Histopathological pattern of abnormal uterine bleeding in endometrial biopsies

Abnormal uterine bleeding is a common presenting complaint in gyanecology out patient department. Histopathological evaluation of the endometrial samples plays a significant role in the diagnosis of abnormal uterine bleeding. This study was carried out to determine the histopathological pattern of the endometrium in women of various age groups presenting with abnormal uterine bleeding. Endometrial biopsies and curettings of patients presenting with abnormal uterine bleeding was retrospectively studied. A total of 403 endometrial biopsies and curettings were analyzed. The age of the patients ranged from 18 to 70 years. Normal cyclical endometrium was seen in 165 (40.94%) cases, followed by 54 (13.40%) cases of disordered proliferative endometrium and 44 (10.92%) cases of hyperplasia. Malignancy was seen in 10 (2.48%) cases. Hyperplasia and malignancy were more common in the perimenopausal and postmenopausal age groups. Histopathological examination of endometrial biopsies and curettings in patients presenting with abnormal uterine bleeding showed a wide spectrum of changes ranging from normal endometrium to malignancy. Endometrial evaluation is specially recommended in women of perimenopausal and postmenopausal age groups presenting with AUB, to rule out a possibility of any preneoplastic condition or malignancy.

The chemical and mechanical differences between alginate-like exopolysaccharides isolated from aerobic flocculent sludge and aerobic granular sludge

This study aimed to investigate differences in the gel matrix of aerobic granular sludge and normal aerobic flocculent sludge. From both types of sludge that fed with the same municipal sewage, the functional gel-forming exopolysaccharides, alginate-like exopolysaccharides, were isolated. These two exopolysaccharides were chemically fractionated, and investigated by FT-IR spectroscopy. The isolated polymers were made into a gel by calcium addition and the mechanical properties of these reconstituted gels were measured by a low load compression tester. The viscoelastic behavior of the gels was described by a generalized Maxwell model. The alginate-like exopolysaccharides derived from aerobic granules had significantly higher amount of poly(guluronic acid) blocks but lower amount of poly(guluronic acid-manuronic acid) blocks in the chemical structure, while the alginate-like exopolysaccharides derived from aerobic flocculent sludge had equal amount of poly(guluronic acid) blocks and poly(guluronic acid-manuronic acid) blocks. These differences result in a perfect gel-forming capability of alginate-like exopolysaccharides derived from aerobic granules and bestowed this exopolysaccharides gel a stronger mechanical property as compared to alginate-like exopolysaccharides derived from aerobic flocculent sludge. The different chemical and mechanical properties of these two exopolysaccharides contributed to the distinguished characteristics between aerobic granular sludge and aerobic flocculent sludge.

Design and performance of hybrid constructed wetland systems for high-content wastewater treatment in the cold climate of Hokkaido, northern Japan

The performance of six multistage hybrid constructed wetland systems was evaluated. The systems were designed to treat four kinds of high-content wastewater: dairy wastewater (three systems, average inflow content 2,400-5,000 mg·COD l(-1), 3-6 years of operation); pig farm wastewater, including liquid food washing wastewater (one system, 9,500 mg·COD l(-1), 3 years); potato starch processing wastewater (one system, 20,000-60,000 mg·COD l(-1), 3 years); and wastewater containing pig farm swine urine (one system, 6,600 mg·COD l(-1), 2.8 years) (COD = chemical oxygen demand). The systems contained three or four vertical (V) flow beds with self-priming siphons and surface partitions and no or one horizontal (H) flow bed (three to five beds). In some V flow beds, treated effluents were recirculated (Vr) through the inlet to improve performance. Mean annual temperature was 5-8 °C at all locations. To overcome clogging due to the high load in a cold climate, we applied a safety bypass structure and floating cover material to the V flow beds. Calculated average oxygen transfer rates (OTRs) increased proportionally with the influent load, and the OTR value was Vr > V> H. The relations of load-OTR, COD-ammonium, and a Arrhenius temperature-dependent equation enable the basic design of a reed bed system.

Tomato leaf curl Joydebpur virus: a monopartite begomovirus causing severe leaf curl in tomato in West Bengal

A begomovirus was isolated from tomato plants showing leaf curl and stunting symptoms in farmers' fields near the district of Kalyani, West Bengal, India. Viral genomic components amplified by rolling-circle amplification were cloned and sequenced. The genome organization of this virus was found to be similar to those of Old World monopartite begomovirus, with DNA A and a betasatellite component. Neither alphasatellite nor DNA B component was detected. The begomovirus showed highest sequence identity of 93.6% to tomato leaf curl Joydebpur virus (ToLCJoV-[IN:Kal:Chi:06]) and was thus identified to be an isolate of ToLCJoV. The betasatellite isolated from these samples was identified as tomato leaf curl Joydebpur betasatellite. ToLCJoV-[IN:Kal:Tom:08] alone induced severe symptoms in Solanum lycopersicum, N. benthamiana and N. glutinosa plants, and its severity was enhanced when co-inoculated with the cognate betasatellite. ToLCJoV-[IN:Kal:Tom:08] trans-replicated four more non-cognate betasatellites and induced severe symptoms in N. benthamiana and tomato. Since DNA A replicated efficiently and caused systemic symptom expression, it is hypothesized that ToLCJoV is essentially a monopartite virus, which could have acquired a betasatellite from an unknown source.

Can low dose spinal anesthesia combined with ultrasound guided bilateral ilioinguinal-iliohypogastric nerve blocks avoid use of additional epidural catheter in high risk obstetric cases? Our experience from two cases

Critical obstetric cases associated with cardiac pathology may pose real challenge for anaesthesiologist during Caesarean section. Meticulous perioperative care and suitable selection of anaesthesia technique are the key to successful outcome. Single shot spinal anaesthesia is not used any more because of serious haemodynamic consequence. Progressive and controlled epidural local anaesthetic injection is mostly used in such cases. But recently combined spinal epidural anaesthesia and continuous spinal anaesthesia are suggested due to better precise control of haemodynamics and quicker onset. However, institution of such complex technique may require time which may not be feasible in emergency situations. Use of bilateral ilioinguinal-iliohypogastric nerve block along with low dose spinal anaesthesia may obviate the need of additional epidural catheter in such complicated cases. We hereby present our experience from two cases.

Role of serotonin in seasonal affective disorder

This review was prepared with an aim to show role of serotonin in seasonal affective disorder. Seasonal affective disorder, which is also called as winter depression or winter blues, is mood disorder in which persons with normal mental health throughout most of the year will show depressive symptoms in the winter or, less commonly, in the summer. Serotonin is an important endogenous neurotransmitter which also acts as neuromodulator. The least invasive, natural, and researched treatment of seasonal affective disorder is natural or otherwise is light therapy. Negative air ionization, which acts by liberating charged particles on the sleep environment, has also become effective in treatment of seasonal affective disorder.  

Development, characterization and solubility study of solid dispersions of Cefuroxime Axetil by the solvent evaporation method

Cefuroxime Axetil (Poorly water soluble drug), when prepared as solid dispersion showed improved solubility and dissolution. Therefore, the main purpose of this investigation was to increase the solubility and dissolution rate of Cefuroxime Axetil by the preparation of its solid dispersion with urea, using the solvent evaporation method. Physical mixtures and solid dispersions of Cefuroxime Axetil were prepared by using urea as a water-soluble carrier in various proportions (1:1, 1:2, 1:3, 1:4, 1:5, 1:6, and 1:7 by weight), by employing the solvent evaporation method. The drug release profile was studied and it was found that the dissolution rate and the dissolution parameters of the drug from the physical mixture as well as solid dispersion were higher than those of the intact drug. The Fourier Transform Infrared (FTIR) spectra revealed no chemical incompatibility between the drug and urea. Drug-polymer interactions were investigated using differential scanning calorimetry (DSC) and Powder X-Ray Diffraction (PXRD).

Functional characterization of βC1 gene of Cotton leaf curl Multan betasatellite

Whitefly-transmitted Begomoviruses having circular single stranded DNA genome cause severe leaf curl diseases in the tropical and subtropical region. The majority of Old World monopartite begomoviruses with DNA A component is associated with a satellite DNA of 1.3 kb length referred to as betasatellites. The presence of betasatellite is required to express typical symptoms in the primary hosts. Increased symptom expression in betasatellite's presence is attributed to a 13-15 kDa βC1 protein encoded by the βC1 gene on complementary sense strand. The exact mechanism by which the βC1 protein contributes to the symptoms' severity and helper viral DNA's accumulation is not yet understood. Here, we studied the βC1 protein of Cotton leaf curl Multan betasatellite, associated with mono and bipartite begomoviruses. The βC1 protein was expressed in prokaryotic system as 6XHis-βC1 fusion protein and recombinant protein showed size- and sequence-specific DNA binding activity. The host proteins which may interact with βC1 were identified by binding βC1 recombinant protein with heptapeptide in phage display library. The βC1-interacting host proteins predicted belong to metabolic and defense pathways, indicating that βC1 protein has a pivotal role in viral pathogenicity.

Rheological evaluation of thermoreversible and mucoadhesive nasal gels of Zolmitriptan

BACKGROUND AND OBJECTIVES

Rheological evaluation of thermoreversible mucoadhesive nasal gel of zolmitriptan is done to determine the steady shear behaviour and gelation temperature. The thermoreversible mucoadhesive polymers are sucessesfully used to increase the contact time of the therapeutic compound in the nasal cavity as well as they cause enhancement in permeation of drug through the nasal mucosa.

MATERIAL AND METHODS

Pluronic (F127) and Pluronic (F 68) were used as thermoreversible polymers in combination with a mucoadhesive polymer obtained from natural resource Zolmiriptan anti migraine drug obtained from Cipla Ltd. Rheometer Brookfield R/S- CPS- PI having cone-and-plate geometry was used for steady shear behaviour study and the gelation temperature was determined by Brookfield R/S plus Rheometer (Brookfield viscometer Ltd, Harlow, Essex, UK) fitted with spindle and Eurotherm cone/plate geometry.

RESULTS

Steady shear behaviour study concludes as content of mucoadhesive polymer starts increasing subsequently the viscosity of the solution starts increasing in the same manner. Gelation temperature study suggests that as the mucoadhesive content was increased in formulation the gelation temperature of the formulation was decreased subsequently. So it was concluded from the study that gelation temperature of the formulation was influenced by the mucoadhesive content. Temperature increases the gelation time of the formulation.

CONCLUSIONS

Above studies indicate that even small difference in the composition of the thermoreversible mucoadhesives gel formulations may cause major change in the rheological behaviour. Although the gelation temperatures of all the three formulations L1, L2 and L3 were below the human nasal temperature, they show different responses to the varied shear rates at different temperatures below and above the temperature of nasal cavity.

Potential triazole derivatives having significant antiepileptic effect- A Review

Triazole is a five membered heterocyclic moiety of two carbon and three nitrogen atom, triazole are present in two isomeric forms, 1,2,4-triazole and 1,2,3-triazole. Alprazolam, Triazolam and Midazolam are established drugs used in epilepsy which have triazole moiety. Epilepsy is the most frequent neurological disorder characterized by excessive temporary neuronal discharge. The overall prevalence of the disease is 1% of the population and up to 50 million people worldwide. The literature shows that different substitution on triazole moiety exhibit potent antiepileptic activity and less/no neurotoxicity. The maximal electroshock seziures test is most widely used in- vivo models among the various screening models of epilepsy. The present article focused on the previous researches on triazole, which include synthesis, spectral characterization and antiepileptic activity of the synthesized triazole derivatives, and we also go for the development of structure activity relationship of the earlier synthesized triazole derivatives with reference to their pharmacological effect.

A review on an update of NS5B polymerase hepatitis C virus inhibitors

BACKGROUND

Hepatitis C virus (HCV) infection is widespread, abhorrently under-diagnosed, and radically under-treated. Globally, infection with HCV is a major cause of acute hepatitis and chronic liver disease. Therefore, novel HCV inhibitors are required for the treatment of the HCV infected patients.

OBJECTIVE AND PERSPECTIVES

This review gives the detailed knowledge of upcoming therapy such as NS5B polymerase inhibitors that are urgently needed.

CONCLUSION

In the past decade, intensive hard work has focused on the discovery of both structural and nonstructural inhibitors of the HCV NS5B polymerase. These demanding efforts have resulted in various promising agents advancing in clinical development with emphasis on clinical efficacy and impact for future combination studies.

Managing urethral injuries in suburban India-general surgeon's perspective

Although, urethral injuries are relatively uncommon, their incidence has been increasing due to increasing incidence of road traffic accidents. Initial management of urethral injury depends upon the degree and location of the injury, patients' haemodynamic status, and any associated injuries. Besides these factors, availability of clinical infrastructure and clinical expertise also play a significant role in making appropriate management decisions at the time of injury.

Neonatal presentation of familial glucocorticoid deficiency resulting from a novel splice mutation in the melanocortin 2 receptor accessory protein

BACKGROUND

Familial glucocorticoid deficiency (FGD) is a rare autosomal recessive disorder characterised by isolated glucocorticoid deficiency. Mutations in the ACTH receptor/melanocortin 2 receptor (MC2R), the MC2R accessory protein (MRAP) or the STAR protein (STAR) cause FGD types 1, 2 and 3, respectively, accounting for ~50% of all cases.

PATIENT AND METHODS

We report a neonate of Indian origin, who was diagnosed with FGD in the first few days of life. He presented with hypoglycaemic seizures and was noted to have generalised intense hyperpigmentation and normal male genitalia. Biochemical investigations revealed hypocortisolaemia (cortisol 0.223 μg/dl; NR 1-23 μg/dl) and elevated plasma ACTH (170 pg/ml). Serum electrolytes, aldosterone and plasma renin activity were normal. Peak cortisol following a standard synacthen test was 0.018 μg/dl. He responded to hydrocortisone treatment and continues on replacement. Patient DNA was analysed by direct sequencing. The effect of the novel mutation was assessed by an in vitro splicing assay using wild type and mutant heterologous minigenes.

RESULTS

A novel homozygous mutation c.106+2_3dupTA was found in the MRAP gene. Both parents were heterozygous for the mutation. In an in vitro splicing assay, the mutation resulted in the skipping of exon 3.

CONCLUSION

We have identified a novel MRAP mutation where disruption of the intron 3 splice-site results in a prematurely terminated translation product. This protein (if produced) would lack the transmembrane domain that is essential for MC2R interaction. We predict that this would cause complete lack of ACTH response thus explaining the early presentation in this case.

Epidemiological trends of leprosy in an urban leprosy centre of Delhi: a retrospective study of 16 years

This study was done by collecting the retrospective data from 1994 to 2009 of patients attending the urban leprosy centre attached to the department of dermatology, STD & leprosy of PGIMER & Dr. R M L Hospital, New Delhi. The data was analysed according to age, sex, type of leprosy, leprosy reactions, deformities and relapse and compared with the national figures by comparison of proportions after taking the national data per 10,000 population. A total of 3659 patients attended our ULC (Urban Leprosy Centre) among which 2741 were male and 945 females (M:F-3:1). 669 patients (18.2%) were children. The data analysed show a gradual decline in new case detection rate with a marginal rise in 2005 and 2008. Percentage of MB cases was falling consistently till 2005 after which it showed an abrupt rise. The incidence of type 1 reaction varied from 21% in 1994 to 10% in 2009 in PB patients and from 6% in 1994 to 8% in 2009 in MB patients. The trend of type 2 reactions in MB patients showed a slow declining trend. MDT completion rate showed an impressive improvement from 56% in 1994 to 90% in 2009. The number of patients revisiting the ULC with features of relapse also showed a decrease in number. The pattern of visible deformities showed an almost constant trend similar to national figures. Improved MDT completion rate helps in reducing the disease transmission, severity, reactions and disabilities.

A comparative study on the viscoelastic properties of human and animal lenses

A new method of compression between two parallel plates is used to measure the viscoelastic properties of whole and decapsulated human lenses and compare them with other animal species. Compressive load relaxation was performed by deforming the lens by 10% and measuring the force relaxation response for 100 s to obtain thickness, stiffness and relaxation of the induced loading force and Maxwell parameters for human, monkey, porcine and leporine whole and decapsulated lenses. Thickness and percentage loading force relaxation increased linearly with lens age, whereas stiffness and induced loading force increased exponentially. Human and monkey lenses aged at different rates. Loading force relaxation in a generalized Maxwell model was described by three time constants ranging from 1 to 1000 s. Compressive load relaxation is a very versatile method to study the viscoelastic properties of whole and decapsulated lenses and potentially also artificial accommodating lenses. The data presented in the study will help researchers choose the most suitable animal lenses based on the desired properties and age to be mimicked from the human lenses.

CXCL13 mediates prostate cancer cell proliferation through JNK signalling and invasion through ERK activation

OBJECTIVES

  The focus of this study was to determine the dedicator of cytokinesis 2 (DOCK2), extracellular signal-regulated kinase 1/2 (ERK1/2), c-Jun N-terminal kinase-1 (JNK) and Akt signals involved in CXCL13-mediated prostate cancer (PCa) cell invasion and proliferation.

MATERIALS AND METHODS

  Androgen-sensitive (LNCaP), hormone-refractory (PC3) cells and normal cells (RWPE-1) were used to determine CXCL13-mediated PCa cell invasion and proliferation. Immuno-blotting, fast activated cell-based (FACE) ELISA, caspase activity, cell invasion and proliferation assays were performed to ascertain some of the signalling events involved in PCa cell proliferation and invasion.

RESULTS

  Unlike androgen-sensitive LNCaP cells, we report for the first time that the hormone-refractory cell line, PC3, expresses DOCK2. CXCL13-mediated LNCaP and PC3 cell invasion was regulated by Akt and ERK1/2 activation in a DOCK2-independent fashion. CXCL13 also promoted LNCaP cell proliferation in a JNK-dependent fashion even in the absence of DOCK2. In contrast, CXCL13 induced PC3 cell proliferation through JNK activation, which required DOCK2.

CONCLUSIONS

  Our results show CXCL13-mediated PCa cell invasion requires Akt and ERK1/2 activation and suggests a new role for DOCK2 in proliferation of hormone-refractory CXCR5-positive PCa cells.

Analysis of carriers of hepatitis B virus from a tertiary referral hospital: does the viral load change during the natural course of infection?

This study was designed to determine the prevalence, forms of transmission, mutational profile and viral load at baseline of hepatitis B virus (HBV) carriers in Delhi. HBV surface antigen (HBsAg)-positive patients were enrolled and evaluated clinically for liver function, serological markers for hepatitis B and HBV DNA quantitation. Tests were carried out again 1 year later and the results were compared. Liver biopsy was carried out on all carriers with active viral replication. HBV DNA-positive samples were subjected to polymerase chain reaction single-stranded conformation polymorphism (PCR-SSCP) to screen mutations in the Precore, core, and the X-gene prior to sequencing analysis. Among the 100 patients examined, HBeAg was detected in 23% and 40% were HBV DNA-positive. Of the 40 HBV DNA-positive cases, 8 had precore/core mutations, [G1896A (10%), T2066A (12.5%), T2050C (10%), and G1888A (7.5%)]. No X gene mutants were detected. Reduction in viral load was higher in HBeAg-positive patients, as compared to HBeAg-negative patients, over 1 year. At follow-up, 2/8 HBV mutants corresponded with altered liver function and morphological changes suggestive of chronic hepatitis. One patient was re-designated as DNA-negative on follow-up and had wild-type virus infection with a relatively low viral load. The predominant route for HBV transmission was determined to be parenteral. Twenty percent of the HBV carriers were infected with precore and core mutant HBV. Although the clinical and biochemical profiles of these HBV carriers remained largely stable on follow-up, there was evidence of spontaneous reduction in the mean viral load over the 1-year study period.

Electron arc therapy for bilateral chest wall irradiation: treatment planning and dosimetric study

AIMS

The treatment of patients with synchronous bilateral breast cancer is a challenge. We present a report of dosimetric data of patients with bilateral chest walls as the target treated with electron arc therapy.

MATERIALS AND METHODS

Ten consecutive patients who had undergone electron arc therapy to the bilateral chest wall for breast cancer were analysed. After positioning and immobilisation, patients underwent computed tomography scans from the neck to the upper abdomen. Electron arc plans were generated using the PLATO RTS (V1.8.2 Nucletron) treatment planning system. Electron energy was chosen depending upon the depth and thickness of the planning target volume (PTV). For all patients, the arc angle ranged between 80 and 280° (start angle 80°, stop angle 280°). The homogeneity index, coverage index and doses to organs at risk were evaluated. The patient-specific output factor and thermoluminescence dosimetry (TLD) measurements were carried out for all patients. The total planned dose to the PTV was 50Gy/25 fractions/5 weeks.

RESULTS

The mean PTV (± standard deviation) was 568.9 (±116)cm(3). The mean PTV coverage was 89 (±5.8)% of the prescribed dose. For the right lung, the mean values of D(1) and D(10) were 46 (±7.6) and 30 (±9)Gy, respectively. For the left lung, the mean values of D(1) and D(10) were 45 (±7) and 27 (±8)Gy, respectively. For the heart, the mean values of D(1), D(5) and D(10) were 21 (±15), 13.5 (±12) and 9 (±9)Gy, respectively. The mean values of TLD at various pre-specified locations on the chest wall surface were 1.84, 1.82, 1.82, 1.89 and 1.78Gy, respectively

CONCLUSION

The electron arc technique for treating the bilateral chest wall is a feasible and pragmatic technique. This technique has the twin advantages of adequate coverage of the target volume and sparing of adjacent normal structures. However, compared with other techniques, it needs a firm quality assurance protocol for dosimetry and treatment delivery.

Establishment of lacZ marked strain of phosphate solubilizing bacterium in the rhizosphere and its effect on plant growth in mungbean

The establishment of lacZ marked strain of P-solubilizing bacterium Pseudomonas in the rhizosphere of mungbean (Vigna radiata) under pothouse conditions was studied. The lacZ marker was transferred to Pseudomonas P-36 on LB medium using donor strain of E. coli. The lacZ marked strain formed blue colonies on selective media and could be identified from soil on the basis of this character. The lacZ marked strain was able to survive in rhizosphere of mungbean under pothouse conditions and maintained a population of about 10(4) g(-1) of rhizosphere soils up to 60 days study period. Positive effect of inoculation with P-solubilizing bacterium on dry matter yield, P and N-uptake was observed using rock phosphate and single super phosphate as P sources with and without farmyard amendment.

Isolation and Characterization of a Facultatively Aerobic Bacterium That Reductively Dehalogenates Tetrachloroethene to cis-1,2-Dichloroethene

A rapidly-growing facultatively aerobic bacterium that transforms tetrachloroethene (PCE) via trichloroethene (TCE) to cis-1,2-dichloroethene (cis-1,2-DCE) at high rates in a defined medium was isolated from a contaminated site. Metabolic characterization, cellular fatty acid analysis, and partial sequence analysis of 16S rRNA showed that the new isolate, strain MS-1, has characteristics matching those of the members of the family Enterobacteriaceae. Strain MS-1 can oxidize about 58 substrates including many carbohydrates, short-chain fatty acids, amino acids, purines, and pyrimidines. It can transform up to 1 mM PCE (aqueous) at a rate of about 0.5 (mu)mol of PCE(middot) h(sup-1)(middot)mg (dry weight) of cell(sup-1). PCE transformation occurs following growth on or with the addition of single carbon sources such as glucose, pyruvate, formate, lactate, or acetate or with complex nutrient sources such as yeast extract or a mixture of amino acids. PCE dehalogenation requires the absence of oxygen, nitrate, and high concentrations of fermentable compounds such as glucose. Enterobacter agglomerans biogroup 5 (ATCC 27993), a known facultative bacterium that is closely related to strain MS-1, also reductively dehalogenated PCE to cis-1,2-DCE. To our knowledge, this is the first report on isolation of a facultative bacterium that can reductively transform PCE to cis-1,2-DCE under defined physiological conditions. Also, this is the first report of the ability of E. agglomerans to dehalogenate PCE.

Olmsted syndrome

Olmsted syndrome is a rare disorder characterized by the combination of periorificial, keratotic plaques and bilateral palmoplantar keratoderma. New associated features are being reported. Olmsted syndrome is particularly rare in a female patient, and we report such a case in a six year-old Indian girl, who presented with keratoderma of her soles since birth and on her palms since the age of two years along with perioral and perinasal hyperkeratosis. She had sparse, light brown, thin hair. Although the psychomotor development of the child was normal until 18 months of age, the keratoderma plaques had restricted the child's mobility after that stage.

Annular vesiculobullous eruptions in type 2 reaction in borderline lepromatous leprosy: a case report

An untreated case of BL presented with clinical features of type 2 reaction (T2R) confirmed by histopathology. The case was a 18-year-old female with borderline lepromatous leprosy who developed annular vesiculobullous eruptions oversome of the pre-existing plaques on arms and upper back along with fever and severe neuritis after a short course of ofloxacin intake prescribed for urinary tract infection. In addition to the above lesions, some of the existing lesions showed acute exacerbation characterized by erythema, oedema, tenderness and vesiculobullous eruption. This can be considered as an example of leprous exacerbation as described in older literature. T2Rs are common in lepromatous leprosy and not so uncommonly are observed in borderline lepromatous leprosy. The vesiculobullous and crusted lesions developing over the existing borderline plaques, some of them presenting in an annular pattern in T2R in the form of leprous exacerbation, have been reported rarely in the literature.

A dose verification method for high-dose-rate brachytherapy treatment plans

AIM

To evolve a fast dose verification method for high-dose-rate (HDR) brachytherapy treatment plans and to demonstrate its applicability in different clinical cases.

MATERIALS AND METHODS

We developed a software tool in VC++ for the Varisource HDR unit for HDR dosimetry plan verification using TG-43 parameters. HDR treatment dosimetry of a number clinical cases using Varisource was verified by comparison with the treatment planning system (TPS).

RESULTS

A number of different types of clinical cases treated by Varisource were evaluated. TPS calculated dose values and verification code calculated dose values were found to agree to within 3% for most of the dose calculation points.

CONCLUSIONS

We have validated with clinical cases a fast and independent dose verification method of the dosimetry at selected points for HDR brachytherapy treatments plan using TG-43 parameters. This can be used for the verification of the TPS calculated dose at various points. The code is written to work with Varisource, but it can conceivably be modified for other sources also by using the fitted constant of the respective source.