Pelvic Area Research Articles

Quantification and assessment of Day-To-Day interfraction set-up errors in radiotherapy treatment delivery based on EPID detector

Abstract Introduction: The aim of this study was to determine whether the EPID detector can serve as an effective tool for interfractional dose control. Accurate radiotherapy delivery is vital for successful treatment, prompting advancements in dosimetry methods, particularly for dynamic techniques. Linear accelerators use kilovoltage and megavoltage X-rays to verify patient positioning, a standard practice essential for minimizing geometric and dosimetric errors. While integrated imaging systems typically use orthogonal radiographs, this method increases radiation exposure and fails to account for intra-fractional movements, risking undetected errors. To ensure patients receive the planned radiation dose, in-vivo dosimetry is performed by measuring the dose at various locations on the patient's body, which simultaneously verifies correct positioning. Discrepancies can reveal incorrect positioning or significant movements, thus enhancing treatment accuracy. This study investigates transit dosimetry using Electronic Portal Imaging Devices (EPID) to verify patient positioning during treatment. It establishes tolerance ranges and response criteria for the head and neck and pelvic areas, providing insights into the concordance between planned and actual dose distributions. Material and methods: The analysis included 30 patients treated with dynamic techniques in the pelvic (Pelvis) and head and neck (Head&Neck) areas. For each fraction, a fluence map was recorded using the EPID detector. This allowed for repeated comparisons between summary fluence maps across treatment fractions, totaling 1552 comparisons for the Head&Neck area and 2339 for the Pelvis area. To evaluate the correspondence between fluence map pairs, gamma indices were calculated using specified accuracy criteria. Results: Statistical analysis employed Chi-squared or Fisher's exact test, establishing significant correspondence within defined limits. For the Head&Neck area, repeatability was found within 3 mm and 4%; for the Pelvis area, it was within 4 mm and 4%. Conclusions: This method of verifying treatment repeatability is practical for clinical use, requiring no additional dose and not hindering treatment delivery.

Comparative magnetic resonance imaging-based study of pelvic floor morphology and function before pregnancy and after primigravida vaginal delivery

BackgroundVaginal childbirth is one of the main risk factors for pelvic floor dysfunction. Magnetic resonance imaging (MRI) can facilitate quantitative evaluation of the morphology and function of the pelvic floor in static and dynamic environments. The objective of this study was to investigate the changes in pelvic floor morphology and function in primigravida women before pregnancy (BP) and after vaginal delivery.MethodsPrimigravida women underwent pelvic floor MRI scans BP, at 3 months postpartum (3mPP), and at 6 months postpartum (6mPP). Various pelvic floor MRI data were measured, including the obturator internus muscle (OIM) area, anterior pelvic area, puborectalis muscle thickness (PRT), levator plate angle (LPA), iliococcygeal angle, bladder–pubococcygeal line (B-PCL), uterus–pubococcygeal line (U-PCL), puborectal hiatus line, muscular pelvic floor relaxation line, levator hiatus area, urethral mobility, bladder neck descent, and cervix descent.ResultsIn the resting state, the OIM area and PRT decreased whereas the anterior pelvic area increased from BP to 3mPP. During the straining maneuver, all parameters except U-PCL and urethral mobility showed statistically significant differences (P < 0.05). The OIM area and PRT increased whereas the anterior pelvic area decreased from 3mPP to 6mPP. During the straining maneuver, B-PCL, bladder neck descent, levator hiatus area, and LPA showed statistically significant differences (P < 0.05). In the resting state, the OIM area and PRT decreased whereas the anterior pelvic area increased from BP to 6mPP. During the straining maneuver, B-PCL, muscular pelvic floor relaxation line, and bladder neck descent showed statistically significant differences (P < 0.05).ConclusionVaginal delivery can cause pelvic floor injury that may gradually recover over time. However, the injury does not fully recover to the pre-pregnancy level within 6mPP.

Association of preoperative ultrasonographic parameters of the contralateral kidney with long-term serum creatinine in cats treated for unilateral ureteral obstruction

IntroductionPrediction of renal recovery after surgical management of feline unilateral ureteral obstruction (UO) is crucial to guide therapeutic decisions, but predictors of this outcome are still lacking. Despite the functional importance of the contralateral kidney, there is currently no precise description of its ultrasonographic (US) features. In addition, US parameters of both the renal collecting system and the renal parenchyma have been identified in human medicine as prognostic factors in the case of UO but have not been described in veterinary medicine. The aim of this study was to evaluate an association between preoperative structural US renal parameters and long-term International Renal Interest Society (IRIS) stage after successful renal decompression with subcutaneous ureteral bypass (SUB) device in cats with unilateral UO.MethodsThis retrospective study included 60 cats with unilateral UO and evaluated preoperative US parameters of both kidneys, including measurements of parenchymal and pelvic areas as well as a renal score. Cats were divided according to their serum creatinine at 3 months postoperatively into group A (IRIS stages I and II) and group B (IRIS stages III and IV).ResultsA higher US chronic kidney disease (US-CKD) score of the kidney contralateral to the UO was associated with long-term IRIS stages III and IV. It also appeared as a fair discriminator of long-term IRIS stage IV, with an area under the curve of 0.74. The optimal cutoff value for accurately identifying cats with long-term IRIS stage IV was a US-CKD score &amp;gt; 7, with a specificity of 98%, a sensitivity of 25%, and a positive likelihood ratio of 12.75. No preoperative US parameters regarding the obstructed kidney, including parenchymal and pelvic areas, were significantly associated with long-term creatinine.ConclusionUltrasonographic scoring of contralateral chronic kidney disease abnormalities is associated with IRIS stage following treatment of feline unilateral UO with a SUB device and serves as a specific indicator of cats presenting with long-term IRIS stage IV.

Progression of nutritional impact symptoms in cancer patients undergoing radiotherapy.

To analyze the presence of nutritional impact symptoms (NIS) throughout radiotherapy treatment in the head and neck, thorax, abdomen, and pelvis areas. A prospective cohort study was conducted with individuals undergoing radiotherapy for cancer. Three assessments were carried out: at the start of radiotherapy, midway through, and in the last week of treatment. Clinical, anthropometric data, and the Patient-Generated Subjective Global Assessment (PG-SGA) were used to assess symptoms. A total of 254 participants were evaluated at the start, 165 at the midpoint, and 120 at the end of the treatment. More than half of the participants at all stages were elderly. At the start, 51.6% were women, while at the end, 57.5% were men. Pelvic tumors were the most common, followed by tumors in the head and neck and thorax. The prevalence of NIS increased from 58.2% at the beginning to 76.9% at the midpoint (RR 1.32; 95% CI 1.17-1.48; p = < 0.001) and 78.3% at the end of treatment (RR 1.34; 95% CI 1.18-1.52; p = < 0.001). Odynophagia was the most reported symptom among patients with head and neck tumors, increasing from 24.5 to 66.6%, and from 3.0 to 22.2% by the end of treatment in patients with thoracic tumors. Diarrhea was common at the end of treatment among those with abdominal (69.2%) and pelvic (35.8%) tumors. NIS increased during radiotherapy. The location of tumors influences symptom prevalence, highlighting the need for continuous nutritional support.

Experience modulates gaze behavior and the effectiveness of information pickup to overcome the inversion effect in biological motion perception.

The inversion effect in biological motion suggests that presenting a point-light display (PLD) in an inverted orientation impairs the observer's ability to perceive the movement, likely due to the observer's unfamiliarity with the dynamic characteristics of inverted motion. Vertical dancers (VDs), accustomed to performing and perceiving others to perform dance movements in an inverted orientation while being suspended in the air, offer a unique perspective on this phenomenon. A previous study showed that VDs were more sensitive to the artificial inversion of PLDs depicting dance movements when compared to typical and non-dancers if given sufficient dynamic information. The current study compared the gaze behaviors of non-dancers, typical dancers, and VDs when observing PLDs of upright and inverted dance movements (either on the ground or in the air) to determine if the PLDs were artificially inverted. Behavioral results replicated the previous study, showing that VDs were more sensitive in detecting inverted movements. Eye-tracking data revealed that VDs had longer fixations, primarily directed at the depicted dancer's pelvic area. When performing movements in the air, the depicted dancer was suspended via a harness around their pelvis, providing unique dynamic information that specified the movement's canonical orientation. In contrast, although typical dancers also attended to the pelvic area, their lack of experience with perceiving and performing vertical dance movements limited their ability to interpret the dynamic information effectively. These findings highlight the role of specialized visuomotor experience in enhancing biological motion perception and have implications for training techniques that leverage visual strategies to improve performance in complex or unfamiliar movement contexts.

Histological Study of Skin Structures From Selected Body Areas in the Varanus komodoensis.

The skin of the Komodo dragon (Varanus komodoensis) is covered by a form of armour formed mainly of scales, which often co-occur with osteoderms. Scales are keratinized, non-mineralized structures in the uppermost layer of the epidermis that are in contact with each other to form a system in which individual scales are isolated from each other by a softer skin fold zone. In the Varanus, the surface of the scales is flat and smooth (thoracic limb, abdomen, and tail areas), domed and smooth (head area) or domed with conical ornamentation (dorsal surface, pelvic limb-dorsal surface areas). In contrast, osteoderms are mineralized structures that are an integral part of the skin, located below the epidermal surface and positioned parallel (head, tail, thoracic limb-dorsal surface, thoracic limb-palmar surface, and tail) or obliquely (pelvic limb-dorsal surface, groin, abdomen) to the surface. Regardless of the body region, osteoderms are structures that are completely anchored in the dermis, and their surface is smooth and devoid of ornamentation. Tangential sections of the osteoderms demonstrate concentric resting lines. Histological sections of the varanid dermis show the presence of collagen bundles, parallel interlacing or crossing bundles of collagen fibers of varying thickness and degree of compactness, accompanied by muscle fibers. In the area of skin close to the osteoderm, loosely arranged bundles of collagen fibers are present, while in the zone distal to the osteoderm, a compact arrangement of these fibers is present. This study documents the morphological diversity and distribution of osteoderms and scales in selected areas of the body of V. komodoensis. Scales are characterized by a high polymorphism related to body region, while osteoderms show a high morphological similarity independent of the area of occurrence.

Complex Large-Deformation Multimodality Image Registration Network for Image-Guided Radiotherapy of Cervical Cancer.

In recent years, image-guided brachytherapy for cervical cancer has become an important treatment method for patients with locally advanced cervical cancer, and multi-modality image registration technology is a key step in this system. However, due to the patient's own movement and other factors, the deformation between the different modalities of images is discontinuous, which brings great difficulties to the registration of pelvic computed tomography (CT/) and magnetic resonance (MR) images. In this paper, we propose a multimodality image registration network based on multistage transformation enhancement features (MTEF) to maintain the continuity of the deformation field. The model uses wavelet transform to extract different components of the image and performs fusion and enhancement processing as the input to the model. The model performs multiple registrations from local to global regions. Then, we propose a novel shared pyramid registration network that can accurately extract features from different modalities, optimizing the predicted deformation field through progressive refinement. In order to improve the registration performance, we also propose a deep learning similarity measurement method combined with bistructural morphology. On the basis of deep learning, bistructural morphology is added to the model to train the pelvic area registration evaluator, and the model can obtain parameters covering large deformation for loss function. The model was verified by the actual clinical data of cervical cancer patients. After a large number of experiments, our proposed model achieved the highest dice similarity coefficient (DSC) metric compared with the state-of-the-art registration methods. The DSC index of the MTEF algorithm is 5.64% higher than that of the TransMorph algorithm. It will effectively integrate multi-modal image information, improve the accuracy of tumor localization, and benefit more cervical cancer patients.

Advancements in Laparoscopic Techniques for Perineal Hernias—Technical Success and Complications Data

Purpose: Multimodal approaches, including radiochemotherapy and surgical resection, are commonly used to treat rectal malignancies. Postoperative perineal hernias, though not uncommon, have shown an increasing incidence in recent years. Managing symptomatic perineal hernias presents a challenge, with a high recurrence rate after repair. This retrospective study investigates the laparoscopic placement of a non-absorbable mesh for treating pelvic floor hernias involving bowel displacement. Methods: This study included all consecutive patients requiring hernia repair due to symptomatic perineal hernias following minimally invasive abdominoperineal resection. All patients had a history of local radiation therapy. Data were collected on surgery duration, intra- and postoperative complications, and hernia recurrence rates. Results: Laparoscopic displacement of the small bowel from the pelvis was performed on eight patients, and closure of the pelvic floor hernia area was achieved using non-absorbable mesh placement. All procedures were successful, and no perioperative complications were recorded. Only one early complication occurred, classified as Clavien-Dindo II. Conclusions: The laparoscopic procedure, serving as a safe method for repositioning the small intestine and closing a perineal hernia using a mesh, has shown promising outcomes. The use of a non-absorbable mesh as an alternative to native tissue appears to be effective, with no observed recurrent hernias. However, further evaluation through long-term results or a larger cohort study is still pending.

Double-J Ureteral Stenting in Obstetrics and Gynecology: Pivotal or Problematic?

Background and Objectives: Double-J stents are urinary catheters that are frequently used in urology. They are now also used in other specialist areas such as obstetrics and gynecology. However, the use of double-J stents is not without side effects. The aim of this review was to highlight the indications and possible adverse effects of the use of these stents in obstetrics and gynecology. Materials and Methods: We analyzed works published after 1995 in the PUBMED, SCOPUS, and Web of Science databases related to the use of double-J stents in obstetrics and gynecology, as well as reported adverse events. We carried out a narrative review of the available literature on this topic. Results: We identified 69 relevant publications that we included in the review. In obstetrics, indications include the treatment of gestational hydronephrosis, some urological conditions during pregnancy, such as obstructive urinary calculi, with or without superinfection, or intraoperative use for cesarean section or hysterectomy after cesarean section, to protect from, or to solve, ureteral lesions. In gynecology, they are used preoperatively or intraoperatively to protect the ureter during gynecological operations in the pelvic area or postoperatively to repair some ureteral injuries. They are also indicated for ureteral obstructions that occur after pelvic radiotherapy for gynecological neoplasms. Complications associated with the use of double-J stents include more frequent urinary tract infections, lower urinary tract symptoms, calcifications and misplacements. Conclusions: Double-J stents are widely used in obstetrics and gynecology and are characterized by good efficiency and safety, although some side effects may occur (lower urinary tract symptoms, hematuria, complications in birth outcomes), which do not limit their use. Summary of evidence: In this review, we analyzed the indications and complications of double-J ureteral stenting in obstetric and gynecologic patients. We found that the procedure is safe, both in the treatment of ureteral obstruction and in the resolution of postoperative complications. No serious complications of ureteral stenting have been noted that would constitute a contraindication to its use. Future prospective studies in large patient cohorts are necessary to validate our data.

Optimization of Radiation Dose and Effective Dose for CT Pelvis Examinations in Main Hospitals in ALTaif Region

Introduction: CT scan is one of the medical imaging methods that irradiate patients with significant amounts of radiation. These amount of radiation doses must be well estimated if the imaging area is in part containing radiation-sensitive organs such as the pelvic area. Objectives: the objectives of the current study were to assess radiation dose during pelvis and Abdomen CT imaging and estimate the effective dose as well as to propose diagnostic reference level (DRL).Methodology: 200 adult patients irradiated in two major governmental hospital in Taif city, Saudi Arabia, patients’ demographic data from was collected such as weight, height, and age. Scanner specifications and scan parameters for each pelvis examination were recorded in special data collection sheet. Volume CT dose index (CTDIvol and dose length product (DLP) were utilized to estimate the radiation dose and effective dose. Microsoft Excel was used to analyse the data.Main Results: there was variation in scanning parameters among two hospitals under study and this result in variation in effective dose between two hospitals. The average DLP, CTDIvol and effective dose were 368.5, 390.7 mGy-cm,10.2,10.8 mGy and 7, 7.4 mSv for hospital one and two respectively. Conclusion: Based on the third quartile of DLP and CTDIw, the recommended DRL for both hospitals was 405 mGy-cm and 21.75 mGy, respectively. The findings revealed a reduced effective dose value when compared with previous studies.

Use of surface tracking recordings to identify pitfalls during surface-guided radiotherapy.

The precise daily positioning of patients during radiation therapy determines the quality of the entire treatment. To avoid additional radiation exposure from regular cone-beam CT (CBCT) scans, surface-guided radiotherapy systems (SGRT) are increasingly used. The aim of this prospective clinical study was to evaluate the advantages, feasibility, and pitfalls of SGRT using the surface tracking recorder prototype of the camera component of ExacTrac Dynamic (Brainlab AG, Munich, Germany). This system combines both surface-based imaging technology and athermographic camera that records patients via thermal imaging to accurately measure patient geometry. The surfaces of patients with various tumor entities and therefore different regions of interest (ROIs) were recorded with the surface camera during positioning and throughout treatment. Subsequently, these surface camera datasets were analyzed to compare the accuracy of patient positioning with the current treatment standard (X-ray-based IGRT). The camera components were used only as an imaging tool and not to correct any deviations. For evaluation of typical pitfalls, errors > 5 mm for extracranial indications and > 2 mm for cranial indications were analyzed using parameters extracted from the surface recordings and the corresponding CBCT shifts. In total, 162 displacement vector datasets for 130 patients were generated and evaluated. The smallest deviations were found in the head and neck regions (mean deviation 1.9 mm/0.8°). The largest mean translational deviation (4.8 mm) and mean rotational deviation (1.1°) were found in the pelvic area. In all regions, most datasets showed clinically acceptable deviations; however, large outliers were observed in some measurements, particularly longitudinally. These outliers are of special interest because they may indicate mistakes in the use of SGRT, and they were therefore analyzed separately in detail. Several reasons for the outliers were identified, and potential solutions to avoid these pitfalls are presented. This observational study demonstrated the advantages and pitfalls of SGRT by using the surface tracking recorder prototype of the camera component of ExacTrac Dynamic. These pitfalls can be avoided through thorough application of SGRT. This study may serve as apractical guide for clinicians already using or introducing SGRT for patient positioning.

Tolérance à court et moyen terme d’une radiothérapie prostatique hypofractionnée selon la technique du boost intégré

PurposeThis retrospective study was conducted to ensure that irradiation of the pelvic lymph node areas associated with simultaneous hypofractionated boost to the prostate according to the protocol implemented at the university hospital of Tours (France) does not result in excess urinary and digestive toxicity in the short and medium term. Materials and methodsThe study population included patients with localized unfavourable intermediate or high-risk prostate cancer. The dose delivered was 65Gy in 25 fractions of 2.6Gy to the prostate and seminal vesicles, and 50Gy in 25 fractions of 2Gy to the pelvic lymph nodes. Acute toxicity events (between the start of radiotherapy and the first follow-up consultation) and medium-term toxicity events (after the first follow-up consultation) were assessed using the CTCAE version 5.0 classification. ResultsSixty-three patients were treated according to the protocol between January 1st, 2020, and October 31st, 2022. The majority of them had high-risk prostate cancer (79%). The median follow-up was 15 months. Very few patients reported grade 3–4 toxicity acutely (6% urinary and 0% digestive toxicity) or in the medium term (7% urinary and 0% and digestive toxicity). ConclusionRadiotherapy of pelvic lymph node areas with simultaneous hypofractionated boost to the prostate is feasible, with low rates of severe acute and medium-term toxicity.

Automatic delineation of cervical cancer target volumes in small samples based on multi-decoder and semi-supervised learning and clinical application

Radiotherapy has been demonstrated to be one of the most significant treatments for cervical cancer, during which accurate and efficient delineation of target volumes is critical. To alleviate the data demand of deep learning and promote the establishment and promotion of auto-segmentation models in small and medium-sized oncology departments and single centres, we proposed an auto-segmentation algorithm to determine the cervical cancer target volume in small samples based on multi-decoder and semi-supervised learning (MDSSL), and we evaluated the accuracy via an independent test cohort. In this study, we retrospectively collected computed tomography (CT) datasets from 71 pelvic cervical cancer patients, and a 3:4 ratio was used for the training and testing sets. The clinical target volumes (CTVs) of the primary tumour area (CTV1) and pelvic lymph drainage area (CTV2) were delineated. For definitive radiotherapy (dRT), the primary gross target volume (GTVp) was simultaneously delineated. According to the data characteristics for small samples, the MDSSL network structure based on 3D U-Net was established to train the model by combining clinical anatomical information, which was compared with other segmentation methods, including supervised learning (SL) and transfer learning (TL). The dice similarity coefficient (DSC), 95% Hausdorff distance (HD95) and average surface distance (ASD) were used to evaluate the segmentation performance. The ability of the segmentation algorithm to improve the efficiency of online adaptive radiation therapy (ART) was assessed via geometric indicators and a subjective evaluation of radiation oncologists (ROs) in prospective clinical applications. Compared with the SL model and TL model, the proposed MDSSL model displayed the best DSC, HD95 and ASD overall, especially for the GTVp of dRT. We calculated the above geometric indicators in the range of the ground truth (head-foot direction). In the test set, the DSC, HD95 and ASD of the MDSSL model were 0.80/5.85 mm/0.95 mm for CTV1 of post-operative radiotherapy (pRT), 0.84/ 4.88 mm/0.73 mm for CTV2 of pRT, 0.84/6.58 mm/0.89 mm for GTVp of dRT, 0.85/5.36 mm/1.35 mm for CTV1 of dRT, and 0.84/4.09 mm/0.73 mm for CTV2 of dRT, respectively. In a prospective clinical study of online ART, the target volume modification time (MTime) was 3–5 min for dRT and 2–4 min for pRT, and the main duration of CTV1 modification was approximately 2 min. The introduction of the MDSSL method successfully improved the accuracy of auto-segmentation for the cervical cancer target volume in small samples, showed good consistency with RO delineation and satisfied clinical requirements. In this prospective online ART study, the application of the segmentation model was demonstrated to be useful for reducing the target volume delineation time and improving the efficiency of the online ART workflow, which can contribute to the development and promotion of cervical cancer online ART.

Size of Pelvic Outlet as a Potential Risk Factor of Fecal Incontinence: A Population-Based Exploratory Analysis.

The impact of pelvic bone structure on fecal incontinence (FI) is unclear. We assessed the association between weight-adjusted pelvic area and FI. This was a population-based analysis of the National Health and Nutrition Examination Survey in 2005-2006. Participants who completed the bowel health survey and dual-energy x-ray absorptiometry were included. On multivariable analysis of 2,772 participants, the lowest pelvic area quartile predicted increased FI compared with the third (odds ratio [OR]: 2.05, confidence interval [CI]: 1.18-3.56, P = 0.014) and fourth (OR: 1.94, CI: 1.02-3.70, P = 0.045) quartiles. Sex-stratified analyses found similar association among female patients only. Small pelvic area on dual-energy x-ray absorptiometry is a potential risk factor of FI.

Long-term effects of pelvic floor training in male chronic pelvic pain, correlation between subjective and objective outcomes: a study protocol for a randomised controlled trial

IntroductionChronic primary pelvic pain syndrome (CPPPS) is a condition characterised by pain in the pelvic area together with lower urinary tract symptoms. Pathophysiology remains largely unclear. Common treatment modalities show...

Is the High-Intensity Focused Electromagnetic Energy an Effective Treatment for Urinary Incontinence in Women?

To assess the effectiveness and safety of high-intensity focused electromagnetic technology (HIFEM) used as a therapeutic approach in patients with stress and mixed urinary incontinence. Thirty-five females suffering from stress and mixed urinary incontinence were included in the study. The electromagnetic chair (BTL EMSELLA®) was applied to the patient's pelvic area twice a week for 28minutes, totaling 6 sessions. The patients' "International Consultation on Incontinence Questionnaire-Short Form" (ICIQ-SF) scores and the number of daily absorbent pad usage were recorded. Results were evaluated after the sixth session and at a first-month follow-up. The average ICIQ-SF score at baseline was 10.18 ± 4.19 (ranging from 2-18) which declined to 5.33 ± 3.97 after six sessions, and further improved to 4.26 ± 3.94 points at the one-month follow-up. After six sessions, an average improvement of 52.06% in ICIQ-SF score was observed, and after one month of follow-up, an average improvement of 59.6% was detected, which was found to be statistically significant (p=0.038). In addition, the mean number of pads used per day decreased to 1.25 ± 1.54 after treatment, a significant improvement was observed, and the mean daily pad use decreased further to 0.91 ± 1.11 at the first-month follow-up. HIFEM has demonstrated in our study its ability to safely and effectively treat female patients suffering from stress and mixed urinary incontinence, as evidenced by significant improvements in symptoms and quality of life observed in clinical trials.

Prevalence of Symptoms of Bladder Pain Syndrome/Interstitial Cystitis Among Adult Females in the Saudi Arabia

Introduction: Bladder pain syndrome/interstitial cystitis (BPS/IC) is characterized by repeated pain, pressure, or discomfort in the bladder and pelvic area, and presents both diagnostic and therapeutic challenges for clinicians and researchers because of its enigmatic and poorly comprehended nature. The purpose of this study was to identify the prevalence of bladder pain syndrome/interstitial cystitis in a tertiary care center in the Central region of Saudi Arabia. Methodology of the study: The study shall be a cross-sectional survey conducted at King Khalid Hospital, Majm

Developmental Patterns and Risk Factors of Scoliosis After Hemipelvectomy for the Pelvic Bone Tumor.

Postoperative scoliosis is often seen after hemipelvectomy for malignancies involving the pelvic area, but the details remain unclear. The objectives were to investigate the development patterns and risk factors of scoliosis after hemipelvectomy. We retrospectively reviewed 30 patients who underwent hemipelvectomy at our hospital between 1998 and 2020. The risk factors of scoliosis with a Cobb angle of ≥10° were investigated. The postoperative Cobb angle significantly increased in all patients compared with the preoperative one (p < 0.001), and the change ratio of the Cobb angle was significantly higher during the first postoperative year than thereafter. The external hemipelvectomy (EH) group demonstrated a larger Cobb angle and a higher change ratio than the internal hemipelvectomy group. Nine patients developed scoliosis with a final Cobb angle of ≥10°, and the risk factors were EH (p = 0.017), P1+2+3+4 resection according to the Enneking classification (p = 0.005), iliac crest resection (p = 0.004), L5/S resection (p = 0.020), and no pelvic ring reconstruction after hemipelvectomy (p = 0.004). Approximately 30% of patients who underwent hemipelvectomy developed scoliosis with a Cobb angle of ≥10°, and this angle increased rapidly during the first postoperative year. Hence, careful follow-up of scoliosis is required after hemipelvectomy.

Systemic investigation of pelvimetric profile in three strains of Deoni cattle

The present research work was designed to establish baseline data of the pelvimetric profile in Deoni Cattle. Deoni cattle (270) of three strains, i.e. Wannera, Balankya and Shevera were selected and divided into six age groups: Group I (12 to 24 months), II (25 to 36 months), III (37 to 48 months), IV (49 to 60 months), V (61 to 72 months) and VI (73 to 84 months) with 45 animals in each group. Body weight along with different pelvimetric parameters such as distance between two angles of haunch (A), distance between two ischial tuberosities (B), distance between level of croup and hip joint (C) and distance between tuber coxae and tuber ischia (D) were measured to determine the transverse and vertical diameter of pelvic inlet and outlet which were used to calculate pelvic area of inlet and outlet. The pelvic area values for both inlet and outlet showed highly significant differences within groups, but no significant difference was observed between the three strains of each group. From the results of the study, it can be concluded that the pelvic area of Deoni cattle increases with the age and it has significant positive correlation with the parity and body weight. Thus, pelvimetric profile can be used as a marker for selection of young Deoni heifers and cows for breeding purposes to lower dystocia incidences.

КЛИНИЧЕСКИЙ СЛУЧАЙ ВРОЖДЕННОЙ АНОМАЛИИ КОСТНО-СУСТАВНОЙ СИСТЕМЫ «ТАЗОВЫЙ ПАЛЕЦ», МЕТОДЫ ДИАГНОСТИКИ

The variants of congenital anomalies of the pelvic area and the frequency of their occurrence were studied in the article. The main theories of the origin of the anomalies were presented. The special attention was paid to the additional diagnostic methods.