Research Article
Clinical Application of Portal Dosimetry for Pre-treatment Dosimetric Verification Across Various Diagnoses Using Electronic Portal Imaging Integrated with Epibeam
Issue:
Volume 13, Issue 1, February 2025
Pages:
1-7
Received:
19 December 2024
Accepted:
3 January 2025
Published:
7 February 2025
DOI:
10.11648/j.ajcem.20251301.11
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Abstract: Introduction and Objective: Unlike other LA users, most Elekta users use a 2D Array or other external devices for Patient specific QA purpose. In India, we experimented with a third-party portal dosimetry system called EPI Beam from DosiSoft, France, for PSQA. EPI (Electronic Portal Imaging) Beam Portal Dosimetry is a method used to verify the dose delivery in radiation therapy. It utilizes the Elekta iViewGT EPID to measure the radiation dose distribution delivered to the patient. The acquired portal images are then compared with the predicted dose distribution from the treatment planning system (TPS). The objective of this study is to analyze the gamma pass rate with this technology in various sites and treatment techniques in 100 patients. Material and methods: Pre-treatment verification using Portal Dosimetry was performed on 100 patients utilizing an Elekta iViewGT™ EPID and EPI Beam software on an Elekta Harmony Pro linear accelerator having 6 MV, 15 MV, and 6FFF photon energies. Elekta’s portal dosimetry system eliminates the need for a separate QA plan or a phantom, as the patient's treatment plan is directly delivered to the Electronic Portal Imaging Device (EPID) panel. The delivered dose is then calculated and compared to the planned dose, ensuring accurate dose delivery and proper linear accelerator functioning before the patient’s first treatment fraction. Results: In all plans that were done by Volumetric Modulated Arc Therapy (VMAT) for various diagnoses were analyzed and the average gamma pass rate for Head and Neck, Thoracic, Pelvis, Breast, are 99.34%, 98.97%, 98.78% and 99.35% respectively. Conclusions: The gamma evaluation indicates a good correlation between predicted and acquired EPID image doses. The EPID-based pre-treatment verification using EPI Beam from DosiSoft is a time-saving and comfortable tool for performing pre-treatment verification. This method enhances the precision and safety of cancer treatments.
Abstract: Introduction and Objective: Unlike other LA users, most Elekta users use a 2D Array or other external devices for Patient specific QA purpose. In India, we experimented with a third-party portal dosimetry system called EPI Beam from DosiSoft, France, for PSQA. EPI (Electronic Portal Imaging) Beam Portal Dosimetry is a method used to verify the dose...
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Research Article
A Study of Knowledge About Metered-Dose Inhaler Technique Among Health Care Providers in a Tertiary-Level Hospital
Mohammad Abdul Motalib*
Issue:
Volume 13, Issue 1, February 2025
Pages:
8-13
Received:
9 January 2025
Accepted:
22 January 2025
Published:
11 February 2025
DOI:
10.11648/j.ajcem.20251301.12
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Abstract: Background: According to the National Asthma Prevalence Study (NAPS), around seven million people in Bangladesh suffer from asthma. While inhaled medications are key to asthma treatment, incorrect inhaler techniques remain a global issue. This study aimed to assess healthcare providers' knowledge of metered-dose inhaler techniques in a tertiary hospital. Aim of the study: The aim of the study was to evaluate the knowledge and proficiency of healthcare providers in performing nine-steps of the metered-dose inhaler technique in a tertiary-level hospital. Methods: This cross-sectional observational study in the Department of Internal Medicine at Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital, Dhaka, from July to December 2015, involved 108 healthcare providers. Ethical approval and informed consent were obtained. Data were collected via interviews and observations, and analyzed using SPSS version 17.0 with Chi-square tests, considering p < 0.05 as significant. Results: In a study of 108 healthcare providers, 42.2% were in their fourth decade of life, with a mean age of 30.8 years. Of the respondents, 74.1% were doctors, while 25.9% were nurses. All respondents counseled on inhaler use, and 72.2% recommended inhaler medications. Over 70% removed the cap and shook the inhaler vigorously, with 96.3% breathing out slowly and completely. Doctors outperformed nurses in most steps, with significant differences except for breathing out slowly and completely (p = 0.228). Conclusion: Healthcare providers, particularly nurses, lack proficiency in the final steps of the metered-dose inhaler technique, with doctors generally outperforming nurses in all steps.
Abstract: Background: According to the National Asthma Prevalence Study (NAPS), around seven million people in Bangladesh suffer from asthma. While inhaled medications are key to asthma treatment, incorrect inhaler techniques remain a global issue. This study aimed to assess healthcare providers' knowledge of metered-dose inhaler techniques in a tertiary hos...
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Research Article
Assessment of Awareness of Anti-Tuberculosis Drug Resistance Among Tuberculosis Patients in a North-Central State of Nigeria
Oyeniyi Rasheed Muhammed,
Israel Olukayode Popoola,
Muhammed Mubashir Babatunde Uthman,
Ebenezer Obi Daniel*,
Taiwo Aderemi Popoola,
Ahmed Mamuda Bello,
Michael Avwerhota,
Adebanke Adetutu Ogun,
Celestine Emeka Ekwuluo,
Samuel Danladi Sam,
Solomon Utenwojo Adejo,
Michael Olabode Tomori,
Adedamola Amos Ogundeji,
Jacob Adebowale Adewole
Issue:
Volume 13, Issue 1, February 2025
Pages:
14-23
Received:
9 November 2024
Accepted:
23 November 2024
Published:
17 February 2025
DOI:
10.11648/j.ajcem.20251301.13
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Abstract: Tuberculosis (TB), a disease that remains preventable and curable, continues to represent a significant global health burden, particularly in regions like Nigeria. In this context, the emergence of drug-resistant strains of Mycobacterium tuberculosis poses an escalating challenge. This study aimed to assess awareness of anti-TB drug resistance among TB patients in Kwara State, Nigeria. Utilizing a descriptive cross-sectional design, data were gathered from 272 TB patients across six local government areas (LGAs) using a multi-stage sampling technique. Respondents were selected through a pre-tested, semi-structured questionnaire, targeting crucial socio-demographic factors, awareness levels, and other factors associated with drug resistance. Results revealed that 51.0% of the participants were male, and 64.5% lived in rural areas, with 43.3% having attained tertiary education. Alarmingly, over half of the respondents—62.8%—displayed poor awareness of anti-TB drug resistance, with only 4.1% demonstrating adequate knowledge of the concept. Additionally, merely 19.6% of the patients understood drug resistance, while only 6.5% were aware that multidrug-resistant TB (MDR-TB) is curable. These findings are concerning, especially since 10.2% of participants exhibited resistance to at least one first-line anti-TB drug, such as 2.9% to Isoniazid and 3.3% to Rifampicin. Furthermore, dual resistance to Rifampicin and Isoniazid was identified in 4.0% of respondents. Socio-demographic factors significantly affected TB prevalence, particularly among younger adults (40.8% of respondents were aged 30–39 years) and males (51.0%). However, there was no significant association found between resistance patterns and HIV status, as only 4.1% of respondents were HIV-positive. Contrastingly, behavioral factors such as alcohol consumption (17.1%) and history of close contact with TB patients (6.5%) were linked to increased drug resistance. Among those tested for second-line drug resistance, 4.1% displayed resistance, with specific cases involving combinations like Kanamycin and Protionamide. Notably, 27.8% had a history of incarceration, and 40% had been previously admitted to a hospital, both recognized as factors contributing to the spread of drug-resistant strains. Further analysis showed that only 10 (4.0%) of respondents experienced delayed treatment commencement, while 49.4% of participants reported never receiving any health talks or awareness about TB from their healthcare providers. Despite 86.9% of patients being informed about the lengthy treatment duration, there was a clear need for more comprehensive health communication. This study underscores the necessity for intensified public health interventions, emphasizing patient education, early diagnosis, and routine drug susceptibility testing prior to treatment initiation.
Abstract: Tuberculosis (TB), a disease that remains preventable and curable, continues to represent a significant global health burden, particularly in regions like Nigeria. In this context, the emergence of drug-resistant strains of Mycobacterium tuberculosis poses an escalating challenge. This study aimed to assess awareness of anti-TB drug resistance amon...
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