[Maximum dose] points in cervical and endometrial cancer medium dose rate brachytherapy

Best dose distribution in target volume and control of Organ at Risk [OAR] dose are the two main goals in brachytherapy. In this study in vivo dosimetry in 4 rectal points was performed by Transillumination Dosimeter [TLD] s and the measured doses were compared in different patients. One point was reported to have the maximum dose in each patient and the very dose was considered as rectal dose according to ICRU-38 prescription; however, the next higher dose was also considered the same as the highest point when the difference was not more than 10% of the highest value. In more than 50% of the cases the 1[st] and 2[nd] highest points were in the same range with less than 10% variation. There were 3 points in approximately equal dose in 7% of cases. These findings are challenging with the IVTU-38 recommendations reporting the existence of a sole maximum rectal dose. So it seems wise to consider an isodose plate of maximum doses instead of one point only

Evaluation and treatment of colorectal cancer in shahid rahnemoon and afshar hospitals, Yazd-Iran

Colorectal cancer is the most common cancer of the alimentary system. In women, it is the second leading cause of mortality after breast cancer while in men it is the third leading cause of death after lung and prostate carcinoma. Prevalence is more in population older than 50 years and increases in older people. Therefore, best treatment and prognosis is early diagnosis of disease. This study was a retrospective, cross-sectional study that included files of 191 patients of Shahid Rahnemoon and Afshar hospitals [two main hospitals] in Yazd, Iran from 1992 till 1999. The aim was to evaluate the abundance and distribution of colorectal cancer with respect to staging, age, occupation, residence, clinical signs and method of treatment. All of the patients had a cancer pathology report. f Results: Of the total of 191 patients with colorectal cancer, 186 cases were adenocarcinoma and 5 cases were lymphoma. Prevalence rate in men was more than women and their age range was between 28 and 94 years. 127 patients [67%] were in the 60 - 69 years age group, while 7.3% were in the 20 -39 years age group. 106 patients [55.5%] were men and 85 patients [44.5%] were women. 64.9% were urban dwellers and 35.1% were rural. Surgical treatment included; abdominoperinneal resection [A.P.R] in 55 patients [28.8%], anterior resection [A.R] and anastomosis in 40 patients [20.9%], right and left hemicolectomy, each in 25 patients and rectosigmoiedectomy and anastomosis in 18 patients [19.4%]. Results of treatment were as follows: 177 patients [92.76%] had relative recovery post operation, 5 cases [2.6%] were discharged from the hospital against medical advice, 3 cases [1.6%] died and 6 cases [3.1%] were discharged with poor condition after laparotomy. Most of the patients with colorectal cancer referred with rectorrhagia, main type of cancer was adenocarcinoma [97.4%] and the most frequent surgical procedure performed was A.P.R. Further research projects in the field of diagnosis, treatment and prognosis of these patients can be helpful in the treatment of these patients

[Efficacy of propranolol and amiodarone on prevention of atrial fibrillation after CABG]

Atrial fibrillation is the most common arrhythmia following CABG. This complication can cause palpitation, significant hemodynamic instability and thromboembolic events. This prospective randomized study evaluate prophylactic effects of propranolol low dose amiodarone and high dose amiodarone in patients candidate for CABG. Three hundred consecutive patients undergoing elective CABG were randomly categorized into three groups [each group contains 100 patients]. Patients in group1 [control group] received 10mg/TDS propranolol per oral [P.o], preoperatively. Patients in group 2 received 10mg propranolol TDS, P.o plus 350mg/24h amiodarone. Patients in group 3 received 10mg propranolol TDS P.o plus 1000mg/24h amiodarone 24 hours before operation. Atrial fibrillation occurred in 12 patients [12%] in group 1, four patients [4%] in group 2 and 10 patients [10%] [P=0.035] in group 3. AF occurred in 10.36% of men and 3.84% of women. There was no AF in off- pump groups and 9.73% in on-pump groups This study suggested the combination of propranolol plus low dose amiodarone for post CABG atrial fibrillation prophylaxy

[Carotid artery sonography findings in 291 patients undergoing CABG]

Doppler ultrasonography [DUS] is the most preferable method for screening of carotid artery disease in patients undergoing CABG. The purpose of this study was to investigate the frequency of carotid artery disease and determine the relation between known risk factors of atherosclerosis and rate of carotid artery narrowing in order to identify high-risk groups among patients scheduled for isolated elective coronary artery bypass grafting [CABG] procedures. Two-hundred ninety-one patients [222 males and 69 females] undergoing isolated coronary artery bypass grafting were preoperatively evaluated by carotid artery Doppler ultrasomography and the morphology of carotid artery was determined. Age, sex, cervical bruit, diabetes mellitus [DM], hypertension, hyperlipidemia, smoking, history of cerebrovascular event [CVE] and coronary angiographic findings were investigated to define the high-risk group for carotid artery disease. Data were analyzed by SPSS software and P<0.05 was considered significant. Patients ages ranged from 35 to 95 years [mean of 57.6 +/- 10.4 years]. Eleven patients [3.8%] had history of cerebrovascular events [CVE]. 13 patients [4.5%] had cervical bruit. Left main coronary artery involvement was observed in 19 patients [6.4%]. In 127 patients [43.6%] carotid scanning was normal, fifty nine patients [20.4%] had less than 50% stenosis [mild stenosis], ninty seven patiens [33.3%] had 50-70% stenosis [moderate stenosis], and eight patiens [2.7%] had more than 75% stenosis [severe stenosis]. Calcified plaque was observed in 109 patients [37.5%]. Previous cerebral ischemic events [P=0.297], diabetes mellitus [P=0.467], hypertension [P=0.110], hyperlipidemia [P=0.08], smoking [P=0.401], age >60 years [P=0.84], female sex [P=0.730], and left main coronary disease [P=0.390] were not identified as high-risk factors for carotid artery stenosis greater than 50%. But positive MI history [P=0.025], and cervical bruit [P=0.002], were significantly related to 50% carotid artery stenosis. Based on the results of this study, we can not suggest DUS as a routine screening method in all patients undergoing CABG, except for patients with history of MI and cervical bruit. Another important finding was that 56.4% of patients posted for CABG had different degrees of carotid artery stenosis which requires a long term CVA prophylaxis program