ABSTRACT
Objective?The word “telemedicine” literally translates to “healing at a distance.” In the current scenario of the coronavirus disease 2019 (COVID-19) pandemic and shut outpatient department, the patients are facing difficulty in consultation. This article evaluated the use of telemedicine in the management of pediatric surgical patients. Materials and Methods?In this observational cohort study, from April 2020 to August 2020, all patients who took advice on phone/WhatsApp were assessed for addressing their complaints. The data was collected and analyzed. Result?A total of 307 patients were provided consultation via telecommunication. The male to female ratio was 2.3:1. Fifty-six (18.2%) patients called on an emergency basis, while the remaining 251 (81.8%) patients called for nonemergency or routine problems. Of these, attendants of 25 (8.14%) patients were not able to state the situation adequately. They were called to the department. Of these, 11 (3.5% of total) patients were admitted. One-hundred and eighty-three (59.6%) patients were in the department's follow-up, while the remaining 124 (40.4%) were new patients. The attendants of 296 (96.4%) patients were satisfied by using this modality of consultation. Conclusion?In the current scenario, telecommunication may help us to avoid unnecessary travel to the hospital. It may be helpful to deal with minor clinical complaints and evaluating for an emergency.
ABSTRACT
Context: Better locoregional control and increased overall survival by continuous hyper fractionated accelerated radiotherapy have been shown in unresectable nonsmall cell lung carcinoma (NSCLC). Dose escalation and neoadjuvant chemotherapy (NACT) along with continuous hyperfractionated accelerated radiotherapy week end-less (CHARTWEL) were also tried for improved survival. In this present study, we compared the results of NACT followed by CHARTWEL against NACT followed by conventional concurrent chemo-radiation therapy. Aims: The aim of this study is to compare the locoregional control and toxicities in NSCLC Stage IIIA and B in both arms. Settings and Design: Randomized, prospective single-institutional study with a study population comprising all locally advanced unresectable NSCLC patients enrolled in 2014 at our institute. Subjects and Methods: All enrolled patients were randomized into two arms-CHARTWEL and concomitant chemo-radiotherapy (CCRT), after three weeks of the fourth cycle of NACT. In CHARTWEL arm 30 patients received two-dimensional radiotherapy (RT) 58.5 Gy/39 fr/2.5 weeks while in CCRT arm 30 received 66 Gy/33 fr/6.5 weeks. Disease response was evaluated at 6 months and toxicity assessment during and after treatment completion. Data were analyzed using tools such as percentage, mean, Chi-square test and P value. Chi-square and P value was calculated by statistical online software (http://quantpsy.org). Results: 28% of patients in study arm and 20% in control arm had complete response at 6 months after RT. Locoregional disease control was observed in 44% in study arm and 32% in control arm of patients. There was no statistical difference in grades of toxicities or overall survival (OS)/disease-free survival except persistent esophagitis Grade III seen in two patients of study arm. Conclusions: Study suggests that CHARTWEL in combination with NACT is an effective strategy to treat patients with locally advanced lung cancer with the advantage of a smaller dose and shorter duration. Although large multivariate studies still needed