Dosimetric verification of pre-treatment intensity modulated radiation therapy in the commissioning process

Background: commissioning tests are recommended before implementing Intensity Modulated Radiation Therapy. This study evaluated five different plans of IMRT mocks for different modulation indices

Materials and Methods: IMRT tests were done in slab phantom for both 6MV and 15 MV photon energies using a 2D array ion chamber dosimeter

Results: the acceptance criteria were based on 3% /3mm. All tests passed the gamma criteria except for the prostate test with 15 MV photon beams and C shape test for both 6 MV and 15 MV energies. The Ratio passing points for Multi target test in 6 MV and 15 MV plans were 93.1% and 91.5%, respectively. The results of the prostate tests with 3%/3mm was 92.3% for 6MV and 91.2% for 15 MV in 4%/4 mm tolerance limit. For Head and Neck test with the same gamma criteria, the percentages of the points were 93.2 and 94 for 6 MV and 15 MV plans, respectively. For C shape tests, the used gamma criteria were 4%/ 4 mm. The ratio passing points were 94.9% and 94.3% for 6MV and 15MV plans, respectively. However, C shape hard test could not pass the gamma criteria of 4%/ 4mm for 6MV

Conclusion: results showed that by increasing the complexity of the IMRT plan, the verification test must be done in a more strict-manner, because a small change in dose delivery can cause a large discrepancy between planned and real dosimetry and may produce hot spots in organs or a cold spot in the target volume

Radiation treatment planning for prostate cancer: a new dosimetric comparison of five and seven fields IMRT plans

Background: To compare the dosimetric coverage of the planning target volume [PTV] and the dose delivered to the main Organs at Risk [OARs] in 5 and 7-field techniques of Intensity Modulated Radiation Therapy [IMRT] in patients with local prostate cancer

Materials and Methods: Twelve patients with local prostate cancer underwent 5 and 7-field IMRT planning. The delivery of IMRT was carried out using the sliding technique. The dose coverage for PTV was designated to >/= 98% of the PTV covered by 95% of the prescribed dose. Dose conformity was evaluated by comparing the volume of nontarget tissue receiving maximum, and average of the prescribed dose and the dose of 33%, 50%, and 66% of the volumes on both planning sets. For target, this evaluation was made with comparing the Conformity Index [CI] and Inhomogeneity Index [HI]. In addition, we compared the monitor units used for dose delivery in both planning techniques

Results: All the 5 and 7-field IMRT plans differed slightly in the measured parameters, and none of them have statistically significant differences with each other except for the monitor units where significant differences were observed in favor of the 5-field IMRT plans [p=0.000]. In all of the 5-field IMRT plans the mean dose delivered to OARs were very similar or less than that of the 7-field plans

Conclusion: In comparison to the 7-field technique, the 5-field IMRT technique has resulted in improved IMRT dose conformity, homogeneity, and lesser MUs used for radiation therapy. However, this difference was not significant

comparative effects of a gluteus medius strength training program and balance training program on postural control in adult and elder women

Purpose: The purpose of this study was studying the comparative effects of a gluteus medius strength training program and balance training program on postural control in adult and elder women

Method: this study is semi-experimental with pre-test - post-test design. Forty five elderly women [55-65 aged] participated in this study and divided randomly in three groups: gluteus medius [GM], balanced and control. The Experimental groups performed their training program for 6 weeks and three times per week. Prior and after to starting training program, the balance measured by Berg Balance Test [BBT]. Dependent t-test and ANOVA used to analyze the data [P<0/05]

Results: The results show that GM training [p=0/003] and balance training [p=0/012] improve balance significantly in elderly women. There are significant differences between GM group and control group [p=0/005] and between balance group and control group [p=0/001] but no significant different between GM and balance group [p=0/6]

Discussion: In conclusion, strengthening GM may improve postural control in elderly women

Challenges of implementing Iranian national laboratory standards

After four years of publishing the Iranian National Laboratory Standard and following a strategic plan to implement its requirements, it was decided to review the taken actions, evaluating the achievements and the failures, as well as analyzing the gaps and planning the interventional activities to resolve the problems. A thorough evaluation revealed that the progress of implementation process varies considerably in different provinces, as well as in laboratories in different public and private sectors. Diversity and heterogeneousity of laboratories throughout the country is one of unresolvable problems. Although we encounter shortage of resources in the country, improper allocation or distribution of resources and budgets make the problems more complicated. Inadequacy of academic training in laboratory sciences has resulted in necessity of holding comprehensive post-graduate training courses. Revising academic curriculum of laboratory sciences could be mostly helpful, moreover there should be organized, training courses with pre-determined practical topics. providing specific technical guidelines, to clarify the required technical details could temporarily fill the training gaps of laboratory staff. Inadequate number of competent auditors was one of the difficulties in universities. Another important challenge returns to laboratory equipment, developing the national controlling system to manage the laboratory equipment in terms of quality and accessibility has been planned in RHL. At last cultural problems and resistance to change are main obstacles that have reduced the pace of standardization, it needs to rationalize the necessity of establishing laboratory standards for all stakeholders

[Antifungal effect of cerumen on fungi causing otomycosis]

Otomycosis which is caused by saprophytic fungi can be treated by topical antifungal agents. Sometimes eradication of the disease is difficult in patients with risk factors. Considering controversies about the anti-microbial effect of cerumen, this research was performed in Babul, was focused on revealing the antifungal effect of cerumen of healthy people on fungi causing otomycosis. This experimental study was carried out on the 60 samples of healthy people's ear canal secretion. The average ages of the subjects were between 2-85 years. The antifungal activity of cerumen solution on 4 species of fungi including; Aspergillus fumigatus, Aspergillus niger, Candida albicans [clinical isolate] and standard Candida albicans were analyzed by paper disc diffusion and micro dilution methods. 10% of cerumen showed antifungal activity in paper disc diffusion; whereas in the micro dilution method all of samples had antifungal activity. The most antifungal effect observed was on Aspergillus niger [27 samples] and the least effect on the species of Candida albicans [16 samples]. According to the obtained results, cerumen has different effects on fungal growth, thus it is necessary to study more about components of cerumen for new approaches in future

[Comparison of excyclotorsion induced by two surgical methods in rabbit eyes]

Compaison of excyclotorsion induced by horizontal transposition of vertical rectus muscles versus vertical transposition of horizontal rectus muscles in rabbit eyes. In this exprimental study, group 1 underwent full tendon nasal transposition of the superior rectus and full tendon temporal transposition of the inferior rectus [10 adult rabbits]; group 2 underwent superior transposition of the lateral rectus and inferior tranposition of the medical rectus [10 adult rabbits]. External limbal marking was used to estimate the magnitude of excyclotorsion resulting from muscle surgery. The mean angle of excyclotorsion in group 1 was 31 +/- 1.8 degree, ranging from 28-35 degree. The mean angle of excyclotorsion in group 2 was 12.85 +/- 1.6 degree, ranging from 10-16 degree. Excyclotorsion induced by horizontal transposition of vertical rectus muscles was significantly larger than that induced by vertical transposition of horizontal rectus muscles [P<0.001]. The amount of excyclotorsion after LR displacement [1.1 +/- 0.8 degree] was significantly smaller than the amount of excyclotorsion after MR displacement [12.6 +/- 1.7 degree] [P<0.001]. Althaugh the mean angle of excyclotorsion induced by horizontal transposition of vertical rectus muscles was larger than that of vertical transposition of horizontal rectus muscles, superior displacement of the LR muscle induced no significant change in globe torsion. The torsional effect of horizontal transposition of vertical rectus muscles can be changed varying amounts of globe torsion

immunohistochemistry study of lesions due to avian infectious bronchitis [Serotype 4/91] on different tissues in specific pathogen free chicks

Thirty specific pathogen free [SPF] 20-day-old chicks were inoculated by the intra-tracheal [n = 15] or oral [n = 15] routes with serotype 793/B of IBV, isolated of Iran. Two groups of 15 SPF chicks which as controls received PBS, either by the intra-tracheal or oral route. All the chicks were observed and examined daily for clinical signs. Each day for 5 days three chicks from each infected and control group were post-mortemed and examined pathological changes in the trachea, lungs, kidneys and intestines. Sections of these tissues were prepared, stained and examined microscopically for histopathological and immunohistochemical changes. Grossly, a small amount of clear mucus and slight congestion were found only in the lumen of the trachea and the lungs of the group chicks which were infected with IBV. The kidneys were pale and slightly enlarge. Immunohistochemical examination revealed similar changes in the kidneys of both groups of chicks infected by the intra-tracheal and oral routes. Viral antigens were detected in the infected cells. The viral antigens were apparent prior to the development of lesions and were detected in the cytoplasm of epithelial cells by 3 days post infection with IBV. The results of this study clearly indicate that IBV [serotype 793/B], isolated in Iran by Momayes et al. [2001], is capable of causing lesions in different tissues most severely in the kidneys of experimentally infected chicks. On the other hand, the serotype has a greater affinity and positive tropism for the kidney than to other tissues

Serologic evidence of bluetongue infection in one-humped camels [Camelus dromedarim] in Kerman province, Iran

Herein, we presented the first report on bluetongue [BT] disease in 10 pregnant camels in a herd from Kerman province, Iran. All sera samples were tested serologically [AGID, C-ELISA]. We also used the Razi-BK cell line, performed primary culture of ovine kidney and inoculated intravenously the embryonated chicken eggs [ECE] to culture and isolate the BT virus. Efforts to culture and isolation of BT virus have met with very limited success. Following precipitation test [AGID] and C-ELISA, 5 of 10 sera in AGID test, and all in C-ELISA became positive. Further studies are needed on the ecology of camels and vector midges to clarify the reason for infection of the camels in Iran

hematological changes in severe burn patients hospitalizing in Tehran burn centers

The hematological changes in burn patients can at times manifest as severe complications. Investigating the hematological changes in hospitalized severe burn patients. In this descriptive study, 120 patients with severe burn were chosen by convenience sampling from 3 burn centers: Towhid, Shahid Motahary and 15[th] Khordad hospitals during the period of 2002 - 2003. The cases were surveyed during first, third and seventh days following burn injury. A single specialist evaluated the complete blood count [CBC] profiles at 3 time intervals. WBC was increased on the first post-burn day; however, it was decreased on the 3[rd] and 7[th] post-burn days, although within normal limits. RBC, hemoglobin and hematocrit were gradually reduced during the mentioned time intervals. Platelet counts were changed drastically, as on the 3rd post-burn day; the presence of thrombocytopenia was evident while on the 7[th] day the count was increased. The correlation between WBC and band cells on the first and 7[th] post-burn days were significant [P=0.001], while it was insignificant on the 3[rd] day [P>0.001]. Since following the severe burns the occurrence of a noticeable change in platelet counts was considerable, the evaluation of MPV for differential diagnosis of thrombocytopenia is recommended