Diffuse Large B Cell Lymphoma of Lacrimal Drainage System : A Rare Case Report.

Tumours of lacrimal drainage system are a rare entity and among these rare tumours lymphomas are a rarity. We report a case of 65 year old male who presented with mass inferior to left lacrimal sac region which was diagnosed as Diffuse Large B Cell Lymphoma on histopathology and immunochemistry. The patient underwent excision biopsy followed by chemotherapy and is disease free till writing of this report.

Yoga Technique of Sutra Neti Causing Nasopharyngeal Stenosis: A Case Report.

Yoga is becoming way of life world over to stay fit and agile both physically and mentally. Sutra neti is an ancient yoga practice in which a thread/tube is passed through nostrils and taken out through mouth and is then moved back and forth. This technique is believed to clean nasal passages and is considered relatively safe. We report a case of nasopharyngeal stenosis caused due to this ancient practice. People and yoga trainers all over the world should be made aware of this complication of sutra neti as it is difficult to treat and has high recurrence rate. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-03865-4.

Effect of Surface Treatment of Zirconia on the Shear Bond Strength of Resin Cement: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aimed to evaluate the effect of different surface treatments on the shear bond strength (SBS) values between zirconia and resin cement compared to untreated specimens. The effects of various surface treatments on the bond strength between zirconia and resin cement were investigated by searching relevant articles on PubMed, ScienceDirect, and Google Scholar databases. A total of 13 studies that met the inclusion and exclusion criteria and addressed the research question were selected for statistical analysis. The studies were evaluated for heterogeneity, and a meta-analysis was performed. In total, 13 in vitro studies were included in accordance with the eligibility criteria. All 13 studies consistently demonstrated that silica coating yielded the highest SBS, followed by sandblasting and laser treatments. The meta-analysis using a random-effect model indicated a significant intergroup comparison, except for a few studies. Among the three treatments examined, the silica coating of zirconia was identified as the most effective in enhancing the bond strength between zirconia and resin cement. Further controlled laboratory and clinical studies are necessary to validate these findings and explore additional factors that may influence the effects of these surface treatments.

Use of Paramedian Forehead Flap in an Octogenarian:A Case Report.

Increase in life expectancy has led to increased number of octogenarian and nonagenarians population. These old people have increased chances of developing skin tumours like slow growing basal cell carcinoma on the sun exposed parts of body. Many a times surgeons all over the world are bit conservative in managing these elderly patients and compromise on cosmetic aspects due to very advanced age of these patients. This report is about an 87-year-old female with BCC of nasal dorsum who underwent a major surgical procedure to maintain facial aesthetics.

Performance evaluation of Monaco radiotherapy treatment planning system using CIRS Thorax Phantom: Dosimetric assessment of flattened and non-flattened photon beams.

Aim: The present study was undertaken to evaluate the performance of different algorithms for flattening filter-free (FFF) and flattened (FF) photon beams in three different in-homogeneities. Materials and Method: Computed tomography (CT) image sets of the CIRS phantom maintained in the SAD setup by placing the ionization chamber in the lung, bone, and tissue regions, respectively, were acquired. The treatment planning system (TPS) calculated and the ionization chamber measured the doses at the center of the chamber (in the three mediums) were recorded for the flattened and non-flattened photon beams. Results: The results were reported for photon energies of 6 MV, 10 MV, 15 MV, 6 FFF, and 10 FFF of field sizes 5 × 5 cm2, 10 × 10 cm2, and 15 × 15 cm2. In the bone inhomogeneity, the pencil beam algorithm predicted that the maximum dose variation was 4.88% of measured chamber dose in 10-MV photon energy for the field size 10 × 10 cm2. In water inhomogeneity, both the collapsed cone and Monte Carlo algorithm predicted that the maximum dose variation was ± 3% of measured chamber dose in 10-MV photon energy for the field size 10 × 10 cm2 and in 10-MV FFF photon energy for the field size 5 × 5 cm2, whereas in lung inhomogeneity, the pencil beam algorithm predicted that the highest dose variation was - 6.9% of measured chamber dose in 10-MV FFF photon energy for the field size 5 × 5 cm2. Conclusion: FF and FFF beams performed differently in lung, water, and bone mediums. The assessment of algorithms was conducted using the anthropomorphic phantom; therefore, these findings may help in the selection of appropriate algorithms for particular clinical settings in radiation delivery.

Seroprevalence of Antibodies Against SARS-CoV-2 Among Health Care Workers at a Tertiary Care Hospital in Uttarakhand: A Retrospective Study.

Background The number of confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections is vastly underestimated. In this context, seroprevalence surveys are of utmost importance to assess the proportion of the population that has already developed antibodies against the virus and might potentially be protected against subsequent infection. Health care workers (HCWs) face a greater risk of developing SARS-CoV-2. Therefore, the present retrospective study was undertaken to estimate the prevalence of antibodies against SARS-CoV-2 among healthcare workers at a tertiary care institute in Uttarakhand, India. Material and methods Data were gathered from hospital records of 704 healthcare workers admitted to the coronavirus disease 2019 (COVID-19) unit and attended the COVID OPD of the tertiary care institute between July 15 to Aug 14, 2020. Result Out of the 704 recruited participants, 14 (1.99%) were seropositive for immunoglobulin G (IgG) antibodies against SARS-CoV-2. The cumulative prevalence of SARS-CoV-2 infection (presence of antibodies or past or current positive reverse transcription-polymerase chain reaction (RT-PCR)) was 4.40%. Conclusion The present study shows a low prevalence of SARS-CoV-2 IgG antibodies among health care workers. In addition, posting in COVID-19-positive areas was not associated with increased seropositivity. More studies are warranted to assess IgG/IgM antibodies against SARS-CoV-2 among those HCWs who are exposed to COVID-19 patients.

Recurrence pattern with respect to two different dose fractionations in patients with locally advanced head and neck cancer treated with chemoradiation using image-guided volumetric arc therapy.

BACKGROUND: Patients with head and neck cancer were treated with either 70 Gy in 35 fractions (Arm A) or 66 Gy in 30 fractions (Arm B). MATERIALS AND METHODS: Total 168 patients of carcinoma oropharynx, larynx, and hypopharynx treated with radical chemoradiation in two Arm A versus B (65 vs. 103 patients). RESULTS: With a median follow-up of 16 months (0-67), 2 year disease-free survival (DFS) and overall survival (OS) was 56.3% versus 62.1% (p = 0.64) and 44.5% versus 53.0% (p = 0.51) in Arm A versus B. Total 22 (33.8%) versus 28 (27.2%) failed locoregionally. Majority of failures were infield for both primary (17 vs. 23 cases) and nodes (13 vs. 12) in Arm A versus B. Ten (71.4%) vs. 10 (76.9%) had nodal failure in index nodal level only. CONCLUSION: Commonly seen failure in head-neck radical chemoradiation is within infield high-risk volume, nodal failure being most common in index nodal level.

Evaluating impact of medium variation on dose calculated through planning system in a low cost in-house phantom.

Purpose: In radiotherapy, accuracy in dose estimation of dose calculation methods is critical. The influence of deformity on radiation dose calculations derived by planning system is evaluated in present study. The goal of study was to create a low-cost inhomogeneous phantom for measuring absorbed dose using an Ionisation chamber and Gafchromic film, which was validated using treatment planning system (TPS) dose outcome.Methods:and Materials: The central axis dose calculations were computed using Pencil Beam Convolution algorithm (PBC), Collapsed Cone Convolution (CCC) and Monte Carlo (MC) algorithm in the Monaco treatment planning system using an In-house phantom (20 × 20 × 20cm3) made up of acrylic sheet containing water and inhomogeneous material wooden powder equivalent to lung. Phantom was scanned in Computed Tomography (CT) scanner and image set was sent to the planning workstation. The depth dose evaluations were performed using ionization chamber and Gafchromic film with same beam settings and monitor units in every setup. Following that, the calculated doses obtained from TPS and measured depth doses were compared.Results: The results was reported for photon energies 6MV, 10MV, 15MV, 6FFF and 10FFF at varying field sizes of 4 × 4 cm2, 5 × 5 cm2, 10 × 10 cm2, and 15 × 15 cm2. MC maximum dose variation predicted was 2.06% in 15MV of measured chamber dose and -2.06% of measured gafchromic film dose in 6MVFFF. CCC maximum dose variation predicted was 2.68% of measured chamber dose in 6MV and 3.31% of measured gafchromic film dose in 6MV whereas PB maximum dose variation predicted was -5.94% in 15MV of measured chamber dose and -11.6% of measured gafchromic film dose in 6MVFFF.Conclusion: Low-cost in-house phantoms can be utilised to assess point and planar doses during patient-specific quality assurance in centres that don't have accessibility to phantoms due to the high cost of commercially available tools.

Investigation of tube voltage dependence on CT number and its effect on dose calculation algorithms using thorax phantom in Monaco treatment planning system for external beam radiation therapy.

Introduction: The accuracy of dose calculation algorithms depends on the electron density and computed tomography (CT) number of medium scanned. Our study aimed to verify the impact of different CT scanning protocols on Hounsfield unit (HU) and effect on dose calculation algorithms. Materials and Methods: CIRS thorax phantom with different density material plugs was scanned at varying tube voltages from CT scanner and HU values were measured in treatment planning system (TPS). Calibration curves of electron density at different tube voltages were plotted and used for dose calculation with different calculation algorithms at varying high energy megavoltage photon energies. Results: Insignificant difference is obtained in electron density curves plotted at different tube voltages. The mean variation in HU values was found at different tube voltages for bone, lung, and water are 896.75 (standard deviation [SD] 122.88), -799.25 (SD 5.74), and -17.5 (SD 0.57), respectively. The estimated P values for change in HU values were 0.089, 0.258, and 0.121 for bone, lung, and water, respectively. Pencil beam (PB) convolution and collapsed cone algorithms show no significant dose difference, i.e., <1% variation and Monte Carlo (MC) shows maximum dose difference up to 1.4%. Conclusion: Third-generation algorithms such as MC shows dependence on varying tube voltages in dose calculation. Calibration curves plotted at different kVp in TPS advised to be chosen wisely to avoid any dosimetric errors in different medium.

Trimetallic composite nanofibers for antibacterial and photocatalytic dye degradation of mixed dye water.

Membrane technology is an advanced approach to making a healthier and cleaner environment. Using such catalytic membrane technology to get clean, usable water by removal of dye impurities as well as pathogenic microbes is the main goal behind the research work. Here, we present the synthesis and efficacy study of polymethyl methacrylate (PMMA)-based Ag/ZnO/TiO2 trimetallic bifunctional nanofibers with antibacterial and photocatalytic activity. The nanofibers have been proven to be effective for the degradation of methylene blue (MB 93.4%), rhodamine B (Rh 34.6%), auramine-O (Au 65.0%) and fuchsin basic (FB 69.8%) dyes individually within 90 min in daylight. The study is further extended in abating a mixture of these dyes from contaminated water using composite nanofibers. Also, in the case of a mixture of these dyes (3 ppm each), nanofibers show dye degradation efficiency (DDE) of 90.9% (MB), 62.4% (Au) and 90.3% (FB and Rh) in 60 min. The role of Ag nanoparticles with a synergic photocatalytic effect on ZnO and TiO2 is also demonstrated. Also, PMMA/ZnO/TiO2 composite fiber membrane in synergy with silver particles shows better antibacterial activity against Gram-negative bacteria E. coli, making PMMA/Ag/ZnO/TiO2 fibers a promising candidate in water purification.

Endoscopic transcanal myringoplasty:Is learning curve a myth?

OBJECTIVE: To investigate the feasibility of transcanal endoscopic myringoplasty in the hand of young beginner surgeons who had just completed the residency programme. METHODS: In a three year period (August 2012 to August 2015), 44 ears in 42 patients were operated upon by a beginner surgeon through the transcanal endoscopic approach in a subdistrict level hospital located in the north western ranges of the Himalayan region. RESULTS: Of the 42 patient, 19 were male and 23 female. The mean age was 26.23 years (range: 15-47 years). In 40 ears, complete perforation closure was achieved at six months (success rate: 90.9%). The mean air conduction PTA preoperatively was 40.84 dB HL and improved to 28.06 dB HL postoperatively (p < .001). The mean AB gap preoperatively was 22.40 dB, which improved to 9.1 dB postoperatively (p < .001). CONCLUSION: Endoscopic transcanal myringoplasty is safe and reliable even in young beginners' hands. Surgeons can consider endoscopic approach early in their careers without the fear of learning curve. The cost of endoscopic equipment is about one tenth as compared to open approach under a operating microscope, and an added advantage.