Three dimensional radiotherapy techniques propose the opportunity of delivering the dose distribution which is well conformed to target volume while minimizing the exposure by radiations to nearby organs. However, second cancer incidences from the radiations are rare and much late effects after radiotherapy techniques. The purpose of dose distribution is vital as imprecision in dose parameters can produce further complications. The critical organs of the patients are usually received low radiations due to the complex radiation fields which are close or relatively far from target and may be a cause to produce secondary cancer risk. Therefore, numerous parameters regarding to the radiotherapy treatment planning must be discussed. This study aims to calculate the dose distribution, dose volume histograms (DVHs), life time secondary cancer risk, solid cancer risk or excess absolute risk (EAR) using the different modalities of radiotherapy (APBI – accelerated partial breast irradiation, EBRT – external beam radiotherapy). Breast cancer is global dilemma and considerable improvements have been made in the outcomes with early stage breast cancer patients. In our analysis, due to the steep dose gradient and the prescription to 10 mm tissue depth, Accelerated partial breast irradiation (APBI) with 50 kV x-ray miniature source and MammoSite brachytherapy with Ir-192 Source delivered the highest maximal dose to the ipsilateral breast. MammoSite brachytherapy delivered higher maximal dose to heart than after three dimensional conformal radiotherapy (3D-CRT) and significantly lower using the tangential IMRT. The risk of solid cancer is generally related to radiotherapy. In general, the incidences of secondary cancers are related to the actual dose received by the irradiated organ. In our study, secondary cancer risk is estimated from the breast radiotherapy techniques. IORT associated with less second cancer risk (0.02%) for ipsilateral lung in comparison to APBI and EBRT. Second cancer risk observed by IORT for contralateral breast is less in comparison to APBI and EBRT. The risk calculated from EBRT for the ipsilateral lung (2.9%) and contralateral lung (0.2%). Tangential IMRT and 3D-CRT irradiated the higher volume of contralateral breast and ipsilateral lung for the dose (<1 Gy). EAR decreased for contralateral breast, ipsilateral lung and contralateral lung for 3D-CRT and tangential IMRT viiiin comparison to multibeam IMRT and VMAT by using linear, linear-exponential and plateau models. In order to get better accuracy in dose distribution, it is point of interest to compare the dose distribution by treatment planning system, applicators and sources. High dose-rate (HDR) brachytherapy techniques are commonly used to treat the tumours such as the breast, cervix and prostate. In these brachytherapy techniques, applicators are inserted close to tumours while the radioactive sources are adjusted at suitable position for the desired delivery of dose. Intracavitary brachytherapy (ICBT) constitutes an essential component in the radiation therapy of cervical cancer. With high-dose-rate (HDR) afterloading units, ICBT procedures require multiple applications spread over time. In our study, The GammaMedplus HDR remote brachytherapy afterloading system with single high active (usually about 10 Ci) cylindrical 192 Ir source having active dimensions of 0.6 mm diameter and 3.6 mm length was used. The planning was done using treatment planning software (ABACUS 3.1). It is noted that total average dose and standard deviation of dose for nine patients by Ring applicator at bladder, rectum, RPWRP and LPWRP was of 4.26 ± 0.35 Gy, 2.72 ± 0.29 Gy, 0.98 ± 0.11 Gy and 0.83 ± 0.16 Gy respectively whereas total average dose and standard deviation of dose for five patients by Fletcher applicator at bladder, rectum, RPWRP and LPWRP was of 4.05 ±0.73 Gy, 3.02 ± 0.76 Gy, 1.22 ± 0.25 Gy and 1.23 ±0.38 Gy respectively.
ناطق کی شادی 2010 میں ہوئی۔ان کی زوجہ پاک آرمی میں ڈاکٹر تھیں ۔ان کی شادی تقریباً 5 سال رہی لیکن یہ شادی مزید نہ چل سکی اور بیوی سے علیحدگی ہو گئی یعنی 2015 ئ میں طلاق ہو گئی۔انہوں نے شادی کا دوبارہ تاحال نہیں سوچا۔ اللہ تعالیٰ نے بیٹی جیسی رحمت سے نوازا جس کا نام’’وجیہہ فاطمہ ‘‘ ہے۔بیٹی اپنی والدہ کے ساتھ لاہور میں ہی رہتی ہیں۔
Introduction: Anatomy is still taught in medical schools as a basis for studying pathophysiology and surgery. Lack of integration of basic and clinical disciplines reduced teaching hours, and poor teaching methodologies have a significant effect on anatomical knowledge and medical education standards. Objectives: To evaluate the perspectives of undergraduate students of MBBS, fresh MBBS graduates, teaching faculty of anatomy, and consultants on the importance and reconstruction of the anatomy curriculum. Materials & Methods: A total of 600 subjects participated in this cross-sectional study. A feedback form was used to collect data regarding time allocation, clinical relevance, integration, and clear viewpoints in basic histology, embryology, and gross anatomy. The form included free text, binomial, and 5-point Likert scale replies. Results: Analysis of the results revealed that all stakeholders universally preferred integrated anatomy teaching throughout the academic years of medical school instead of demanding block during the early two years. According to the study, students experienced inadequacies in their anatomical knowledge when they started their clinical training. Conclusion: This study contributes further to the ongoing discussions in anatomical sciences education by revealing that new doctors believe that anatomical instruction should be prioritized regardless of their career goals.
A Linguistic Study of The Psychological Aspects of Aphasia This is a cross disciplinary study as it draws upon ideas from neurology, linguistics, developmental psychology and philosophy and examines the effects of emotional security on the process of language recovery after aphasia. Language recovery after aphasia is generally studied by using the standardized terminologies from the domains of first language acquisition and second language learning. This orients and controls the ways in which researchers look into this phenomenon ignoring its own uniqueness. Overemphasis on concepts such as neural plasticity and critical period has resulted in neglecting the emotional and psychological aspects of the process. The neurological and linguistic debates over aphasia support the existence of a critical period till which the human brain can retain its plasticity. This study challenges these ideas by discovering the positive effects of emotional stability and security on language recovery of an aphasic even when s/he had crossed the so-called critical period. The study covers one year of the linguistic recovery process of the research participant. The data collection methods included audio recordings of the research participant’s speech, diary notes about her linguistic performance and discussions with her physician about the same. The insights drawn in the end strongly support the positive effects of emotional security on language recovery after aphasia. The study concludes with grounded theory that emerges from the data. The researcher has named it as her theory of emotionicology. This theory is based on the serendipitous discovery that not only initiation of positive emotions help in language recovery but also inclusion of the negative emotion, that is, aggression in controlled and mild forms (at advanced stages of recovery) can be used for further fuelling the speech production process. It is, however, suggested that aggression has to be employed with caution and should be applied only by a trained caregiver in brief episodes (of say 10-15 seconds) when the aphasic is emotionally and physically secure. This study also stresses that for the betterment of the aphasic, the caregiver has to acquire emotional competence as a skill. The understanding in the end is purely subjective, and situated. Thus, no generalization claims follow.