Tibial shaft fracture is the most common type of long bone fracture. The most common cause of fracture shaft tibia is vehicular accident followed by fall. Severe complications and major disabilities are common outcome of this fracture. This study was conducted to find out results and advantage of interlocking nailing for the management of tibial fractures. A prospective study had been conducted at SRTR Govt. Medical College Ambejogai, Maharashtra State, from Jan 2011 to Dec 2013. Twenty eight patients of closed or grade1compound fracture tibia who underwent fixation by interlocking nail were included in this study. Patient evaluated completely in the form of history, clinical and radiological evaluation. All the fractures united with union time ranging from 12 weeks to 28 weeks. In majority cases mode of injury was vehicular accident. None of the patients developed complications like hardware breakdown, patellar tendinitis, deep infection and nonunion The results obtained in this study have shown that interlocking nailing is ideal method of fixation of fracture tibia with least complications.
Background: The aim of this prospective study is to correlate radiological and intraoperative nodal characterization with pathological examination of pelvic and para-aortic nodes in operable epithelial ovarian cancer. Methods: The patients with epithelial ovarian cancer who had surgical cytoreduction were included in the study. These patients were subjected to radiological assessment of the abdomen with CT scan for nodal deposits in the para-aortic and pelvic region and it was followed by surgical cytoreduction. Intraoperatively, the nodes were palpated before, and after nodal basin, facial planes were dissected. After nodal dissection, the lymph nodes were grossed and sampled clinically as significant and insignificant and placed in separate jars. These nodes were pathologically assessed. Pathologically positive nodes were correlated with radiological, intraoperative and grossing findings. Results: Of the 27 patients, mean age was 45.6±10.9 years. Nine patients underwent upfront surgery, 18 patients underwent interval cytoreduction. A significant correlation was obtained (P Value <0.001) with grossing after surgery with the final histopathological report. The probable chance of identifying significant lymph nodes obtained in final pathological report from grossing after surgery in para-aortic nodes, right pelvic nodes, left pelvic nodes, right common iliac nodes and left common iliac nodes were 55%, 50%, 67.7%, 81.25% and 61.53% were positive for deposits and for insignificant lymph nodes obtained in final pathological report from grossing after surgery were 83.3%, 86.3%, 89.1%, 79% and 92% respectively were negative for deposits. Conclusion: Grossing after surgical dissection of the lymph nodes best correlates with final histopathology. CT scan findings for lymph nodal status in epithelial ovarian cancer does not correlate with final pathology.
Three-dimensional conformal radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) are the three main radiotherapy treatment techniques for cervical cancer. Whether either technique significantly reduces the radiation exposure to organs at risk remains unclear. We dosimetrically compared the irradiated volumes of bone marrow, bladder and rectum in cervical cancer patients using 3DCRT, IMRT and VMAT techniques in those patients with FIGO stage IIIB cervical cancer, receiving chemo irradiation at our institute. A total of 10 patients were dosimetrically compared. Significant reduction in V10, V20, V30, V40, V50 Gy of bone marrow was observed with IMRT and VMAT when compared to 3DCRT. Similar results were seen with V20, V30, V40, V50 Gy of bladder, and V40, V50 Gy of rectum. While comparing IMRT and VMAT, statistically significant dose reduction was noted in V20 Gy of bone marrow and V20 and V30 Gy of bladder with VMAT. When compared with 3DCRT the use of IMRT and/or VMAT reduced the radiation exposure to bone marrow, bladder, and rectum volumes at various radiation dose levels. VMAT can further reduce the radiation exposure to bone marrow and bladder when compared with IMRT. Thus, we propose the use of VMAT in cervical cancer to reduce the OAR toxicities.
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