Sensitivity of megavoltage photon beam Monte Carlo simulations to electron beam and other parameters

The BEAM code is used to simulate nine photon beams from three major manufacturers of medical linear accelerators (Varian, Elekta, and Siemens), to derive and evaluate estimates for the parameters of the electron beam incident on the target, and to study the effects of some mechanical parameters like target width, primary collimator opening, flattening filter material and density. The mean energy and the FWHM of the incident electron beam intensity distributions (assumed Gaussian and cylindrically symmetric) are derived by matching calculated percentage depth-dose curves past the depth of maximum dose (within 1% of maximum dose) and off-axis factors (within 2sigma at 1% statistics or less) with measured data from the AAPM RTC TG-46 compilation. The off-axis factors are found to be very sensitive to the mean energy of the electron beam, the FWHM of its intensity distribution, its angle of incidence, the dimensions of the upper opening of the primary collimator, the material of the flattening filter and its density. The off-axis factors are relatively insensitive to the FWHM of the electron beam energy distribution, its divergence and the lateral dimensions of the target. The depth-dose curves are sensitive to the electron beam energy, and to its energy distribution, but they show no sensitivity to the FWHM of the electron beam intensity distribution. The electron beam incident energy can be estimated within 0.2 MeV when matching either the measured off-axis factors or the central-axis depth-dose curves when the calculated uncertainties are about 0.7% at the 1 sigma level. The derived FWHM (+/-0.1 mm) of the electron beam intensity distributions all fall within 1 mm of the manufacturer specifications except in one case where the difference is 1.2 mm.     

Safety of vaginal birth after cesarean delivery.

OBJECTIVE: To compare the outcomes of labor induction in women with a history of 1 cesarean section (CS) who undergo trial of labor. METHODS: A prospective observational study of 702 pregnant women who had 1 previous CS was conducted at Women's Hospital, Hamad Medical Corporation, Doha, Qatar, between April 2003 and April 2004. Those with no history of vaginal delivery were assigned to one group and those with a history of vaginal delivery were assigned to another group, and the latter group was then divided into 2 subgroups according to the results of trial of labor. RESULTS: Of these 702 women with a history of 1 CS, 62.4% also had a history of vaginal delivery. After trial of labor, vaginal delivery occurred more often among women with no history of vaginal delivery (64.8%). Moreover, trial of labor resulted in a vaginal delivery more often in women who were delivered only once and by CS (87.7%) than in women who also had a history of vaginal delivery (79.2%). CONCLUSION: These findings indicate that women who have had a CS should strongly consider natural delivery for subsequent pregnancies.     

Comparison between Negative T waves characteristics in acute coronary syndrome and pulmonary embolism

Background

Electrocardiogram (ECG) is the first available modality used in patients with chest pain and dyspnea in emergency rooms.We aimed to study differences between acute coronary syndrome (ACS) and acute pulmonary embolism (APE) in patients presented primarily with abnormal negative T waves on their admission Electrocardiogram.

The effects of smoking on corneal endothelial cells: a cross-sectional study on a population from Isfahan,Iran

Purpose: The aim of this study is to compare the effect of smoking in corneal endothelial cell number and morphology by specular microscopy on a non-smoker population.

Methods: Our cross-sectional study was performed on 150 participants from a non-smoker population. Non-contact specular microscopy (Tomey Corporation Inc., Nagoya, Japan) was performed in the center of the cornea of all subjects. The cell density (CD), average cell size (AVG), percent of hexagonality (HEX%) and central corneal thickness (CCT) were calculated and compared in both groups.

Results: Totally, 76 eyes of 76 smokers and 74 eyes of 74 non-smokers were enrolled in the study from 2015 to 2016. The mean age of smokers and non-smokers were 48.61?±?17.04 and 46.39?±?13.02, respectively. The mean number of pack/year among the smokers was 17.36?±?14.68. Also, the mean values of AVG and CD were significantly different for these two groups (p?=?0.011 and p?=?0.039, respectively). Other corneal endothelial variables did not show a significant difference between smokers and non-smokers (p?>?0.05). However, smokers with severe nicotine dependency had significantly greater AVG and lower CD in comparison with the non-smokers (p?=?0.004 and p?=?0.013, respectively).

Conclusion: Our study showed that smoking can cause significant changes in some of the corneal endothelial variables, but not all of them.     

Antioxidant and hepatoprotective effects of Solanum xanthocarpum leaf extracts against CCl4-induced liver injury in rats

Context: Solanum xanthocarpum Schard. and Wendl. (Solanaceae) has been used in traditional Indian medicines for its antioxidant, anti-inflammatory, and antiasthmatic properties.

Objective: The present study demonstrates the antioxidant and hepatoprotective effects of S. xanthocarpum. On the basis of in vitro antioxidant properties, the active fraction from column chromatography of the methanol extract of S. xanthocarpum leaves (SXAF) was chosen as the potent fraction and used for hepatoprotective studies in rats.

Materials and methods: The antioxidant activity was evaluated by 2,2′-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), 2,2-diphenyl-1-picrylhydrazyl (DPPH), and reducing power assays. Rats were pre-treated with 100 and 200?mg/kg b.w. of SXAF for 14?d with a single dose of CCl₄ in the last day. Hepatoprotective properties were determined by serum biochemical enzymes, aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), antioxidant enzymes (SOD, CAT, GSH, and GST), and histopathology studies.

Results: SXAF exhibited significant antioxidant activity in scavenging free radicals with IC₅₀ values of 11.72?µg (DPPH) and 17.99?µg (ABTS). Rats pre-treated with SXAF demonstrated significantly reduced levels of serum LDH (1.7-fold), ALP (1.6-fold), and AST (1.8-fold). Similarly, multiple dose SXAF administration at 200?mg/kg b.w. demonstrated significantly enhanced levels of SOD (1.78?±?0.13), CAT (34.63?±?1.98), GST (231.64?±?14.28), and GSH (8.23?±?0.48) in liver homogenates. Histopathological examination showed lowered liver damage in SXAF-treated groups.

Discussion and conclusion: These results demonstrate that SXAF possesses potent antioxidant properties as well as hepatoprotective effects against CCl₄-induced hepatotoxicity.