Mahatma Gandhi Memorial Medical College

About: Mahatma Gandhi Memorial Medical College is a education organization based out in Indore, Madhya Pradesh, India. It is known for research contribution in the topics: Dyslipidemia & Lipid profile. The organization has 210 authors who have published 123 publications receiving 1085 citations. The organization is also known as: MGM Medical College.

Clinical Experience of Intensity Modulated Radiotherapy Pre-Treatment Quality Assurance for Carcinoma Head and Neck Patients with EPID and IMatriXX in Rural Center.

Abstract: Background: Radiation therapy techniques as Intensity Modulated Radiotherapy (IMRT), rapid arc have been used for treatment of cancer with high accuracy. Objective: Verification of planned and delivered dose distribution is important, therefore current study aims to analyse quality assurance (QA) results of IMRT by Electronic Portal Imaging Device (EPID) and IMatriXX in head and neck Carcinoma (Ca H&N) patients.Material and Methods: In this experimental study, performance of an EPID and IMatriXX was assessed with dose measurements using ionization chamber. Calibrated IMatriXX and EPID are used for pre-treatment patient specific quality assurance (PSQA), for 122 patients’ plans of Ca H&N with IMRT treatment technique on linear accelerator. Dose images were acquired and compared with gamma evaluation (3% / 3 mm) and three scalar parameters, named average γ (γavg), maximum γ (γmax) and area gamma <1, were analyzed in the region of interest. Results: The γ correlation comparisons yielded average correlation of 0.990 and 0.982 for IMatriXX and EPID respectively. Maximum value of gamma is 0.998, while minimum gamma is 0.872 for IMatriXX and 0.953 for EPID. For students, unpaired ‘t’ test analysis is applied for comparison to two data sets. P-value was set at 0.005 which, for this study, was computed 0.001, showing good correlation between measured data with IMatriXX and EPID. Conclusion: The EPID and IMatriXX have significantly improved dosimetric properties, resulting in more sensitive, accurate measurements before actual treatment. The result shows EPID can be replaced with other dosimetry method and ionization chamber measurements. Portal imager is an efficient, accurate and sensitive dosimetry tool and is also the basis of pre-treatment quality assurance protocol.

Evaluation of beneficial effects of addition of intramuscular human tetanus immunoglobulin to intrathecal therapy in the treatment of tetanus

Abstract: Background: The treatment of tetanus has evolved from supportive management only to specific treatment to neutralize the tetanus toxins – tetanospasmin & tetanolysin. Human Tetanus Immunoglobulin (HTIg) is a large molecule and cannot cross the blood brain barrier. Introduction of intrathecal therapy considerably decreased mortality in the disease. Combined administration of intramuscular and intrathecal HTIg should neutralize the tetanus toxins in the circulation and central nervous system simultaneously. The study was done to detect beneficial effects of adding intramuscular HTIg to the intrathecal therapy. Methods: 125 patients of tetanus were randomized to two groups. Study group was given intrathecal plus intramuscular HTIg while control group was given intrathecal HTIg alone. Each group was subdivided into three grades according to severity. Mortality rate and three sequential recovery parameters i.e. duration of spasms, shift to oral therapy and duration of hospital stay were measured. Results: No significant difference in mortality was found. However, in patients who survived, the addition of intramuscular HTIg lead to a benefit of 2.07, 2.67 & 2.31 days in mild, moderate & severe grades respectively in the duration of spasms. Further, it became possible to start oral therapy 2.13, 1.6 & 1.8 days earlier in mild, moderate & severe tetanus. Duration of hospital stay was reduced by 3.87 days, 2.36 days and 3 days in mild, moderate and severe tetanus respectively. Conclusions: Though the addition of intramuscular HTIg to intrathecal therapy in tetanus does not confer any survival benefit, it causes faster recovery in patients who survive.

Tarlov Cyst: A Case Report

Abstract: Case Report: Tarlov cyst is rare perineural cyst, which may be symptomatic and present with with low back pain, sciatica, coccydynia or cauda equina syndrome. Symptomatic tarlov cyst needs to be removed surgically. We present such a rare case of symptomatic sacral cystic mass (tarlov cyst) presenting with severe lower back pain for months which was successfully treated by sacral laminotomy and cyst excision. The aim of reporting this case was to create awareness among the surgeons regarding this rare entity and to include it in differential diagnosis of chronic low back pain.

The study of the effect of C-PAP therapy in type-II diabetic patients with obesity and obstructive sleep apnea

Abstract: Type II diabetes mellitus (T2DM) is closely associated with Obstructive sleep apnea (OSA) and obesity. Type 2 diabetes and OSA may be pathophysiologically independent conditions although the joint association with obesity or visceral adiposity. There is a consistent relationship between obesity and OSA, which has been reported in 60-90% of OSA patients. The prevalence of obesity increases with a parallel increase in the prevalence of OSA. Continuous positive airway pressure (CPAP) therapy is an effective choice of treatment for OSA, an overnight test, or titration some patients may reduce apnea events by minimizes airway collapse by CPAP. Several studies showed that the effect of drug treatment with 3 months of C-PAP in patients with type 2 diabetes. In the present study, we include 300 patients in different groups, out of the 100 patients undergoing treatment of CPAP therapy minimum for three months. Blood sugar, HbA1c, and lipid profile were measured and an overnight sleep study was done. The obtained data shows the significant effect of therapy on physiological and biochemical parameters. AHI and BMI were highly significant in group II and Group III when compared to group I. FBS, HbA1C, and Lipid profile parameters also gave significance results (p-value <0.001) in group II and group III when compared with healthy subjects (group I).