ABSTRACT
Background The imaging of the lumbar canal is an important aspect of low back pain (LBP) management. Magnetic resonance imaging (MRI) has gained widespread acceptance for the evaluation of spine anatomy. Objective The objective of the study is to compare the MRI findings of the anteroposterior diameter, transverse diameter, and thecal sac area of the lumbar vertebral canal in symptomatic low back pain patients to that of patients without low back pain. Methods The cross-sectional study included 200 subjects of which 100 subjects (49 males and 51 females) were symptomatic cases of low back pain and 100 subjects (53 males and 47 females) had no symptoms of low back pain and were enrolled as controls. The MRI scans were studied for the anteroposterior diameter, transverse diameter, and thecal sac area of the lumbar vertebral canal. Results In our study, the anteroposterior diameter of the lumbar vertebral canal among cases was found to have a mean of 14.42, 14.09, 13.44, 13.63, and 13.79 with a standard deviation (SD) of 1.25, 1.32, 1.75, 1.75, and 2.65 at L1, L2, L3, L4, and L5 levels, respectively. The anteroposterior diameter of the lumbar vertebral canal among controls was found to have a mean of 15.26, 15.16, 14.71, 14.68, and 15.28 with an SD of 1.60, 1.67, 1.30, 1.36, and 1.97 at L1, L2, L3, L4, and L5 levels, respectively. The difference in anteroposterior diameters of the lumbar vertebral canal was found to be statistically significant at each level, between cases and controls. The transverse diameter of the vertebral canal was found to be smaller in cases as compared to controls with a statistically significant difference at each of the levels studied. The thecal sac area of the vertebral canal was found to be less in subjects with low back pain at each of the vertebral levels studied. Conclusion The study results provide insight into the lumbar vertebral parameters in the study population and give comparative data among the symptomatic low back pain patients and control subjects without low back pain. The MRI reflected decreased anteroposterior diameter, transverse diameter, and thecal sac area of the lumbar vertebral canal among symptomatic low back pain patients.
ABSTRACT
BACKGROUND: Breast cancer is the most commonly diagnosed cancer causing death among females worldwide. Radiotherapy after lumpectomy/mastectomy in breast cancer cases is a successful treatment modality taking five weeks to complete. The aim of the present study is to compare the effectiveness of hypo-fractionated radiotherapy in breast cancer patients with conventional radiotherapy with respect to outcome and toxicity. METHODS: Sixty patients were randomly divided equally into a conventional group, Group A (dose: 50 Gy in 25 fractions), and a hypo-fractionated short-course radiotherapy group, Group B (dose: 40 Gy in 16 fractions). After thorough clinical and laboratory examination of all patients, the disease status was assessed prior to radiotherapy and three and six months after completion of radiotherapy. The cardiopulmonary function was assessed using echocardiography and pulmonary function tests prior to the procedure. The assessment of the development of toxicity (dysphagia, skin, lung, and lymphedema) was done during every clinical visit. RESULTS: The mean age of patients was 53.28 ± 9.73 years in Group A, and 55.67 ± 10.41 years in Group B (p=0.82). The right breast was involved in 13 (43.4%) patients in Group A and 14 (46.6%) in Group B, and the left breast was involved n 17 (56.6%) patients in Group A and 16 (53.4%) in Group B (p=0.81). Most of the patients were post-menopausal; 24 (80%) in Group A and 25 (83.4%) in Group B (p=0.91). Eleven (36.6%) patients were of stage T2N1M0 in both groups. However, no statistical difference was observed between the groups in the TNM (tumor, node, and metastasis) staging using the AJCC (American Joint Committee on Cancer) criteria (p=0.26). On comparing the responses in Group A and Group B, no significant difference was observed in either of the groups from immediate post-treatment to the 12-month follow-up period (p=0.53 and p=0.64, respectively). CONCLUSION: Hypo-fractionated radiotherapy is as effective as conventional radiotherapy and can be used as an alternative method for treatment following breast cancer surgery.
ABSTRACT
Background Cardiovascular disease is a leading cause of morbidity and mortality. Therefore, it is essential to prevent cardiovascular diseases by correcting modifiable risk factors such as lowering lipid levels, lowering blood pressure, improving eating habits, giving up smoking, etc. The present study assessed the efficacy of herbal preparation containing Allium sativum (A. sativum), Commiphora mukul (C. mukul), and Trigonella foenum-graecum (T. foenum-graecum) in patients with hyperlipidemia. Methodology Patients were given extracts of A. sativum 350 mg, T. foenum-graecum 350 mg, C. mukul 200 mg, Picrorhiza kurroa (P. kurroa) 200 mg, and Piper nigrum (P. nigrum) 5 mg. Unichem Laboratories, Mumbai, provided placebo tablets similar in shape and size to herbal tablets. Patients were assessed for compliance, and a complete lipid profile was done at DO, D15, D46, D76, and D106. In addition, total cholesterol and high-density lipoprotein-cholesterol (HDL-C) serum triglyceride were estimated by the respective methods throughout the study. Results The weight of the patients remained stable, the mean weight before being 65.42 ± 8.35 kg and after completion of the study being 65.42 ± 8.35 kg. There were no changes in the ECG during or after the drug therapy in any of the patients. Group A comprised nine patients, and group B had ten patients. Serum creatinine (mg %) was 0.94 and 0.95, fasting blood sugar mg (%) was 111.05 and 99.63, and postprandial blood sugar (mg %) was 150.89 and 147.94 on pre-treatment and post-treatment, respectively. The mean serum triglyceride levels in group A were 271.11, 261.11, 293.89, 167.22, and 128.89, and serum HDL- C levels were 46.11, 46.11, 54.44, 52.22, and 54.44. Serum triglyceride levels in group B were 268, 268.5, 202, 171, and 116, and serum HDL- C levels were 48.5, 48, 50, 50, and 53.5 on day 0, 15, 46, 76, and 106, respectively. A significant reduction in total cholesterol levels was observed on D46, D76, and D106, with a maximum reduction on D76 (25.36%). Similarly, a reduction in serum triglyceride was also observed on D46, D76, and D106, with a maximum reduction on D106 (52.02%). A significant difference was observed (P <0.05). There was also a significant reduction of low-density lipoprotein cholesterol (LDL-C) on D46, D76, and D106, with the maximum reduction on D76 (28.79%). There was a significant rise of HDL-C on D46 and D106, with a maximum rise on D106 (15.41%). A significant difference was observed (P <0.05). Conclusion The study drugs are safe and efficacious in reducing the total cholesterol, serum triglycerides, LDL-C levels, and increasing HDL-C levels.
