Indian Brachytherapy Society consensus recommendations for brachytherapy in breast cancer.

Purpose: This consensus statement of Indian Brachytherapy Society (IBS) aims to generate practical and reproducible guidelines allowing for direct implementation in the Indian scenario.

Material And Methods: IBS board of directors appointed a panel of physicians with expertise in breast cancer and, in particular, breast brachytherapy, to develop a consensus statement. First, a literature review on breast brachytherapy was conducted, focusing on randomized trials, prospective studies, and multi-institutional series.

Knowledge and Attitude Regarding Human Milk Banking among Antenatal Mothers Attending Antenatal Clinic.

Background Breast milk is the ideal food that has essential nutrients for the normal growth and development of infants. It contains antibodies that help to protect against many common childhood illnesses. For infants who cannot receive breast milk from their own mothers, due to maternal illness, death, medication, disability, insufficient milk production, allergies, or prematurity, donated breastmilk can become the ideal option.

Gynecological brachytherapy hybrid training: The Tata Memorial Centre and BrachyAcademy experience.

Purpose: The lack of training is a significant barrier to practicing brachytherapy (BT). Tata Memorial Centre, alongside international BT experts and BrachyAcademy, developed a hybrid gynecological BT training module. This study outlines the preparation, organization, and execution of the 2022-2023 Mumbai training, evaluates its effectiveness, and highlights areas for improvement.

Patterns of quality assurance and treatment planning for stereotactic body radiation therapy in India - A survey.

Aim: The use of stereotactic body radiation therapy (SBRT) is an increasing trend in the country. The aim of this study is to gain knowledge on patterns of quality assurance (QA) and treatment planning (TP) aspects with respect to SBRT.

Materials And Methods: A questionnaire with multiple choice was designed to determine practices of SBRT covering areas such as years of experience, type of linear accelerator, tumor-motion strategies, calculation algorithm used in the TP system (TPS), the protocol used for small field dosimetry, the detector used for small field dosimetry and QA, respiratory management during delivery.

Volumetric and geometric changes in the parotid glands and target volume during image-guided radiotherapy for locally advanced oropharyngeal cancers.

Purpose: This study aimed to evaluate the volumetric and geometric changes in the parotid glands and target volume during image-guided radiotherapy (IGRT) for locally advanced oropharyngeal cancers.

Materials And Methods: Twenty patients receiving radiotherapy using IGRT at a dose of 70 Gy/35 fractions/7 weeks for locally advanced oropharyngeal cancers were accrued. Radiotherapy planning computed tomography (CT) scans were performed at pre-radiotherapy (RT), 20, 40, and 60 Gy for each patient.

Intelligent digital tools for screening of brain connectivity and dementia risk estimation in people affected by mild cognitive impairment: the AI-Mind clinical study protocol.

More than 10 million Europeans show signs of mild cognitive impairment (MCI), a transitional stage between normal brain aging and dementia stage memory disorder. The path MCI takes can be divergent; while some maintain stability or even revert to cognitive norms, alarmingly, up to half of the cases progress to dementia within 5 years. Current diagnostic practice lacks the necessary screening tools to identify those at risk of progression.

A Simplified Approach for Determination of Inflection Points of Flattening Filter-Free Photon Beam Using In-House Developed Software and Derivation of Reference Levels.

Aim: This article aimed to present the salient features of the in-house developed Java program for the determination of inflection point and dosimetric parameters of flattening filter-free (FFF) photon beam. Reference levels for the dosimetric parameters of the FFF photon beams were also presented.

Materials And Methods: Beam profiles of 6 MV FFF and 10 MV FFF photon beams for a collimator setting of 20 cm × 20 cm measured at 10 cm depth in an isocentric setup acquired from various institutions were analyzed using an in-house developed Java program and manual method.

Most common health problems in general practice among adolescents, and young adults' survivors of lymphoma: a register-based cohort study in Norway.

Background: The aim was to investigate the distribution of health problems in general practice (GP) among adolescent and young adult (AYA) survivors of lymphoma and to compare problem rates with the general population.

Methods: All GP consultations between 2006 and 2020 were identified from the national GP claims register. Diseases and complaints presented 3-10 years after the cancer diagnosis were identified using the International Classification of Primary Care codes (ICPC-2) and compared by applying logistic regression models, presented with odds ratio (OR) and 95%CI.

Building Community Health Literacy to Achieve Health Equity: Insights from Ethiopian Tewahedo Social Services Community Leader in a County-Level Health Literacy Initiative.

This perspectives article shares insights from a county-level project in Franklin County, Ohio, to build collective organizational health literacy (HL) capacity across new sustainable networks to advance community-level HL. We provide an overview of the initiative followed by specific insights from a cultural liaison, the article's first author, who works in a community-based organization. He shares his collectivist perspective in building HL capacity at the grassroots level toward community-level goals.

Intensity-Modulated Radiation Therapy Alone Versus Intensity-Modulated Radiation Therapy and Brachytherapy for Early-Stage Oropharyngeal Cancers: Results From a Randomized Controlled Trial.

Purpose: The objective of this study was to compare clinical outcomes of intensity-modulated radiation therapy (IMRT) alone versus IMRT + brachytherapy (BT) in patients with T1-T2N0M0 oropharyngeal squamous cell cancers (OPSCC).

Methods And Materials: This open-label randomized controlled trial was conducted at Tata Memorial Hospital, Mumbai, India. Patients with stage I and II OPSCC were considered for IMRT to a dose of 50 Gy/25 fractions/5 weeks in phase I followed by randomization (1:1) to further treatment with IMRT (20 Gy/10 fractions/2 weeks) or BT (Ir high dose rate, 21 Gy/7 fractions/2 fractions per day).

Quality Improvement Process with Incident Learning Program Helped Reducing Transcriptional Errors on Telecobalt Due to Mismatched Parameters in Different Generations.

Purpose: Higher frequency of transcriptional errors in the radiotherapy electronic charts for patients on telecobalt was noted. We describe the impact of the quality improvement (QI) initiative under the department's incident learning program (ILP).

Materials And Methods: The multidisciplinary quality team under ILP was formed to identify the root cause and introduce methods to reduce (smart goal) the current transcription error rate of 40% to <5% over 12 months.

Indication and Outcome of Paediatric Keratoplasty at a Tertiary Referral Eye Hospital in Nepal.

Introduction: Paediatric keratoplasty is rarely performed surgery with high risk of graft failure. Developing countries have not benefited due to lack of sufficient facilities and trained surgeons.

Objectives: The objectives of the study were to analyze the indications and its outcome in terms of vision and graft survival.

Non-invasive in vivo assessment of 11β-hydroxysteroid dehydrogenase type 1 activity by F-Magnetic Resonance Spectroscopy.

11β-Hydroxysteroid dehydrogenase type 1 (11β-HSD1) amplifies tissue glucocorticoid levels and is a pharmaceutical target in diabetes and cognitive decline. Clinical translation of inhibitors is hampered by lack of in vivo pharmacodynamic biomarkers. Our goal was to monitor substrates and products of 11β-HSD1 non-invasively in liver via Fluorine magnetic resonance spectroscopy (F-MRS).

Implementation and Challenges of International Atomic Energy Agency/American Association of Physicists in Medicine TRS 483 Formalism for Field Output Factors and Involved Uncertainties Determination in Small Fields for TomoTherapy.

Purpose: International Atomic Energy Agency published TRS-483 to address the issues of small field dosimetry. Our study calculates the output factor in the small fields of TomoTherapy using different detectors and dosimetric conditions. Furthermore, it estimates the various components of uncertainty and presents challenges faced during implementation.

Case Report: Successful Use of Minoxidil to Promote Facial Hair Growth in an Adolescent Transgender Male.

Increasing numbers of trans and gender diverse young people are presenting to health services seeking gender-affirming medical care. While testosterone therapy in transgender males is generally effective in inducing masculinization, some adolescents encounter barriers to accessing such treatment or may not wish to experience all the changes that usually accompany testosterone. Here, we describe the case of a 17 year old trans male who presented with gender dysphoria but was initially unable to start testosterone therapy.

Alphabet strategy for diabetes care: A checklist approach in the time of COVID-19 and beyond.

Chronic disease management requires achievement of critical individualised targets to mitigate again long-term morbidity and premature mortality associated with diabetes mellitus. The responsibility for this lies with both the patient and health care professionals. Care plans have been introduced in many healthcare settings to provide a patient-centred approach that is both evidence-based to deliver positive clinical outcomes and allow individualised care.

Derivatization with 2-hydrazino-1-methylpyridine enhances sensitivity of analysis of 5α-dihydrotestosterone in human plasma by liquid chromatography tandem mass spectrometry.

Liquid Chromatography tandem mass spectrometry (LC-MS/MS) is the gold-standard approach for androgen analysis in biological fluids, superseding immunoassays in selectivity, particularly at low concentrations. While LC-MS/MS is established for analysis of testosterone and androstenedione, 5α-dihydrotestosterone (DHT) presents greater analytical challenges. DHT circulates at low nanomolar concentrations in men and lower in women, ionizing inefficiently and suffering from isobaric interference from other androgens.

Measurement of the small field output factors for 10 MV photon beam using IAEA TRS-483 dosimetry protocol and implementation in Eclipse TPS commissioning.

Dosimetry of small fields (SF) is vital for the success of highly conformal techniques. IAEA along with AAPM recently published a code of practice TRS-483 for SF dosimetry. The scope of this paper is to investigate the performance of three different detectors with 10 MV with-flatting-filter (WFF) beam using TRS-483 for SF dosimetry and subsequent commissioning of the Eclipse treatment planning system (TPS version-13.

What is the dosimetric impact of isotropic vs anisotropic safety margins for delineation of the clinical target volume in breast brachytherapy?

Purpose: The purpose of the study was to report dosimetric differences for breast brachytherapy plans optimized for clinical target volume (CTV) generated using conventional isotropic expansion of tumor bed volume (TBV) and Groupe Européen de Curiethérapie-European Society for Radiotherapy and Oncology (GEC-ESTRO) recommendations to expand the TBV anisotropically to achieve a total safety margin of 2 cm (resection margin size + added safety margin).

Methods: Institutional records of 100 patients who underwent accelerated partial breast irradiation using multicatheter interstitial brachytherapy from May 2015 to March 2020 were reviewed retrospectively. Two sets of CT-based plans were made, one with 1-cm isotropic margins around the tumor bed (CTV_ISO) and the other with anisotropic margins (CTV_GEC).

Coverage with dosimetric concordance index (CDCI): a tool for evaluating dosimetric impact of inter-observer target variability in brachytherapy.

Purpose: The aim of this study was to propose an index for evaluating dosimetric impact of inter-observer target delineation variability in brachytherapy.

Material And Methods: The coverage with dosimetric concordance index (CDCI) is expressed as CDCI and CDCI. The CDCI is the mean coverage of target volume with common volume irradiated by prescription dose among all observers and represents the condition of worst target coverage.

A comparison of long-term clinical outcomes of accelerated partial breast irradiation using interstitial brachytherapy as per GEC-ESTRO, ASTRO, updated ASTRO, and ABS guidelines.

Purpose: The purpose of this study is to evaluate long-term clinical outcomes of women treated with accelerated partial breast irradiation (APBI) using multicatheter interstitial brachytherapy (MIB-APBI) with risk groups defined by Groupe Européen de Curie-thérapie and the European Society for Radiotherapy & Oncology (GEC-ESTRO), American Society for Radiation Oncology (ASTRO), updated ASTRO, and American Brachytherapy Society (ABS) guidelines and to elucidate the most appropriate guideline that could differentiate outcomes among its risk groups.

Methods And Materials: Two hundred forty women underwent MIB-APBI during July 2000 to March 2013. Comparisons of long-term clinical outcomes (local control [LC], disease-free survival [DFS], cause-specific survival [CSS], and overall survival [OAS]) stratified by the risk groups proposed by the aforementioned patient selection guidelines were carried out on a prospectively maintained database.

Family Planning Practice among People Living with Human Immuno Deficiency Virus/Acquired Immune Deficiency Syndrome.

Background: Family planning among people living with Human Immuno Deficiency Virus/Acquired Immune Deficiency Syndrome is proved to be effective in preventing Human Immuno Deficiency Virus transmission through sexual and mother to child transmission.We studied family planning practice among people living with Human Immuno Deficiency Virus/Acquired Immune Deficiency Syndrome at reproductive age and its associated factors.

Methods: We conducted a cross-sectional study in four anti retro viral therapy centers in eastern Nepal from September 2015 to February 2016.