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Agarwal JP, Krishnatry R, Panda G, Pathak R, Vartak C, Kinhikar RA, James S, Khobrekar SV, Shrivastava SK, D'Cruz AK, Deshpande DD. An Audit for Radiotherapy Planning and Treatment Errors From a Low-Middle-Income Country Centre. Clin Oncol (R Coll Radiol) 2018; 31:e67-e74. [PMID: 30322681 DOI: 10.1016/j.clon.2018.09.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 08/21/2018] [Accepted: 08/24/2018] [Indexed: 10/28/2022]
Abstract
AIMS To report the findings of an audit for radiotherapy errors from a low-middle-income country (LMICs) centre. This would serve as baseline data for radiotherapy error rates, their severity and causes, in such centres where modern error reporting and learning processes still do not exist. MATERIALS AND METHODS A planned cross-sectional weekly audit of electronic radiotherapy charts at the radiotherapy planning and delivery step for all patients treated with curative intent was conducted. Detailed analysis was carried out to determine the step of origin of error, time and contributing factors. They were graded as per indigenous institutional (TMC) radiotherapy error grading (TREG) system and the contributing factors identified were prioritised using the product of frequency, severity and ease of detection. RESULTS In total, 1005 consecutive radically treated patients' charts were audited, 67 radiotherapy errors affecting 60 patients, including 42 incidents and 25 near-misses were identified. Transcriptional errors (29%) were the most common type. Most errors occurred at the time of treatment planning (59.7%), with "plan information transfer to the radiation oncology information system" being the most frequently affected sub-step of the radiotherapy process (47.8%). More errors were noted at cobalt units (52/67; 77.6%) than at linear accelerators. Trend analysis showed an increased number of radiotherapy incidents on Fridays and near-misses on Mondays. Trend for increased radiotherapy errors noted in the evening over other shifts. On severity grading, most of the errors (54/60; 90%) were clinically insignificant (grade I/II). Inadequacies and non-adherence towards standard operating procedures, poor documentation and lack of continuing education were the three most prominent causes. CONCLUSION Preliminary data suggest a vulnerability of LMIC set-up to radiotherapy errors and emphasises the need for the development of longitudinal prospective processes, such as voluntary reporting and a continued education system, to ensure robust and comprehensive safe practises on par with centres in developed countries.
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Affiliation(s)
- J P Agarwal
- Department of Radiation Oncology, Tata Memorial Centre, Parel, Mumbai, India; Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, India
| | - R Krishnatry
- Department of Radiation Oncology, Tata Memorial Centre, Parel, Mumbai, India; Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, India.
| | - G Panda
- Department of Radiation Oncology, Tata Memorial Centre, Parel, Mumbai, India; Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, India
| | - R Pathak
- Department of Radiation Oncology, Tata Memorial Centre, Parel, Mumbai, India; Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, India
| | - C Vartak
- Department of Radiation Oncology, Tata Memorial Centre, Parel, Mumbai, India; Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, India
| | - R A Kinhikar
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, India; Department of Medical Physics, Tata Memorial Center, Parel, Mumbai, India
| | - S James
- Department of Radiation Oncology, Tata Memorial Centre, Parel, Mumbai, India; Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, India
| | - S V Khobrekar
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, India; Tata Memorial Hospital, Parel, Mumbai, India
| | - S K Shrivastava
- Department of Radiation Oncology, Tata Memorial Centre, Parel, Mumbai, India; Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, India
| | - A K D'Cruz
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, India; Tata Memorial Hospital, Parel, Mumbai, India
| | - D D Deshpande
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, India; Department of Medical Physics, Tata Memorial Center, Parel, Mumbai, India
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Singh P, Saha T, Mishra P, Parai MK, Ireddy S, Lavanya Kumar M S, Krishna S, Kumar SK, Chaturvedi V, Sinha S, Siddiqi MI, Panda G. Additional synthesis on thiophene-containing trisubstituted methanes (TRSMs) as inhibitors of M. tuberculosis and 3D-QSAR studies. SAR QSAR Environ Res 2016; 27:911-937. [PMID: 27885861 DOI: 10.1080/1062936x.2016.1243575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 09/28/2016] [Indexed: 05/28/2023]
Abstract
We earlier reported thiophene-containing trisubstituted methanes (TRSMs) as novel cores carrying anti-tubercular activity, and identified S006-830 as the phenotypic lead with potent bactericidal activity against single- and multi-drug resistant clinical isolates of Mycobacterium tuberculosis (M. tb). In this work, we carried out additional synthesis of several TRSMs. The reaction scheme essentially followed the Grignard reaction and Friedel-Crafts alkylation, followed by insertion of a dialkylaminoethyl chain. We also performed microbiological evaluations including in vitro screening against the virulent strain M. tb H37Rv, cytotoxicity assessment in the Vero C-1008 cell line, and 3D-QSAR studies with comparative molecular field analysis (CoMFA) and comparative molecular similarity index analysis (CoMSIA). CoMFA and CoMSIA models yielded good statistical results in terms of q2 and r2 values, suggesting the validity of the models. It was concluded that a para-substituted benzene ring with bulkier electron-donating groups and aminoalkyl chains are required for higher inhibitory capacity against M. tuberculosis. We believe that these insights will rationally guide the design of newer, optimal, TRSMs.
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Affiliation(s)
- P Singh
- a Institut des Biomolécules Max Mousseron , Montpellier , France
- b Medicinal and Process Chemistry Division , CSIR-Central Drug Research Institute , Lucknow , India
| | - T Saha
- b Medicinal and Process Chemistry Division , CSIR-Central Drug Research Institute , Lucknow , India
| | - P Mishra
- b Medicinal and Process Chemistry Division , CSIR-Central Drug Research Institute , Lucknow , India
| | - M K Parai
- b Medicinal and Process Chemistry Division , CSIR-Central Drug Research Institute , Lucknow , India
| | - S Ireddy
- b Medicinal and Process Chemistry Division , CSIR-Central Drug Research Institute , Lucknow , India
| | - S Lavanya Kumar M
- b Medicinal and Process Chemistry Division , CSIR-Central Drug Research Institute , Lucknow , India
| | - S Krishna
- c Molecular and Structural Biology Division , CSIR-Central Drug Research Institute , Lucknow , India
| | - S K Kumar
- d Biochemistry Division , CSIR-Central Drug Research Institute , Lucknow , India
| | - V Chaturvedi
- d Biochemistry Division , CSIR-Central Drug Research Institute , Lucknow , India
| | - S Sinha
- d Biochemistry Division , CSIR-Central Drug Research Institute , Lucknow , India
| | - M I Siddiqi
- c Molecular and Structural Biology Division , CSIR-Central Drug Research Institute , Lucknow , India
| | - G Panda
- b Medicinal and Process Chemistry Division , CSIR-Central Drug Research Institute , Lucknow , India
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Abstract
Adult-onset cataract (AOC) is a major ocular health problem and is the number one cause of blindness in the world. It is interesting to note that if the development of cataract is delayed by 10 years, the number of cataract surgeries needed would decrease by 45%. To prevent or delay cataract, the molecular pathological mechanisms underlying the lens change have to be understood, and this requires that the genes involved in such mechanisms should be identified. Hence, in this study we aim to identify AOC families which show a clear mendelian inheritance pattern, as only these families would be ideal for mapping the genes responsible. Over a period of 8 months, from September 1995-April 1996, 17 families with two or more affected members were identified. Segregation analysis showed autosomal dominant inheritance in multiple affected families. We propose to map the genes responsible for cataract in these families by linkage analysis and mutational screening of candidate genes.
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Affiliation(s)
- R Vijaya
- Department of Genetics and Molecular Biology, Vision Research Foundation, Madras, India
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