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Introduction The radiotherapy of left-sided breast cancers is challenging because of neighboring critical organs, posing an increased risk of complications. Various radiation delivery techniques have been used to deliver the desired dose of radiation to the target area while keeping the doses to nearby structures within constraints. The main aim of this study is to quantify doses delivered to the organs at risk (OARs) including heart, left lung, spinal cord, and contralateral breast, and to the planning target volume (PTV) using Field-in-Field (FIF) and Volumetric Modulated Arc Therapy (VMAT). Patients and methods A retrospective review of 15 left-sided breast cancer patients was done. All the patients underwent breast-conserving surgery and adjuvant radiation. For every patient, two different radiation treatment plans were formulated and compared for the PTV coverage and doses to OARs, including heart, ipsilateral lung, spinal cord, and contralateral breast. The radiation treatment techniques utilized for this purpose were FIF and VMAT. The homogeneity index (HI), and conformity index (CI) required for the treatment planning were also calculated. Data was analyzed using Statistical Package for the Social Sciences (IBM Corp., Armonk, USA). An Independent T-test was used for statistical analysis. Results The mean age was 41 years and the majority of them were stage II. Total nine patients were given 4005centi Gray (cGy) in 15 fractions (fr) followed by 10Gy boost, hence receiving a total dose of 5005cGy in 20fr. While remaining six patients were given a total dose 4005cGy in 15fr without any boost. All patients were hypofractionated and the dose was delivered at a rate of 267cGy per fr. The FIF technique utilized in breast cancer radiation significantly reduced the mean doses to OARs: mean heart dose (3.81cGy), ipsilateral lung dose (V16- 15cGy), mean contralateral breast dose (0.03cGy), and maximum spinal cord dose (0.18cGy); as compared to VMAT technique which delivered comparatively higher doses: mean heart dose (8.85cGy), ipsilateral lung dose (V16- 19.82cGy), mean contralateral breast dose (4.59cGy), and maximum spinal cord dose (7.14cGy). There was a significant mean difference between doses of OARs and all p-values were statistically significant (p

Introduction: Thinking, planning or even unsuccessful attempts of suicide come under the definition of suicidal ideation. The risk factor known to be the most important cause for suicidal thoughts is anxiety or feeling stressed, to which medical students are predisposed to due to a wide range of reasons from academics to personal pressures. Objectives: To establish the risk factors and frequency of suicidal ideation amongst medical students. Methodology: A cross-sectional study was done to ascertain the frequency of suicidal ideation and the risk factors causing it in medical students. A questionnaire was formulated and filled by the participants with a 100% response rate. Final data were analyzed with the help of SPSS version 17.0 and the descriptive statistics e.g. percentage and frequencies were calculated. Results: Out of the 250 participants, 84% reported they have depression. 34% of the total students that participated claimed to have suicidal ideation in the previous year. 5.6% reported experiencing suicidal ideation once a week. 7.2% of participants reported that they might be capable of attempting suicide while 4.4% of participants reported that they are definitely capable of committing suicide. Of the total 2.4% reported having attempted suicide while 0.4% reported having attempted suicide more than once in their life. Conclusion: The crux of this research was that the vulnerability of these medical students to feel depressed and experience suicidal ideation is high. The most significant contributor to this trend, as the research explores, is the stress level due to the academic burden that the medical students experience.

Successful cementation of low fracture gradient reservoir sections poses its own challenges for the operators. Such cement systems shall be competent enough to endure the stresses being imposed throughout the life cycle of the well ( cycles of pressure and temperature changes imposed by perforations, well testing, work-over operations and etc.) and at the same the existence of relatively low fracture gradients formations will limit the upper range density of such systems. Blended light weight cement systems by adopting a new approach to designing cement slurries effectively decouple the physical properties of set cement from the slurry properties and density, resulting in high performance lightweight cement slurries. Conventional blends have some components with limited pressure rating that will collapse trader high pressure and therefore the slurry properties can change dramatically to the point where the cementing job objectives can be jeopardized. The before mentioned challenge becomes more evident when the case is related to the cementation of a deep and low fracture gradient reservoir section. Rajian oil field in north of Pakistan have been put into regular production since 1994 with reservoir section total depths of 3850 m ( +/ -). Recent development wells required the operator to use light weight cement where conventional light weight blended solution could not be utilized due to the excessive down-hole pressures those system would be subjected to during the cementation operations. This paper will briefly review the existing methods to achieve light weight cement slurry and will focus on the high-pressure light-weight blended slurry system through a case study in Rajian field.