A comparative study of Conventional and CT based planning of Target volumes and organs at risk in Intra cavitary brachytherapy for Carcinoma of cervix

Introduction: Cervical cancer is the third most common malignancy in women worldwide, and it remains the leading cause of cancer related deaths in women in developing countries. In the management of cervical cancer, both intracavitary brachytherapy (ICBT) and external radiotherapy (ERT) are essential as they deliver a high dose to the primary tumor and low doses to adjacent organ. The dose can be delivered either by conventional orthogonal radiograph mapping or by the 3- dimensional computed tomography mapping. In the present study, we have compared both the techniques. Aim and objectives: To compare intracavitary brachytherapy (ICBT) planning methods for cervical cancer based on orthogonal radiographs (conventional plan) and computed tomography sections (CT plan). Materials and methods: This was a prospective study, conducted in the department of Radiotherapy, MNJ Institute of Oncology and Regional Cancer Centre, over a period of two years from November 2012 to November 2014. The study consisted of total 25 registered patients having confirmed diagnosis of Squamous cell carcinoma of cervix. All the patients underwent conventional and CT planning for brachytherapy. One arm received the conventional plan of radiotherapy while the other arm received computed tomography (CT) based plan. Radhika Rani, R. Srikanth. A comparative study of Conventional and CT based planning of Target volumes and organs at risk in Intra cavitary brachytherapy for Carcinoma of cervix. IAIM, 2016; 3(9): 200-209. Page 201 Results: The patient age ranged from 35 to 65 years. The mean age was 47 years. The results of the study demonstrates that CT-guided brachytherapy planning is superior in terms of both conformity of target coverage and evaluation of OARs .Although this superiority was clear for small GTVs, for large GTVs both the conventional and CT-Plans had the drawbacks of inadequate target coverage and /or excessive radiation doses to normal organs. Conclusions: The conventional plan with the point A calculation relies on reference points on orthogonal films ,not tumor volumes defined on CT, which may cause underestimation of tumor doses. Likewise, the calculation of rectum and bladder doses made with ICRU reference points, not with bladder and rectal volumes may not reflect the actual organ doses. To overcome such problems, 3D CT-guided brachytherapy treatment planning is recommended.

Pyramidal molar roots in primary and permanent dentition along with non syndromic oligodontia in a 11 year old boy.

Primary and permanent molars are usually multi rooted. At times we can encounter cases with a single root, called pyramidal root. Oligodontia is defined as the developmental absence of six teeth or more, excluding third molars. It can be isolated (Oligodontia-I) or as a part of a syndrome (Oligodontia-S) such as in ectodermal dysplasia. The present report describes a case of single-rooted primary and permanent molars associated with oligodontia in an 11 year old boy with no apparent systemic complications.

Management of three fused primary teeth.

Fusion is a dental anomaly in which two dental germs have developed separately and then become united. It is often confused with germination, unless until carefully evaluated clinically and radiographically. This paper describes a case of a six year old boy who presented with pain and swelling in right lower back tooth region. Intra oral examination revealed three fused primary teeth, which were confirmed radiographically. Radiographs also revealed missing permanent tooth buds associated with them. Since all the fused teeth were pulpally involved they were managed by pulpectomy. The incidence, prevalence, complications and treatment modalities are also discussed in this case report.

Chocolate mouth rinse: Effect on plaque accumulation and mutans streptococci counts when used by children.

Background: Glucosyltransferases (GTF) play an important role in the adherence of bacteria to acquired pellicle. Cocoa bean husk extract (CBHE) has been shown to possess anti-glucosyltransferase and antibacterial activity. Aim: This study aimed to evaluate the effect of CBHE on plaque accumulation and mutans streptococcus count when used as a mouth rinse by children. Materials and Methods: Scaling of the teeth of the selected children was done and the children were instructed to refrain from their routine oral hygiene practices till the morning of the fourth day; they were instead given a placebo mouth rinse for use during this period. On the fourth day, saliva was collected from each subject for microbiological analysis and plaque was disclosed and scored using the modified Quigley and Hein plaque index; later, the teeth were cleaned. After 1 week, scaling of the subjects was done and they were given CBHE mouth rinse to rinse their mouth, following the above protocol. The data was statistically analyzed using Wilcoxon's signed rank test. Results: There was a 20.9% decrease in mutans streptococci counts and a 49.6% decrease in plaque scores in the CBHE group as compared to the placebo group, which was highly significant (P value Conclusion: CBHE is highly effective in reducing mutans streptococci counts and plaque deposition when used as a mouth rinse by children.