Daily morning quality assurance (QA) for all available beams using conventional phantom measures only output and beam quality. PTW QUICKCHECKwebline (PTW QCw) is a compact movable light-weight dosimetry equipment used for daily QA, capable of measuring flatness, symmetry, beam quality and output constancy of a given beam in a single exposure. The purpose of this study was to analyze and monitor the output constancy of a medical linear accelerator using PTW QCw and assess the overall performance of the PTW QCw. The output parameters of 4, 6 and 15 MV photon beams and 4, 6, 8, 10, 12 and 15 MeV electron beams of the Elekta Synergy linear accelerator in Kathmandu Cancer Center were analyzed. It was found in the study that all the parameters were well within the recommended tolerance limit of ±3%. Some known modifications in the settings of the linear accelerator gantry, couch, and collimator were introduced separately during the exposures, and the percentage variations from the baseline values were noted to check the sensitivity of the PTW QCw using 6 MV photon beam. The PTW QCw was able to detect the deviations introduced to the external irradiation conditions for both photon and electron beams under daily testing conditions. The results from this study suggest that daily dosimetric consistency measurements using the PTW QCw helps to monitor the overall performance of the linear accelerator.
Occupational radiation safety and health is the most neglected aspect in the health sector in Nepal. There has been gross negligence in occupational safety and health as a whole in Nepal. This paper is a review of previously published articles on topics of occupational radiation safety and health in Nepal. Keywords such as Nepal, occupational safety, radiation safety, radiation risk, and health were used to search for relevant articles in PUBMED and Google Scholar. A total of 15 research articles were reviewed, which dealt with different forms of occupational radiation risks and exposure, regulatory works and consequently its knowledge and awareness among the professionals. The reviewed articles are basically of 3 types: analytical or progress reports, knowledge or awareness assessment, and measurement-based research articles. The overall status of occupational radiation safety and health does not look satisfactory. Although occupational radiation safety and health is a very important issue at an individual, social and national level in any hospital, agricultural or industrial sector, it has not received much attention so far in Nepal. This is evident by the minimal number of literature available on the status of occupational radiation safety and health in Nepal. Standard work situations and criteria have to be set up and regular radiation monitoring should be done to ensure the maintenance of quality at work. In addition, workshops, seminars, symposiums, training courses, and Continuing Professional Education (CPE) programs should be organized regularly to raise the level of radiation awareness in the profession. The state agencies need to develop and update respective national laws, policy and programs for occupational radiation safety and health. There is an utmost need for extensive researches to be performed covering overall radiation health and other services of the professionals in Nepal where radiation is being used for their advantageous purposes.
One of the important goals of the use of X-rays is to diagnose a disease and its extent and minimizing the adverse effect. In diagnostic X-ray, there is an important issue concerning the quality of the image and the exposure of radiation to the patient. Regular practice of quality control in diagnostic X-ray is essential to provide good quality images, decrease hazard to patients, and enhance the appropriate diagnosis. Quality control tests were carried out at six fixed X-ray units at National Academy of Medical Sciences, Bir Hospital and National Trauma Center. Parameters like kVp accuracy, timer accuracy, Reproducibility of kV, time and dose, variable mA and radiation output Linearity with the acceptance limits were checked. Radiation leakage, spatial resolution, contrast resolution and field alignment tests were also carried out. Quality control tests of kVp dose, dose rate, HVL, mAs, beam alignment and leakage radiation shows mixed results. The measured values were within limit in four X-ray units. Until now we do not have any regulations in Nepal on acceptance testing of x-ray units after installation. The need for quality assurance of X-ray needs to be taken to avert detrimental effects to patients and staff. Institutes must introduce a mandatory system for acceptance tests of X-ray when installed and alongside regular quality control programs.
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