Dosimetric comparison of radiotherapy treatment plans done by IMRT and VMAT technique in head and neck cancer patients

Background: The increasing patient load in radiotherapy centres demands selection of the technique that provides plans with optimal dosimetry in terms of target volume coverage, organs at risk (OAR) sparing and a lesser treatment time. This study was designed to compare the two widely practised conformal techniques, IMRT and VMAT in head and neck cancer patients in terms of planning target volume (PTV) coverage, OAR sparing and treatment delivery parameters. Materials and methods: For ten postoperative head and neck cancer patients who had been treated by IMRT technique virtual VMAT plans were generated for study purposes. The dose prescribed to PTV was 60 Gy in 30 fractions. The dose-volume parameters of PTV and OARs and the treatment delivery parameters were compared amongst both the techniques. Statistical significance was calculated using paired ‘t’ test. Results: Both the plans were comparable in terms of dosimetry. The only significant difference being better conformity in the IMRT plans. The dose to OARs was also comparable in both the techniques except for a significant reduction in the point dose to brainstem with the IMRT technique. Given the treatment delivery parameters, there was a significant reduction in the treatment delivery time and monitor units with the VMAT technique compared to the IMRT technique. Conclusion: VMAT technique gave comparable plans to that of the IMRT technique in terms of dosimetry but reduced the treatment time. It seems feasible in radiotherapy centres with increased patient load

Molecular mechanisms of cell death: recommendations of the Nomenclature Committee on Cell Death 2018.

Over the past decade, the Nomenclature Committee on Cell Death (NCCD) has formulated guidelines for the definition and interpretation of cell death from morphological, biochemical, and functional perspectives. Since the field continues to expand and novel mechanisms that orchestrate multiple cell death pathways are unveiled, we propose an updated classification of cell death subroutines focusing on mechanistic and essential (as opposed to correlative and dispensable) aspects of the process. As we provide molecularly oriented definitions of terms including intrinsic apoptosis, extrinsic apoptosis, mitochondrial permeability transition (MPT)-driven necrosis, necroptosis, ferroptosis, pyroptosis, parthanatos, entotic cell death, NETotic cell death, lysosome-dependent cell death, autophagy-dependent cell death, immunogenic cell death, cellular senescence, and mitotic catastrophe, we discuss the utility of neologisms that refer to highly specialized instances of these processes. The mission of the NCCD is to provide a widely accepted nomenclature on cell death in support of the continued development of the field

What are the factors responsible for increase in SARS-CoV-2/Covid-19 Pandemic related cases and death in India in 2021? How does environmental, host & agent factors of epidemiological triad do influence & can be utilised to manage ongoing pandemic cases and deaths?

Background: – This time last year in 2020 India was under lockdown phase, many theories about India’s surprisingly low rates of Sars-CoV-2 infection included variety of factors including hot weather, natural immunity, heard immunity, robust health system, highly qualified doctors and the country’s high proportion of young people; some also attributed it to the country’s harsh lockdown. India was doing so well that in megacities like Mumbai and Delhi, officials had begun dismantling temporary COVID-19 facilities. Comparing it to current scenario in April 2021, cases and deaths are soaring. The shortage of beds and space is so acute that people are dying in car parks and other places while waiting to be admitted in hospitals. Daily rates are currently over 300,000, the world’s highest-ever daily infection rate. The SARS-CoV-2/ Covid -19 pandemic is still going on and globally as well as in India particularly healthcare system is overstressed with this new burden added with previous NCD(non communicable diseases) & CD(communicable diseases). The First human case of this global pandemic was reported from Wuhan city of China in December 2019. The first case of covid-19 in India was found in January 2020. Today India is having more than 3 lakh cases per day and thousands of deaths daily due to this pandemic. The situation is very worse as compared to previous year and is worsening day by day due to several factors. Objective: – The main objective of this study is to illustrate the key features of Covid -19 virus, host human beings factors, irresponsibility’s and environmental factors responsible for continuation and recurrence of this pandemic as well as worsening of pandemic day by day. Setting and design: – Different aspects of Covid -19 structural variations, mutations, host factors, environmental factors (internal & external) and its effect will be analysed. Brief details about epidemiological triad will be outlined. Methodology: – The explanation will be given to title through analysis of several factors responsible for increase in cases. The cause of perpetuation of Covid -19 can be understood by the way of infections and other related factors. Result: - Several factors are responsible for the continuation and worsening of pandemic situation in India of the pandemic. Of great concern today is a new ‘double mutant’ B1617 variant, identified in India last year, that is spreading across the country as well as triple variants discovered recently and studies are going on to know more. Although scientists are still investigating whether or not the variant is more deadly & more infectious, it does contain the L452R mutation that affects the virus' spike protein. This protein is very significant because through this the virus hooks on to our cells receptor. Early research suggests that this mutation makes the virus more infectious. This doesn’t necessarily mean that the variant will be any more deadly, but it means that more people are at risk. Conclusion: – In the epidemiological triad we have agent/host/environment. The clinical approach is based on individuals & standard treatment guidelines-protocols and public health approach is based on population strategy to control this pandemic. Various strategies and approaches are required to prevent epidemic through assessment of important parameters and indicators (see figure 1) to control the ongoing disaster and hazards of pandemic Keywords: – SARS-Cov-2, Covid-19, Pandemic, Strain, India, increase cases , deat

How do we can control SARS-CoV-2/ Covid -19 pandemic through various clinical and public health approaches? What are the agent (Covid-19 virus), host & environmental factors responsible for continuation & recurrence of SARS-CoV-2/ Covid -19 pandemic?

Abstract Background – The SARS-CoV-2/ Covid -19 pandemic is still going on and globally healthcare system is overstressed with this new burden added with previous NCD & CD in existence. The First human case of this global pandemic was reported from Wuhan city of China in December 2019. There are two main approaches to control this pandemic. The clinical approach based on individuals & standard treatment guidelines-protocols and public health approach based on population strategy to control this pandemic. Objective – The main objective of this study is to illustrate the key features of Covid -19 virus & other factors responsible for continuation and recurrence of this pandemic. The next objective is to illustrate various strategies and approaches to prevent epidemic through assessment of important parameters and indicators (see figure 1) to control the ongoing disaster and hazards of pandemic. Setting and design – Different aspects of Covid -19 structural variations and its effect is analysed. Text and figure details about epidemiological triad and various steps to be monitored and modified are outlined. The clinical and public health approaches is explained in stepwise manner in figure1. Methodology – The methods to control the pandemic under clinical and public health approach is discussed here. The methods to control perpetuation of Covid -19 can be achieved by the controlling and modifying way of infections spread and other determinant. Both clinical and public health approach methods are outlined with their importance in this article in brief. Result- Several factors are responsible for the continuation of the pandemic. The CCP (Covid -19control plan) with public health and clinical approaches can be utilized to prevent further spread in different settings. Conclusion – In the epidemiological triad we have agent/host/environment; the public health approach will deal with these three parameters. The clinical approach targets sick individuals (host) infected with SARS-Cov-2/Covid-19.The control of pandemic can be achieved only through a definite universal control plan incorporating both clinical and public health approach. See figure 1. Keywords – SARS-Cov-2, Covid-19, Pandemic, Epidemiology, Strain, CC