Dosimetric study of hypo fractionated adjuvant post mastectomy radiotherapy with and without bolus and assessment of acute toxicity of treatment: a single institution study

Background: Moderate hypo fractionated PMRT is convenient for patients and is particularly beneficial in busy radiotherapy department like in developing nations. Furthermore, PMRT can be given with or without bolus as per institution protocol. The purpose of this study was to do dosimetric comparison of with and without bolus plans in patient undergoing hypo fractionated PMRT and to assess acute toxicity of treatment.Methods: Our study is single institution prospective study done at DMCH cancer center Ludhiana, Punjab, India. Study period was from March 2020 to October 2020 and we included post mastectomy patients irradiated by hypo fractionated regime. After CT simulation and contouring, rapid arc radiotherapy plans were evaluated and DVH analysis was done for PTV and OARs. Acute toxicity was assessed during treatment and 1 month post radiotherapy treatment. Ethical approval was not taken due to COVID 19 pandemic emergency, but also hypofractionated PMRT is standard of care. Statistical analysis was done on SPSS, Version 20.0Results: A total of 30 patients were analyzed which received mean PTV dose of 42.3Gy in 16 fractions (8 fractions with and 8 without bolus).We were able to achieve adequate PTV coverage in plan sum which included both bolus and non-bolus plan. However, use of bolus resulted in statistically significant increase in low dose volume mainly V4Gy of ipsilateral lung in left sided breast cancer cases. Despite use of bolus no patient had above grade I skin toxicity.Conclusions: Moderate hypo fractionated PMRT with and without bolus is well tolerated with minimal acute side effects. It is important to note that use of bolus results in higher V4Gy volume of ipsilateral lung more precisely in left side breast cancer cases

The Cosmos of a Public Sector Township: Democracy as an Intellectual Culture

The public sector plays an important role in responding to the rights of citizens and evolving norms of social interest (Qu 2015). Qu argues that the nature of public enterprise is never final and there is a constant negotiation between the private and the public emergence of life and rights. One such space where the tension between the private and the public manifests itself is the public sector township or the residential colony in India. The sociality of hierarchy in public sector organizations manifest itself in the public sector township and may nurture everyday aspirations, angsts and divides. The officer lives in a bigger hone, in a bungalow, and the clerk lives in a smaller home, many times with a larger family. [excerpt

Motivation to quit tobacco; Impact of different types of anti-tobacco state-sponsored media propaganda messages

Introduction: Antitobacco media messages can easily reach the mass and play a very positive and significant role in changing the motivational stages among recent quitters. Motivation is the key to changing human behaviour. Motivation can be intrinsic and extrinsic. To modify tobacco-related behaviour, one must have an inherent motivation to quit tobacco. However, the outside factors, for example, protobacco advertisements, antitobacco advertisements, peer pressure, celebrity influence, and family members' influence cannot be ignored. Method: A total of 400 recent tobacco quitters were enrolled from four colleges via a multistage sampling method. Time series research design was used for data collection at three time periods 0, 1, and 3 months. Study participants were divided into four groups: 1) personal testimony group, 2) health warning group, 3) celebrity-influenced public service announcements, and 4) natural exposure group. Media messages containing antitobacco video clippings and pictures were delivered to the participants via phone thrice a week, as per the groups assigned. All four groups were assessed for the motivational stage via contemplation ladder at 0, 1, and 3 months of intervals. Results: Antitobacco personal testimonial media messages are most effective in enhancing the motivation to quit tobacco, followed by the antitobacco health warning messages, which are also proven to be effective in maintaining high motivation levels to remain abstinent from smoking. However, public service announcements are ineffective in keeping the motivation to quit tobacco at higher smoking. Conclusion: Overall, the antitobacco state-sponsored media messages, personal testimonials, and health warnings about tobacco products effectively maintain and enhance motivation to quit tobacco

A study on Knowledge and Awareness about Blood Donation among Undergraduate Medical Students in a Tertiary Care Centre in Haryana, India

Introduction :This study was undertaken to study Knowledge and Awareness about Blood Donation among Undergraduate Medical Students which would serve the dual purpose of stimulating the curiosity of medical students about safe blood bank practises and at the same time lets the teaching staff know about those areas of the subject where they need to focus while teaching the students. There is paucity of studies on this subject in Northern India. Material & Methods :The study was conducted on 150 2nd year MBBS students of 2017 entrance batch of this tertiary care centre by the Department of Pathology. A questionnaire covering various aspects of blood donation was prepared. The answers were analysed to know the particular areas where the teachers need to focus while educating the students on the subject of blood donation. Scoring was done out of maximum 20 marks. Results :18 students scored between 5 and 10 marks. 115 students scored between 10 and 15 marks and 17 scored between 15 and 20 marks. The students showed good knowledge about blood donor requirements, preservation of donated blood and about mismatched transfusions. However, they showed lack of knowledge in fields of transfusion transmissible infections, blood fractions and sophisticated blood banking procedures. Conclusions :Assessing the knowledge of medical students about blood transfusion through questionnaire serves the dual purpose of stimulating the curiosity of medical students about safe blood bank practises and at the same time lets the teaching staff know about those areas of the subject where they need to focus while teaching the students

FNAC findings of head and neck lesions in our Institute- A 3 year retrospective study

Background: There are several lesions of the head and neck region which are routinely encountered by different clinicians in patients among all age groups and diagnoses varies from benign lesions to malignancies. To identify these lesions, various diagnostic tools such as FNACs are being used which help the clinicians in a great way.Methods: This is a retrospective study done from August 2016 to October 2019 in a tertiary care hospital. All cases received in Department of Pathology were included in this study. It included a total of 310 cases. FNAC (including USG guided) were done from palpable masses of head and neck regions preferably from thyroid and breast lumps. Data entry and analysis were done using SPSS version 20.Results: A total of 310 patients who underwent FNAC of the head and neck region were included in this study. Maximum number of patients were in the age group of 21 to 30 years i.e. 85(27.42%) . In this study, 273(91.30%) cases were benign and 26(8.70%) cases were malignant lesions with aspirates from lymph nodes being the maximum. In our study, majority of the thyroid lesions 111(92.5%) belong to benign category II.Conclusion: It is concluded that FNAC proves to be a first line of investigation in the diagnosis of head and neck swellings. Here, most of the swellings occurred in the head and neck region. Thyroid FNA smears were also reported using the Bethesda system which helped in achieving more precise cytological diagnosis

Histopathological Spectrum of Gall Bladder Diseases: A Three-Year Retrospective Study in a Rural Tertiary Care Hospital in Haryana, North India

Background: Gallstones is the most common condition leading to cholecystectomy with a prevalence within India ranging from 2% to 29%. Long standing cases can induce mucosal changes in gall bladder mucosaranging from chronic cholecystitis, metaplasia, dysplasia and finally carcinoma gall bladder. Although malignancy is the most important condition to be ruled out on histopathology, it is important to understand the intermediate pathologies leading to this.Aim:1)To study the histomorphological spectrum of diseases affecting gall bladder in rural population of Haryana. 2)To identify the frequency of gall bladder carcinoma in this region of Haryana and its demographic correlation with other studies. Material methods: This was a 3 year retrospective study conducted in Department of pathology, Adesh medical college, Shahabad(M), Kurukshetrafrom a period of December 2016 to December 2019. Results were compiled into non neoplastic, pre-neoplastic and neoplastic category to study the spectrum of lesions in gall bladder specimens. Data collected was analyzed using (SPSS) v. 20.0 software. Results:Most of the histopathological changes were found in female gender with associated multiple mixed stones. Overall and among non-neoplastic category chronic cholecystitis was thecommonest pathology.Incidence of carcinoma was low (0.4%) as compared to studies from different regions of country.Conclusion:Present study provides an insight into the incidence, clinical profile and association of gall bladder conditions with gall stones in a tertiary care center serving the rural population of Haryana, North India