Till date scientists are struggling to understand the complete mechanism of carcinogenesis. In future, the real time detection of cancer may help scientists to identify some of the complicated biological mechanisms. Certain special features of cancer cells enable researchers to deliver the drug or to develop the right drug therapy. These cell properties include over expression or over activity in uptake of certain nutrients e.g. folic acid and increased permeability. Listed properties might vary depending upon the type of cancer and can be fully exploited by using nanoparticles either to detect the site of cancer or to direct the drug at the affected site. Product approach like drug conjugates, complexes serves as a good platform to solve issues like solubility, toxicity, poor penetration and stability related to cancer drugs. Beside this, several drug delivery platforms are under development by researchers in academia as well as in industry to deliver therapeutic molecules and new chemical entities to the targeted site in body. Amongst them, nanotechnology both at molecular and supramolecular level is a leading platform and can help to image, detect and treat cancer. Surface modification of nanoparticles by coating or anchoring their surface with special markers, materials, peptide, proteins, antibodies or antigens add extra feature and thereby can enhance the effectiveness. These treatments can be used individually or in combined form. In this review, advances on nanotechnological platform are discussed together with some assisting techniques like magnetic field, photo or light field, sonic rays are touched upon. New biological therapies that are advancing in this direction include the antisense therapy, cell therapy, gene therapy, radiation therapy and SiRNA interfaces which are discussed in brief in this article. This article gives short overview on use of complementary and alternative medicine for treatment of cancer such as traditional Chinese medicine (TCM), Ayurveda to avoid toxic effects of synthetic drugs.

http://www.ijcto.org/index.php/IJCTO/article/download/0301.14/ijcto.0301.14pdf

Cancer research and therapy: Where are we today?

Context: Urban population in India is growing exponentially. The public sector urban health delivery system has so far been limited in its reach and is far from adequate. Aims: This study aims to estimate routine immunization coverage and associated factors among children (12–23 months and 60–84 months) in the urban Kochi Metropolitan Area of Kerala. Settings and Design: A cross-sectional study was conducted in Kochi Metropolitan area. Materials and Methods: A cluster sampling technique was used to collect data on immunization status from 310 children aged between 12 and 23 months and 308 children aged between 60 and 84 months. Statistical Analysis: Crude coverage details for each vaccine were estimated using percentages and confidence intervals. Bivariate and multivariate analysis were conducted to identify factors associated with immunization coverage. Results: Among the children aged 12–23 months, 89% (95% CI 85.5%-92.5%) were fully immunized, 10% were partially immunized, and 1% unimmunized. Less than 10 years of schooling among mothers (OR 2.40, 95% CI 1.20–4.81) and living in a nuclear family (OR 1.72, 95% CI 1.06–3.14) were determinants associated with partial or unimmunization of children as per multivariate analysis. The coverage of individual vaccines was found to decrease after 18 months from 90% to 75% at 4–5 years for Diphtheria Pertussis Tetanus (DPT) booster. Bivariate analysis found lower birth order and belonging to the Muslim religion as significant factors for this decrease. Conclusion: Education of the mother and nuclear families emerged as areas of vulnerability in urban immunization coverage. Inadequate social support and competing priorities with regard to balancing work and home probably lead to delay or forgetfulness in vaccination. Therefore, a locally contextualized comprehensive strategy with strengthening of the primary health system is needed to improve the immunization coverage in urban areas.

Assessment of vaccine coverage and associated factors among children in urban agglomerations of Kochi, Kerala, India

PURPOSE The aim of this study is to validate the RayStation Monte Carlo (MC) dose algorithm using animal tissue neck phantoms and a water breast phantom. METHODS Three anthropomorphic phantoms were used in a clinical setting to test the RayStation MC dose algorithm. We used two real animal necks that were cut to a workable shape while frozen and then thawed before being CT scanned. Secondly, we made a patient breast phantom using a breast prosthesis filled with water and placed on a flat surface. Dose distributions in the animal and breast phantoms were measured using the MatriXX PT device. RESULTS The measured doses to the neck and breast phantoms compared exceptionally well with doses calculated by the analytical pencil beam (APB) and MC algorithms. The comparisons between APB and MC dose calculations and MatriXX PT measurements yielded an average depth difference for best gamma agreement of <1 mm for the neck phantoms. For the breast phantom better average gamma pass rates between measured and calculated dose distributions were observed for the MC than for the APB algorithms. CONCLUSIONS The MC dose calculations are more accurate than the APB calculations for the static phantoms conditions we evaluated, especially in areas where significant inhomogeneous interfaces are traversed by the beam.

https://aapm.onlinelibrary.wiley.com/doi/pdf/10.1002/acm2.12733

Validation of the RayStation Monte Carlo dose calculation algorithm using realistic animal tissue phantoms.

Objective

To assess willingness for the coronavirus disease 2019 (COVID-19) vaccine and identify the factors attributing to the willingness.

Design

A cross-sectional study was conducted, adopting an exponential, non-discriminative snowball sampling technique. The questionnaire collected the socio-demographic profile, history of COVID-19 infection, presence of co-morbidities (diabetes mellitus, hypertension, chronic obstructive pulmonary disease (COPD), asthma, cancer), willingness, and preference of vaccine among participants. An online platform (Google Forms) was used to collect data from all over India. A total of 2032 Indian adults aged above 18 years were included in the study.

Results

Around 1598 (78.6%) expressed willingness to receive the COVID vaccine, and among the healthcare providers (HCPs), 579 (80.3%) were willing for COVID vaccination. Factors like the belief that the vaccine is necessary (aOR=1.68, 95% CI =1.34 to 2.11), respondents having no history of COVID infection (aOR=0.71, 95% CI: 0.52 to 0.97), having trust in the government (aOR=6.09, CI: 4.59 to 7.98), people who felt the cost of the vaccine didn’t matter (aOR=4.92, CI: 3.80 to 6.37), and respondents with no perceived risk of COVID infection (aOR=0.63; CI: 0.47 to 0.83) were more associated with willingness for COVID vaccination.

Conclusions

An effective vaccine should be well-received by the public. The responsibility lies with the government, health authorities, and manufacturers to take appropriate steps to dispel rumors in order to ensure people’s understanding and acceptance.

/pdf/determinants-of-willingness-for-covid-19-vaccine-3qhg2ihj3n.pdf

Determinants of Willingness for COVID-19 Vaccine: Implications for Enhancing the Proportion of Vaccination Among Indians

Purpose Our purposes are to compare the accuracy of RaySearch's analytical pencil beam (APB) and Monte Carlo (MC) algorithms for clinical proton therapy and to present clinical validation data using a novel animal tissue lung phantom. Methods We constructed a realistic lung phantom composed of a rack of lamb resting on a stack of rectangular natural cork slabs simulating lung tissue. The tumor was simulated using 70% lean ground lamb meat inserted in a spherical hole with diameter 40 ± 5 mm carved into the cork slabs. A single-field plan using an anterior beam and a two-field plan using two anterior-oblique beams were delivered to the phantom. Ion chamber array measurements were taken medial and distal to the tumor. Measured doses were compared with calculated RayStation APB and MC calculated doses. Results Our lung phantom enabled measurements with the MatriXX PT at multiple depths in the phantom. Using the MC calculations, the 3%/3 mm gamma index pass rates, comparing measured with calculated doses, for the distal planes were 74.5% and 85.3% for the APB and 99.1% and 92% for the MC algorithms. The measured data revealed up to 46% and 30% underdosing within the distal regions of the target volume for the single and the two field plans when APB calculations are used. These discrepancies reduced to less than 18% and 7% respectively using the MC calculations. Conclusions RaySearch Laboratories' Monte Carlo dose calculation algorithm is superior to the pencil-beam algorithm for lung targets. Clinicians relying on the analytical pencil-beam algorithm should be aware of its pitfalls for this site and verify dose prior to delivery. We conclude that the RayStation MC algorithm is reliable and more accurate than the APB algorithm for lung targets and therefore should be used to plan proton therapy for patients with lung cancer.

https://aapm.onlinelibrary.wiley.com/doi/pdf/10.1002/acm2.12777

Validation of the RayStation Monte Carlo dose calculation algorithm using a realistic lung phantom

In vitro dosimetric verification prior to patient treatment has a key role in accurate and precision radiotherapy treatment delivery. Most of commercially available dosimetric phantoms have almost homogeneous density throughout their volume, while real interior of patient body has variable and varying densities inside. In this study an attempt has been made to verify the physical dosimetry in actual human body scenario by using goat head as "head phantom" and goat meat as "tissue phantom". The mean percentage variation between planned and measured doses was found to be 2.48 (standard deviation (SD): 0.74), 2.36 (SD: 0.77), 3.62 (SD: 1.05), and 3.31 (SD: 0.78) for three-dimensional conformal radiotherapy (3DCRT) (head phantom), intensity modulated radiotherapy (IMRT; head phantom), 3DCRT (tissue phantom), and IMRT (tissue phantom), respectively. Although percentage variations in case of head phantom were within tolerance limit (< ± 3%), but still it is higher than the results obtained by using commercially available phantoms. And the percentage variations in most of cases of tissue phantom were out of tolerance limit. On the basis of these preliminary results it is logical and rational to develop radiation dosimetry methods based on real human body and also to develop an artificial phantom which should truly represent the interior of human body.

Radiation dose verification using real tissue phantom in modern radiotherapy techniques.

Introduction: Immunization is one of the most cost-effective measures in public health to date, preventing at an approximately 2 to 3 million fatalities in young children every year. As per recent World Health Organisation (WHO) bulletin, these lifesaving vaccines have been successfully averted around 20 million premature deaths and 500 million disease cases. Inspite of this progress the routine vaccine coverage is slow to rise as challenges still live for the underserved, inaccessible and vulnerable children. It is therefore essential to evaluate the coverage of immunization at periodic intervals and to take the required measures to enhance the vaccination status in the State Bihar. Aims and Objective: This study aims to find out the vaccination coverage in different Blocks of study area. Material and Methods: The study was community based cross sectional study which was conducted between January to March 2019 in the selected villages of 59 low performing blocks of Bihar. The study subjects were all the children aged 12-23 month old from selected low performing blocks of the Bihar. Results-Corrected FIC of the study was 90.85%. Close to nine percent (8.8%) children thou have started vaccination could not able to complete it. Rest of the beneficiaries are completely left out. The most common reason for incomplete immunization was unavailability of child on the day of vaccination followed by sickness of the child. Conclusion: The overall Immunization coverage of Bihar is less than the National Immunization coverage as per NFHS-4. This study shows higher rate of immunization as far as Corrected Immunization Coverage is concerned.

Immunization coverage among children aged 12-23 months: A cross sectional study in low performing blocks of Bihar, India

The word “Rabies” is derived from Latin word ‘Rabus’, which in turn is derived from the Sanskrit word ‘Rabhas’ which means ‘to do violence’. It is transmitted to humans usually by bites and licks of rabid animals. In India, the dog has always existed as the main reservoir of rabies. The WHO World Survey of Rabies for the year 1997 gave an estimate of between 35,000 and 50,000 cases annually. Globally Asia contributes to highest Rabies mortality; with the highest incidence reported in India followed by China. National Multicentric Rabies Survey projected the latest figure of 20565 human deaths from rabies annually; thereby contributing approximately 60% to the total Asian deaths. The actual number of cases and deaths in India may be much higher because ABSTRACT

/pdf/descriptive-profile-of-patients-attending-antirabies-clinic-45c21yzawo.pdf

Descriptive profile of patients attending antirabies clinic: a hospital based study of animal bite cases in Patiala

Background: Craniospinal irradiation (CSI) of medulloblastoma poses technological challenges due to the involvement of large treatment volume. Commonly, the whole treatment length is covered with two different isocentric plans in which the junction is shifted after every five fractions to overcome the possibility of hot and cold spot. Objective: This study aims to evaluate dosimetrically and clinically the innovative planning technique for the CSI which doesn’t need re-planning and re-setup of patients after every five fractions. Material and Methods: Computed tomography was done for fifteen (ten children and five adults) patients diagnosed with medulloblastoma. Treatment planning for 36 Gray (Gy) in 20 fractions (#) at the rate of 1.8Gy/# was done on the treatment planning system. A single plan for children was created with two bilateral fields of 6 Mega Voltage (MV) energy for cranium and one posterior field of 6 MV for spinal cord (C1-S2). Two plans for adult patients were created, first plan was with two bilateral fields of 6 MV for cranium and two posterior oblique fields of 6 MV for cervical and the part of thoracic spinal cord (up to T8-T9). The second plan was with a single posterior field of 15 MV covering remaining thoracic (T8-T9 to T12), lumbar and sacrum (up to lower border of S2) spine. After careful evaluation of all the plans, treatment was delivered; acute toxicities were recorded. Results: 95% of prescribed dose was received by more than 95% of planning target volume in all the plans with the acceptable hot spot and good homogeneity index. All the patients reported common radiation induced acute toxicities (headache, vomiting, weakness) during radiotherapy. Conclusion: The new planning technique for CSI has acceptable dosimetric and acute clinical possibilities; therefore it can be used for CSI for improved homogeneous dose delivery.

https://jbpe.sums.ac.ir/article_46368_890379fcac03f0e15436bdc77c463c24.pdf

Craniospinal Irradiation in Medulloblastoma using High Energy Medical Linear Accelerator: an Innovative Approach to Planning Technique

The health of future generations is to a great extent determined by the child’s growth and development within the uterus. The success of fetal life determines not only the health of the newborn, but also has a major effect on adult health and disease risk. Good perinatal health is therefore essential to individuals, to society and to future generations. Antenatal care (ANC) is an opportunity to encourage a positive pregnancy experience and improved maternal and child survival. Care in the antenatal period is also essential for supporting the long-term growth and development of the child as its part of the critical “1000 days” window. Globally two in three (65%) of pregnant women received the WHO recommended at least 4 antenatal visits throughout pregnancy. Latest study has shown a lower still birth rate, among mothers with a minimum of eight antenatal visits, based on which the minimum recommended number of antenatal contacts has now been increased from 4 to 8. According to World ABSTRACT

/pdf/utilization-of-antenatal-care-services-in-rural-population-25upl3eyxx.pdf

Shradha Mishra

Papers

Radiation dose verification using real tissue phantom in modern radiotherapy techniques.

Immunization coverage among children aged 12-23 months: A cross sectional study in low performing blocks of Bihar, India

Descriptive profile of patients attending antirabies clinic: a hospital based study of animal bite cases in Patiala

Craniospinal Irradiation in Medulloblastoma using High Energy Medical Linear Accelerator: an Innovative Approach to Planning Technique

Utilization of antenatal care services in rural population of north India: a cross sectional study