Regular Screening Research Articles

The ESSAG-trial protocol: A randomized controlled trial evaluating the efficacy of offering a self-sampling kit by the GP to reach women underscreened in the routine cervical cancer screening program

BackgroundIn Flanders (Belgium), women not screened for cervical cancer (CC) within the last three years receive an invitation letter from the regional screening organization, the Centre for Cancer Detection (CCD), encouraging them to have a cervical specimen taken by their general practitioner (GP) or gynecologist. However, the coverage for CC screening remains suboptimal (63%). The offer of a self-sampling kit (SSK, for HPV testing) by a GP may trigger participation among women who do not attend regular screening. MethodsThe ESSAG-trial is a cluster-randomized controlled trial with three arms, each including 1125 women aged 31–64 years, who were not screened for CC in the last 6 years. In arm A, GPs offer a SSK when eligible women consult for any reason. In arm B, women receive a personal GP signed invitation letter including an SSK at their home address. In the control arm, women receive the standard invitation letter from the CCD. The primary outcome is the response rate at three months after inclusion. Secondary outcomes are: screen test positivity; compliance with foreseen follow-up among screen-positives; costs per invited and per screened women; as well as contrasts between trial arms and between socio-demographic categories. ConclusionThe ESSAG-trial will assess the effect of GP-based interventions using SSKs on CC screening participation among hard-to-reach populations. Findings will inform policymakers about feasible strategies on increasing CC screening that may be rolled-out throughout the whole region. Trial registrationClinicalTrials.gov: NCT05656976

Human papilloma virus (HPV)-related information acquisition and seeking behavior among infected women: A single center cross-sectional survey in Shanghai, China.

Lacking of adequate knowledge is an obstacle to effective prevention of cervical cancer, yet factors that affect the information acquisition and seeking behavior as well as the information communication process are not well studied. We assessed information acquisition and seeking behavior, as well as perceived barriers of doctor-patient communication regarding human papilloma virus (HPV)-related information of infected women. Among 437 participants, 405 (93%) expressed demands for HPV-related information, while only a small proportion (100/437, 22.9%) actively sought information and felt obstacles comprehending. Web-based channels were most frequently utilized and medical personnel were the most trusted information source. Patients' satisfaction was significantly correlated with doctor's patience (r = 0.581, p < 0.001) and emotional caring (r = 0.555, p < 0.001). Compared to patients not actively seeking information, those actively seeking information were more likely to be single (p = 0.005), had higher education (p = 0.009) and monthly individual-level income (p = 0.023), and was more likely to undergo regular cervical cancer screening (p = 0.003), and were already or willing to be vaccinated (p = 0.008). The actively seeking information group also achieved higher scores in HPV knowledge test (p = 0.007). Public health interventions targeting HPV-infected women using specifically designed educational materials may influence information seeking behavior, increase HPV literacy and knowledge, which could potentially increase HPV vaccine uptake and cervical cancer screening rate.

Pap Smears Cytology of Cervical Abnormalities in Derna, Libya

The study aimed to provide information about the prevalence of various cervical lesions diagnosed by Papanicolaou smear tests among women in the city of Derna, in eastern Libya. The reporting of the Pap smears is based on the 2014 Bethesda system. The study included seventy-two cervical Pap smears cytology received at the Noor-AL-Huda Medical Center Pathology Laboratory in Derna City, east of Libya, and processed using conventional smear techniques. The data was gathered retrospectively from March 2022 to August 2023. A total of 72 cervical Pap smears were included in the study. The majority of the cases reported were Negative for Intraepithelial Lesions or Malignancy (NILM) 54 (75%). Out of the 72 reports, 2 (2.7%) were unsatisfactory. Low-grade Squamous Intraepithelial Lesions (LSIL) were found in 8 cases (11.11%), and 4 (5.5%) were High-grade Intraepithelial Lesions (HSIL). Atypical Squamous Cells cannot exclude HSIL (ASC-H) were found in 4 cases (5.5%). LSIL and HSIL were more common among women aged 30-40 years. The age of the patients included in this study ranged from 30 to 56, with a mean age of 40 years. These findings emphasize the importance of a well-organized cervical screening program. In particular, women over 30 years should be educated about the importance of Pap smears and encouraged to undergo regular screening.

Cervical Cancer Screening Services in Nepal: A Descriptive Crosssectional Study.

Cervical cancer, the most prevalent cancer among women, is also the primary cause of cancer-related deaths in reproductive age women in Nepal. The study aims to assess the situation of cervical cancer screening services in Nepal. This cross-sectional study used quantitative methods to understand the situation of cervical cancer screening in 572 health facilities of Nepal. The research was conducted to assess screening facilities, the allocation of separate screening rooms, the availability of screening services on a routine basis throughout the week, screening facilities that are free of charge, human resources, and the availability of treatment. It was conducted in October to December 2022. The research was carried out among 572 healthcare facilities, out of which 134 (23.42%) had provision for cervical cancer screening services. Ethical approval was obtained from the Nepal Health Research Council (NHRC) under reference number 397/2022 P. Amongst those 134, 72 (53.73%) healthcare facilities had assigned separate rooms for screening intentions. One hundred and two (76.12%) healthcare facilities provided regular screening services throughout the week, while 112 (83.58 %) had free-of-charge screening services. Concerning trained personnel, 121 (90.30%) health facilities had personnel trained in visual inspection with Acetic acid, 9 (6.72%) had personnel trained in use of colposcopy, and 5 (3.73%) had personnel trained in use of Loop Electrosurgical Excision Procedure (LEEP). Lastly, 31 (23.13%) healthcare facilities offered treatment choices for cervical cancer. Most of the health care facilities did not have provision of cervical screening. Amongst those who had the provision, personnel trained in loop electrosurgical excision procedure colposcopy.

Broad‐spectrum and sensitive screening of more than 1000 compounds in equine urine using liquid chromatography/high‐resolution mass spectrometry

RationaleTo uphold the integrity of horseracing and equestrian sports, it is critical for an equine doping control laboratory to develop a comprehensive screening method to cover a wide range of target substances at the required detection levels in equine urine.MethodsThe procedure involved the enzymatic hydrolysis of 3 mL urine samples followed by solid‐phase extraction using HF Bond Elut C18 cartridge. The resulting extracts were then separated on a C18 reversed‐phase column and analyzed using liquid chromatography/high‐resolution mass spectrometry (LC/HRMS) in both electrospray ionization positive and negative modes in two separate injections. The analytical data were obtained in full scan and product ion scan (PIS) modes in an 11 min LC run.ResultsThe method can detect 1011 compounds (in both positive and negative ion modes). Over 95% of the target compounds have limits of detections (LODs) ≤10 ng/mL, and more than 50% of the LODs are ≤0.5 ng/mL. The lowest LOD can reach down to 0.01 ng/mL. The applicability of the method was demonstrated by the successful detection of prohibited substances in overseas and domestic equine urine samples.ConclusionsWe have successfully developed a regular screening method for equine urine samples that can detect more than 1000 compounds at sub‐ppb levels in both positive and negative ion modes with full scan and PIS using LC/HRMS. Furthermore, this method can theoretically be expanded to accommodate an unlimited number of prohibited substances in full‐scan mode.

Patient with Diabetic Foot Ulcer Admitted in Surgery Ward; Risk Factors, Associations and Grades of Presentation

Background: The management of chronic diabetic foot ulcers (DFU) poses a great challenge to the treating physician and surgeon. The aim of this study was to identify the risk factors, clinical presentation, and outcomes associated with chronic DFU. Objective: To determine the various risk factors for diabetic foot ulcers and study their associations. To study the grades of diabetic foot ulcers at presentation. Method: Purposive sampling. This study was done in the Surgery department of Shaheed Ziaur Rahman Medical College Hospital (SZMCH), Bogura for period of twelve (12) months. 100 cases were selected after informed consent. Study group (A) comprises of 50 cases of type 2 diabetes with diabetic foot ulcer and control group (B) comprises of 50 cases of age and gender matched type 2 diabetics without foot ulcers. Patients having serious systemic illness, type I diabetics and non-diabetic patients presenting with foot ulcer were excluded. Age, gender, duration of diabetes, duration of ulcer, glycemic control, presence of neuropathy and vascular disease were documented. Grading and Staging of ulcer was done according to New University of Texas Diabetic Wound Classification. Various risk factors were compared between the two groups. Data analyzed via SPSS version 17 with significant p-value &lt; 0.05. Results: Among 100 cases (64 % males &amp; 36 % females); mean age was 58.50 ± 9.8 (group A) versus 50.40 ± 10.5 (group B). Mean duration of diabetes was longer in group A (10.49 ± 7.06 years) vs. group B (8.34 ± 4.83 years) (p = 0.019). Glycemic control was poor in group A (72 %) vs. group B (56 %) (p = 0.045). There was significantly more peripheral vascular disease in group A (50 %) vs. group B (32 %) (p= 0.005). Sensory neuropathy was more in group A (90 %) vs. group B (38 %) (p &lt; 0.0001). Grade-I ulcer was present in 16 % cases, Grade-II in 38 % and Grade-III in 46 %. Conclusion: Neuropathy carries highest risk for diabetic foot ulcer, followed by peripheral vascular disease and poor glycemic control. Therefore, diabetic patient must be educated about these risk factors, foot care and self-examination and to have regular screening by clinician. Appropriate glycemic control and timely medical and surgical intervention may reduce morbidity in diabetics.

Exploring Perceived Stress Among Clinical &amp; Non-clinical Students in Mumbai: A Cross-Sectional Study from India

Objective: Mental health has become a global concern. Therefore, this study aimed to assess perceived stress among students from Mumbai, India and to explore its association with socioeconomic, demographic, lifestyle, academic and work-related factors. Methods: A cross-sectional study was conducted among college students from various co-ed colleges in Mumbai from March 2023 to June 2023. The Perceived Stress Scale (PSS-10) questionnaire was used to measure the perceived stress. Descriptive statistics, chi-square tests, t-tests, and multivariable linear regression analyses were performed to analyze the data. P-values &lt; 0.05 were considered significant. Results: A total of 1230 students enrolled in the study, with a mean age of 20.24 ± 2.39 years. The mean PSS score was 21.51 ± 5.73. Gender, residence, health problems, sleep duration, and non-practice of meditation were significantly associated with higher perceived stress scores, whereas, the type of course pursued did not show a significant association. Conclusion: This study highlights the prevalence of moderate perceived stress among college students in Mumbai, India. This emphasizes the need for interventions such as promoting healthy lifestyle habits, encouraging participation in extracurricular activities, organizing yoga and meditation sessions and conducting regular screenings for timely identification and management of stress and related conditions.

Prevalence of Autism risk among children undergoing regular Psychophysical Development Screening in Kazakhstan

BackgroundInformation about the situation with autism in Kazakhstan is extremely limited due to the lack of research on autism in both Kazakhstan and Central Asia. The prevalence of autism spectrum disorder risk among young children during routine screening was assessed using the M-CHAT-R/F tool. MethodsThis study took place in the offices of pediatric neurologists and family doctors in three primary healthcare organizations in the Karaganda, Kazakhstan. The researchers offered participation in the study and M-CHAT-R checklist completion during visits by parents and children to pediatric neurologists and family doctors for the purpose of screening for psychophysical development. Linear regression analysis was used to determine risk factors for the development of autism spectrum disorder. ResultsThe results of an analysis of 526 study participants showed the prevalence of high-risk autism spectrum disorders to be 27.4 %. Factors associated with a high risk of autism spectrum disorder in this study were child age, gender, parental age, and a diagnosis of developmental disorder. ConclusionsThe use of specific tools to screen for developmental disorders by primary care organizations is recommended. Primary care providers have regular contact with children before they reach school age and can provide family-centered, comprehensive, and coordinated care, including more comprehensive medical assessments.

Breast Cancer Prevention Practices and Knowledge in Italian and Chinese Women in Italy: Clinical Checkups, Free NHS Screening Adherence, and Breast Self-Examination (BSE).

Breast cancer remains a significant global concern, underscoring the critical need for early detection and prevention strategies. Primary and secondary preventive measures, such as routine screenings and behaviors like breast self-examination (BSE), play a crucial role in facilitating early diagnosis. While the National Health System (NHS) in Italy offers free regular screenings for women aged 50-69, there is a lack of clarity regarding the participation of both Italian and Chinese women residing in Italy in these screening programs. This study aims to bridge this knowledge gap by thoroughly assessing the involvement in regular clinical check-ups and the types of screening employed, the adherence to free screenings offered by the NHS, and the practice of BSE among women aged 50-69 of these two groups. Furthermore, it investigates their knowledge and perceptions regarding breast cancer and BSE. Results reveal disparities in breast cancer control practice between Italian and Chinese women in Italy: the former demonstrates higher adherence to clinical checkups (53% vs. 3%, p < 0.001), while both groups show low participation in free NHS screenings (70% vs. 4%, p < 0.001). Additionally, Chinese women reported significantly lower frequency of mammography (96% vs. 33%, p < 0.001) and ultrasound (69% vs. 16%, p < 0.001). The frequency of BSE also differed substantially, with 47% of Chinese women never performing BSE compared to 12% of Italian women (p < 0.001). This comprehensive exploration provides valuable insights, attitudes, and knowledge into the disparities and potential areas for improvement in breast cancer prevention, thus contributing to the overall well-being of these communities. The findings highlight the necessity for educational initiatives aimed at improving awareness and participation in screenings, particularly among the Chinese population. These initiatives could have profound implications for patient education by equipping women with the knowledge and skills necessary to engage in proactive health behaviors.

From Gestational Diabetes to Fatty Liver: Tracking the Journey to Prediabetes and Diabetes in Women – A Prospective Observational Study

Background: Gestational diabetes mellitus (GDM) and non-alcoholic fatty liver disease (NAFLD) are recognized risk variables for the development of prediabetes and diabetes. Understanding the combined effect of these conditions on the progression to glucose intolerance is crucial for developing effective prevention strategies. The study aimed to examine the incidence of prediabetes and diabetes in females with a history of GDM and NAFLD, in contrast to those with only one or neither condition, and to identify key risk factors related with these outcomes. Methods: 200 women were enrolled in a prospective observational study and allocated into four groups: Group A (GDM only), Group B (NAFLD only), Group C (both GDM and NAFLD), and Group D (control group with neither condition). Participants were followed for two years, with incidence rates of prediabetes and diabetes recorded. Baseline characteristics were assessed, and Cox proportional hazards models were used to identify significant risk factors. Results: The highest incidence of prediabetes and diabetes was observed in Group C, with 60% developing prediabetes and 50% developing diabetes. Group A had 40% prediabetes and 20% diabetes incidence, Group B had 36% and 24%, respectively, and Group D had 20% and 10%. Higher BMI, family history of diabetes, history of GDM, and presence of NAFLD were significant risk factors, while healthy dietary habits were protective. Conclusion: Females with a history of both GDM and NAFLD are at a considerably higher risk of developing prediabetes and diabetes. These findings underline the importance of targeted prevention and early intervention strategies in this high-risk population. Recommendations: Healthcare providers should prioritize monitoring and managing women with both GDM and NAFLD to prevent the onset of prediabetes and diabetes. Regular screening and promoting healthy lifestyle modifications are essential to mitigate these risks. Keywords: Gestational Diabetes Mellitus, Non-Alcoholic Fatty Liver Disease, Prediabetes, Diabetes, Risk Factors, Preventive Strategies

Chronic respiratory health symptoms and associated factors among exposed and unexposed residents to cement dust, in Moodubidire, Dakshina Kannada, Karnataka; a comparative cross sectional study

Background Exposure to cement dust poses significant risks to respiratory health, particularly among occupational workers. However, the impact of non-occupational cement dust exposure on nearby residents’ pulmonary well-being is often overlooked, particularly in the context of India. This study explores chronic respiratory health symptoms and their predictors in residents exposed to cement dust within a 1 km radius of a cement factory, comparing them with residents residing 5 kms away from the plant. Methods Using a comparative cross-sectional approach, we sampled 542 individuals from both exposed and unexposed communities using a multi-stage sampling technique. In-person interviews were conducted to collect relevant information, and descriptive methods were employed for data analysis. Univariate and multivariate logistic regression models were utilized to identify factors predicting self-reported chronic respiratory symptoms. Adjusted odds ratios and 95% confidence intervals were calculated to quantify the strength of the relationships. Results The results revealed a notable disparity in respiratory health between the two groups. Approximately 80% of residents within 1 km proximity to the cement industry reported respiratory symptoms, compared to 31% in the more distant community. Exposed residents were significantly more likely to experience respiratory manifestations, with odds ratios ranging from 5.3 kms to 5.4 kms compared to their unexposed counterparts. Conclusions While it was expected that the cement-exposed group would exhibit a higher burden of chronic respiratory symptoms, a surprising finding was that nearly one-third of non-exposed adult residents living in close proximity also reported adverse respiratory symptoms. This highlights the need for informed policies, including regular screening programs for respiratory health among proximate residents, and effective measures to control dust emissions from cement plants. Overall, the study emphasizes the importance of addressing respiratory health disparities in both occupational and non-occupational settings related to cement dust exposure.

Prevalence of Diabetic Nephropathy among Patients of Type 2 Diabetes at Tertiary Care Hospital Lahore

Background: Diabetic nephropathy is a significant complication of Type 2 Diabetes Mellitus, often leading to chronic kidney disease (CKD) and potentially progressing to End-Stage Renal Disease (ESRD). Approximately 90% of individuals with diabetes and hypertension may develop ESRD in the later stages of the disease. Objective: The study aimed to determine the prevalence of diabetic nephropathy among patients with type 2 diabetes at a tertiary care hospital in Lahore. Methods: This retrospective study included 100 reports from the chemical pathology and microbiology laboratory at Fatima Memorial Hospital, Lahore, covering renal function tests (RFT) such as Urea, Blood Urea Nitrogen (BUN), Creatinine, and estimated Glomerular Filtration Rate (eGFR), as well as HbA1c levels and Albuminuria. Data collection involved accessing electronic medical records (EMRs) to obtain comprehensive clinical data, including patients' medical history, duration of diabetes, glycemic control measurements, blood pressure, and prescribed medications. The study included patients with type 2 diabetes and kidney disease, excluding those without renal disease. Ethical approval was obtained from the Institutional Review Board (IRB) of FMH College of Medicine and Dentistry, adhering to the principles of the Declaration of Helsinki. Data were analyzed using IBM SPSS version 25, with categorical variables expressed as frequencies and percentages and continuous variables as mean ± standard deviation (SD). Correlation analysis was conducted, with a p-value of less than 0.05 indicating statistical significance. Results: The study included 100 participants, with 53% being male and 47% female. The mean age was 59.19 years (SD = 18.812), ranging from 18 to 91 years. Albuminuria was present in 88% of participants. Elevated serum creatinine was observed in 93%, HbA1c levels &gt;6.4% in 68%, high urea levels in 87%, and eGFR &lt;60 in 14%. Correlation analysis showed a significant positive correlation between HbA1c and eGFR (Spearman's rho = 0.432, p &lt; 0.001) and between urea and serum creatinine (Spearman's rho = 0.701, p &lt; 0.001). Conclusion: The high prevalence of albuminuria and elevated renal function markers among individuals with type 2 diabetes underscores the importance of early detection and comprehensive management. Regular screening for urinary albumin, stringent glycemic control, and optimal blood pressure management are crucial for preventing the progression of diabetic nephropathy.

Knowledge, Practice and Factors associated with Utilization of Cervical Cancer Screening Services.

Cervical cancer is treatable with regular screening and follow-up practices. The utilization of cervical cancer utilization services is found to be unsatisfactory in the context of Nepal. The objective of this study was to assess the factors that influence knowledge, practice, and utilization of cervical cancer screening among women in the Dhulikhel Municipality, Nepal. A cross-sectional study was conducted on 156 married women residing in Dhulikhel Municipality. The study participants were selected using the convenience sampling method. A standard questionnaire was used to collect the information. This study examined socio-demograhic data, knowledge, practice, and factors associated with cervical cancer screening. Descriptive and inferential statistics were used to analyze the data. Only one-fifth (17.9%) of the participants had received a cervical cancer screening. Most participants possessed a sufficient level, 134 out of 85.9%, of information about cervical cancer and cervical cancer screening. Annual healthcare visits (p=0.00), participant knowledge (p=0.014), and perceived barriers (p=0.001) were statistically significant factors in the uptake of cervical cancer screening. Out of those who felt they were highly susceptible, just one-fourth, or 25%, had undergone cervical cancer screening services. The number of medical visits, participants' knowledge, and perceived barriers had a significant impact on the uptake of cervical cancer screening. However, there was not found any relationship between the use of cervical cancer screening and perceived susceptibility and other socio-demographic factors.

An improved approach for automated cervical cell segmentation with PointRend

Regular screening for cervical cancer is one of the best tools to reduce cancer incidence. Automated cell segmentation in screening is an essential task because it can present better understanding of the characteristics of cervical cells. The main challenge of cell cytoplasm segmentation is that many boundaries in cell clumps are extremely difficult to be identified. This paper proposes a new convolutional neural network based on Mask RCNN and PointRend module, to segment overlapping cervical cells. The PointRend head concatenates fine grained features and coarse features extracted from different feature maps to fine-tune the candidate boundary pixels of cell cytoplasm, which are crucial for precise cell segmentation. The proposed model achieves a 0.97 DSC (Dice Similarity Coefficient), 0.96 TPRp (Pixelwise True Positive Rate), 0.007 FPRp (Pixelwise False Positive Rate) and 0.006 FNRo (Object False Negative Rate) on dataset from ISBI2014. Specially, the proposed method outperforms state-of-the-art result by about 3%\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$3\\%$$\\end{document} on DSC, 1%\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$1\\%$$\\end{document} on TPRp and 1.4%\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$1.4\\%$$\\end{document} on FNRo respectively. The performance metrics of our model on dataset from ISBI2015 are slight better than the average value of other approaches. Those results indicate that the proposed method could be effective in cytological analysis and then help experts correctly discover cervical cell lesions

Age and Gender Strongly Influence Visual Impairment in Schoolchildren

Background: Blurred vision caused by refractive errors, which result from an imbalance between the axial length and optical power of the eye, is prevalent worldwide. This condition, if undiagnosed in school-aged children, can significantly affect learning and development. Specific background: In Basra City, the prevalence of refractive errors and their impact on students' academic performance remains underexplored. Knowledge gap: There is limited data on the correlation between visual acuity and academic levels in elementary school pupils in this region, especially concerning demographic factors such as age and gender. Aims: This study aimed to determine the prevalence of visual impairment (VI), evaluate the visual acuity of elementary school pupils, and describe the characteristics of visually impaired students. Additionally, it sought to assess the relationship between visual acuity, age, gender, and academic performance. Results: A cross-sectional study was conducted on 200 students from Basra primary schools using a Snellen visual acuity chart. The results revealed that 24% had poor grades, 37% had moderate grades, and 39% had good grades. No significant relationship was found between visual acuity and academic performance, but a strong correlation was observed between visual acuity and both age and gender. Novelty: The study emphasizes the need for early detection of refractive errors in elementary school students and the significant correlation between visual acuity and demographic factors, especially age and gender. Implications: These findings suggest the need for regular vision screenings in schools to ensure early intervention and reduce the long-term impact of visual impairments on children’s educational and social development. Highlights: Prevalence: High rates of visual impairment found among Basra elementary students. Correlation: Visual acuity strongly linked to age and gender, not academic performance. Recommendation: School vision screenings are vital for early detection and intervention. Keywords: Refractive errors, Visual acuity, Elementary students, Basra City, Vision screening

Control of HPV infection leading to cervical cancer

HPV is the most common sexually transmitted infection and can lead to cancer. Vaccination has been considered as a very effective measure against HPV and along with regular screenings is recommended for the prevention of cervical cancer. In this study we propose and analyze a model for the transmission dynamics of Human Papilloma Virus (HPV). We discuss the optimal vaccination strategy in the case when multiple vaccines are available. We have considered an ODE based compartmental model, incorporating sex structure, we also consider HPV leading to cervical cancer by including pre-cancerous and cancerous compartments in the model. Adding the pre-cancerous and cancerous compartments will help us better understand the role of vaccination in prevention of cancers due to HPV. Using standard techniques from dynamical systems theory, we determine the disease free (DFE) and endemic steady states (EE). We determine a threshold quantity, the basic reproductive number R0 in terms of the model parameters, such that, the DFE is stable when R0<1 and the EE is stable in the case R0>1. The goal of control measures is to try an reduce R0 to be below the threshold value of 1, the regime in which the disease will ultimately be driven to extinction. We also prove the existence of a backward bifurcation in the model, epidemiologically this means that the long time behavior of the model depends on the initial infected population and that the disease may be harder to control, and the condition R0<1 may not suffice to eradicate the disease. Finally, using optimal control theory we consider the effective vaccination strategies using multiple vaccines, the goal is to study the best vaccination strategy using multiple vaccines. Our results show that a higher coverage with vaccines that provide protection against multiple strains, although more expensive, is best suited to control HPV transmission and subsequent development of cancer.

FREQUENCY OF THYROID DYSFUNCTION IN CASES OF METABOLIC SYNDROME PRESENTING AT TERTIARY CARE HOSPITAL

Metabolic syndrome is a cluster of conditions that increase the risk of heart disease, stroke, and diabetes. Thyroid dysfunction is frequently observed in patients with metabolic syndrome, impacting their overall health outcomes. Objective: To determine the frequency of thyroid dysfunction in patients with metabolic syndrome. Methods: This cross-sectional study was conducted at the Department of Medicine, Ayub Teaching Hospital, Abbottabad, from September 2023 to March 2024. A total of 120 patients diagnosed with metabolic syndrome were included. The patients' thyroid function was assessed through clinical evaluation and laboratory tests, including serum levels of TSH, free T3, and free T4. Statistical analysis was performed using descriptive statistics to determine the frequency of thyroid dysfunction, with results expressed as percentages and means ± standard deviations. Results: The average age of the 120 patients was 44.64±9.01 years. The frequency of thyroid dysfunction among these patients was 68.4% (82/120). Subclinical hypothyroidism was present in 27.5% (33/120), hypothyroidism in 14.2% (17/120), and subclinical hyperthyroidism in 4.2% (5/120). Conclusion: The study found a high frequency of thyroid dysfunction (68.4%) in patients with metabolic syndrome, with subclinical hypothyroidism being the most prevalent form. These findings highlight the importance of regular thyroid function screening in patients with metabolic syndrome to ensure early diagnosis and management.

Non-invasive hemoglobin screening device: a promising digital method for reducing anemia prevalence through routine screening and timely intervention

ABSTRACT Background Several non-invasive technologies are nowadays available in the market which claim to determine the hemoglobin levels instantly without the requirement of the blood sample. But no study has shown the significance of such non-invasive devices on a routine basis for determining their impact on anemia reduction programs. This study is conducted to determine the impact of regular hemoglobin screening on the women population to determine its potential in reducing anemia, using a digitalized non-invasive device. Method A cross-sectional study was conducted on 203 women of reproductive age group, residing in the Moradabad district. Repetitive readings were taken after a time interval of a minimum of 1 month for determining the impact of regular screening. The entire data collection process was carried out using the EzeCheck mobile app. Results It was observed that the prevalence of anemia was reduced upon the second time screening and was accepted by the women population. Repetitive testing has a significant impact on reducing anemia prevalence. Also, the simplified non-invasive technology for estimating the hemoglobin values, makes the user more comfortable to take the test. Conclusion Non-invasive devices should be used regularly to keep track of hemoglobin levels which will help in the effective treatment of anemia. The mobile app-based testing could help to easily evaluate the reports of the patients from any remote location with instant result interpretation and health assistance.

Research on lncRNA CTBP1-DT as a potential therapeutic target to regulate cell function in colorectal cancer

BackgroundColorectal cancer, which originates from the human colon or rectum, is one of the leading causes of death worldwide. Timely diagnosis and interventional therapy can significantly improve the prognostic survival of colorectal cancer patients, making regular screening and early detection essential.AimTo investigate the regulatory function of lncRNA CTBP1-DT (CTBP1-DT) on colorectal cancer cells and to assess its diagnostic significance.MethodsA total of 102 patients with colorectal cancer and 92 healthy individuals were selected. The levels of CTBP1-DT and microRNA-30a-5p (miR-30a-5p) in serum and cell samples of the above subjects were compared by RT-qPCR. The effects of CTBP1-DT and miR-30a-5p dysregulation on the biological functions of colorectal cancer cells were analyzed via CCK-8, flow cytometry and Transwell assays. In addition, the ability of CTBP1-DT and miR-30a-5p to early identify colorectal cancer patients was determined through ROC curve.ResultsSerum CTBP1-DT was elevated in patients with colorectal cancer, which was obviously higher than in healthy controls. The expression of serum miR-30a-5p was downregulated in colorectal cancer. Both CTBP1-DT and miR-30a-5p have the value of distinguishing colorectal cancer, and the combined diagnostic ability is higher. Knockdown of CTBP1-DT directly targeted miR-30a-5p to repress cell activity and metastatic ability, whereas deregulation of miR-30a-5p eliminated the above inhibitory effects.ConclusionOverexpression of CTBP1-DT has a certain application potential in the diagnosis of colorectal cancer and may be a therapeutic target for colorectal cancer.

Suicidal Ideation and Its Correlates Among Incarcerated Persons in Taiwan

ABSTRACT The prison environment is stressful, and suicidal behavior remains a significant issue. Recent studies on Taiwanese prisons have focused on factors associated with suicidal ideation among incarcerated persons. Using data from 1,362 respondents in 25 prisons, this study found a relatively low prevalence of suicidal ideation (<10%). Structural Equation Modeling (SEM) analysis revealed that depression, vicarious victimization, and victimization experiences increase suicidal tendencies, while family support and good staff relations reduce them. Recommendations include evidence-based suicide prevention interventions such as staff training, regular risk screening, restricted access to lethal tools, quality mental health care, and multidisciplinary management for high-risk individuals.