A Study to Analyze Impact of Treatment Couch and Immobilization Devices on Surface Dose for Megavoltage Photon Beams.

PURPOSE/OBJECTIVE: The purpose of this study is to investigate the effect of treatment couch and immobilization devices on surface dose for megavoltage photon beams. MATERIAL/METHODS: Percentage surface dose (PSD) measurement was carried out in Elekta Synergy™ Linear accelerator using PTW Markus® Parallel plate ionization chamber of volume 0.05cm3 with water equivalent RW3 Slab phantom (PTW, Germany). The measurement depth was considered at 0.07mm. The reference PSD was measured at 0° gantry angle with 10×10cm2, 20×20cm2 and 30×30cm2 field sizes and 100cm SSD for 4MV, 6MV and 15MV photon beams. For comparison, PSD measurement was carried out at 180° gantry angle inclusion of treatment couch (TC), All in One positioning system (AIO - PS) and Vac lok Cushions (VLC). RESULTS: Beam angle at 0°, for field sizes 10×10cm2, 20×20cm2 and 30×30cm2, the PSD was observed as 30.9%, 40.5%, 48.7% for 4MV; 23.7%, 33.8%, 42.2% for 6MV; and 17.0%, 29.6%, 38.6% for 15MV respectively. Beam angle at 180° with TC, an increase in PSD by maximum of 65.0% for 4MV, 64.9% for 6MV and 55.9% for 15MV as compared to 0° angle. The PSD increased when beam angle was 180° with TC and AIO - PS were 65.0% for 4MV, 67.4% for 6MV, and 60.9% for 15MV than 0° angle. Similarly, increased PSD for beam angle at 180° with TC and VLC were 66.8% for 4MV, 66.8% for 6MV and 61.3% for 15MV as compared to 0° angle. CONCLUSION: For all three-photon energies, at 180° gantry angle, the PSD increased significantly in case of TC, VLC, and AIO - PS for all the field sizes as compared to gantry angle at 0°. It is necessary to consider TC, AIO - PS and VLC during dose calculation to ensure accuracy of patient treatment delivery.

Idiopathic Basal Ganglia Calcification: Fahr's Syndrome, a Rare Disorder.

Fahr's syndrome is a rare neurological disorder with varied clinical manifestations. It is characterized by the progressive deposition of calcium in the walls of the blood vessels of basal ganglia and dentate nuclei of the cerebellum in young and middle-aged people. It is important for neurologists, geneticists, psychiatrists, dentists, and other appropriate care specialists to have a thorough knowledge of this syndrome as any of them could be the first person to diagnose the disease. This case report of Fahr's syndrome presents the signs and symptoms of the patient and the treatment for oral conditions were done.

Intracranial Cryptococcoma-Clinicopathologic Correlation and Surgical Outcome: A Single-Institution Experience.

OBJECTIVE: To describe clinical characteristics of patients with intracranial cryptococcoma, clinicopathologic findings, and outcomes after surgery. MATERIALS AND METHODS: Clinical data were collected from hospital case records, and pathologic confirmation was done by a neuropathologist. Clinical details, imaging features, and treatment modalities were evaluated and correlated with outcomes based on regular follow-up. RESULTS: This case series included 5 cases of histology- and culture-proven intracranial cryptococcoma. Three patients (60%) were aged between the 3rd and 5th decades. Three cases were supratentorial in location, and 2 were in the posterior fossa. One patient presented with seizures. Three patients (60%) presented with fever. Three patients (60%) had papilledema, and 4 (80%) had signs of meningeal irritation. Four patients (80%) were immunocompetent. Only 1 patient was immunocompromised. All lesions were peripherally enhancing on computed tomography. Four of 5 patients underwent surgical decompression without any residue. Only 1 patient underwent stereotactic biopsy. All patients received antifungal therapy. One patient who was immunocompromised developed multiorgan failure and died after 2 months after surgery (20%). Of 5 cases, 4 (80%) had a good outcome with a mean follow-up of 5 years. CONCLUSIONS: Cryptococcus gattii is a rarer species implicated in intracranial cryptococcoma that is seen along with the more common Cryptococcus neoformans. Early diagnosis and surgical decompression followed by intravenous amphotericin B therapy for at least 6 weeks and concomitant therapy with fluconazole for prolonged periods may reduce morbidity and mortality.

Tubercular esophagocutaneous fistula: Rare case report.

Tubercular esophagocutaneous fistula is a rare entity with only about five cases reported so far. It can be as a result of primary involvement of esophagus by tuberculosis or due to spread of infection from adjacent structures like lungs or mediastinal lymph nodes. The fistula usually heals with initiation of antitubercular therapy and surgery is rarely required. Here we report a case of 65-year-old diabetic male who developed esophagocutaneous fistula secondary to caseation of mediastinal lymph nodes and was successfully treated with antitubercular treatment.

A prosthodontic management of severely resorbed anterior ridge defect - a case report.

The Dental profession has devoted most of its history to restoring the effects of dental disease. The public's interest in Dental health and beauty has become an engine that continues to drive the demand for cosmetic dental procedures. In the past, achieving a beautiful smile required submission to extensive invasive procedures and expensive fixed dental prosthetic restorations. Advancements in restorative material formulations and adhesive technology have expanded such possibilities. Despite many recent advances in aesthetic dentistry techniques and materials, certain cases remain difficult to restore. Replacing missing anterior teeth presents a serious challenge to the clinicians especially with a large ridge defect. Such cases require not only replacement of the missing teeth but also the restoration of the bone defect, aesthetics and phonetics. While the conventional treatment approaches like fixed partial denture or an option of implant may not justify the restoration of the defects. A combination of fixed and removable restoration provides good alternative. The aim and purpose of this case report is to describe a multidisciplinary approach of managing a patient who reported with a similar complaint of missing anterior teeth with anterior ridge defect hoping to get not only her teeth but also her lost smile.

Estimation of Circulating Immune Complexes in patients with Oral Leukoplakia and Oral Submucous Fibrosis: A Case Control Study.

PURPOSE OF THE STUDY: The present study was conducted to estimate the serum levels of Circulating Immune Complexes in patients with Oral Leukoplakia ,Oral sub mucous fibrosis and normal subjects and correlate these values with the clinical grades of the diseases. MATERIALS AND METHODS: The study consisted of 25 Oral Leukoplakia patients, 25 Oral sub mucous fibrosis patients and 25 Normal subjects. RESULTS: The mean serum levels of CIC showed a gradual increase from normal subjects to Oral Leukoplakia patients and showed a high values in Oral sub mucous fibrosis patients. The mean serum levels of CIC also showed a gradual increase from clinical grade I to grade IV of Oral sub mucous fibrosis. CONCLUSION: Serum levels of CIC may be taken as a prognostic marker for disease progression of patients with Oral Leukoplakia and Oral sub mucous fibrosis.

Rehabilitation of partially eviscerated eye with custom made ocular prosthesis-a case report.

Human eyes are the most precious gift from nature; presence of a pair of eye not only gives expression to life but also adds dignity to the face. The loss of an eye causes disfigurement of the face and causes anxiety, stress and depression in their life. The rehabilitation of patients with congenital or acquired defects of the eye is a challenging job. The aim of the rehabilitation is to restore the patient's normal appearance, comfort along with reasonable functional eye movements. This case report describes the rehabilitation of partially eviscerated eye of the patient with custom made ocular prosthesis.