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Introduction: The practice of medicine is an honorable profession besides being accompanied by a demanding environment. This study aimed to find out the professional quality of life of medical doctors working in Kathmandu valley. Methods: A descriptive cross-sectional study was conducted among 174 Nepalese medical doctors working in different hospitals of Kathmandu valley. Ethical approval was taken from the Ethical Review Board of the Nepal Health Research Council (Reference Number: 830). The data collection tool used in the study was WHO Professional Quality of Life Scale-5 to collect data about Compassion satisfaction, Burnout and Secondary traumatic stress among medical doctors working in Kathmandu valley. Data analysis was done in the Statistical Package for the Social Sciences version 16.0. Results: Out of 174 participants, 101 (58%), 126 (72.4%) and 135 (77.6%) were found to have moderate level of Compassion satisfaction, Burnout and Secondary Traumatic Stress respectively. Conclusions: More than half, nearly two-third, and more than two-third participants had moderate levels of Compassion satisfaction, Burnout and Secondary Traumatic Stress respectively. The overall study findings reflected good balance between Compassion satisfaction and Compassion fatigue (burnout and secondary traumatic stress) among the Nepalese medical doctors. Further assessment of professional quality of life of doctors as well as other health care workers via Multifaceted and large-scale study is recommended.

Extracorporeal irradiation is relatively a rare method used in the management of malignant bone tumors . It consists of en block removal of the tumor bearing bone segment, removal of the tumor from the bone, irradiation and re implantation back in the body. Keywords: extracorporeal irradiation; malignant bone tumors; osteosarcoma.

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Introduction: Cervical carcinoma is an important women’s health problem throughout the world. There are very few published data on this disease in Nepal. We wanted to study the pattern of cervical carcinoma based on hospital data. Methods: A 10 years retrospective study of scenario of cervical carcinoma was conducted. The data have been analyzed according to age, occurrence of other cancers, histological type, religion, risk factors and district wise. Results: The number of cervical carcinoma showed a rising pattern over the 10 year period. The median age of the patients was 45 years and maximum frequency (33%) of cases were found in the age group 40 to 49 years. Squamous cell carcinoma comprised 40% of cases, Adenocarcinoma 4% and 1.1% cases were of mixed variety. 92% of cases were Hindu by religion. 43% of patients were smoker in our study, 5% had positive family history. Chitwan with 7.35% had the maximum number of cases followed by Rupandehi with 6.40% and Nawalparasi with 5.41%. Conclusions: The cancer pattern revealed by the present study provides valuable leads to cervical cancer epidemiology in Nepal. Routine cytological screening of the population for cervical cancer is highly necessary for its early detection and treatment. Key Words: Cervical carcinoma, hospital based study, Nepal, pattern

Radiotherapy mainly involves treatment of patients with malignant tumors. Even with recognition of the risks of late skin injury, carcinogenesis, leukemogenesis, and genetic damage from all ionizing radiation; radiation therapy also continues to be accepted treatment for benign diseases. Before initiation, the quality of irradiation, total dose, overall time, underlying organs at risk, and shielding factors should be considered. Children should be treated with ionizing radiation only in very exceptional cases and after weighing the pros and cons of the therapy. Direct irradiation of skin areas overlying organs that are particularly prone to late effects (e.g. thyroid, eye, gonads, bone marrow and breast) should be avoided. Radiation protection techniques should be used in all instances. The depth of penetration of the x-ray beam should be chosen according to the depth of the pathologic process. Choice of beam energy usually depends on the depth of the target volume; every effort is made to spare normal underlying tissue in superficial lesions. There are a number of other benign conditions that can be treated with radiotherapy; we present a brief overview of some of the commonly encountered conditions. JNMA J Nepal Med Assoc. 2008 Jul-Sep;47(171):151-155.

Brachytherapy is potentially useful in the treatment of head-and-neck cancers, because most tumor sites, such as the lip, tongue, floor of mouth, tonsil, pharynx, nasopharynx, sinuses, and neck, are accessible for the placement of afterloading applicators and catheters. 1 It has the advantage of delivering a higher radiation dose to the tumor while sparing surrounding normal tissue from radiation. Furthermore, the overall treatment duration is shorter, and the dose distribution confirms to tumor shape. Brachytherapy is used as “monotherapy” for the treatment of small primary tumors or recurrent disease after external beam radiation therapy (EBRT). Small cancers of the lip (less than 2 cm) are treated equally well with surgery or radiation therapy with excellent cosmetic and functional results seen in radiation therapy. 2 We treated an 18-year old male diagnosed as stage I carcinoma lip with curative interstitial brachy-therapy. He was treated to a dose of 3 Gy per fraction, two fractions per day at interval of 6 hours between the two fractions for 6 days. He therefore received a total dose of 36 Gy with High Dose Rate (HDR) Brachytherapy, which is equivalent to 58.36 Gy conventional radiotherapy dose. At two months follow, the patient is clinically disease free and has no complaints. Key Words: Radiation Therapy, Interstitial Brachytherapy, Carcinoma Lip, Curative Treatment.

Radiation therapy is often used in an attempt to palliate or cure oesophageal neoplasms. However, the radiation tolerance of the normal structures around the oesophagus (heart, lung and spinal cord) restricts the radiation dose that can be delivered. We used a nasogastric catheter to deliver High Dose Intra-luminal Iridium-192 irradiation for carcinoma of the oesophagus using HDR-Varisource machine. This technique for treatment of carcinoma of the oesophagus can help overcome the dose restraints. The external beam radiation dose was about 46 Gy and the intra luminal dose was 5 Gy at 1 cm from central axis. These after loading procedures are simple, fast and accurate and can be used to boost external radiation therapy doses. Since the intra luminal boost delivers a high-localized dose with little side effects, this simple technique should be used to obtain palliation, delay tumour progression, reduce overall treatment time and attempt to improve survival in patients with oesophageal neoplasm. Intra luminal brachytherapy helps achieve good palliation in these neoplasms. abstract Key Words: Radiotherapy, intraluminal / endocavitary radiotherapy, Carcinoma oesophagus.

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