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Background The Covid-19 pandemic and subsequent lockdown in India caused disruptions in cancer treatment due to the restriction on movement of patients. We aimed to maintain continuity in cancer treatment during the lockdown through teleconsultations. We tried to reach out to our patients using telephonic consultations by establishing a Teleconsult Centre facility run by a team of doctors and patient navigators. Methods We telephonically contacted all patients who had outpatient appointments from 23 March to 30 April 2020 at our centre through the Teleconsult Centre to understand their current circumstances, feasibility of follow-up, local resources and offered best possible alternatives to continue cancer treatment, if required. Results Of the 2686 patients scheduled for follow-up during this period, we could contact 1783 patients in 9 working days. Through teleconsultations, we could defer follow-ups of 1034 patients (57.99%, 95% confidence interval [CI] 55.6%–60.3%), thus reducing the need for patients to travel to the hospital. Change in systemic therapy was made in 75 patients (4.2%, 95% CI 3.3%–5.2%) as per the requirements and available resources. Symptoms suggestive of disease progression were picked up in 12 patients (0.67%, 95% CI 0.35%–1.17%), who were advised to meet local physicians. Conclusion Our study suggests that the majority of patients on follow-up can be managed with teleconsultation in times of crisis. Teleconsultation has the potential of being one of the standard methods of patient follow-up even during periods of normalcy.

To study patterns of recurrence in Ga68-PSMA PETCT at rising serum PSA after radical radiotherapy for non-metastatic prostate cancer.Among patients with non-metastatic prostate cancer treated with radical external beam radiotherapy and androgen deprivation therapy, those who underwent Ga68-PSMA PETCT for rising PSA during follow up were analysed. Patterns of recurrence in Ga68-PSMA PETCT were studied. Extra-prostatic recurrences ≤5 were considered oligometastases. Local and oligometastatic recurrences were deemed suitable for focal salvage therapy. Probabilities of identifying recurrent lesion and potentially salvageable recurrences in Ga68-PSMA PETCT in relation to PSA were calculated.Total 114 patients were included (69% high-risk). Radiotherapy was hypofractionated in 57% (moderate 40%, extreme 17%), with median prostate EQD2 78.5 Gy. Median time from radiotherapy to Ga68-PSMA PETCT was 4.3 years (IQR 2.4-6.4), with median PSA 4.7 ng/mL (IQR 2.6-10.7) at scan. Uptake suggesting recurrence was observed in 91.2% patients, with positivity of 75%, 87%, 89%, and 100% at PSA thresholds ≤2, ≤5, ≤10, and10 ng/mL respectively. Probability of detecting recurrence in Ga68-PSMA PETCT increased with higher PSA at scan (AUC = 0.82). Uptake was local in 20 (17.5%), oligometastatic in 39 (34.2%), and polymetastatic in 45 (39.5%) patients. Recurrence was potentially salvageable in 59/104 (56.7%) patients, being 67% at PSA ≤2 ng/mL but only 38% at PSA10 ng/mL. Probability of recurrence being potentially salvageable declined with increasing PSA at scan (AUC = 0.68).Early Ga68-PSMA PETCT for rising PSA after definitive prostate radiotherapy detected majority of recurrent lesions and identified oligorecurrences amenable to focal salvage therapy.

Hands-on learning is a staple in high school science education, as it provides students with a fast-learning curve and a great degree of field competency. However, due to the safety risks associated with high school students in university chemistry laboratory settings, high school students rarely engage in authentic hands-on chemical learning. To bridge the gap between the benefits and drawbacks, this study investigates a method to educate high school students (with no previous experience) about standard chemical laboratory practices. 98 high school students experimented throughout two days to determine the molecular weights and characteristics of various polystyrene samples, essential knowledge for polymer recycling. Students were split into 5 groups so that laboratory usage be organized and staggered. After laboratory safety training was administered, students created different types and concentrations of toluene-based samples and spin casted these samples onto silicon wafers, determining thickness through ellipsometry. With the data, each group calculated molecular weight, propagated error, and wrote laboratory reports. In order to evaluate the extent of learning through this process, students were given pre-training and post-experimentation assessments with the same questions pertaining to laboratory safety, equipment usage, and materials science related topics. On average, students displayed scores 63% higher on the post-experiment assessment compared to those of the pre-training assessment. The results suggest the experience not only taught students about the various materials science concepts, but also improved their laboratory logic. Therefore, our method is recommended to be implemented at the university level for motivated high school and first-year undergraduate students.

The aim of this study was to characterize the educational quality and reliability of YouTube videos related to low back pain (LBP) as well as to identify factors associated with the overall video quality. A review of YouTube was performed using two separate search strings. Video-specific characteristics were analyzed for the first 50 videos of each string. Seventy-seven eligible videos were identified as a result. The mean Journal of the American Medical Association score was 2.25 ± 1.09 (range: 0-4) out of 4. The mean Global Quality Score (GQS) score was 2.29 ± 1.37 (range: 1-4) out of 5. The mean LBP score (LPS) score was 3.83 ± 2.23 (range: 0-11) out of 15. Video power index was a predictor of GQS score (β = 55.78, p = 0.048), whereas the number of likes (β = -2.49, p = 0.047) and view ratio (β = -55.62, p = 0.049) were associated with lower quality scores. Days since initial upload (β = 0.32, p = 0.042) as well as like ratio (β = 0.37, p = 0.019) were independent predictors of higher LPS scores. The results of this study suggest that the overall reliability and educational quality of videos uploaded to YouTube concerning LBP are unsatisfactory. More popular videos demonstrated poorer educational quality than their less popular counterparts. As the prevalence of LBP rises, more accurate and thorough educational videos are necessary to ensure accurate information is available to patients.

Highlights • A knowledge-based planning model was configured for VMAT of cervical cancer. • Knowledge-based plans were comparable, and for some OARs, outperformed clinical plans. • Improved organ sparing was observed, when individual patient geometry was considered., Background and Purpose Knowledge-based planning (KBP) is based on a model to estimate dose-volume histograms, configured using a library of historical treatment plans to efficiently create high quality plans. The aim was to report configuration and validation of KBP for Volumetric Modulated Arc Therapy of cervical cancer. Materials and methods A KBP model was configured from the institutional database (n = 125), including lymph node positive (n = 60) and negative (n = 65) patients. KBP Predicted plans were compared with Clinical Plans (CP) and Re-plans (Predicted plan as a base-plan) to validate the model. Model quality was quantified using coefficient of determination R2, mean square error (MSE), standard two-tailed paired t-test and Wilcoxon signed rank test. Results Estimation capability of the model was good for the bowel bag (MSE = 0.001, R2 = 0.84), modest for the bladder (MSE = 0.008) and poor for the rectum (MSE = 0.02 R2 = 0.78). KBP resulted in comparable target coverage, superior organ sparing as compared to CP. Re-plans outperformed CP for the bladder, V30 (66 ± 11% vs 74 ± 11%, p

BACKGROUND Non-Invasive Positive Pressure Ventilation (NIPPV) is very useful to treat the patients of Hypercapnic Respiratory Failure (HRF) due to Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD). The aim of this study was to understand the clinical profile of patients presenting to the emergency department with AECOPD presenting as hypercapnic respiratory failure and their outcomes. METHODS This was a prospective study included a total of 70 consecutive patients presenting with hypercapnic respiratory failure due to AECOPD. Presence of comorbidities & risk factors of patients were taken into account. Clinical outcomes in form of ICU transfers, patients needing invasive mechanical ventilation (IMV) and mortalities were taken into account. RESULTS Male to female ratio was 1:0.23 with average duration of symptoms of 9.21±3.2 years. Mean age of presentation was 60.6±8.2 years. Smokers constituted 78% (n=55). Out of a total of 70 patients (n=70), 22.8% (n=16) were transferred to the ICU, out of which 17% (n=12) were put on IMV and 11.4% (n=8) of them died. ICU transfers and increased mortality was observed in patients with multiple comorbidities as compared to patients with single comorbidity. CONCLUSIONS Patients with AECOPD with age of more than 60 years, having comorbid conditions, high pCO2 values, had a higher chance of clinical deterioration and transfer to the ICU and warranted need of mechanical ventilation with increased mortality. Early assessment of above parameters can aid in predicting the outcome in such patients.

Purpose The study is an audit of reporting dose and volume specifications as per the ICRU 58 for MUPIT-based interstitial brachytherapy in gynecological cancers. Correlation between total reference air kerma (TRAK) and isodose surface was also evaluated to understand the intensity of treatment in interstitial brachytherapy. Methods and Materials Forty-two patients underwent HDR MUPIT-based interstitial brachytherapy 20 Gy in five fractions after EBRT during 2017–2019. Treated volume, high and low-dose regions, mean central dose, Dose Homogeneity Index (DHI), organ at risk doses, and TRAK values were computed. Results High-dose regions V150 mean was 12.4 cc and V200 was 4.58 cc; and low-dose region was 75.92 cc. The mean treated volume was 59.8 cc. The mean central dose was 3.7 Gy. DHI was 79%. The mean D2cm3 bladder and rectum were 2.9 Gy and 2.8 Gy. The mean TRAK was 0.16 cGy per fraction per hour at 1 m. TRAK values showed significant correlation with various isodose volumes (TRAK and V100: r = 0.943 p Conclusions Our study shows compliance with ICRU 58 recommendations along with certain deviations. Local recurrence rate is acceptable. TRAK shows correlation with surface isodose in MUPIT-based brachytherapy and should to be evaluated in future studies.

Snow physical properties, snow cover and glacier facies are important parameters which are used to quantify snowpack characteristics, glacier mass balance and seasonal snow and glacier melt. This study has been done using C-band synthetic aperture radar (SAR) data of Indian radar imaging satellite, radar imaging satellite-1 (RISAT)-1, to estimate the seasonal snow cover and retrieve snow physical properties (snow wetness and snow density), and glacier radar zones or facies classification in parts of North West Himalaya (NWH), India. Additional SAR data used are of Radarsat-2 (RS-2) satellite, which was used for glacier facies classification of Smudra Tapu glacier in Himachal Pradesh. RISAT-1 based snow cover area (SCA) mapping, snow wetness and snow density retrieval and glacier facies classification have been done for the first time in NWH region. SAR-based inversion models were used for finding out wet and dry snow dielectric constant, dry and wet SCA, snow wetness and snow density. RISAT-1 medium resolution scan-SAR mode (MRS) in HV polarization was used for first time in NWH for deriving time series of SCA maps in Beas and Bhagirathi river basins for years 2013–2014. The SAR-based inversion models were implemented separately for RISAT-1 quad pol. FRS2, for wet snow and dry snow permittivity retrieval. Masks for layover and shadow were considered in estimating final snow parameters. The overall accuracy in terms of R2 value comes out to be 0.74 for snow wetness and 0.72 for snow density based on the limited ground truth data for subset area of Manali sub-basin of Beas River up to Manali for winter of 2014. Accuracy for SCA was estimated to be 95 % when compared with optical remote sensing based SCA maps with error of ±10 %. The time series data of RISAT-1 MRS and hybrid data in RH/RV mode based decompositions were also used for glacier radar zones classification for Gangotri and Samudra Tapu glaciers. The various glaciers radar zones or facies such as debris covered glacier ice, clean or bare glacier ice radar zone, percolation/refreeze radar zone and wet snow, ice wall etc., were identified. The accuracy of classified maps was estimated using ground truth data collected during 2013 and 2014 glacier field work to Samudra Tapu and Gangotri glaciers and overall accuracy was found to be in range of 82–90 %. This information of various glacier radar zones can be utilized in marking firn line of glaciers, which can be helpful for glacier mass balance studies.

The present study aims to estimate the long term changes in sea ice areal extent (SIAE) around Antarctica using Special Sensor Microwave Imager (SSM/I) satellite data (1988–2011). Daily, weekly and monthly brightness temperature (TB) maps of Antarctica have been generated. Temporal variation in monthly averaged TB values of sea ice have been analyzed and an increasing trend is observed in TB. Sea ice concentration (SIC) values are estimated and the concentration class 0.85–0.95 is observed as the main contributor in sea ice areal extent during the Antarctic peak winter month i.e. September and October. SIC changes rapidly from October onwards and shows fast melting of sea ice, however, from April start of freezing has been observed. Continuous increase in SIAE is observed from February to September in all the analyzed years (1988–2011) data. In this observation period maximum SIAE is observed in September 1989 and minimum in February 1993. The Moderate Resolution Imaging Spectroradiometer (MODIS) data is used for the validation of SIAE values. SSM/I and MODIS estimated SIAE values are compared (R2 = 0.98) and a relation between them is established by performing regression analysis. This relation is further used for the estimation of corrected SIAE values. The monthly average sea ice extent maps of last three decades have been analyzed and a shift in onset of freezing of sea ice has been observed. The period of frozen sea has also been observed as decreased.

We sought to examine the incidence of complications and change in pulmonary artery pressure in patients with pulmonary hypertension who were undergoing pulmonary angiography.A retrospective review was performed for all patients who underwent pulmonary angiography over a 10-year period at a single institution. Patients with moderate pulmonary hypertension (pulmonary artery pressure, 30-59 mm Hg) and severe pulmonary hypertension (pulmonary artery pressure,/= 60 mm Hg) served as the study population. Demographic data, clinical indication, pre- and postcontrast pulmonary artery pressure measurements, type of pulmonary hypertension, contrast agent volume, complications, and American Society of Anesthesiologists (ASA) classification were recorded for all patients and compared.Two hundred two of 612 patients who underwent pulmonary angiography had pulmonary hypertension. Moderate pulmonary hypertension was present in 155 patients (77%) and severe pulmonary hypertension, in 47 patients (23%). Three (2.0%) of four complications were fatal. The complication rate was higher in patients with severe pulmonary hypertension compared with patients with moderate pulmonary hypertension but not statistically significant (6.3% vs 0.6%, p = 0.63). Patients with complications had a higher mean ASA score than those without complications (4.0 vs 3.0, p = 0.03). Patients with lung transplants had the greatest increase in pulmonary artery pressure after pulmonary angiography compared with all other clinical indications (16.75 +/- 12.97 mm Hg vs 5.46 +/- 6.86 mm Hg, p = 0.003).The complication rate of pulmonary angiography in patients with pulmonary hypertension is low. However, in severely ill patients with acute pulmonary hypertension, pulmonary angiography should be undertaken with extreme caution.

Peak expiratory flow rate (PEFR) is a simple, reliable, and easily reproducible and measurable lung function test. It has not been formally assessed whether the PEFR values measured with peak flow meter are in close correlation with the values measured by digital spirometer. The present study is carried out to determine whether there is a significant difference between the PEFR values derived from digital spirometer and peak flow meter in patients with respiratory symptoms. How to cite this article Tiwari VK, Bansal S, Sood S, Kumar A, Shukla R. Comparative Evaluation of Peak Expiratory Flow Rate between Computerized Spirometry and Peak Flow Meter. Int J Adv Integ Med Sci 2016;1(3):93-94.

PURPOSE To determine the acute and short-term effects the Sutura 8-F SuperStitch and Perclose 6-F Closer devices have on the femoral artery, as determined by angiography and pathologic examination. MATERIALS AND METHODS From a common carotid artery cutdown, eight pigs underwent pelvic angiography (i) before placement of bilateral common femoral artery vascular sheaths, (ii) after sheath insertion, and (iii) after device deployment. Two pigs were immediately killed; six survived 4 weeks for repeat angiography and vessel harvest. RESULTS Average vessel diameter before sheath insertion was 5.9 mm=0.6 and 5.8 mm=0.6 for vessels with Perclose and Sutura devices, respectively. After deployment of the Sutura device, there was a 44.7% ( P = .001) mean diameter reduction from preprocedural diameters, compared to a 59.3% reduction ( P P = .53) versus the diameter immediately after sheath placement. After deployment of the Perclose device, there was a mean vessel diameter reduction of 43.8% ( P = .05) versus the diameter immediately after sheath placement. At 4-week angiography, all vessels returned to their original diameters before sheath insertion. Pathologic examination showed mild adventitial fibrosis creating a "fibrous hood" surrounding the suture and vessel. CONCLUSIONS Despite significant luminal compromise after device deployment, all vessels appeared normal on angiography at 4 weeks. Contrary to the normal angiographic findings, both devices incited periadventitial fibrosis, which created a fibrous hood around the suture and vessel.