Dosimetric comparison of three dimensional conformal radiation therapy versus intensity modulated radiation therapy in accelerated partial breast irradiation.

AIM OF STUDY: Breast conserving surgery (BCS) is the standard treatment for stage I and II breast cancer. Multiple studies have shown that recurrences after lumpectomy occur mainly in or near the tumor bed. Use of accelerated partial breast irradiation (APBI) allows for significant reduction in the overall treatment time that results in increasing patient compliance and decreasing healthcare costs. We conducted a treatment planning study to evaluate the role of intensity modulated radiation therapy (IMRT) with regards to three‑dimensional conformal radiation therapy (3DCRT) in APBI. MATERIALS AND METHODS: Computed tomography planning data sets of 33 patients (20 right sided and 13 left sided) with tumor size less than 3 cm and negative axillary lymph nodes were used for our study. Tumor location was upper outer, upper inner, central, lower inner, and lower outer quadrants in 10, 10, 5, 4 and 4 patients, respectively. Multiple 3DCRT and IMRT plans were created for each patient. Total dose of 38.5 Gy in 10 fractions were planned. Dosimetric analysis was done for the best 3DCRT and IMRT plans. RESULTS: The target coverage has been achieved by both the methods but IMRT provided better coverage (P = 0.04) with improved conformity index (P = 0.01). Maximum doses were well controlled in IMRT to below 108% (P < 0.01). Heart V2 Gy (P < 0.01), lung V5 Gy (P = 0.01), lung V10 Gy (P = 0.02), contralateral breast V1 Gy (P < 0.01), contralateral lung V2 Gy (P < 0.01), and ipsilateral uninvolved breast (P < 0.01) doses were higher with 3DCRT compared to IMRT. CONCLUSION: Dosimetrically, IMRT–APBI provided best target coverage with less dose to normal tissues compared with 3DCRT‑APBI.

Repair of cleft lip on relatively older children with anthropometrical surgical outcome.

A prospective study was done on 54 patients aged over 6 months with cleft lip with or without cleft palate admitted in the department of pediatric surgery of Mymensingh Medical College Hospital during the period from Oct 2002 to Dec 2004. The anthropometrical surgical outcome was evaluated by measuring the length, diameter and thickness of hemilip and diameter of nostril both pre and postoperatively (according to schedule). Patients were categorized into three groups according to their age. Mean Corrective rate was evaluated and it was shown 95% in the 1(st) age group, 93% in 2(nd) age group and 95.55% in the 3(rd) group. Complication was evaluated in only 16.66% of patients. Regarding the out come scar, cupid's bow, notching, labial and nasal symmetry were taken in consideration. Beside these this study might play a comparative role with the results of correction of cleft lip in early age.

Caesarean section: an historical riddle.

Etymologically, the word 'Caesar' originates from the Latin word 'Caedaere' meaning - 'to cut'. So cutting remains the core point, but little is known about the real origin of the history of Caesarean Section. There is evidence that, the ancient Hindus excelled in surgery and many operations were performed, including caesarean section. This operation was mentioned several times in the Mishnah of Rabbi Judah, the first large commentary on the Hebrew Bible. There are also several mythological anecdotes in Hindu, Buddhist and Greek mythologies. The myth of caesarean section did not even escape the keen eyes of William Skakespeare. The landmarks, treatises and the advancement in this operative procedure are presented in this article.

JU-2, a novel phosphorous-containing antifungal antibiotic from Streptomyces kanamyceticus M8.

A novel phosphorous-containing antifungal antibiotic JU-2 was isolated from Streptomyces kanamyceticus M8. Quantitative chemical analysis shows the presence of two phenylalanines, two glucose, one linoleic acid, one crucic acid and one phosphonamide moiety per molcule of the antibiotic. JU-2 shows strong inhibitory activity against various pathogenic and non-pathogenic fungi but no activity against bacteria and yeast.

Glimpses of the history of insulin.

The discovery of the insulin which took place at Toronto, Canada in 1921-22 is one of the most important medical discoveries of the modern age. For this miracle, Prof. John James Macleod and Frederic Grant Banting were Jointly awarded the Nobel Prize in 1923 for Physiology or Medicine. Frederick Sanger a British biochemist discovered the structure of insulin in 1958 and was awarded Nobel prize for chemistry. Diabetes mellitus is called Madhumeha in ancient Indian Ayurvedic medicine. Egyptians and Greeks knew about it. Greek physician Aretaeus of Capadocia first suggested the term "Diabetes" and described it. Though insulin was discovered about 80 years ago research interest in it still continues unabated. This paper also gives case details of the first patient on whom Insulin was first tried and chronology of research on pancreas and Insulin.

History of medicine in the twentieth century: an overview.

The study of history is part of man's awareness of himself and the nature and place of his society in the world at large. The history of medicine is no exception. The past is always a guide to the present and the present sets the scene for the future. That is where lies the significance of the study of the history of medicine in the twentieth century. The medical achievements of this century ranks as one of the supreme epochs of human enterprise and endeavour. Medicine needed to march a par with the dynamic history of a changing scientific world. In fact, it did so.

History of women in surgery: an overview.

The history of women as medical and surgical practitioners stretches back to at least 3500 B. C. Wall painting in tombs and temples of ancient Egypt show them performing surgical procedures and there is also evidence that women surgeons were practicing in ancient Sumeria, Babylon, Greece and Rome. During the middle ages as per formal decree issued by the church in the twelfth century monks were prohibited from "blood-letting" or performing operations. This effectively relegated wound treatment, bleeding and bone-setting to barbers and women. Women were particularly valued for their skill in obstetrics and midwifery. In this way an overview with regard to the history of women in surgery is presented here in chronological order.

Doctors in literature.

Both, medicine and creative literature map out the mind of mankind and expose the beauty of nature and the biological world. Literature gives insight into the inner dynamics of the human mind. Doctors of medicine know the cell-the building block of the body and mind. They can easily penetrate into the innermost sanctum of the human mind. They see things as they really are not as they themselves are. Creative writers are keen observers of everything around them. Keen observation very often tells or give clues to scientific truth. World literature offers a galaxy of those creative minds. It is a brief account of the contribution of doctors in literature over the centuries. It is, by no means, comprehensive. It is an overview.

Corpus Hippocraticum 'on the sacred disease'.

The Hippocratic Corpus was attributed to all branches of healing including internal medicine, surgery, and obstetrics. The Hippocratic collection of treatises (or corpus) was mostly written between 430 and 330 B.C. and some are later works. Some 600 years after Hippocrates, the Corpus were further systematized by Galen and later still by the Persian Islamic physician Avicenna and others. The Corpus provides an insight into the origin and development of rational medicine in the west.

Universalism in medicine through the ages.

Since man was formed in the divine likeness, God being considered as the source of all truth and goodness, mankind must possess this inherent goodness. It is however, this inherent goodness reflected in the healing activities of mankind which every culture and race has given witness to in all periods of time. This developing in different cultures in different ways throughout the world as a thread of continuity linking the brilliant discoveries of the medical sciences of our own time with that has gone before.

Glimpses of Islamic medicine.

The fall of the Roman Empire during the fifth century A.D. Ushered in the beginning of the Dark Ages. After this, in Europe further progress of Greco-Roman medicine originated from Hippocrates was halted. The ideas about medicine and hygiene were kept alive in monasteries only. The Arabs made advances in medicine at a time when the rest of Europe was in the Dark Ages. Islamic system or the rulers of the day actively encouraged scholarship and growth of knowledge. The Islamic gift of the day to the world of medicine was simply unique.

Galen's use of Aristotle.

The thought of Aristotle has stamped itself on the whole subsequent course of Natural philosophy including the philosophy of healing art since the 4th century B. C. He is known to be the great codifier of ancient Natural philosophy. He developed coherent theories of generation and functional morphology of animals and heredity in his treaties. Aristotle dissected about 70 species of animals and founded the basis of comparative Anatomy.

Aristotle's ethical theory & modern health care.

The Greek physician of antiquity - Hippocrates (460-356 B.C.) is called the Father of Modern Medicine and the Hippocratic Oath to which doctors of modern medicine traditionally and formally express their allegiance, forms the basic foundation of medical ethics. The tradition of Western ethical philosophy began with the ancient Greeks. From Socrates (469-399 B.C.) and his immediate successors, Plato (427-347 B.C.) and Aristotle (384-322 B.C.), there is a clear line of continuity, through Hellenistic period (from the death of Alexander the Great (323 B.C.) to the end of Ptolemic dynasty (30 B.C.) and the Roman annexation of Egypt - broadly post-Aristotelian and medieval thought to the present day. But the society has qualitatively and quantitatively changed since the Industrial Revolution in the late 18th and 19th centuries. Society, today, is just a collection of discrete individuals, each with his or her own purposes and interests. Hence it has become almost imperative to apply the principle of autonomy to issues in the ethics of health care. The aim of this short essay is, therefore, an attempt to explore the relevance, if any, of Aristotelian ethical theory to the modern health care.

Ethical aspects of the Hippocratic Oath and its relevance to contemporary medicine.

For centuries the Hippocratic Oath was the example of medical etiquette and as such, determined the professional attitude of physicians in modern medicine. This essay includes a short biographical account of Hippocrates, throws some light on the origin of the oath, cites the text of the oath (in English) and gives an ethical interpretation of the oath. Analysis of the past very often offers creative guidance to the present and also to the future, and the Hippocratic oath is no exception.

Medicine through the ages.

History of medicine chronologically traces its development from guesswork about the actions of prehistoric man through the centuries to some aspects of the present day. The intellectual and cultural centres of the world have moved over time to time from place to place. In earlier times all knowledge was part of a conglomerate which one polymath might be able to master in a way no longer open to anyone now. The history of medicine through the ages has been presented here under different subdivisions, such as The Past, The Middle Ages, The Twelfth century Renaissance and Medicine and the Renaissance (Newton's century) etc.