Evaluation of depth dose characteristics of superficial X-rays machine using different kVp and applicators diameter

Radiotherapy Treatment Planning requires different dosimetric quantities as input in order to calculate a desired dose distribution. This study has been focused to evaluate the depth dose characteristics of superficial X-rays being used for radiotherapy treatment. Computerized 3-D water phantom of multi-data system was used. The measurements were made through PTW [Physikalirsch-Technische Werkstalten] farmer type NT-30006 waterproof ionization chamber of 0.6cc, and PTW electrometer for digital dose rate reading in Gy/min using five different diameter applicators and filters at five different values of accelerating potentials [kVps]. The dose rate at various kVp X-ray beams was observed to decrease significantly with increasing depth in water phantom for all applicator diameters from 98% [at 0.1cm depth] down to 43% [at 2cm i.e. reference condition]. The dose rate increases by increasing the value of kVp with a maximum at 150 kVp [1.6 and 0.93 Gy/min for respective applicator diameters 2.5cm and 10cm]. Applicator with 2.5cm diameter demonstrates better dose rate at 85kVp at different depths. PDD decreases lower than 50% for all combination of applicators and kVps at/or above 2cm depth so these measurements should not be considered for treatment planning. Higher energy X-rays are suggested to be used for applicators of higher diameters and smaller energy X-rays for applicators having smaller diameters

Impact of wealth status on health outcomes in Pakistan

Maternal and childhood morbidity and mortality are high in Pakistan and health disparities exist. Multivariate logistic regression analysis of the Pakistan Demographic and Health Survey database 2006-07 was performed. There was an excess of 25 neonatal, 34 infant and 41 under-five deaths per 1000 live births in the poorest quintile of wealth index compared with the richest. Women in the richest quintile had a 35%, 38% and 20% higher probability of getting prenatal care, delivery by skilled provider and emergency obstetric care, respectively. Pakistan needs to enhance social equity so development benefits can accrue to the underprivileged by introducing social protection interventions so that those in the informal sector are not excluded from accessing health care, scaling-up poverty reduction strategies and promoting intersectoral action. This study assesses the independent impact of wealth status, as determined by a validated index, on health outcomes in Pakistan

Individual differences and stress-performance relationship

Medicine is a high risk profession. Infectious diseases, dealing with difficult patients, accidents on the job, and other hazards have shortened the careers of many practitioners. The extent to which they experience stress turns into poor performance in terms of quality of patient care. Personality traits are often thought to affect the stress that a person perceives. Specific types of personalities seem to be more susceptible to the effects of stress than others. Job performance is associated with different levels of stress. The purpose of the present study was to investigate any effect of job stress on job performance and effect of personality type on the stress-performance relationship. All 55 house officers enrolled at Ayub Teaching Hospital at the time of study were included in the study. Primary data was gathered through questionnaire designed to address personality type and to gathered information about job stress and performance. Individual semi-structured interviews and observations were used to collect information in order to find out how the work patterns have been influenced by environmental factors. The data obtained through questionnaire was analysed using the statistical methods including descriptive statistics, Spearman's correlation and multiple regression. The results indicated that Type A individuals tend to experience more stress than Type B, however no major statistical differences were found. Type a individuals performed slightly better than Type B. Identification of house officers' personality traits will be helpful in assessing stress and designing different stress coping strategies to reduce their level of stress and improve their performance. The correlation between job stress and job performance among house officers with Type A personality characteristics is high