Normal tissue tolerance dose for cervical radiotherapy to the NTCP model using a method of least square fit

The purpose of this study is to evaluate the impact of Normal Tissue Complication Probability (NTCP) models on radiation treatment plans. We estimated NTCP parameters for the organs at risk (OARs) for cervical cancer radiotherapy. We pooled individual patient data from fifty patients who were treated with External Beam Radiotherapy technique between March 2012 and November 2013 in a part of Northern Nigeria with the exclusion of patients who had other gynaecological malignancies. Three basic methods were followed during the radiotherapy planning of these patients which included the pre-planning stage, planning radiotherapy treatment stage and treatment delivery. Various tests were carried out on these patients which helped to confirm the diagnosis after which they were treated using the linear accelerator, computed tomography simulator and the treatment planning system. We calculated the normal tissue tolerance doses for partial volumes of the organs using the values of the above –said parameters for published data on normal tissue tolerance doses. This article shows a graphical representation of the computed NTCP for left femur, right femur and skin presented and a fairly good correspondence is found between the curves for head of femurs and skin. Keywords: Normal Tissue Tolerance Dose, Normal Tissue Complication Probability, Method of Least Square Fit, Cervical Radiotherap

Observation On The Rates, Benefits And Complications Of Episiotomy In A Tertiary Health Institution In Nigeria

This was an observational study undertaken at the University of Benin Teaching Hospital, Benin City from September 1, 2001 to October 31, 2002. The women who delivered per vagina with episiotomy were analyzed and compared with those who delivered without it. Outcome measures were 2nd stage duration, birth weight, Apgar score, perineal tear, perineal pain, dyspareunia and incontinence in the pueperium. There were 1,404 vaginal deliveries and 34.5% of them had episiotomy. Episiotomy was more frequent in nulliparous (65.7%) than multiparous (17.4%) women. The commonest indication for episiotomy was tight perineum (75.2%) followed by vacuum extraction (8.6%), forceps delivery (6.6%), fetal prematurity (4.1%), assisted breech delivery (2.9%) and the delivery of big babies (2.9%). The duration of second stage was not influenced by episiotomy but the Apgar score at one minute was better with episiotomy. Blood loss was more with episiotomy. Perineal tear occurred more in women who delivered without episiotomy. (25.6%vs.4.1%; P=0.0001; OR=12). Dyspareunia was more common after vaginal delivery with episiotomy. Conclusively, episiotomy was associated with a better Apgar score at one minute and it protected against perineal tear. However blood loss at delivery was more with episiotomy. Perineal pain and dyspareunia were commoner with it. Keywords: Episiotomy, Indications, Complications Annals of Biomedical Science Vol. 1 (2) 2002: pp. 141-14

Female Genital Mutilation (FGM): Australian Midwives’ Knowledge and Attitudes

Female genital mutilation (FGM) is a women's health and human rights issue attracting global interest. My purpose in this qualitative study was to report the knowledge and attitudes of Australian midwives toward FGM. Verbatim transcription and thematic analysis of semistructured interviews with 11 midwives resulted in these themes: knowledge of female genital mutilation and attitude toward female genital mutilation. Significant gaps in knowledge about FGM featured prominently. The midwives expressed anger toward FGM and empathy for affected women. Recommendations include increased information on FGM and associated legislation among midwives and other health providers in countries where FGM may be encountered