Life Five Dimension Scale (EQ5D).

In several regions throughout the globe, caesarean sections constitute the most common nonobstetric surgery, followed by hysterectomy, which is the surgical excision of the uterus. While it is not the only solution for reproductive organ issues, it is the most effective technique to treat many illnesses over the long term. The uterus is a very critical reproductive organ for all age groups as this is not only essential for giving birth but also for hormonal-related physiology in women's life. The quality of life is impacted by a number of hysterectomy-related effects on females. Physical, psychological, environmental, and social relations are some of these impacts. All EuroQol five-dimensions (EQ5D) subscales significantly improved, as per the research 's findings. Preoperative psychosocial status, perioperative pain, indication of hysterectomy, complications occur during surgery, and mode of hysterectomy postoperative infection had been discovered as determinants of quality of life outcome following hysterectomy. In most of the subjects we noticed small, however, noticable improvements in all component of EQ5D Scale. The strengths of EQ5D questionnaire lie in its simplicity and moreover it is available in several languages.

Radiobiological modeling of radiation-induced acute mucosal toxicity (oral mucositis and pharyngeal mucositis): A single-institutional study of head-and-neck carcinoma.

Purpose/Objective(s): This study aimed to estimate the fitting parameters of sigmoidal dose-response (SDR) curve of radiation-induced acute oral and pharyngeal mucositis in head-and-neck (H and N) cancer patients treated with Intensity Modulated Radiation Therapy (IMRT) for the calculation of normal tissue complication probability (NTCP). Materials and Methods: Thirty H-and-N cancer patients were enrolled to model the SDR curve for oral and pharyngeal mucositis. The patients were evaluated weekly for acute radiation-induced (ARI) oral and pharyngeal mucositis toxicity, and their scoring was performed as per the common terminology criteria adverse events version 5.0. The radiobiological parameters, namely n, m, TD50, and γ50 were calculated from the fitted SDR curve obtained from the clinical data of H-and-N cancer patients. Results: ARI toxicity for oral and pharyngeal mucosa in carcinoma of H-and-N cancer patients was calculated for the endpoint oral mucositis and pharyngeal mucositis. The n, m, TD50, and γ50 parameters from the SDR curve of Grade 1 and Grade 2 oral mucositis were found to be [0.10, 0.32, 12.35 ± 3.90 (confidence interval [CI] 95%) and 1.26] and [0.06, 0.33, 20.70 ± 6.95 (CI 95%) and 1.19] respectively. Similarly for pharyngeal mucositis, n, m, TD50, and γ50 parameters for Grade 1 and Grade 2 were found to be [0.07, 0.34, 15.93 ± 5.48 (CI. 95%) and 1.16 ] and [0.04, 0.25, 39.02 ± 9.98(CI. 95%) and 1.56] respectively. Conclusion: This study presents the fitting parameters for NTCP calculation of Grade 1 and Grade 2 ARI toxicity for the endpoint of oral and pharyngeal mucositis. The provided nomograms of volume versus complication and dose versus complication for different grades of oral mucositis and pharyngeal mucositis help radiation oncologists to decide the limiting dose to reduce the acute toxicities.

Radiobiological modeling of radiation-induced acute rectal mucositis: A single-institutional study of cervical carcinoma.

Purpose: This study aimed to estimate the fitting parameters of sigmoidal dose-response (SDR) curve of radiation-induced acute rectal mucositis in pelvic cancer patients treated with Intensity Modulated Radiation Therapy (IMRT) for the calculation of normal tissue complication probability (NTCP). Materials and Methods: Thirty cervical cancer patients were enrolled to model the SDR curve for rectal mucositis. The patients were evaluated weekly for acute radiation-induced (ARI) rectal mucositis toxicity and their scoring was performed as per Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. The radiobiological parameters, namely n, m, TD50, and γ50 were calculated from the fitted SDR curve obtained from the clinical data of cervical cancer patients. Results: ARI toxicity for rectal mucosa in carcinoma of cervical cancer patients was calculated for the endpoint rectal mucositis. The n, m, TD50, and γ50 parameters from the SDR curve of Grade 1 and Grade 2 rectal mucositis were found to be 0.328, 0.047, 25.44 ± 1.21 (confidence interval [CI]: 95%), and 8.36 and 0.13, 0.07, 38.06 ± 2.94 (CI: 95%), and 5.15, respectively. Conclusion: This study presents the fitting parameters for NTCP calculation of Grade 1 and Grade 2 ARI rectal toxicity for the endpoint of rectal mucositis. The provided nomograms of volume versus complication and dose versus complication for different grades of rectal mucositis help radiation oncologists to decide the limiting dose to reduce the acute toxicities.

Radiobiological modeling of radiation-induced acute proctitis: A single-institutional study of prostate carcinoma.

Purpose: To estimate the fitting parameters of the sigmoidal dose response (SDR) curve of radiation-induced acute proctitis in prostate cancer patients treated with intensity modulated radiation therapy (IMRT) for the calculation of normal tissue complication probability (NTCP). Materials and Methods: Twenty-five prostate cancer patients were enrolled and evaluated weekly for acute radiation-induced (ARI) proctitis toxicity. Their scoring was performed as per common terminology criteria for adverse events version 5.0. The radiobiological parameters namely n, m, TD50, and γ50 were calculated from the fitted SDR curve obtained from the clinical data of prostate cancer patients. Results: ARI toxicity for rectum in carcinoma of prostate patients was calculated for the endpoint of acute proctitis. The n, m, TD50, and γ50 parameters from the SDR curve of Grade 1 and Grade 2 acute proctitis are found to be 0.13, 0.10, 30.48 ± 1.52 (confidence interval [CI] 95%), 3.18 and 0.08, 0.10, 44.37 ± 2.21 (CI 95%), 4.76 respectively. Conclusion: This study presents the fitting parameters for NTCP calculation of Grade-1 and Grade-2 ARI rectum toxicity for the endpoint of acute proctitis. The provided nomograms of volume versus complication and dose versus complication for different grades of acute proctitis in the rectum help radiation oncologists to decide the limiting dose to reduce the acute toxicities.

Radiobiological modelling of radiation-induced acute skin toxicity (dermatitis): A single institutional study of breast carcinoma.

Purpose: The purpose of the study was to estimate the fitting parameters of the sigmoidal dose response (SDR) curve of radiation-induced acute dermatitis in breast cancer patients treated with intensity-modulated radiation therapy for calculation of normal tissue complication probability (NTCP). Materials and Methods: Twenty-five breast cancer patients were enrolled to model the SDR curve for acute dermatitis. The acute radiation-induced (ARI) dermatitis toxicity was assessed weekly for all the patients, and their scores were determined using the common terminology criterion adverse events version 5.0. The radiobiological parameters n, m, TD50, and γ50 were derived using the fitted SDR curve obtained from breast cancer Patient's clinical data. Results: ARI dermatitis toxicity in carcinoma of breast patients was calculated for the end point of acute dermatitis. The n, m, TD50, and γ50 parameters from the SDR curve of Grade-1 dermatitis are found to be 0.03, 0.04, 28.65 ± 1.43 (confidence interval [CI] 95%) and 1.02 and for Grade-2 dermatitis are found to be 0.026, 0.028, 38.65 ± 1.93 (CI. 95%) and 1.01 respectively. Conclusion: This research presents the fitting parameters for NTCP calculation of Grade-1 and Grade-2 acute radiation-induced skin toxicity in breast cancer for the dermatitis end point. The presented nomograms of volume versus complication probability and dose versus complication probability assist radiation oncologists in establishing the limiting dose to reduce acute toxicities for different grades of acute dermatitis in breast cancer patients.

Improving functional properties of pea protein through "green" modifications using enzymes and polysaccharides.

Pea proteins have gained significant interest in recent years. The objective of this study was to enhance pea protein functional properties through enzymatic and/or conjugation modifications and understand the physicochemical properties of the modified proteins. Molecular changes of the proteins were characterized, and protein functionality, in vitro digestibility, and sensory properties were analyzed. The proteins crosslinked with transglutaminase showed significantly improved water holding capacity (5.2-5.6 g/g protein) compared with the control pea protein isolate (2.8 g/g). The pea proteins conjugated with guar gum showed exceptional emulsifying capacity (EC) and stability (ES) of up to 100% compared with the control protein (EC of 58% and ES of 48%). Some sequentially modified pea proteins, such as transglutaminase crosslinking followed by guar gum conjugation had multiple functional enhancement (water holding, oil holding, emulsifying, and gelation). The functionally enhanced pea proteins had comparable sensory scores as the control protein.

Assessment of correlation of COVID-19 infection and periodontitis- A comparative study.

Background: Periodontal disease constitutes a group of diseases involving inflammatory aspects of the host caused by several microbial agents that affect periodontal tissues and could have systemic implications. Objective: The present study was conducted to assess the correlation of COVID-19 infection and severity of periodontitis in subjects who has mild form of the disease as compared to subjects having moderate form of the disease. Materials and Methods: The study included 116 subjects suffering from COVID-19 that were equally divided into two groups, each based on a convenient sampling methodology. Group I had a moderate form of COVID that required hospitalization and Group II had a mild form of COVID and were treated at home. The stage of periodontal disease was assessed in both groups. Also, laboratory parameters such as level of C-reactive protein (CRP), white blood cell (WBC), D-dimer, vitamin D, and lymphocytes were also assessed. Statistical analysis was done using Chi-square and multiple logistic regression analysis. Results: More than 75% of subjects in both groups were non-smokers. Subjects having more than one comorbid condition were more in number in Group I (51.7%) as compared to Group II (24%). Severe periodontitis (stages 2-4) was found in 81% of subjects in Group I and 46.2% of subjects in Group II [Figure 1]. The odds of getting severe periodontal disease were 6.32 times more in subjects belonging to Group I as compared to Group II. Subjects having more than one comorbid condition were 4.43 times at risk of severe periodontitis as compared to subjects with no co-morbidity. Conclusion: Severe form of periodontal disease was associated with moderate-to-severe COVID-19 infection and levels of lymphocytes, WBCs, and CRP were elevated in subjects belonging to Group I.

A mathematical model to predict the different isodose volumes using TRAK value in HDR intracavitary brachytherapy for revised Manchester and ICRU-89 based Point A plans using computer tomography images.

Purpose: To find out the simple relationship between Total Reference Air Kerma (TRAK) and various isodose volumes. Calculated isodose volumes were compared with experimental data for revised Manchester and International Commission on Radiation Units and measurements (ICRU)-89 Point A-based treatment plans. The accuracy of the formula was compared with the results of other relationships available in the literature. Materials and Methods: Dosimetric data from 62 intracavitary brachytherapy (ICBT) treatment plans of 31 patients with cervical cancer were studied. Each patient had treatment plans normalized to revised Manchester and ICRU-89 Points A (Aflange and Aicru89). For each treatment plan, TRAK values, V350, V700, V1050, and V1400 were obtained. The modeling curve was plotted between Isodose volume (Vd) and the ratio of d/TRAK obtained from Aflange plans to get a mathematical relation. The results of this formula were compared with the experimental data and outcomes of other formulas available in the literature. A paired-sample t-test was performed to assess the statistical significance. Results: In the case of revised Manchester-based Aflange normalization plans, the mean isodose volume of V350, V700, V1050, and V1400 were 285.98 ± 32.3 cm3, 101.96 ± 10.63 cm3, 52.71 ± 4.72 cm3, and 31.44 ± 2.33 cm3 respectively. Likewise, for ICRU-89 based Aicru89 normalization plans, the mean isodose volumes of V350, V700, V1050, and V1400 were 304.11 ± 26.17 cm3, 108.88 ± 8.29 cm3, 56.62 ± 3.69 cm3 and 34 ± 2.23 cm3 respectively. The mean difference was significant. The Mathematical relationship developed was [INLINE:1]. No correlation was found between TRAK and D0.1cm3,D2cm3 for organs at risk. Conclusions: The developed formula calculated isodose volumes within the accuracy of ± 3% in ICBT plans.