Exceptional Tumor Regression in Diffuse Intrinsic Pontine Glioma Post-Radiotherapy: A Case Study.

BACKGROUND Diffuse intrinsic pontine glioma represent approximately 10% to 20% of all pediatric central nervous system tumors. Classic brain stem symptoms are cranial nerve deficits, long tract signs, ataxia, alone or in combination. Focal radiotherapy has been the standard of care in patients with diffuse intrinsic pontine gliomas with minimum response. Here, we present an unusual case with excellent tumor regression with radiotherapy and good clinical outcome. CASE REPORT A 13-year-old girl presented with headache and imbalance during walking for the past 2-3 months, along with a deviation of the right eye in the last month. Brain magnetic resonance imaging (MRI) suggested a well-defined solid cystic altered-signal-intensity lesion involving the pons and medulla, causing its expansion up to the midbrain on the left side. The lesion was 4.6×3.7×3.6 cm. We applied the intensity-modulated radiotherapy technique (IMRT) using a 6-MV photon beam with the conventional dose fractionation of 54 Gy in 30 fractions (1.8 Gy/fraction). Three months later, MRI brain with spectroscopy and perfusion showed evidence of non-enhancing, altered-signal-intensity lesion in the pons and medulla, measuring 1.9×2.2×2.4 cm. CONCLUSIONS Early detection of symptoms of DIPG in a young patient along with effective radiological investigation with valid tumor board decision as definitive radiotherapy as a sole therapeutic treatment option and with robust radiotherapy planning resulted in an excellent response, with 80% reduction in gross tumor volume (GTV) as seen in pre-radiotherapy (RT) and post-RT MRI images.

Multi-Organizational Insights Into Radiological Safety Standards in High-Dose Rate Brachytherapy.

The review provides an extensive study of regulations and recommendations set forth by organizations worldwide in the domain of high-dose rate (HDR) brachytherapy for the prevention and mitigation of radiation hazards. The relevant reports and publications by the International Commission on Radiological Protection (ICRP), International Atomic Energy Agency (IAEA), American Association of Physicists in Medicine (AAPM), United States (US) Nuclear Regulatory Commission (NRC), and Atomic Energy Regulatory Board (AERB) were accessed, and necessary information was compiled to clarify and understand concepts, similarities, and differences in safety standards concerning to the topic. The regulations and guidance are categorized under three major components of safety, namely layout, equipment, and source. Layout category accesses structure, design, layout, and survey. The equipment category summarizes the requirements of equipment, installation, commissioning, quality assurance (QA) and performance, safety precautions and preparedness, safety procedures, and instructions. The source category includes requirements for sealed source possession and use, calibration, categorization, certification, licensing, QA tests, and security. IAEA gives inclusive guidance on radiation protection and regulatory requirements, forming the basis of reference for other organizations worldwide. AERB regulates the radiation facilities in India; therefore, most set-ups follow their safety standards and instructions.

Engineering with Biomedical Sciences Changing the Horizon of Healthcare-A Review.

In the dynamic realm of healthcare, the convergence of engineering and biomedical sciences has emerged as a pivotal frontier. In this review we go into specific areas of innovation, including medical imaging and diagnosis, developments in biomedical sensors, and drug delivery systems. Wearable biosensors, non-wearable biosensors, and biochips, which include gene chips, protein chips, and cell chips, are all included in the scope of the topic that pertains to biomedical sensors. Extensive research is conducted on drug delivery systems, spanning topics such as the integration of computer modeling, the optimization of drug formulations, and the design of delivery devices. Furthermore, the paper investigates intelligent drug delivery methods, which encompass stimuli-responsive systems such as temperature, redox, pH, light, enzyme, and magnetic responsive systems. In addition to that, the review goes into topics such as tissue engineering, regenerative medicine, biomedical robotics, automation, biomechanics, and the utilization of green biomaterials. The purpose of this analysis is to provide insights that will enhance continuing research and development efforts in engineering-driven biomedical breakthroughs, ultimately contributing to the improvement of healthcare. These insights will be provided by addressing difficulties and highlighting future prospects.

• Integration of engineering into diagnostics leads to early disease detection through medical imaging.• Biosensors offer cost-effective, simple, and reliable early detection of abnormal health parameters. A smart drug delivery system requires fewer drugs compared to conventional methods.• Use of natural materials will enhance the biocompatibility of nanomaterials.• Nanomaterial enhanced tissue regeneration.

Addressing Global Gaps in Mammography Screening for Improved Breast Cancer Detection: A Review of the Literature.

Breast cancer is the second most common cancer globally, with 2.3 million new cases annually, constituting 11.6% of all cancer cases. It is also the fourth leading cause of cancer deaths, claiming 670,000 lives a year. This high incidence of breast cancer morbidity worldwide has increased the urgent need for standardized and adequate screening methods, including clinical breast examination, self-breast examination, and mammography screening tests for non-symptomatic individuals. Mammography is considered the gold standard for breast cancer screening, with early randomized control trials showing significant reductions in mortality rates in women aged 50 and over (International Agency for Research on Cancer and American College of Radiology). Despite this, discrepancies in mammography practices across different healthcare settings regarding adherence to international standards raise concerns. A comprehensive review of the vast literature looking at the practices and norms of mammography screening worldwide highlighted several domains that present limitations to screening. These include epidemiological data deficits, lack of educational training offered to radiographers and varied image quality indices, exposure technique, method of breast compression, dose calculation, reference levels, screening frequency intervals, and diverse distribution of resources, particularly in developing countries. These factors shed light on the substantial discrepancies in the implementation and efficacy of screening programs, underscoring the necessity for future research endeavors to collaborate in creating coherent, standardized, evidence-based guidelines. Addressing these issues can enhance the feasibility, sensitivity, and accessibility of screening programs, resulting in favorable impacts on the early diagnosis and survival of breast cancer on a global scale.

Esophageal Varices Presenting With Massive Hematemesis in a Chronic Alcoholic: A Case Report on a Rare Condition.

Esophageal varices are life-threatening complications in which the enlargement of the esophageal veins causes bleeding and reduces blood flow to the esophagus. They are complications caused by portal hypertension, renal failure, hepatic dysfunction, and infection. The leading cause of esophageal varices is cirrhosis, as patients with this disease are more susceptible to forming esophageal varices. Bleeding episodes occur due to the rupture of the blood vessels. We present the case of a 45-year-old male patient in the hospital with a history of chronic alcohol use and clinical symptoms of hematemesis, a distended abdomen, and melena. The patient experienced mild symptoms of giddiness and dizziness after undergoing various radiological investigations, laboratory tests, ultrasonography (USG), and CT scans. USG diagnosed portal hypertension, gross ascites, pleural effusion, and hepatosplenomegaly. A CT scan diagnosed the patient with esophageal varices and testicular carcinoma. Laboratory tests diagnosed anemia. The treatment plan included oral and intravenous iron supplements, blood transfusions, vitamin B12, folate supplements, and nonselective beta-blockers to manage portal hypertension and reduce variceal bleeding risk. During acute bleeding episodes, vasoconstrictors and endoscopic band ligation were employed. Regular endoscopies and hepatic venous catheterization were conducted to monitor and manage the condition. Follow-up included regular assessments of hemoglobin levels, iron status, liver function tests, and periodic endoscopies. The patient's adherence to beta-blockers was closely monitored. Esophageal varices, often resulting from portal hypertension because of cirrhosis, require early diagnosis and a combination of pharmacological and endoscopic treatments to prevent complications. Advances in treatment have reduced mortality rates, but effective management of portal hypertension and liver dysfunction remains crucial.

Emerging Applications of Picture Archiving and Communication Systems and Their Impact on Research and Education: A Literature Review.

In recent times, technological advancements have remarkably improved picture archiving and communication system (PACS) capabilities beyond their conventional use in radiology departments. Researchers and instructors have started employing PACS functionalities to improve medical research processes, promote interdisciplinary collaborations, and facilitate learning. To illustrate this point further, the PACS enables researchers to handle and analyze huge amounts of imaging data with superior precision and speed, supporting innovative studies in areas like disease progression, treatment outcomes, and imaging modalities. Moreover, a PACS integrated with artificial intelligence (AI) algorithms leads to significant improvements in image processing, diagnostic accuracy, and personalized treatment, thus marking a new approach to medical imaging. The PACS supported by AI is mostly transformative since they allow for improved early disease detection capabilities as well as automated image processing and decision assistance, which increase diagnostic accuracy and clinical outcomes. Such systems can rapidly process large quantities of visual data with an accuracy rate surpassing earlier endeavors. In medical research, however, combining PACS with AI allows challenging imaging datasets to be examined, thereby making findings that were not previously possible. The capacity to combine imaging outcomes with clinical information is valuable for medical students and professionals in the field of education. They can access extensive medical image collections and case studies using PACS. This link is critical for teaching and learning as it allows students to interact with concrete events and improve their diagnostic accuracy in a controlled environment. This review discusses how the PACS affects educational courses and clinical outcomes based on the available literature. Our aim was not only to outline recent research or developments but also to present a comprehensive overview regarding the growing role played by PACS in the modern healthcare system and academics. Similarly, we look at the challenges and opportunities associated with the wide adoption of PACS, highlighting possible future areas of study or teaching methodologies. Issues such as data security, interoperability, and the need for defined protocols are included to give an exhaustive understanding of what PACS can and cannot do. Through this study, we stress PACS's revolutionary potential in advancing research methodology and educational practices, eventually contributing to enhanced patient care and knowledge dissemination in healthcare areas. The continual growth of PACS technology and its applications is expected to reshape the landscape of medical research and education, making it a vital component in the quest for medical excellence. By knowing the present trends and future potential, stakeholders in healthcare and education may better employ PACS to reach their objectives and boost overall results.

An Atypical Presentation of a Unicameral Bone Cyst in the Left Humerus: A Case Report.

Simple bone cysts (SBCs) are the most common osteolytic lesions in children, often leading to pathological fractures of non-weight-bearing bones. These benign tumors primarily arise in the proximal humerus, femur, or calcaneus. The cystic cavity is filled with serous or serosanguineous fluid and lined by a thin fibrovascular connective tissue membrane. The etiological factors include disturbances in bone growth, local venous obstruction, synovial origin disorders, and genetic predispositions. SBCs are most frequently observed in individuals from birth to 20 years of age. The report presented a case of a 12-year-old male patient who was admitted to the hospital with a history of a mass on his left upper arm. The mass had an acute onset and gradually progressed to its current size over three to four weeks, after which it became nonprogressive. The patient had been healthy until the age of four, after which he experienced frequent fractures of the left arm following trivial trauma. Multiple traumas led to the gradual formation of a diffuse mass over the upper part of the humerus. Radiological imaging modalities, such as X-ray and magnetic resonance imaging, are crucial in diagnosing bone cysts and evaluating their clinical conditions. Treatment can involve the injection of bone marrow or steroids into the cyst to facilitate the healing process.

Investigating and Analyzing Prognostic Factors and Their Impact on Recurrent Cervical Cancers.

The incidence of cervical cancer in India is significantly high, and the average recurrence age is much less. The standard line of treatment consists of concurrent chemoradiotherapy. If a recurrence occurs, the treatment options or set of interventions are limited and suboptimal. Through this review, we have analyzed and classified the possible prognostic factors for cervical cancer into three broad categories, viz., (a) disease-related factors, (b) patient-related factors, and (c) treatment-related factors. Disease-related factors include tumor histology, tumor size, stage, parametrial involvement (PMI), Prognostic Nutritional Index (PNI), lymphovascular space invasion (LVSI), and nodal status. Patient-related factors include overall treatment time (OTT), nutritional status, hemoglobin level, comorbidities, and age. Treatment-related factors include addition of chemotherapy, techniques of external beam radiotherapy (EBRT), techniques of brachytherapy, and quality assurance for radiation therapy delivery. Out of these, extremely significant prognostic factors were tumor size and stage, nodal status, PMI, nutritional status, and addition of chemotherapy. Impactful factors include younger age, histology, LVSI, associated comorbidities, hemoglobin level, OTT, and patient-specific quality assurance. The factor that is not related or significant is the technique used for EBRT and brachytherapy delivery.

A Multimodality Treatment Approach for the Management of Recurrent Cervical Cancer in an Elderly Female Patient: A Case Report.

Squamous cells in the cervix can develop into a type of cervical cancer. Cervical squamous cells are the cells that line the outside of the cervix. These thin, flat cells have a striking resemblance to fish scales under a microscope. Squamous cell carcinomas (SCCs) are the most common type of cervical cancer. We report the case of a 60-year-old woman with SCC devoid of a family history of cancer or related diseases. Following a biopsy confirming SCC, the patient's contrast-enhanced computed tomography scan revealed a somewhat enlarged cervix along with a white discharge per vagina. The patient underwent a Wertheim hysterectomy and was diagnosed with microinvasive SCC, adenomyosis, and negative lymph nodes. Two years after being free from disease, the issue reappeared even with routine follow-ups. The patient underwent six rounds of chemotherapy, followed by chemoradiation and interstitial brachytherapy. The multimodality therapy method applied to an aged female patient experiencing recurrent SCC of the cervix is demonstrated in this case study. It underlines how crucial regular follow-ups and multimodal therapy are to control recurrent cervical cancer.

Interdisciplinary Approach Toward Reirradiation of Cancer Patients.

As systemic therapies, alongside radiation, for cancer treatment continue to evolve, the radiation oncology community is facing an increasing number of reirradiation (re-RT) of tumor sites subject to recurrences. There are multiple factors associated with choosing re-RT as a treatment option for a previously irradiated site. The factors include the site of previous radiotherapy (RT), the current extent of the disease, the nature of recurrence, the technique used for previous irradiation, and the previous RT details including dose and dose fractionation. There is a persistent heterogeneity in the workflow and decision-making in cancer care centers worldwide. The current review is an attempt to dive into the practices of decision-making for re-RT, interdisciplinary attention given to the re-RT patients, and acceptable doses to the organ at risk (OAR) deduced from the understanding of previous RT and radiobiology of the tumor and sites evidence of better techniques for effective execution.

Adaptive Radiotherapy for Carcinoma Endometrium With Lymphocele: A Case Report.

The case report details the adaptive radiotherapy management of a 75-year-old female diagnosed with high-grade endometrial carcinoma. The patient, who was known to be hypertensive with no other comorbidities and no family history of cancer, presented with a complaint of bleeding per vagina for six months. Following extensive investigations, she underwent a laparoscopic radical hysterectomy. Postoperative histopathology confirmed endometrial adenocarcinoma International Federation of Gynecology and Obstetrics (FIGO) stage IA, grade III. The adjuvant treatment plan included adjuvant chemoradiotherapy to the postoperative tumor bed and draining lymph nodes. On planning computed tomography (CT), the patient's lymphocele responded remarkably to radiation therapy, an unusual outcome that underscores the potential efficacy of adaptive radiotherapy in complex cases.

Microwave Ablation for Osteoid Osteoma in a Young Patient: A Case Report.

Osteoid osteoma (OO) is a common benign ossifying lesion that is most prevalent among youth. Usually, it attacks the diaphyseal or metaphyseal bones that are tubular. The common hallmark of muscle pain is the reported occurrence of night pain that is nearly always present, yields satisfactory responses from nonsteroidal anti-inflammatory medications, and may be joined by complaints regarding physical activities. Also, it shows typical signs of study procedures like computed tomography (CT) and magnetic resonance imaging (MRI). A nidus, which is the primary marker in the diagnostic formation of shadowed images, is a crucial sign of an OO. This source is usually portrayed as an oval lytic lesion, measuring 1 cm flat and surrounded by a region of reactive ossification. It is laborious to diagnose OO since the condition is frequently confused with many other ones, and testing and therapy may be delayed and complicated as a result. There are still few studies on OO diagnosis and distinguishing of surrogate conditions. Unfortunately, either ablation or resection can be said to be the cure. Improved detection of OO shows the possibility for prompt diagnosis, fewer patient discomfort and side effects, less cost involved in unnecessary treatments, and a rightly diagnosed condition.

Enhancing Radiological Diagnosis: A Comprehensive Review of Image Quality Assessment and Optimization Strategies.

Image quality plays a pivotal role in the accurate diagnosis and effective management of diseases in radiology. This review explores the principles, methodologies, and strategies for assessing and optimizing image quality across various imaging modalities, including X-ray, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and nuclear medicine. We discuss key factors influencing image quality, such as spatial resolution, noise, contrast, and artifacts, and highlight techniques for quality assurance, image optimization, and dose reduction in clinical practice.

Artificial Intelligence Applications for Biomedical Cancer Research: A Review.

Artificial intelligence (AI) has rapidly evolved and demonstrated its potential in transforming biomedical cancer research, offering innovative solutions for cancer diagnosis, treatment, and overall patient care. Over the past two decades, AI has played a pivotal role in revolutionizing various facets of cancer clinical research. In this comprehensive review, we delve into the diverse applications of AI across the cancer care continuum, encompassing radiodiagnosis, radiotherapy, chemotherapy, immunotherapy, targeted therapy, surgery, and nanotechnology. AI has revolutionized cancer diagnosis, enabling early detection and precise characterization through advanced image analysis techniques. In radiodiagnosis, AI-driven algorithms enhance the accuracy of medical imaging, making it an invaluable tool for clinicians in the detection and assessment of cancer. AI has also revolutionized radiotherapy, facilitating precise tumor boundary delineation, optimizing treatment planning, and enabling real-time adjustments to improve therapeutic outcomes while minimizing collateral damage to healthy tissues. In chemotherapy, AI models have emerged as powerful tools for predicting patient responses to different treatment regimens, allowing for more personalized and effective strategies. In immunotherapy, AI analyzes genetic and imaging data to select ideal candidates for treatment and predict responses. Targeted therapy has seen great advancements with AI, aiding in the identification of specific molecular targets for tailored treatments. AI plays a vital role in surgery by offering real-time navigation and support, enhancing surgical precision. Moreover, the synergy between AI and nanotechnology promises the development of personalized nanomedicines, offering more efficient and targeted cancer treatments. While challenges related to data quality, interpretability, and ethical considerations persist, the future of AI in cancer research holds tremendous promise for improving patient outcomes through advanced and individualized care.

Human-Robot Collaboration for Healthcare: A Narrative Review.

Robotic applications have often quickly transitioned from industrial to social. Because of this, robots can now engage with people in a natural way and blend in with their surroundings. Due to the lack of medical professionals, growing healthcare costs, and the exponential rise in the population of vulnerable groups like the ill, elderly, and children with developmental disabilities, the use of social robots in the healthcare system is expanding. As a result, social robots are employed in the medical field to entertain and educate hospitalized patients about health issues, as well as to assist the elderly and sick. They are also employed in the dispensing of medications, rehabilitation, and emotional and geriatric care. Thus, social robots raise the standard and effectiveness of medical care. This article explains how patients and healthcare professionals collaborate with robots in the healthcare industry. The objectives of this collaboration are to resolve moral and legal concerns, improve patient outcomes, and improve healthcare delivery. It has a broad range of uses, including telemedicine, rehabilitation, and robotic surgical support. Human-robot interaction is the term used to describe interactions between social robots and people. Many obstacles stand in the way of human-robot interaction in healthcare, including safety concerns, acceptability issues, appropriateness, usefulness, and the worry that robots may replace human carers. In the end, these difficulties result in a poor adoption rate for robotic technology. As a result, the applications and difficulties of human-robot interaction in healthcare are thoroughly evaluated in this research. This study also reviews future safety prospects from human-robot interaction in healthcare, as well as ethical and usability issues including privacy, trust, and safety, and our aims to provide a comprehensive overview of the use of robots in healthcare, including their applications, benefits, challenges, and prospects, to facilitate a deeper understanding of this evolving field.

Emerging Applications of Biomedical Science in Pandemic Prevention and Control: A Review.

The COVID-19 pandemic has made it abundantly clear how crucial biomedical science is to pandemic control and prevention on a global scale. The importance of biomedical science in the fight against pandemics has increased with the appearance of new, deadly infectious diseases. Biomedical science and engineering have been presented as possible areas for combating the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) due to the unique challenges raised by the pandemic, as reported by epidemiologists, immunologists, and doctors, including the survival, symptoms, protein surface composition, and infection mechanisms of COVID-19. These multidisciplinary engineering concepts are applied to design and develop prevention methods, diagnostics, monitoring, and therapies. An infectious disease outbreak that has spread over a sizable region, such as several continents or the entire world, and is affecting a sizable number of people is referred to as a "pandemic. While current knowledge about the SARS-CoV-2 virus is still limited, various (old and new) biomedical approaches have been developed and tested. Here, we review the emerging applications of biomedical science in pandemic prevention and control, including rapid diagnosis tests, the development of vaccines, antiviral therapies, artificial intelligence, genome sequencing, and personal protective equipment. Biomedical science and nanotechnology are two fields that have the potential to combine to develop emerging applications for combating pandemics. In this review, we also discuss the intersection of biomedical science and nanotechnology in pandemic prevention and control.