Assessing the impact of magnetic resonance treatment simulation (MRSIM) on target volume delineation and dose to organs at risk for oropharyngeal radiotherapy

Introduction: Assessing the use of a radiation therapy (RT) planning MRI performed in the treatment position (pMRI) on target volume delineation and effect on organ at risk dose for oropharyngeal cancer patients planned with diagnostic MRI (dMRI) and CT scan. Methods: Diagnostic MRI scans were acquired for 26 patients in a neutral patient position using a 3T scanner (dMRI). Subsequent pMRI scans were acquired on the same scanner with a flat couch top and the patient in their immobilisation mask. Each series was rigidly registered to the patients planning CT scan and volumes were first completed with the CT/dMRI. The pMRI was then made available for volume modification. For the group with revised volumes, two IMRT plans were developed to demonstrate the impact of the modification. Image and registration quality was also evaluated. Results: The pMRI registration led to the modification of target volumes for 19 of 26 participants. The pMRI target volumes were larger in absolute volume resulting in reduced capacity for organ sparing. Predominantly, modifications occurred for the primary gross tumour volume (GTVp) with a mean Dice Similarity Coefficient (DSC) of 0.7 and the resulting high risk planning target volume, a mean DSC of 0.89. Both MRIs scored similarly for image quality, with the pMRI demonstrating improved registration quality and efficiency. Conclusions: A pMRI provides improvement in registration efficiency, quality and a higher degree of oncologist confidence in target delineation. These results have led to a practice change within our department, where a pMRI is acquired for all eligible oropharyngeal cancer patients.</p

The impact of the COVID-19 pandemic on the education of medical, dental and non-medical healthcare professionals in Bangladesh : findings and connotation

Lockdown measures in response to the COVID-19 pandemic had an appreciable impact on the education of all medical, dental, and non-medical healthcare professional (HCP) students. These included the closure of universities necessitating a rapid move to e-learning and new approaches to practical’s. However initially, there was a lack of knowledge and expertise regarding e-learning approaches and the affordability of internet bundles and equipment. We initially con-ducted two pilot studies to assess such current challenges, replaced by a two-stage approach including a full investigation involving 32 private and public universities during the early stages of the pandemic followed by a later study assessing the current environment brought about by the forced changes. Top challenges at the start of the pandemic included a lack of familiarity with e-learning approaches, cost of the internet, lack of IT equipment and the quality of the classes. Universities offered support to staff and students to a varying degree to address identified challenges. Since then, e-learning approaches have widened the possibilities for teaching and learning at convenient times. However, challenges remain. In conclusion, there were considerable challenges at the start of them pandemic. Several key issues have been addressed with hybrid learning here to stay. Remaining challenges include a lack of ICT equipment. However, new innovations will continue

Nutritional Study of Picky Eaters: A Case Control Study

Background: Picky eating is a relatively common problem during childhood. Picky eating may cause parents considerable concern leading to physician visits and may cause conflict between parents regarding handling of their child’s eating behavior.&#x0D; Objectives: The present study was conducted to compare the nutritional status and daily calorie consumption among children with and without picky-eating-behavior.&#x0D; Methods: The present study was conducted out in the Department of Paediatrics, Sir Salimullah Medical College and Mitford Hospital, Dhaka and private chambers of paediatrician, general physician from July 2013 to December 2013. The case was defined as a child who had anorexia or took one or two favorite foods as explained by the parents in an otherwise healthy child with picky eating disorder, while a control was defined as a child without having picky eating disorder.&#x0D; Results: Thirty percent of the parents of cases complained that their children were not growing well as opposed to only 4% of the control group (p&lt;0.05). Complaint of abdominal pain was considerably higher in the former group than that in the latter group (p&lt;0.05). The history of forceful feeding was present in 20% of the cases compared to none in the control (p&gt;0.05). The mean 24 hours intake of calorie was lower in the cases than that in the control, but the difference did not reach the level of significance (p&gt;0.05). In terms of nutritional status very few children (8%) with picky eating behavior were wasted (low weight-for-height) (p&gt;0.05). However, 26% of the picky-eaters were underweight in terms of BMI compared to 7% of the controls, but the difference was not statistically significant (p&gt;0.05).&#x0D; Conclusion: The study concluded that the children with picky-eating-behavior are almost similar to their control counterparts in terms of nutritional status (wasting, stunting and BMI) and calorie consumption.&#x0D; DS (Child) H J 2021; 37(1): 59-63</jats:p

Effect of methanol extract of Dicranopteris linearis against carbon tetrachloride- induced acute liver injury in rats

Background: Dicranopteris linearis (family Gleicheniaceae) has been reported to possess anti-inflammatory and antioxidant activities but no attempt has been made to study its hepatoprotective potential. The aim of the present study was to determine the hepatoprotective effect of methanol extracts of D. linearis (MEDL) against carbon tetrachloride (CCl4)-induced acute liver injury in rats. Methods: 6 groups (n = 6) of rats received oral test solutions: 10% dimethyl sulfoxide (DMSO), 200 mg/kg silymarin, or MEDL (50, 250, and 500 mg/kg), once daily for 7 consecutive days, followed by hepatotoxicity induction with CCl4. Blood and liver were collected for biochemical and microscopic analysis. The extract was also subjected to antioxidant studies (e.g. 2, 2-diphenyl-1-picrylhydrazyl (DPPH)- and superoxide anion-radical scavenging assays, oxygen radical absorbance capacity (ORAC) test and total phenolic content (TPC) determination), phytochemical screening and HPLC analysis. Results: Pretreatment with MEDL and silymarin significantly (P < 0.05) reduced the serum levels of AST, ALT and ALP, which were increased significantly (P < 0.05) in DMSO-pretreated group following treatment with CCl4. Histological analysis of liver tissues in groups pretreated with MEDL and silymarin showed mild necrosis and inflammation of the hepatocytes compared to the DMSO-pretreated group (negative control group). The MEDL showed higher DPPH- and superoxide anion-radical scavenging activity as well as high TPC and ORAC values indicating high antioxidant activity. Conclusions: MEDL exerts hepatoprotective activity that could be partly contributed by its antioxidant activity and high phenolic content, and hence demands further investigation

Thyroid Peroxidase Antibody among Hypothyroid Patients and Clinical and Biochemical Response to L-Thyroxine Replacement Therapy

This study was carried out in the Department of Medicine, Rajshahi Medical College, in 2006-2007 to study the thyroid peroxidase (TPO) antibody level among hypothyroid patients and to find out the effects of L-thyroxine therapy in TPO-antibody titer. After thorough physical examination and relevant investigations, 100 patients of hypothyroidism were enrolled in this study. The selected patients were given L-thyroxine replacement therapy at a dose of 50-150 microgram/d. Before starting L-thyroxine, serum was collected from all patients to estimate anti TPO-antibody level. All patients were followed-up after 12-28 weeks of full dose of L-thyroxine therapy. Patients with high TPO-Abs at baseline, only 17.6% turned into euthyroid (based on composite clinical score), whereas about 42% of the patients who did not have high TPO-Abs became euthyroid suggesting that patients with high TPO Abs may show significantly poor response to treatment compared to the patients without high TPO Abs (p &lt; 0.001). Patients with high TPO-Ab titers also showed a decreased biochemical response (TSH values) compared to the patients without high TPO-Ab positive patients. So, TPO-Ab plays a significant role in causation of the disease and is also associated with poor treatment response with L-thyroxine replacement therapy.&#x0D; TAJ 2018; 31(2): 45-49</jats:p

Clinical Presentations and Outcome of Acute Glomerulonephritis in Children

Acute post streptococcal glomerulonephritis (APSGN) is the most common type of acute glomerulonephritis (AGN) in childhood. It has not been studied well in Bangladesh. To evaluate the clinical characteristics, complications and outcome of Acute post streptococcal glomerulonephritis (AGN). the department of Pediatric Nephrology at Sir Salimullah Medical College and Mitford Hospital, Dhaka. A prospective study from April 2011 to March 2012 were conducted among the patients diagnosed as AGN in outdoor and indoor department. Hospital records of all 34 children who had been admitted to Sir Salimullah Medical College and Mitford Hospital were reviewed. All demographic, clinical, paraclinical data and consumed medications were obtained. Among 34 cases female and male ratio were 2.4:1; mean age of was 8.76 yrs. ± 2.5 SD and peak age 7.6. Etiology of AGN was post infectious glomerulonephritis (PIGN) 85.3%, ASO titer was raised in 88.2%, 41.2% had raised blood urea, and 32.4%raised serum creatinine level. All children presented with microscopic hematuria (100%), hypertension (100%), and edema (100%), other findings are fever (55.9%), oliguria (94.1%), abdominal pain (52.9%). History of sore throat and pyoderma was present in 41.2% and 44.1% cases respectively. Complications like hypertensive encephalopathy three (8.8%), urinary tract infection (UTI) one (2.9%) total seven (20%) were heart failure two (5.9%) and Acute kidney injury (AKI) one (2.9%), total seven (20%) were expired. Majority of cases manifest typically with edema, oliguria and hematuria. It usually has an uneventful course.&#x0D; Bangladesh Med J. 2019 Jan; 48 (1): 13-17</jats:p