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Diabetic wounds or ulcers are major complication of diabetes mellitus. Diabetes is a metabolic disorder that impedes the normal steps of wound healing process Major increase in morbidity in diabetic patients is due to macro and micro vascular complications including failure of wound healing process. Diabetes is the cause for more than 3/4 th lower limb amputation Increased glucose in the tissue precipitates infection. The aim of this study is to establish whether topical application of human epidermal growth factor enhance wound healing better than conventional povidone-iodine dressing in diabetic wounds. For one group of patients, topical application of recombinant human epidermal growth factor gel over the wound and wound dressing was done twice daily For other group of patients, topical application of povidone-iodine over the wound and wound dressing done twice daily. The Human Epidermal Growth Factor Application group patients equally belonged to the male gender class interval (n=15, 50%). In the Conventional Povidone Iodine Dressing group patients, majority belonged to the male gender class interval (n=15, 50%). The association between the intervention groups and gender distribution is considered to be not statistically significant since p > 0.05 as per fishers exact test. The results of the study conclude that the topical application of human epidermal growth factor enhances wound healing significantly and is better than conventional povidine iodine dressing.

images, computed tomography (CT) images plays two vital roles, namely defining pretreatment tumor and tumor responses to treatment, of which the later impacts greatly the treatment decision. However, the recent modern advancements in imaging analysis, namely radiomics, extracts additional quantitative features from medical images, such as CT, positron emission tomography (PET), and magnetic resonance imaging (MRI), to uncover patient's response to treatment as well as the chance of developing side effects (Gillies et al., 2016). CT radiomics is a conventionally practiced prognostic feature in radiation therapy. Various clinical, phantom, and texture analysis of CT radiomics have discussed both its reliability in assessing tumor response to treatment and its limitations. However, such limitations outweigh the established purpose of CT radiomics (Nardone et al.,

Purpose:The purpose of this present work was to fabricate an in‐house software based respiratory monitoring, controlling and breath‐hold device using computer software programme which guides the patient to have uniform breath hold in response to request during the gated radiotherapy.Methods:The respiratory controlling device consists of a computer, inhouse software, video goggles, a highly sensitive sensor for measurement of distance, mounting systems, a camera, a respiratory signal device, a speaker and a visual indicator. The computer is used to display the respiratory movements of the patient with digital as well as analogue respiration indicators during the respiration cycle, to control, breath‐hold and analyze the respiratory movement using indigenously developed software.Results:Studies were conducted with anthropomophic phantoms by simulating the respiratory motion on phantoms and recording the respective movements using the respiratory monitoring device. The results show good agreement between the simulated and measured movements. Further studies were conducted for 60 cancer patients with several types of cancers in the thoracic region. The respiratory movement cycles for each fraction of radiotherapy treatment were recorded and compared. Alarm indications are provided in the system to indicate when the patient breathing movement exceeds the threshold level. This will help the patient to maintain uniform breath hold during the radiotherapy treatment. Our preliminary clinical test results indicate that our device is highly reliable and able to maintain the uniform respiratory motion and breathe hold during the entire course of gated radiotherapy treatment.Conclusion:An indigenous respiratory monitoring device to guide the patient to have uniform breath hold device was fabricated. The alarm feature and the visual waveform indicator in the system guide the patient to have normal respiration. The signal from the device can be connected to the radiation unit in near future to carry out the gated radiotherapy treatment.

Purpose: In this innovative work we have developed Gynecological Brachytherapy shielding & Non Shielding Applicators and compared with the commercially available applicators by using the indigenously developed 3D Printing machine. Methods: We have successfully indigenously developed the 3D printing machine. Which contain the 3 dimensional motion platform, Heater unit, base plate, ect… To fabricate the Gynecological Brachytherapy shielding & non shielding applicators the 3D design were developed in the computer as virtual design. This virtual design is made in a CAD computer file using a 3D modeling program. Separate programme for the shielding & non shielding applicators. We have also provided the extra catheter insert provision in the applicator for the multiple catheter. The DICOM file of the applicator were then converted to stereo Lithography file for the 3D printer. The shielding & Non Shielding Applicators were printed on a indigenously developed 3D printer material. The same dimensions were used to develop the applicators in the acrylic material also for the comparative study. A CT scan was performed to establish an infill‐density calibration curve as well as characterize the quality of the print such as uniformity and the infill pattern. To commission the process, basic CT and dose properties of the printing materials were measured in photon beams and compared against water and soft tissue. Applicator were then scanned to confirm the placement of multiple catheter position. Finally dose distributions with rescanned CTs were compared with those computer‐generated applicators. Results: The doses measured from the ion Chamber and X‐Omat film test were within 2%. The shielded applicator reduce the rectal dose comparatively with the non shielded applicator. Conclusion: As of submission 3 unique cylinders have been designed, printed, and tested dosimetrically. A standardizable workflow for commissioning custom 3D printed applicators was codified and will be reported.

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Introduction: Endometrial cancer (EC) is a leading cause of female cancer in developed countries. The total abdominal hysterectomy and bilateral salpingo-oophorectomy with pelvic lymph node dissection is the primary management of endometrial cancer. Afterwards vaginal brachytherapy can be preferred either alone or combined with external beam radiotherapy to avoid the vault recurrence. This study was to assess the in-house multichannel applicator for HDR vaginal brachytherapy and dosimetric compression with the single channel applicator through DVHs. The main objective of this study was to design and development of an in-house multichannel applicator for HDR vaginal brachytherapy and dosimetric compression with the single channel applicator through DVHs. Materials and Methods:The multichannel applicator is a solid cylinder with 3 cm diameter, 13 cm length. It has a central channel surrounded by eight channels with a periphery arrangement in a single circle. We randomly selected eleven patients with endometrial carcinoma and 7Gy/per fraction of HDR dose was prescribed to CTV. Retrospectively, two 3D inverse treatment plans were created for each patient, with single channel loading and multichannel loading and the dose distribution of both plans could be compared. CTV coverage, rectum and bladder doses were compared. Results: The DVH analysis showed statistically significant difference between single and multichannel plan, that is for D95 of CTV (p=0.008), D100 of CTV (p=0.004) and 2cc of CTV (p=0.003). The p value for 1cc, 2cc and V70 are 0.003, 0.003 and 0.003 for rectum. On the other hand, bladder DVHs showed large difference between single and multichannel plan yet it is not statistically significant, and the p values for 1cc, 2cc and V 80 are 0.012, 0.009 and 0.225. Conclusion: The authors conclude that in house multichannel applicator with 3D inverse treatment planning techniques improves the dosimetric advantage over single channel applicators.