Abstract: Two different testicular tissues have to be distinguished in regard to radiation damage: first the seminiferous tubules, corresponding to the sites of spermatogenesis, which are extremely radiosensitive. Second the testosterone secreting Leydig cells, which are considered to be less radiosensitive. This study aims to estimate testicular dose and the associated risks for infertility and hereditary effects from Abdominal and pelvic irradiation. Radiotherapy was simulated on a humanoid phantom using a 15 MV photon beam. Testicular dose was measured for various field sizes and tissue thicknesses along beam axis using an ionization chamber and TLD. For transmission Factor Also common method of measuring the absorbed dose distribution and electron contamination in the build-up region of high-energy beams for radiation therapy is by means of parallel-plate Ionisation chambers. Gonadal dose was reduced by placing lead cups around the testes supplemented by a field edge block. For a tumor dose of 100 cGy, testicular dose was 2.96-8.12 cGy depending upon the field size and the distance from the inferior field edge. The treatment at parameters, the presence of gonad shield and the somatometric characteristics determine whether testicular dose can exceed 1 Gy which allows a complete recovery of spermatogenesis.
Abstract: Introduction: Pegylated Interferon and Ribavirin combination is standard of care in the management of chronic HCV infected patients. Efficacy of the therapy is judged by the ability to achieve biochemical and virological response as judged by RVR, EVR, ETR and SVR.Objective: To evaluate the efficacy of newly marketed biosimilar Pegylated Interferon Alpha 40KD (Peg INF) in chronic HCV patients. Materials and methods: This was observational, prospective multicentre study to evaluate the ability of biosimilar pegylated interferon alfa 2a (40KD) along with Ribavirin (weight based) to achieve SVR. The enrolled patients were separated into Naïve (A), Relapsers (B) and Non Responders(C) based on the previous history of interferon exposure and its response. The RGT was followed on ALT and RVR, EVR, ETR and SVR.Results:As per protocol analysis estimated SVR for three groups is 86.6% for naïve, 89.4% for relapsers and 52.4% for non-responders to standard interferon. Conclusion: It is concluded that Bio-similar pegylated interferon alfa-2a (40kD) along with Ribavirin has good anti-viral efficacy in Naïve, Relapsers and Non-responders to standard IFN of chronic HCV infected patients requiring treatment.
Abstract: The present study represents the occupational radiation doses received by selected workers of Nuclear Institute of Medicine and Radiotherapy (NIMRA) Jamshoro Pakistan and conducted to discuss about how we be careful and try to avoid make ourselves overconscious. Film badges with unique identification number were issued to radiation worker to detect occupational radiation doses. In this study, only 08 workers with high radiation doses were assessed amongst 35 radiation workers during the period of January 2012 to December 2012. The selected radiation workers’ occupational doses were according to designated work areas and in the range of 1.21 to 7.78 mSv (mili Sieveret) out of the annual dose limit of 20 mSv. By the comparison of different studies and earth’s HNBR (High Natural Background Radiation) locations’ doses, it is concluded that the worker’s high doses are of magnitude of HNBR Regions and were in the acceptable range of National and International regulatory bodies so we must not to show any type of overconsciousness but be careful in handling the radioactive sources.
Abstract: Nowadays, in most radiotherapy departments, the commercial treatment planning systems (TPS) used to calculate dose distributions needs to be verified; therefore, quick, easy-to-use and low cost dose distribution algorithms are desirable to test and verify the performance of the TPS. In this paper, we put forth an analytical method to calculate the phantom scatter contribution and depth dose on the central axis based on the equivalent square concept. Then, this method was generalized to calculate the profiles at any depth and for several field shapes regular or irregular fields under symmetry and asymmetry photon beam conditions. Varian 2100 C/D and Siemens Primus Plus Linacs with 6 and 18 MV photon beam were used for irradiations. Percentage depth doses (PDDs) were measured for a large number of square fields for both energies, and for 45º wedges which were employed to obtain the profiles in any depth. To assess the accuracy of the calculated profiles, several profile measurements were carried out for some treatment fields. The calculated and measured profiles were compared by gamma-index calculation. All γ–index calculations were based on a 3% dose criterion and a 3 mm dose-to-agreement (DTA) acceptance criterion. The γ values were less than 1 at most points. However, the maximum γ observed was about 1.10 in the penumbra region in most fields and in the central area for the asymmetric fields. This analytical approach provides a generally quick and fairly accurate algorithm to calculate dose distribution for some treatment fields in conventional radiotherapy.
Abstract: The most important subtype of non-Hodgkin-s
lymphoma is the Diffuse Large B-Cell Lymphoma. Approximately
40% of the patients suffering from it respond well to therapy,
whereas the remainder needs a more aggressive treatment, in order to
better their chances of survival. Data Mining techniques have helped
to identify the class of the lymphoma in an efficient manner. Despite
that, thousands of genes should be processed to obtain the results.
This paper presents a comparison of the use of various attribute
selection methods aiming to reduce the number of genes to be
searched, looking for a more effective procedure as a whole.
Abstract: Severe acute respiratory syndrome (SARS) is a respiratory disease in humans which is caused by the SARS coronavirus. The treatment of coronavirus-associated SARS has been evolving and so far there is no consensus on an optimal regimen. The mainstream therapeutic interventions for SARS involve broad-spectrum antibiotics and supportive care, as well as antiviral agents and immunomodulatory therapy. The Protein- Ligand interaction plays a significant role in structural based drug designing. In the present work we have taken the receptor Angiotensin converting enzyme 2 and identified the drugs that are commonly used against SARS. They are Lopinavir, Ritonavir, Ribavirin, and Oseltamivir. The receptor Angiotensin converting enzyme 2 (ACE-2) was docked with above said drugs and the energy value obtained are as follows, Lopinavir (-292.3), Ritonavir (-325.6), Oseltamivir (- 229.1), Ribavirin (-208.8). Depending on the least energy value we have chosen the best two drugs out of the four conventional drugs. We tried to improve the binding efficiency and steric compatibility of the two drugs namely Ritonavir and Lopinavir. Several modifications were made to the probable functional groups (phenylic, ketonic groups in case of Ritonavir and carboxylic groups in case of Lopinavir respectively) which were interacting with the receptor molecule. Analogs were prepared by Marvin Sketch software and were docked using HEX docking software. Lopinavir analog 8 and Ritonavir analog 11 were detected with significant energy values and are probable lead molecule. It infers that some of the modified drugs are better than the original drugs. Further work can be carried out to improve the steric compatibility of the drug based upon the work done above for a more energy efficient binding of the drugs to the receptor.
Abstract: This study had two goals. First, it investigated marital
interaction variables as predictors of treatment outcome in panic
disorder with agoraphobia (PDA) in sixty-five couples with one
spouse suffering from PDA. Second, it analyzed the impact of PDA
improvement, following therapy, on marital interaction patterns of
both spouses. The partners were observed during a problem-solving
task, before and after treatment. Negative behaviors at the outset of
therapy, both in the PDA and the NPDA partners, predicted less
improvement at post-test. It also appears that improvement in some
PDA symptoms following therapy is linked to increase in the
dominant behavior of the NPDA spouse and to an improvement in
terms of his intrusiveness.
Abstract: The paper proposes a methodology to process the signals coming from the Transcranial Magnetic Stimulation (TMS) in order to identify the pathology and evaluate the therapy to treat the patients affected by demency diseases. In particular, a fuzzy model is developed to identify the demency of the patients affected by Subcortical Ischemic Vascular Dementia and to measure the positive effect, if any, of a repetitive TMS on their motor performances. A tool is also presented to support the mentioned analysis.
Abstract: Modeling of complex dynamic systems, which are
very complicated to establish mathematical models, requires new and
modern methodologies that will exploit the existing expert
knowledge, human experience and historical data. Fuzzy cognitive
maps are very suitable, simple, and powerful tools for simulation and
analysis of these kinds of dynamic systems. However, human experts
are subjective and can handle only relatively simple fuzzy cognitive
maps; therefore, there is a need of developing new approaches for an
automated generation of fuzzy cognitive maps using historical data.
In this study, a new learning algorithm, which is called Big Bang-Big
Crunch, is proposed for the first time in literature for an automated
generation of fuzzy cognitive maps from data. Two real-world
examples; namely a process control system and radiation therapy
process, and one synthetic model are used to emphasize the
effectiveness and usefulness of the proposed methodology.
Abstract: Combined therapy using Interferon and Ribavirin is the standard treatment in patients with chronic hepatitis C. However, the number of responders to this treatment is low, whereas its cost and side effects are high. Therefore, there is a clear need to predict patient’s response to the treatment based on clinical information to protect the patients from the bad drawbacks, Intolerable side effects and waste of money. Different machine learning techniques have been developed to fulfill this purpose. From these techniques are Associative Classification (AC) and Decision Tree (DT). The aim of this research is to compare the performance of these two techniques in the prediction of virological response to the standard treatment of HCV from clinical information. 200 patients treated with Interferon and Ribavirin; were analyzed using AC and DT. 150 cases had been used to train the classifiers and 50 cases had been used to test the classifiers. The experiment results showed that the two techniques had given acceptable results however the best accuracy for the AC reached 92% whereas for DT reached 80%.
Abstract: Leprosy is an infectious disease caused by
Mycobacterium Leprae, this disease, generally, compromises
the neural fibers, leading to the development of disability.
Disabilities are changes that limit daily activities or social life
of a normal individual. When comes to leprosy, the study of
disability considered the functional limitation (physical
disabilities), the limitation of activity and social participation,
which are measured respectively by the scales: EHF, SALSA
and PARTICIPATION SCALE. The objective of this work is
to propose an on-line monitoring of leprosy patients, which is
based on information scales EHF, SALSA and
PARTICIPATION SCALE. It is expected that the proposed
system is applied in monitoring the patient during treatment
and after healing therapy of the disease. The correlations that
the system is between the scales create a variety of
information, presented the state of the patient and full of
changes or reductions in disability. The system provides
reports with information from each of the scales and the
relationships that exist between them. This way, health
professionals, with access to patient information, can
intervene with techniques for the Prevention of Disability.
Through the automated scale, the system shows the level of
the patient and allows the patient, or the responsible, to take a
preventive measure. With an online system, it is possible take
the assessments and monitor patients from anywhere.
Abstract: Medical image registration is the key technology in image guided radiation therapy (IGRT) systems. On the basis of the previous work on our IGRT prototype with a biorthogonal x-ray imaging system, we described a method focused on the 2D/2D rigid-body registration using multiresolution pyramid based mutual information in this paper. Three key steps were involved in the method ： firstly, four 2D images were obtained including two x-ray projection images and two digital reconstructed radiographies（DRRs ） as the input for the registration ； Secondly, each pair of the corresponding x-ray image and DRR image were matched using multiresolution pyramid based mutual information under the ITK registration framework ； Thirdly, we got the final couch offset through a coordinate transformation by calculating the translations acquired from the two pairs of the images. A simulation example of a parotid gland tumor case and a clinical example of an anthropomorphic head phantom were employed in the verification tests. In addition, the influence of different CT slice thickness were tested. The simulation results showed that the positioning errors were 0.068±0.070, 0.072±0.098, 0.154±0.176mm along three axes which were lateral, longitudinal and vertical. The clinical test indicated that the positioning errors of the planned isocenter were 0.066, 0.07, 2.06mm on average with a CT slice thickness of 2.5mm. It can be concluded that our method with its verified accuracy and robustness can be effectively used in IGRT systems for patient setup.
Abstract: Thyroid dysfunction is one of the most frequently
reported complications of chronic blood transfusion therapy in patients with beta-thalassemia major (BTM). However, the occurrence of thyroid dysfunction and its possible association with
iron overload in BTM patients is still under debate. Therefore, this
study aimed to investigate the status of thyroid functions and iron overload in adolescent and young adult patients with BTM in Jordan population. Thirty six BTM patients aged 12-28 years and matched controls were included in this study. All patients have been receiving frequent blood transfusion to maintain pretransfusion hemoglobin
concentration above 10 g dl-1 and deferoxamine at a dose of 45 mg kg-1 day-1 (8 h, 5-7 days/week) by subcutaneous infusion. Blood
samples were drawn from patients and controls. The status of thyroid functions and iron overload was evaluated by measurements of serum
free thyroxine (FT4), triiodothyronine (FT3), thyrotropin (TSH) and
serum ferritin level. A number of some hematological and
biochemical parameters were also measured. It was found that hematocrit, serum ferritin, hemoglobin, FT3 and zinc, copper mean values were significantly higher in the patients than in the controls (P< 0.05). On other hand, leukocyte, FT4 and TSH mean values were
similar to that of the controls. In addition, our data also indicated that
all of the above examined parameters were not significantly affected
by the patient-s age and gender. Deferoxamine approach for removing excess iron from our BTM patient did not normalize the
values of serum ferritin, copper and zinc, suggesting poor compliance
with deferoxamine chelation therapy. Thus, we recommend the use
of a combination of deferoxamine and deferiprone to reduce the risk
of excess of iron in our patients. Furthermore, thyroid dysfunction
appears to be a rare complication, because our patients showed
normal mean levels for serum TSH and FT4. However, high mean
levels of serum ferritin, zinc, copper might be seen as potential risk
factors for initiation and development of thyroid dysfunctions and
other diseases. Therefore, further studies must be carried out at
yearly intervals with large sample number, to detect subclinical
thyroid dysfunction cases.
Abstract: This work shows a basic philosophical difficulty in the constructivist foundations of the cognitive posracionalist psychology of Vittorio Guidano. This is a difficulty caused by the problem of the existential crisis. It will be analyzed how Guidano-s suggestions about this problem depend on felt experience. Then it will appear how Guidano-s philosophy and psychotherapy must turn towards a phenomenological approach. Finally, some references are given about Eugen Gendlin-s philosophy which could be considered as a radical way to confront these questions.
Abstract: Evidence-based medicine is a new direction in modern healthcare. Its task is to prevent, diagnose and medicate diseases using medical evidence. Medical data about a large patient population is analyzed to perform healthcare management and medical research. In order to obtain the best evidence for a given disease, external clinical expertise as well as internal clinical experience must be available to the healthcare practitioners at right time and in the right manner. External evidence-based knowledge can not be applied directly to the patient without adjusting it to the patient-s health condition. We propose a data warehouse based approach as a suitable solution for the integration of external evidence-based data sources into the existing clinical information system and data mining techniques for finding appropriate therapy for a given patient and a given disease. Through integration of data warehousing, OLAP and data mining techniques in the healthcare area, an easy to use decision support platform, which supports decision making process of care givers and clinical managers, is built. We present three case studies, which show, that a clinical data warehouse that facilitates evidence-based medicine is a reliable, powerful and user-friendly platform for strategic decision making, which has a great relevance for the practice and acceptance of evidence-based medicine.
Abstract: Content-Based Image Retrieval (CBIR) has been
one on the most vivid research areas in the field of computer vision
over the last 10 years. Many programs and tools have been
developed to formulate and execute queries based on the visual or
audio content and to help browsing large multimedia repositories.
Still, no general breakthrough has been achieved with respect to
large varied databases with documents of difering sorts and with
varying characteristics. Answers to many questions with respect to
speed, semantic descriptors or objective image interpretations are
still unanswered. In the medical field, images, and especially
digital images, are produced in ever increasing quantities and used
for diagnostics and therapy. In several articles, content based
access to medical images for supporting clinical decision making
has been proposed that would ease the management of clinical data
and scenarios for the integration of content-based access methods
into Picture Archiving and Communication Systems (PACS) have
been created. This paper gives an overview of soft computing
techniques. New research directions are being defined that can
prove to be useful. Still, there are very few systems that seem to be
used in clinical practice. It needs to be stated as well that the goal
is not, in general, to replace text based retrieval methods as they
exist at the moment.
Abstract: The plant world is the source of many medicines.
Recently, researchers have estimated that there are approximately
400,000 plant species worldwide, of which about a quarter or a third
have been used by societies for medicinal purposes. The human uses
of plants for thousands of years to treat various ailments, in many
developing countries, much of the population trust in traditional
doctors and their collections of medicinal plants to treat them.
Essential oils have many therapeutic properties. In herbal medicine,
they are used for their antiseptic properties against infectious
diseases of fungal origin, against dermatophytes, those of bacterial
origin. The aim of our study is to determine the antimicrobial effect
of essential oils of the plant Trigonella focnum greacum on some
pathogenic bacteria, it is a medicinal plant used in traditional
therapy. The test adopted is based on the diffusion method on solid
medium (Antibiogram), this method determines the sensitivity or
resistance of a microorganism vis-à-vis the extract studied. Our study
reveals that the essential oil of the plant Trigonella focnum greacum
has a different effect on the resistance of germs. For staphiloccocus
Pseudomonnas aeroginosa and Krebsilla, are moderately sensitive
strains, also Escherichia coli and Candida albicans represents a high
sensitivity. By against Proteus is a strain that represents a weak
sensitivity.
Abstract: In this article we present a methodology which
enables preschool and primary school unlanguaged children to
remember words, phrases and texts with the help of graphic signs -
letters, syllables and words. Reading for a child becomes a support
for speech development. Teaching is based on the principle "from
simple to complex", "a letter - a syllable - a word - a proposal - a
text." Availability of multi-level texts allows using this methodology
for working with children who have different levels of speech
development.
Abstract: Ten percent of the population will develop plantar
fasciitis (PF) during their lifetime. Two million people are treated
yearly accounting for 11-15% of visits to medical professionals.
Treatment ranges from conservative to surgical intervention. The
purpose of this study was to assess the effects of extracorporeal
shockwave therapy (ECSWT) on heel pain, function, range of motion
(ROM), and strength in patients with PF. One hundred subjects were
treated with ECSWT and measures were taken before and three
months after treatment. There was significant differences in visual
analog scale scores for pain at rest (p=0.0001); after activity (p=
0.0001) and; overall improvement (p=0.0001). There was also
significant improvement in Lower Extremity Functional Scale scores
(p=0.0001); ankle plantarflexion (p=0.0001), dorsiflexion (p=0.001),
and eversion (p=0.017),and first metatarsophalangeal joint flexion
(p=0.002) and extension (p=0.003) ROM. ECSWT is an effective
treatment improving heel pain, function and ROM in patients with
PF.
Abstract: Organ motion, especially respiratory motion, is a technical challenge to radiation therapy planning and dosimetry. This motion induces displacements and deformation of the organ tissues within the irradiated region which need to be taken into account when simulating dose distribution during treatment. Finite element modeling (FEM) can provide a great insight into the mechanical behavior of the organs, since they are based on the biomechanical material properties, complex geometry of organs, and anatomical boundary conditions. In this paper we present an original approach that offers the possibility to combine image-based biomechanical models with particle transport simulations. We propose a new method to map material density information issued from CT images to deformable tetrahedral meshes. Based on the principle of mass conservation our method can correlate density variation of organ tissues with geometrical deformations during the different phases of the respiratory cycle. The first results are particularly encouraging, as local error quantification of density mapping on organ geometry and density variation with organ motion are performed to evaluate and validate our approach.