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Background: Hyperglycemia detected during acute illness-like ischemic stroke is associated with adverse outcomes more than in normoglycemic patients. However,very limited data regarding stress hyperglycemia and its prognostic value are available for our Indian population. Aims and Objectives: This study was aimed at comparing the stress hyperglycemic and normoglycemic patients in terms of mortality and functional recovery during 28 days follow-up assessed by the Barthel index for Activities of Daily Living. Materials and Methods: Adult non-diabetic patients with ischemic stroke were assessed for random venous blood glucose and HbA1c levels and divided into two groups: Patients with hyperglycemia and normoglycemia. The Barthel Index for Activities of Daily Living was used to compare mortality and functional recovery on the day of admission, day 3, and day 28 after stroke. Results: Mortality over the 28 days follow-up was significantly higher in hyperglycemic patients (45% vs. 20%,P=0.02). The Barthel Index score on admission (day 0) was 8.75±7.41 among stress hyperglycemic patient whereas it was13.54±11.12 among normoglycemic patient, which was significantly different (P=0.028). Similarly, day 3 (18.89±6.08 vs. 23.26±13.05, P<0.05) and day 28 scores (83.24±7.49 vs. 84.55±12.84, P=0.039) were significantly better in normoglycemic patients. Conclusion: The mortality rate was much higher and functional recovery was much poorer in stress hyperglycemic patients. Further studies should be directed toward determining complications in long-term follow-up related to stress hyperglycemia and the effects of management on patient outcome.

Though adjuvant radiotherapy has an established role in the treatment of carcinoma breast, there is concern regarding irradiation to heart and lung, more on left sided disease. Intensity Modulated Radiation Therapy (IMRT) modulates the intensity of the radiation beams with better accuracy, sparing surrounding normal organs. But it increases integral dose to normal healthy tissues compared to 3-Dimensional Conformal Radiation Therapy (3DCRT). So, our study was aimed at comparing the dosimetry and acute toxicity profile of 3DCRT and IMRT in post-mastectomy patients. In study arm patients received radiotherapy with IMRT and in control arm with 3DCRT, radiation dose being 50 Gy in 25 fractions for 5 weeks for both the arms. We compared the dosimetric data for Planning Target Volume (PTV) and Organ At-risk (OAR) by both techniques along with acute toxicity profile. Dosimetric parameter of PTV coverage V95 and V107 were significantly better in IMRT than 3DCRT (p-value <0.0001). IMRT showed better homogeneity index (0.14 Gy vs 0.26 Gy) and conformity index was also better for IMRT (0.94 Gy vs 0.74 Gy, p-value 0.0028). The mean value of heart V25 in left sided disease was significantly lower in IMRT than 3DCRT (22.59 and 25.64, p value 0.01). V20 of ipsilateral lung was numerically less in IMRT though not significant (31.44 vs 35.3). But low dose volume was significantly more in IMRT, as seen by higher V5 of heart and ipsilateral lung. To conclude, IMRT has better PTV coverage and better sparing of organs at risk with more homogenous and conformal plans than 3DCRT.

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