PurposeRadiotherapy for breast cancer includes different techniques and methods. The purpose of this study is to compare dosimetric calculations using TG-43 dose formalism and Varian Acuros™ BV (GBBS) dose calculation algorithm for interstitial implant of breast using metal catheters in high-dose-rate (HDR) brachytherapy, using 192Ir.Material and methodsTwenty patients who were considered for breast conservative surgery (BCS), underwent lumpectomy and axillary dissection. These patients received perioperative interstitial HDR brachytherapy as upfront boost using rigid metal implants. Whole breast irradiation was delivered TG-43 after a gap of two weeks. Standard brachytherapy dose calculation was done by dosimetry. This does not take into account tissue heterogeneity, attenuation and scatter in the metal applicator, and effects of patient boundary. Acuros™ BV is a Grid Based Boltzmann Solver code (GBBS), which takes into consideration all the above, was used to compute dosimetry and the two systems were compared.ResultsComparison of GBBS and TG-43 formalism on interstitial metal catheters shows difference in dose prescribed to CTV and other OARs. While the estimated dose to CTV was only marginally different with the two systems, there is a significant difference in estimated doses of starting from 4 to 53% in the mean value of all parameters analyzed.ConclusionsTG-43 algorithm seems to significantly overestimate the dose to various volumes of interest; GBBS based dose calculation algorithm has impact on CTV, heart, ipsilateral lung, heart, contralateral breast, skin, and ribs of the ipsilateral breast side; the prescription changes occurred due to effect of metal catheters, inhomogeneities, and scatter conditions.
CYP1A1*2A polymorphic genotypes are associated with an enhanced risk to UADT cancers, in particular, among the habitual tobacco smokers and chewers carrying mutant genotypes in the Tamilians of the Indian population.
Between July 1994 and June 2004, 60 patients with 76 slipped upper femoral epiphyses were managed within the adult trauma service of three hospitals. Treatment was by a single cannulated screw. Of these cases, 53 were unilateral, in 17 of which uncomplicated prophylactic fixation of the contralateral hip was performed. Of the other 36 cases, nine presented with a subsequent slip despite ongoing out-patient care. The subsequent slip was unpredictable in timing and unrelated to the age at the initial slip. It was more often unstable and in one case avascular necrosis developed. The overall rate of avascular necrosis, although in accordance with the literature, was 60% in acute unstable slips with a slip angle greater than 40 degrees. In our experience, prophylactic fixation was safer than continued observation of the contralateral hip.
Gobal challenge of increasing needs with diminishing resources necessitates an innovative out-of-the-box thinking. Fortification of foods by nutraceuticals is a significant business opportunity, but one that still has significant technical challenges. Several factors are critical for the use and acceptance of nutraceuticals, such as, (a) stability at various pH, temperatures & relative humidity, (b) bioavailability, (c) organoleptic acceptance (taste masking) and (d) low cost formulation. Crystal engineering of synergistic combinations of nutraceuticals presented itself as a versatile platform for developing these formulations. Stable and taste masked epigallocatechin gallate, more bioavailable curcumin and biomimetic isoflavone cocrystals were developed at Tata Chemicals Innovation centre and their structures were analyzed by X-ray diffraction, properties by spectroscopic and thermal methods. Human clinical trials and in vitro anti-inflammatory studies of a synergistic formulation of curcumin-'Sustentials curcumin-G', showed four times more bioavailability with pronounced reduction in IL-6 concentrations. A new brand for formulations based on crystal engineering platform, namely, 'Sustentials Curcumin' was launched in the market. A flavour of this research and the challenges in commercialisation journey will be presented with suitable examples.
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