Dosimetric Evaluation of Bladder and Rectal Radiation Dose in Carcinoma Cervix patients using Orthogonal Radiographs and CT Planning in HDR Brachytherapy

INTRODUCTION: Carcinoma of the uterine cervix is the second most common cancer among global women and the first most common cancer in Indian women. The main stay of treatment in locally advanced inoperable carcinoma Cervix is combination of external beam radiotherapy (EBRT) and intracavitary brachytherapy ICBT. Brachytherapy forms an integral part and cornerstone of radiation therapy for both the local control rates and toxicities. Intracavitary brachytherapy has a high therapeutic index by delivering a high dose to the primary cervical lesion and lower dosed to critical structures namely, bladder, rectum resulting in increased local control and survival without increase in toxicity. However, the dose deliver to critical structures are difficult to quantify accurately. AIM AND OBJECTIVE OF THE STUDY: To compare bladder and rectal radiation dose between based dosimetry and CT based dosimetry. MATERIALS AND METHODS: STUDY PERIOD : From June 2010 to August 2010. STUDY DESIGN : Comparative descriptive study. CASE SELECTION : Biopsy proven squamous cell Carcinoma cervix cases of stage IIB – IIIB who had completed EBRT and slated for HDR brachytherapy. NUMBER OF PATIENTS: 30 INCLUSION CRITERIA: 1. All eligible biopsy proven squamous cell carcinoma cervix patients, who had completed EBRT and slated for HDR Brachytherapy. 2. Stage II B – III B where HDR is contemplated. 3. Age: 30 - 60 years. 4. Performance Status: ECOG 0-1 histological proof from primary lesion. 5. Informed consent to be taken. 6. Patient should be fit for anesthesia. EXCLUSION CRITERIA: 1.Age > 60 years. 2. ECOG more than 2. 3. Patients not fit for anesthesia. 4. Patients with stage IV disease. 5. Histology other than squamous cell carcinoma. 6. History of prior radiotherapy / chemotherapy to Ca cervix. CONCLUSION: Radiotherapy is an effective treatment modality for carcinoma cervix. HDR brachytherapy is incorporated along with EBRT in the treatment protocols. Our study suggested that maximum bladder and rectal 3D values were 1.69 and 1.36 times greater than the ICRU reference bladder and rectal doses respectively. Bladder - D2 /dose to ICRU reference point Ratio - 1.69 (p < 0.001 Statistically significant). Rectum - D2 /dose to ICRU reference point Ratio - 1.36 (p < 0.001 Statistically significant). 2D underestimates bladder dose. 2D underestimates the rectal dose. 3D - Image based brachytherapy is the standard of care for locally advanced CA cervix patients in western countries. However, image based brachytherapy, is not widely used in developing countries in routine clinical practice due to various limitations. Further, incorporation of newer imaging modalities, refinements in applicators and planning systems and wider acceptability of conformal brachytherapy may revolutionize brachytherapy practices in carcinoma cervix in Government setups in developing countries

Demand for Foreign Exchange Reserves in India: A Co-integration Approach

Using cointegraion and vector error correction approach, we estimate India’s demand for foreign exchange reserves over the period 1983:1-2005:1. Our results establish that the ratio imports to GDP, the ratio of broad money to GDP,exchange rate flexibility and interest rate differential determine India’s long-run reserves demand function. Our empirical results show that reserve accumulation in India is highly sensitive to capital account vulnerability and less sensitive to its opportunity cost. The speed of adjustment coefficient of vector error correction model suggests that Reserve Bank of India has to engage in more active reserve management practices.foreign exchange reserves; capital account vulnerability; current account vulnerability; cointegration

Scaffolding Blended Listening Task: A Learner- Centred Approach

Task-based language teaching (TBLT) promotes second language learning in a communicative way. Research on low proficiency level learners with regard to TBLT in the Asian context is new and needs to be explored further. The task phases in the blended mode of teaching and learning need to be connected well and learners need to be motivated from the initial phase itself which will add more meaning to student’s learning process. This paper briefly discusses the concept of scaffolding strategies with reference to previous research and also proposes a model with a sample task. The study adopted a quasi-experimental design in order to see the practical implementation of the model. For this reason, 60 pre-service teachers from different teacher education colleges, in Warangal, India are selected. All of them were given a listening test. Through random purposive sampling a sample of 30 pre-service teachers with A1-A2 proficiency levels, from 60 teachers was selected. All of them are given a task motivation questionnaire and then they are randomly categorised into experimental (N=15) and control groups (N=15). The experimental group that received the scaffolding strategies in blended mode outperformed the control group in the post-test listening test. Also, their motivation levels improved compared to the control group. The study has got implications for second language proficiency improvement through TBLT and the role of blended language teaching and learning in improving motivational levels

Implementation of an object-oriented university database using VODAK/VML prototype-2/C++

Object-oriented database (OODB) technology has become very popular and successful in recent years. Currently, there are many commercial object-oriented database systems available that are used for developing large and complex real world applications. In addition, there are many research prototypes of object-oriented databases available. In a joint research project of the CIS Dept at NJIT and GMD-IPSI an object-oriented data model called the Dual Model was developed. Using this Dual Model a university environment database schema was designed. This univesity database schema was implemented using the VODAK/VML OODB prototype - 1. The university database was then reimplemented using the C++ programming language, without any underlying database. In this thesis we have implemented a Dual Model based version of the university database, using the VODAK/VML OODB prototype - 2. This prototype is the first implemented prototype, which separates the structural and semantic aspects of a class definition. It also uses C++ as implementation language, while the previous prototype was based on Smalltalk - 80. To interact with the database we have developed a university database browser using the X11/MOTIF toolkit and C++

Evaluation of nutritional Parameters and carotenoid pigment from Penaeus monodon of Zoea – PL 20 stages fed with live algal diet and Artemia enriched algal diet

This study was subjected to investigate the nutritional value and carotenoid content of Penaeus monodon from Zoea – Post larval 20 stages when fed with five different microalgae and Artemia sp. nauplii enriched with five different microalgae. Among the algae alone treatments, P. monodon fed to Chaetoceros calcitrans showed better growth and length at Z3- M3/PL1 stages. Whereas from PL 1 – PL 20 stages of P. monodon fed with Artemia sp. naupli enriched with D. salina showed better results on the tested parameters when compared to Artemia sp. nauplii enriched with other algal sources. The maximum accumulation of carotenoids and good colouration were observed in the PL 20 stages of the animal fed with Artemia sp. nauplii enriched with Dunaliella salina. The Polyunsaturated fatty acids (PUFA) content seems to be high in P. monodon at Z3- M3/PL 1 stage when fed with C. calcitrans, whereas at PL 20 stages profile is high when fed with Artemia sp. nauplii enriched with D. salina. This study showed that besides diatoms, D. salina has the potential betacarotene pigment and supports better growth and nutritional components

Performance-based Generative Shape Grammar Method: Energy Efficient Facade Design for Fully Glazed Multi-Storied Office Building - Hot and Humid Climate, Chennai, India

The traditional building form design or form-making is an intuitive design method that is neither efficient nor competent for energy-efficient façade design. The form-making design approach threatens sustainable development in India. This paper discusses the new tread of form-finding, a process in which the framework is set for parameters to interact. It suggests a performance-based shape grammar (PBSG) generative design method for façade finding and evaluates it as an energy-efficient facade design method for FGM office buildings for India's hot and humid climate. A research method to develop PBSG rules for a given project framework was demonstrated by redesigning a case sample site and evaluating the existing FGM office building in the sample site. The PBSG methods in two stages apply multiple rules, first for form-finding and later for façade plane-finding for energy efficiency. It was observed that the SG resultant generated form was 42% more energy-efficient than the existing design using the same envelope materials, HVAC equipment, development regulations, and context. The outcome of this study provides a framework for a generative design process using PBSG in the early design stages and proves to be an energy-efficient design method for India's hot and humid climate

ALBI and Child-Pugh Score in Predicting Mortality in Chronic Liver Disease Patients Secondary to Alcohol: A Retrospective Comparative Study

Background/Aims: The severity of liver dysfunction in chronic liver disease (CLD) is often estimated with Child-Pugh (CTP) classification or model for end-stage liver disease (MELD) score. The albumin-to-bilirubin (ALBI) score is a new model for assessing the severity of liver dysfunction, which is simple and more objective. In the present study, we aimed to retrospectively compare the performance of ALBI score with Child-Pugh score for predicting the mortality in patients with CLD. Material and methods: Data of patients with CLD, irrespective of etiology, were retrospectively reviewed. Child-Pugh score and ALBI score were calculated for the patients and results from receiver operating characteristic (ROC) curves were analyzed. Results: The study was conducted on 299 patients of CLD; age distribution was between 20 and 85 years with mean age of patients being 45.7 ± 10.94 years, sex ratio male: female 265:34 with mortality rate of 19.73%. The area under the curve (AUC) of ROC of ALBI and Child-Pugh were 0.586 and 0.549, respectively. Conclusion: Ability of ALBI score for predicting mortality was comparable with that of Child-Pugh score but Child-Pugh score of &gt;10 had better performance of predicting mortality as compared to ALBI score

Humoral immune responses of normals and tuberculosis patients to multiple sonicate antigens prepared from the most prevalent strains of Mycobacterium tuberculosis harbouring single copy of IS6110 from South India

The search for newer species-specific antigens from prevalent strains of Mycobacterium tuberculosis (Mtb) associated with active disease will add substantially to improve the presently available diagnostic tools. We studied the protein profiles of 13 sonicate antigens (S1– S13) prepared from the prevalent strains. The humoral immune response was also studied in 30 normal and 30 tuberculosis (TB) patients. The sonicate antigens S10 and S12 showed maximum differential protein bands in low molecular mass region of 10–30 kDa on SDS–PAGE. Our ELISA results showed significant increase in Mtb-specific IgG antibodies in TB plasma for H37Rv, followed by PPD, S1 and S10 antigens. Immunoblot analysis of S10 antigen showed specific recognition pattern at low molecular mass region by TB plasma alone with 12–77% positivity of protein bands. Thus the sonicate antigen S10 was found to be discriminatory by ELISA and Western blot and hence a good candidate for further purification of its individual proteins to be evaluated for diagnosis

CHARACTERIZING THE ROLE OF FREE FATTY ACID RECEPTORS (FFARs) IN BREAST CANCER CELLS

Ph.DDOCTOR OF PHILOSOPH