An Approach of Initiating Geriatric Screening OPD at the Rural Health Training Centre of SMVMCH, Pondicherry

Objectives: To study the common chronic health problems among the elderly patients attending in recently initiated geriatric screening OPD at the RHTC. Material and Methods: Since one year, screening OPD has been started at RHTC of SMVMCH, for old patients (>60 years), twice a week. A team of trained medical interns, a post-graduate, a faculty in Community Medicine and a counselor screen and counsel the elderly patients for common medical and mental health problems. The screening tool is structured and has been adopted for patients of geriatric OPD at RHTC. The screening tool consist of General Health Questionnaire (GHQ-5), Psychosis screening, Alzheimer’s disease (AD8) questionnaire and checklist of common medical conditions. Patients were screened for early detection of health problems followed by counseling them/their caregivers and referral to specialty OPD for further care. Results: Total 512 elderly patients were screened over 4 months period from the start of geriatric OPD. Out of them, 276 (54%) and 117 (23%) were between the age group of 60-65 years and 66-70 years respectively. Among them 387 (75%) were below poverty line and 68 (13.3%) were having some kind of health insurance. GHQ score indicates that 255 (50%) patients had a score more than one and it was significantly higher among females compared to males. About 76 (16.8%) elderly had a score of > 1 for psychosis, out of which only 12 (14%) were referred to the higher centre. AD8 score shows 204 (40%) patients attended the clinic having a score more than 1 and it is significantly higher among females compared to males. Counseling for caregivers was given only in 13 (6%) of the patients with high AD8 score. Common chronic conditions present among them were joint pains (310, 60%), visual disturbances (247, 48%), hearing difficulty (120, 23.4%) and hypertension (107, 21%). Conclusion: The proportion of people with AD8 score more than 1 is high and most common chronic condition seen is joint pain. The action component of the clinic such as referral of dementia patients, psychosis patients and counseling of their care-givers need to be strengthened

Vegetarianism and cultism

It can be seen that religious worship of lord Shiva and his way of life prevailed in many parts of the Indian subcontinent before 400 BC. In order to know the rituals performed in Shaivism one must do a research beyond its origin and antiquity. The glories of God reveals that only through love one can approach the God and receive God's grace. In this case, the devotional norms of religious leaders like Thayumanavar, Vallalar are taken in detail and explained and develops sovereign thoughts in human society. The Tamil people lived in harmony with nature and admired, protected and praised the beauty of nature. They found God in the beauty of nature. It was called 'Murugu', and this Tamil word means beauty, youth, fragrance and immortality. It is nature that combines all these four thinga and found God in it. Anciet Tamil people felt that worship is the source of all virtue and morality. "Shaivites believe that it is impossible to get divine experience through knowledge and research and it can only be achieved through devotional worship." Such Saivite worship can be divided into two types: temple worship and thoughtful worship. Temple worship has existed in Tamil Nadu since ancient times. It became the lifeblood of social and religious life. Thoughtful worship is called yogic worship. Worshiping the Lord with the inner being as a temple is the thoughtful worship. Love should rule in all spheres of life. It is only then that the sovereign will grow in virtue. This is what that is conveyed to the world by the concept of Saivism and worshi

Virtues in Pathinenkeelkanaku text

Tamil is a language of great antiquity, rich in literature, moral ideas and sweetness. Nannul says virtue, material, pleasure and home are important for a man to lead his life happily. Eleven books out of eighteen books (Pathinenkeelkanaku text) in Tamil literature are books of virtue. Virtue is a knowledge-based philosophy of living by thinking of good deeds that bring as much benefit as possible to all human beings during their lifetime. Morality removes the selfish thoughts of a man and leads him to live a happiest life. All these eleven books of virtue consist of many moral ideas that are helpful for human beings. This article examines the overall virtues in the text and has presented the special features in them

Image-Based Treatment Planning of the Post-Lumpectomy Breast Utilizing CT and 3TMRI

Accurate lumpectomy cavity definition is critical in breast treatment planning. We compared contouring lumpectomy cavity volume and cavity visualization score (CVS) with CT versus 3T MRI. 29 patients were imaged with CT and 3T MRI. Seven additional boost planning sets were obtained for 36 image sets total. Three observers contoured the lumpectomy cavity on all images, assigning a cavity visualization score (CVS ) of 1 to 5. Measures of consistency and agreement for CT volumes were 98.84% and 98.62%, for T1 MRI were 95.65% and 95.55%, and for T2 MRI were 97.63% and 97.71%. The mean CT, T1 MRI, and T2 MRI CVS scores were 3.28, 3.38, and 4.32, respectively. There was a highly significant difference between CT and T2 scores (P < .00001) and between T1 and T2 scores (P < .00001). Interobserver consistency and agreement regarding volumes were high for all three modalities with T2 MRI CVS the highest. MRI may contribute to target definition in selected patients

Adding Customized Electron Energy Beams to TrueBeam Linear Accelerators

Purpose: To better meet clinical needs and facilitate optimal treatment planning, we added two new electron energy beams (7 and 11 MeV) to two Varian TrueBeam linacs. Methods: We worked with the vendor to create two additional customized electron energies without hardware modifications. For each beam, we set the bending magnet current and then optimized other beam-specific parameters to achieve depths of 50% ionization (I50 ) of 2.9 cm for 7 MeV and 4.2 cm for the 11 MeV beam with the 15 × 15 cm2 cone at 100 cm source-to-surface distance (SSD) by using an ionization chamber profiler (ICP) with a double-wedge (DW) phantom. Beams were steered and balanced to optimize symmetry with the ICP. After all parameters were set, full commissioning was done including measuring beam profiles, percent depth doses (PDDs), output factors (OFs) at standard, and extended SSDs. Measured data were compared between the two linacs and against the values calculated by our RayStation treatment planning system (TPS) following Medical Physics Practice Guideline 5.a (MPPG 5.a) guidelines. Results: The I50 values initially determined with the ICP/DW agreed with those from a PDD-scanned in-water phantom within 0.2 mm for the 7 and 11 MeV on both linacs. Comparison of the beam characteristics from the two linacs indicated that flatness and symmetry agreed within 0.4%, and point-by-point differences in PDD were within 0.01% ± 0.3% for the 7 MeV and 0.01% ± 0.3% for the 11 MeV. The OF ratios between the two linacs were 1.000 ± 0.007 for the 7 MeV and 1.004 ± 0.007 for the 11 MeV. Agreement between TPS-calculated outputs and measurements were -0.1% ± 1.0% for the 7 MeV and 0.2% ± 0.8% for the 11 MeV. All other parameters met the MPPG 5.a\u27s 3%/3-mm criteria. Conclusion: We were able to add two new beam energies with no hardware modifications. Tuning of the new beams was facilitated by the ICP/DW system allowing us to have the procedures done in a few hours and achieve highly consistent results across two linacs. PACS numbers: 87.55.Qr, 87.56.Fc

Sustainable dyeing of cotton, silk and leather using natural dye from Bixa orellana seeds: extraction, optimization and assessment of antibacterial activity

IntroductionNatural dyes offer an eco-friendly alternative to synthetic colorants in textile processing. This study explores the sustainable dyeing of cotton, silk, and leather using pigment-rich extracts from Bixa orellana seeds, with a focus on process optimization and antibacterial efficacy.Materials and methodsUsing an array of extraction solvents [water, methanol, ethanol, ethanol: methanol (1:1)] and extraction techniques [direct heat (DH), ultrasonic water bath (USB), ultrasonic probe, (USP)], Bixa orellana seeds were utilized to produce a yellow-orange dye. The color strength of the extracted dye was investigated using a UV-Visible spectrophotometer to measure the absorbance wavelength. The functional groups identified in the extracted natural dye were described using an FTIR spectrophotometer.Results and discussionUsing methanol as the solvent and 5 g of seed at 60°C for 60 min, the highest color yield was observed in USB. Using the ultrasonic water bath dyeing method at 60°C for 40 min without using any moderant, cotton, silk fabric, and leather were effectively colored in a yellow-orange color. The L*, a*, and b* values of the dyed material treated using the USB approach were 80.95, 4.52, 75.35 for cotton, 88.65, -1.35, 62.85 for silk, and 79.55, 015.35, 66.45 for leather, respectively. Compared to the other bacterial reduction, 85.25% of the colored materials showed substantial antibacterial action against Staphylococcus sp. Vibrio sp. (76.69%), Pseudomonas sp. (75.83%), Klebsiella sp. (74.24%), and Micrococcus sp. (74.21%) were the following most prevalent bacteria. The ultraviolet protection factor (UPF) measurements showed that leather and cotton treated with B. orellana seed dye had higher UV radiation shielding properties

Ethnomedical survey of plants used by the Orang Asli in Kampung Bawong, Perak, West Malaysia

<p>Abstract</p> <p>Background</p> <p>A qualitative ethnomedical survey was carried out among a local Orang Asli tribe to gather information on the use of medicinal plants in the region of Kampung Bawong, Perak of West Malaysia in order to evaluate the potential medicinal uses of local plants used in curing different diseases and illnesses.</p> <p>Methods</p> <p>Sixteen informants ranging in age from 35 to 65 years were interviewed. A total of 62 species of plants used by Orang Asli are described in this study based on field surveys and direct face to face communication. These plants belonged to 36 families and are used to treat a wide range of discomforts and diseases.</p> <p>Results</p> <p>The results of this study showed that majority of the Orang Asli, of Kampung Bawong are still dependent on local plants as their primary source of medication. As the first ethnomedical study in this area, publishing this work is expected to open up more studies to identify and assess the pharmacological and toxicological action of the plants from this region.</p> <p>Conclusions</p> <p>Preservation and recording of ethnobotanical and ethnomedical uses of traditional medicinal plants is an indispensable obligation for sustaining the medicinal and cultural resource of mankind. Extensive research on such traditional plants is of prime importance to scientifically validate their ethnomedical claims.</p

An Automated Treatment Planning Portfolio for Whole Breast Radiotherapy

Background: Automation in radiotherapy presents a promising solution to the increasing cancer burden and workforce shortages. However, existing automated methods for breast radiotherapy lack a comprehensive, end-to-end solution that meets varying standards of care. Purpose: This study aims to develop a complete portfolio of automated radiotherapy treatment planning for intact breasts, tailored to individual patient factors, clinical approaches, and available resources. Methods: We developed five automated conventional treatment approaches and utilized an established RapidPlan model for volumetric arc therapy. These approaches include conventional tangents for whole breast treatment, two variants for supraclavicular nodes (SCLV) treatment with/without axillary nodes, and two options for comprehensive regional lymph nodes treatment. The latter consists of wide tangents photon fields with a SCLV field, and a photon tangents field with a matched electron field to treat the internal mammary nodes (IMNs), and a SCLV field. Each approach offers the choice of a single or two isocenter setup (with couch rotation) to accommodate a wide range of patient sizes. All algorithms start by automatically generating contours for breast clinical target volume, regional lymph nodes, and organs at risk using an in-house nnU-net deep learning models. Gantry angles and field shapes are then automatically generated and optimized to ensure target coverage while limiting the dose to nearby organs. The dose is optimized using field weighting for the lymph nodes fields and an automated field-in-field approach for the tangents. These algorithms were integrated into the RayStation treatment planning system and tested for clinical acceptability on 15 internal whole breast patients (150 plans) and 40 external patients from four different institutions in Switzerland, Argentina, Iran, and the USA (360 plans). Evaluation criteria included ensuring adequate coverage of targets and adherence to dose constraints for normal structures. A breast radiation oncologist reviewed the single institution dataset for clinical acceptability (5-point scale) and a physicist evaluated the multi-institutional dataset (use as is or edit). Results: The dosimetric evaluation across all datasets (510 plans) showed that 100% of the automated plans met the dose coverage requirements for the breast, 99% for the SCLV, 98% for the axillary nodes, and 91% for the IMN. As expected, hot spots were more prevalent when multiple fields were combined. For the heart, ipsilateral lung, and contralateral breast, automated plans met constraints for 95%, 92%, and 95% of the plans, respectively. Physician evaluation of the 15 internal patients indicated that all automated plans were clinically acceptable with minor edits. Notably, the use of automated contours with the RapidPlan model resulted in plans that were immediately ready for use in 73% of cases (95% confidence interval, 95% CI [51- 96]) of patients, with the remaining cases requiring minor stylistic edits. Similarly, the physicist\u27s review of the 40 multi-institution patients showed that the auto-plans were ready for use 79% (95% CI [73,85]) of the time (95% CI [73,85]), with edits needed for the remaining cases. Conclusion: This study demonstrates the feasibility of a comprehensive automated treatment planning model for whole breast radiotherapy, effectively accommodating diverse treatment paradigms