International Journal of Medical Research and Review 2022-05-07T09:42:13+0530 Dr D Sharad Gedam Open Journal Systems <p><em><strong>ISSN: <a href="" target="_blank" rel="noopener">2320-8686 (Online)</a>, <a href="" target="_blank" rel="noopener">2321-127X (Print)</a></strong></em></p> Volumetric and dosimetric effects of different slice thickness in radiotherapy planning Computed Tomography for head and Neck cancer 2022-04-06T10:32:42+0530 J Fazilathunnisa S Navitha Jitendra Nigam NS Silambarasan Piyush Kumar <p>Introduction: Accurate estimation of target and Organ at Risk Volume is required to ensuretreatment efficacy and minimal normal tissue toxicity in radiotherapy planning. ComputedTomography slice thickness plays a vital role in volume estimation. It highly impacts smaller volumeorgans such as 1-3cm3.</p> <p>Materials and Methods: CT datasets of 20 head and neck cancer patientswere recruited for this study in each CT data three CT series with a slice thickness of 1.5mm, 3mmand 5mm were imported to the TPS. Eclipse TPS of version 13.6 was used for delineation andtreatment planning.</p> <p>Results: The variability of volumes with CT slice thickness was significant,especially for small volume structures. The maximum volume error of 63% was found in &gt;3ccvolume structures with 5mm slice thickness. Whereas in larger volume structures the differenceswere observed 2%in terms of volume and mean dose. And in terms of homogeneity and conformity,there is no significant difference was found.</p> <p>Conclusion: This study concludes that for head andneck cancer which has many smaller volume structures 1.5mm slice thickness will accuratelyestimate the volume which is clinically useful for OAR near the PTV.</p> 2022-04-02T00:00:00+0530 Copyright (c) 2022 Author (s). Published by Siddharth Health Research and Social Welfare Society Study on the Correlation Between Vitamin D and BMI in Type 2Diabetes Mellitus 2022-04-06T10:35:59+0530 A Ponnambalam G Prabhu <p>Type 2 diabetes mellitus (DM) is associated with increased morbidity and mortality due to thedevelopment of complications, especially due to poor glycaemic control. Besides its role in calciumhomeostasis, Vitamin D has been involved in the pathophysiology as well as glycaemic control oftype 2 DM. 100 patients diagnosed with type 2 DM were included. Vitamin D levels along with BMIwere measured in all the individuals. In our study, we had the youngest patient with 18years andthe oldest patient with 78years. In the present study, we had maximum patients in the age groupbetween 41 to 50 years similar to various other studies. In our study male was 68% with femaleswere 38%. In the present study, we estimated vitamin D levels in all subjects and categorizationwas done as &lt;20 and more than 20 ng/dl.48% of patients had vitamin D levels below 20ng/dl. Inthe present study, we compared the values of BMI with vitamin D levels where we did not noticemuch difference with the mean of individual category. In conclusion, we have identified a correlationconcerning vitamin D levels when compared with BMI statistically. Since the physiological role ofVitamin D in pancreatic beta-cell function and insulin sensitivity is well appreciated, and consideringthat almost 50% of the diabetes patients in the present study are Vitamin D deficient, it issuggested that Vitamin D levels improve the BMI in type 2 diabetes mellitus patients</p> 2022-04-02T00:00:00+0530 Copyright (c) 2022 Author (s). Published by Siddharth Health Research and Social Welfare Society Impact on Undefined Normal Tissue by using different combination of Normal Tissue Objective and Dose Control Ring in IMRT Plans for Cervix cancer 2022-04-29T11:01:24+0530 S Muthukumar S Navitha Jitendra Nigam NS Silambarasan Piyush Kumar <p>Introduction: The normal tissue objective (NTO) is a tool used in inverse planning of Intensity Modulated Radiation Therapy (IMRT) to reduce dose spreading to surrounding normal tissues. The multitude of potential NTO setting combinations challenges optimal NTO tunning. In addition to NTO, Dose Control Ring (DCR) around the target may impact plan quality.</p> <p>Aim and Objective: To find the impact on Undefined Normal Tissue (UNT) by using the different combinations of NTO and DCR in IMRT Plans for Cervical cancer plans.</p> <p>Materials and Methods: Our sample consists of 30 patients with similar treatment prescription doses. Varian Eclipse Treatment Planning System (TPS) of Version13.6 was used in this study. 5 different plans were created for each patient. In every plan beam energy, several beams, Beam angle, Optimization algorithm - Photon optimizer (PO), Calculation algorithm – Anisotropic analytic algorithm (AAA)and evaluation methods were maintained constant. 5 plans were different only in the optimization process. Before generating plans DCR of thickness 1.0 cm and 0.5 cm away from the Planning Target Volume (PTV) was created. The plan with different combinations between NTO and DCR were A. Without NTO, B. Automatic NTO, C. Manual NTO, D. Automatic NTO + DCR, E. Manual NTO + DCR generated. The plan quality was evaluated by comparing PTV: Conformity Index (CI), Homogeneity Index, OAR Doses and mean dose to UNT.</p> <p>Results: HI was better without NTO plans compared to all other plans. CI and OAR doses show a significant difference in Manual NTO along with DCR plans. The mean dose of UNT was less in Manual NTO along with DCR compared to all other plans and it was significantly less.</p> <p>Conclusion: This study shows that manual NTO + Dose Control Ring gives better plan quality in terms of PTV coverage and less dose to Undefined Normal Tissue by maintaining Organ at Risk dose within the tolerance limits.</p> 2022-04-25T00:00:00+0530 Copyright (c) 2022 Author (s). Published by Siddharth Health Research and Social Welfare Society Laboratory profile of COVID-19 Patients at the time of admission 2022-04-29T11:10:24+0530 Indrakshi Basak Vani Krishnamurthy Basak <p>Background: COVID-19 is a recent pandemic, the complete picture of which is yet to be described. Recent advances in the treatment and improved outcomes have been contributed mainly by knowing the pathological and biochemical status of the patients. Further improvement in understanding this disease at all levels will help in formulating appropriate management plans.</p> <p>Objective: To describe the various biochemical and haematological parameters of COVID – 19 positive patients at the time of admission to the hospital for treatment. Method: We analysed the biochemical and haematological parameters of 100 COVID patients admitted to our hospital from June 2020 to September 2020.</p> <p>Results: 60.6% of our subjects were between 40 and 70 Years. 74.7% of the cases were males. Fever and cough were the most frequent complaints and 49. 5% of them had pneumonia at the time of admission. 19% of the patients needed ICU management. The most common haematological abnormality was lymphopenia seen in 79.9% followed by Eosinopenia seen in 46.5%. Reactive lymphocytes were seen in the majority of the patients (84 %). Toxic granules in the neutrophils, fragmented RBCs and significant left shift of neutrophils are found in small proportions. CRP was elevated in 92% of our patients, followed by elevated Ferritin in 78.2%. D-Dimer was elevated in 44.4% of the patients.</p> <p>Conclusion: The majority of Covid patients at presentation have deranged coagulation and increased D-Dimer. Lymphopenia is the most common haematological abnormality.</p> 2022-04-26T00:00:00+0530 Copyright (c) 2022 Author (s). Published by Siddharth Health Research and Social Welfare Society Parasitic Hypoproteinemia :A Diagnostic Dilemma in an Immuno competent Patient 2022-05-07T09:39:25+0530 Somnath Maitra Debes Pal Koushik Ray Sk Adnan Yusuf <p>Strongyloidiasis is caused by a nematode helminth which causes multisystem involvement with signsand symptoms related to the gastrointestinal, pulmonary, dermatological and nervous systems. Theindex case discussed here presented with edema, hypoalbuminemia, malnutrition and anemia withurease positive duodenal ulcer. Duodenal biopsy suggested malabsorption, and strongyloidiasis wasdetected in the biopsy, which clinched the diagnosis and treatment was given with ivermectin, afterwhich the patient improved and responded to treatment. The importance lies in the fact thatparasitic infections may cause malabsorption even in immunocompetent patients, which is a rareentity but must not be missed as it responds to treatment promptly, which is cheap and effective</p> 2022-04-29T00:00:00+0530 Copyright (c) 2022 Author (s). Published by Siddharth Health Research and Social Welfare Society Challenges in managing pubic ramus fractures Routine Computed Tomography for all pubic ramus fractures- Is there a role? 2022-05-07T09:42:13+0530 D. Chowdhury <p>Pelvic fractures are amongst the most common fragility fractures sustained by the elderly patient from falling from a standing height. There are significant complications arising from this type of fracture, ranging from the patient with haemodynamic compromise with an unstable pelvis to a patient with minimal displaced pelvic ring fracture without compromise. In this article, we aim to highlight those patients who may have had an innocuous injury but cannot mobilise despite analgesic optimization. There are currently two strategies undertaken with immediate CT imaging in all patients sustaining pelvic fractures at admission and delayed CT imaging for those patients who cannot mobilise. The main aim of imaging is to exclude the presence of a posterior pelvic ring injury and exclude any vascular injuries in the haemodynamically compromised patient.</p> 2022-04-29T00:00:00+0530 Copyright (c) 2022 Author (s). Published by Siddharth Health Research and Social Welfare Society