Comparison of photon versus electron for tumor bed boost radiotherapy post-breast conserving surgery.

INTRODUCTION: The standard treatment (photon or electron) for tumor bed boost in breast cancer has not yet been clearly established. The aim of this work was to compare photon vs. electron for tumor bed boost radiotherapy post breast-conserving surgery and whole-breast irradiation concerning different dosimetric parameters. METHODS: This study included 51 patients who underwent conservative surgery and adjuvant radiotherapy. Of these, 28 patients had right-sided and 23 patients had a left-sided tumors. All patients in this study were treated with photon and then re-planned with electron plans. RESULTS: Both techniques electron and photon plans provided acceptable results while there was a better performance of the latter in terms of target coverage with statistical significance (p < 0.05). The global and maximum dose was significantly higher with electron compared to photon. Homogeneity index (HI) and conformity index (CI) and conformity number (CN) were better in photon plans, especially in deep-seated tumors. The quality of electron plans differed between patients according to depth, irregular shapes, and location of the tumor bed boost. The results of organs at risk (OARs) for ipsilateral lung and heart showed that photon plans were better than electron plans (p < 0.05), especially at a low dose (V2Gy and V1Gy) for ipsilateral lung. For contralateral breast, both photon and electron had nearly comparable results, where the dose delivered to the contralateral breast for both techniques was close to zero. Interestingly, the number of monitor units (MU) was reduced in electron compared to photon by 15.94% (p < 0.001). CONCLUSIONS: This study recommends the use of photon in treatment of tumor bed boost in conservative breast cancer and then electron as a second line when the former is not available.

Stegomyia indices of Aedes aquatic stages in El Geneina town, Western Sudan.

BACKGROUND: Darfur in Western Sudan has the most volatile camps of internally displaced persons (IDPs) and has experienced several outbreaks of dengue, chikungunya and yellow fever. AIMS: To determine the prevalence and Stegomyia indices of Aedes aquatic stages in El Geneina town, Western Darfur. METHODS: Cross-sectional entomological surveys of immature stages of Aedes were carried out during August-November 2019 in 4 sites with IDP camps and a residential area with no camp. RESULTS: We searched 17 730 houses, IDP camps and buildings of governmental corporations for Aedes larvae, and 6809 (38.4%) were positive for Aedes aquatic stages. Both Aedes aegypti and Aedes vittatus larvae were found. However, Ae. aegypti constituted > 90% of the larvae. Six positive water containers were recorded: tyres, clay pots, barrels, plastic water tanks, flower vases and old cars: 26% of 92 tyres contained Aedes larvae compared to 23.8% of 21 old cars and 17.1% of 44 198 clay pots. This suggested that clay pots were the main source of Aedes. The results showed high infestation of El Geneina town with Aedes immature stages in all study sites including public buildings and residential areas with no IDP camps. Stegomyia indices varied among study sites, and were more elevated in sites with IDP camps. For all sites, House index = 38.40, Container Index = 11.40, Breateu index = 13.60 and Pupa Index = 27. CONCLUSION: Multisectoral response coupled with community participation are urgently needed to reduce the burden of Aedes-borne diseases in the unstable El Geneina town.

Text Message Support for Smoking Cessation During Ramadan: A Focus Group Study With Somali Immigrant Muslim Men.

INTRODUCTION: Somali Muslim male immigrants in Minnesota have a high prevalence of smoking, estimated at 44%, compared with the average smoking rate for adults in the United States (14%). However, the literature has reported spontaneous reductions of smoking during Ramadan. This study sought to gather the views of Somali Muslim men on how faith impacts their smoking, and determine what messaging to incorporate into a tailored text messages intervention that draws on the Muslim faith beliefs and practices during Ramadan to promote smoking cessation. METHODS: Thirty-seven Somali adult male smokers were recruited from community settings to participate in one of five focus groups in Minneapolis and Saint Paul, Minnesota. The research study team developed a semi-structured focus group guide that explored: (1) the experience of Muslim immigrants quitting smoking during Ramadan, (2) views on text messaging interventions to reduce smoking focusing on health and faith, and (3) views on the relationship between faith and smoking. A thematic analysis was conducted. RESULTS: Participants reported reductions in smoking during Ramadan, which was mostly achieved without formal treatment (ie, willpower). There was interest in text messaging interventions that incorporated faith and health-related messages, and that would be delivered around the time of Ramadan. Participants described concerns about the adverse health effects of smoking, including the risk of chronic health issues, cancer, and death. CONCLUSION: Combining faith and health-related text-based messaging, and tailoring interventions around and beyond Ramadan, maybe a valuable approach to help address smoking disparities in the Somali immigrant community. IMPLICATIONS: Ramadan offers a unique window of opportunity to intervene upon smoking for Somali Muslim immigrant men, for whom rates of smoking are high. Combining faith and health-related text-based messaging, and tailoring interventions around and beyond Ramadan, maybe a valuable approach to help address these serious smoking disparities.