Male circumcision has been shown to reduce HIV infection risk in men. Three randomized controlled trials in Africa found that circumcision reduced HIV risk by 50-60%. Based on this evidence, the WHO and UNAIDS recommend promoting male circumcision in high HIV prevalence countries in Africa. In South Africa, male circumcision services have been piloted and national guidelines are being developed to scale up circumcision as part of HIV prevention. Challenges include addressing concerns about reducing comprehensive prevention messages, ensuring quality and safety of services, and promoting gender sensitivity.
Khalid sait saudi belgium seminal march 18 2014Tariq Mohammed
This document summarizes information from a presentation on cervical cancer prevention in Saudi Arabia. It notes that cervical cancer incidence is low in Saudi Arabia but increasing cases are expected as seen elsewhere. The presentation discusses HPV as the primary cause, the availability of HPV vaccines, and the need for a national screening program in Saudi Arabia using HPV testing to help prevent additional cervical cancer cases and deaths. It provides details on an existing cervical cancer screening program in Jeddah as an example for a potential future national program.
Adenocarcinoma in situ (AIS) is the only known precursor to cervical adenocarcinoma. Appropriate management of AIS can prevent invasive adenocarcinoma in many cases. Cytology has lower sensitivity for detecting AIS compared to HPV testing. The usual interval between detectable AIS and invasive adenocarcinoma is at least 5 years, allowing time for screening and intervention. Glandular neoplasms account for about 25% of annual cervical cancer diagnoses. Management of AIS typically involves conization, though hysterectomy is the standard treatment due to the high risk of residual disease with conization alone. HPV testing can help monitor women with AIS who wish to preserve fertility after
This document discusses treatment approaches for early stage cervical cancer. It notes that for invasive cervical cancers measuring less than 2 cm, removal of the parametrium may be omitted. For some very small tumors, pelvic lymphadenectomy can also be omitted as the risk of lymph node metastasis is limited. It also discusses outcomes from vaginal trachelectomy and laparoscopic pelvic lymphadenectomy for early stage cancers. The document considers conservative treatment approaches for stage IA2-IB1 cancers less than 3 cm in size, including a proposed study design stratifying patients based on tumor diameter.
The document provides guidelines for implementing a cervical cancer screening programme in India. It outlines recommendations from an expert group meeting on screening strategies that are suitable for low resource settings. The guidelines address community sensitization, screening at primary health centers and district hospitals, the roles of healthcare workers, screening and evaluation protocols, quality control measures, and human resource development needs. The overall aim is to help start pilot screening programmes using methods like visual inspection that can help reduce the burden of cervical cancer in India.
4 prof james bently management guidelines 2014Tariq Mohammed
This document provides guidelines for colposcopy management from the IFCCP Jeddah Jan 2014 conference and the ASCCP Management Guidelines 2012 and SOGC SCC Colposcopy Guidelines 2012. It discusses recommendations and algorithms for evaluating and managing various abnormal cytology results and histological findings identified during colposcopy, including ASCUS, LSIL, ASC-H, HSIL, AGC, cervical intraepithelial neoplasia grades, and other conditions. Management may involve repeat testing, colposcopy, biopsy, excisional procedures, or return to routine screening depending on the abnormality, risk level, and other factors.
Jean Yves Seror : Interventional Senology Diagnostic and therapeutic : State...breastcancerupdatecongress
This document summarizes interventional senology techniques including biopsy methods and their indications, limitations, and complications. It discusses fine needle aspiration biopsy, core needle biopsy, vacuum-assisted biopsy, and percutaneous excisional biopsy. Fine needle aspiration biopsy is well tolerated but has limitations including insufficient samples and inability to assess microcalcifications. Core needle biopsy provides a histological diagnosis but has a risk of underdiagnosis for small or deep lesions. Vacuum-assisted biopsy allows removal of lesions under 8mm with low complication rates but has limitations for complex fibroadenomas or papillary lesions. Percutaneous excision can diagnose and remove lesions but is not feasible for large or deep masses. New techniques aim to remove lesions
Gardasil - Do we need Cervical Cancer Vaccine in India?Gaurav Gupta
The document provides an overview of HPV disease and the case for HPV vaccination. It discusses the high global and Indian disease burden of cervical cancer caused by HPV, with India accounting for over 27% of new cervical cancer cases and deaths worldwide despite having a small fraction of the global population. Clinical trial data demonstrates over 90% efficacy of the quadrivalent HPV vaccine in preventing cervical, vulvar, vaginal, and anal cancers and genital warts caused by HPV types 6, 11, 16, and 18. Long-term follow up studies show sustained immune memory response and protection for over 7 years. Worldwide and Indian guidelines recommend HPV vaccination for girls aged 9-14 years.
Khalid sait saudi belgium seminal march 18 2014Tariq Mohammed
This document summarizes information from a presentation on cervical cancer prevention in Saudi Arabia. It notes that cervical cancer incidence is low in Saudi Arabia but increasing cases are expected as seen elsewhere. The presentation discusses HPV as the primary cause, the availability of HPV vaccines, and the need for a national screening program in Saudi Arabia using HPV testing to help prevent additional cervical cancer cases and deaths. It provides details on an existing cervical cancer screening program in Jeddah as an example for a potential future national program.
Adenocarcinoma in situ (AIS) is the only known precursor to cervical adenocarcinoma. Appropriate management of AIS can prevent invasive adenocarcinoma in many cases. Cytology has lower sensitivity for detecting AIS compared to HPV testing. The usual interval between detectable AIS and invasive adenocarcinoma is at least 5 years, allowing time for screening and intervention. Glandular neoplasms account for about 25% of annual cervical cancer diagnoses. Management of AIS typically involves conization, though hysterectomy is the standard treatment due to the high risk of residual disease with conization alone. HPV testing can help monitor women with AIS who wish to preserve fertility after
This document discusses treatment approaches for early stage cervical cancer. It notes that for invasive cervical cancers measuring less than 2 cm, removal of the parametrium may be omitted. For some very small tumors, pelvic lymphadenectomy can also be omitted as the risk of lymph node metastasis is limited. It also discusses outcomes from vaginal trachelectomy and laparoscopic pelvic lymphadenectomy for early stage cancers. The document considers conservative treatment approaches for stage IA2-IB1 cancers less than 3 cm in size, including a proposed study design stratifying patients based on tumor diameter.
The document provides guidelines for implementing a cervical cancer screening programme in India. It outlines recommendations from an expert group meeting on screening strategies that are suitable for low resource settings. The guidelines address community sensitization, screening at primary health centers and district hospitals, the roles of healthcare workers, screening and evaluation protocols, quality control measures, and human resource development needs. The overall aim is to help start pilot screening programmes using methods like visual inspection that can help reduce the burden of cervical cancer in India.
4 prof james bently management guidelines 2014Tariq Mohammed
This document provides guidelines for colposcopy management from the IFCCP Jeddah Jan 2014 conference and the ASCCP Management Guidelines 2012 and SOGC SCC Colposcopy Guidelines 2012. It discusses recommendations and algorithms for evaluating and managing various abnormal cytology results and histological findings identified during colposcopy, including ASCUS, LSIL, ASC-H, HSIL, AGC, cervical intraepithelial neoplasia grades, and other conditions. Management may involve repeat testing, colposcopy, biopsy, excisional procedures, or return to routine screening depending on the abnormality, risk level, and other factors.
Jean Yves Seror : Interventional Senology Diagnostic and therapeutic : State...breastcancerupdatecongress
This document summarizes interventional senology techniques including biopsy methods and their indications, limitations, and complications. It discusses fine needle aspiration biopsy, core needle biopsy, vacuum-assisted biopsy, and percutaneous excisional biopsy. Fine needle aspiration biopsy is well tolerated but has limitations including insufficient samples and inability to assess microcalcifications. Core needle biopsy provides a histological diagnosis but has a risk of underdiagnosis for small or deep lesions. Vacuum-assisted biopsy allows removal of lesions under 8mm with low complication rates but has limitations for complex fibroadenomas or papillary lesions. Percutaneous excision can diagnose and remove lesions but is not feasible for large or deep masses. New techniques aim to remove lesions
Gardasil - Do we need Cervical Cancer Vaccine in India?Gaurav Gupta
The document provides an overview of HPV disease and the case for HPV vaccination. It discusses the high global and Indian disease burden of cervical cancer caused by HPV, with India accounting for over 27% of new cervical cancer cases and deaths worldwide despite having a small fraction of the global population. Clinical trial data demonstrates over 90% efficacy of the quadrivalent HPV vaccine in preventing cervical, vulvar, vaginal, and anal cancers and genital warts caused by HPV types 6, 11, 16, and 18. Long-term follow up studies show sustained immune memory response and protection for over 7 years. Worldwide and Indian guidelines recommend HPV vaccination for girls aged 9-14 years.
The international federation for cervical pathology and colposcopy courseTariq Mohammed
This document provides an agenda and speaker information for a 3-day international colposcopy workshop taking place in Jeddah, Saudi Arabia from January 12-14, 2014. The workshop will focus on cervical cancer prevention, advances in understanding HPV, and management of lower genital tract diseases. It will include lectures, hands-on training, and case reviews led by experts from Europe, Canada, and Saudi Arabia. The goal is to train participants and raise awareness of cervical cancer screening and prevention methods.
The document discusses HPV vaccine recommendations and current issues. It provides an overview of HPV vaccine licensure and recommendations, safety data showing the vaccines are very safe, and low national and state HPV vaccination rates, especially for certain populations. Rates in Indiana are among the lowest in the US. It recommends new strategies are needed to increase HPV vaccine acceptance and reduce disparities.
This document summarizes a panel discussion on HPV vaccination in India. Some key points:
- Cervical cancer is a major problem in India, with over 122,000 new cases and 67,000 deaths annually.
- HPV is the primary cause of cervical cancer. Vaccination induces high antibody levels to protect against HPV types 16 and 18, which cause 70% of cervical cancers.
- The best age for vaccination is 11-12 years, before sexual debut. Catch-up vaccination is recommended through age 26.
- Common side effects of HPV vaccination are mild and temporary. Rare severe allergic reactions may occur.
- Vaccination is recommended even for sexually active women and women in monogamous relationships to
Screening for premalignant cervical lesions in Egypt is important given the high incidence of cervical cancer. Visual inspection with acetic acid (VIA) is recommended for screening in developing countries due to its low cost, simplicity, and ability to provide immediate results and treatment. Mansoura University experience found VIA to be a sensitive screening method, detecting cervical lesions. While a positive VIA does not always indicate cancer, it allows for low-cost screening and identification of suspicious lesions requiring further evaluation or treatment.
Dr. nisreen cervical cancer screening in park hayatTariq Mohammed
The document discusses cervical cancer prevalence, incidence, and mortality worldwide and in Saudi Arabia. It notes that cervical cancer is the second leading cause of cancer death in women globally, with over 500,000 new cases and 288,000 deaths annually. In Saudi Arabia specifically, the incidence is very low at 1.9 cases per 100,000 women, accounting for 152 new cases and 55 deaths annually. However, little is known about HPV prevalence and transmission patterns in the country. The challenges in addressing cervical cancer in Saudi Arabia include understanding HPV and abnormal cytology prevalence, sexual practices, implementing screening programs, determining vaccine cost-effectiveness, and ensuring quality screening and colposcopy.
The document summarizes the 2013 guidelines for cervical cancer screening in average-risk women. It recommends that screening should begin at age 21 with conventional or liquid-based cytology every 3 years. From ages 30-65, it is acceptable to continue cytology alone every 3 years, but preferred is co-testing with cytology and HPV testing every 5 years. Screening should stop at age 65 for women with adequate negative prior screening or after total hysterectomy with no history of precancerous lesions. The guidelines do not recommend annual screening or primary HPV testing alone for screening.
Dept. of Health cervical cancer fogsi_ screening test npcdcs_dept. of genera...drdduttaM
This document discusses screening methods for cervical cancer. It begins by defining screening as universal testing of at-risk populations regardless of risk factors. For cervical cancer, screening is suitable because it has a long precancerous phase and simple, non-invasive tests are available. The document then discusses various screening methods including conventional cytology (Pap smear), liquid-based cytology, visual inspection with acetic acid (VIA), HPV DNA testing, and triage tools. It notes that while Pap smears have been effective, alternative strategies like VIA are needed in India due to lack of infrastructure. VIA is described as an inexpensive, simple test that allows for immediate results and screening of large numbers of women.
HPV infection, cervical abnormalities, and cancer in HIV-infected women in Mu...Dr.Samsuddin Khan
Background: HIV-infected women are at a higher risk of cervical intraepithelial neoplasia (CIN) and cancer than women in the general population, partly due to a high prevalence of persistent human papillomavirus (HPV) infection. The aim of the study was to assess the burden of HPV infection, cervical abnormalities, and cervical cancer among a cohort of HIV-infected women as part of a routine screening in an urban overpopulated slum setting in Mumbai, India.
Methods: From May 2010 to October 2010, Médecins Sans Frontières and Tata Memorial Hospital Mumbai offered routine annual Pap smears and HPV DNA testing of women attending an antiretroviral therapy (ART) clinic and a 12-month follow-up. Women with abnormal test results were offered cervical biopsy and treatment, including treatment for sexually transmitted infections (STIs).
Results: Ninety-five women were screened. Median age was 38 years (IQR: 33–41); median nadir CD4-count 143 cells/µL (IQR: 79–270); and median time on ART 23 months (IQR:10–41). HPV DNA was detected in 30/94 women (32%), and 18/94 (19%) showed either low-grade or high-grade squamous intraepithelial lesions (LSIL/HSIL) on Pap smear. Overall, >50% had cervical inflammatory reactions including STIs. Of the 43 women with a cervical biopsy, eight (8.4%) had CIN-1, five (5.3%) CIN-2, and two (2.1%) carcinoma in situ. All but one had HPV DNA detected (risk ratio: 11, 95% confidence interval: 3.3–34). By October 2011, 56 women had completed the 12-month follow-up and had been rescreened. No new cases of HPV infection/LSIL/HSIL were detected.
Conclusion: The high prevalence of HPV infection, STIs, and cervical lesions among women attending an ART clinic demonstrates a need for routine screening. Simple, one-stop screening strategies are needed. The optimal screening interval, especially when resources are limited, needs to be determined.
Cervical Cancer Vaccine - Do we need it in IndiaGaurav Gupta
The document discusses cervical cancer and the HPV virus. It provides epidemiological data on cervical cancer in India, describing it as the most common cancer in Indian women. It explains the link between HPV infection and cervical cancer, noting that HPV vaccination can prevent most cervical cancers. The document discusses two approved HPV vaccines, Gardasil and Cervarix, comparing their efficacy, safety and immune responses elicited. It recommends HPV vaccination as an important strategy for cervical cancer prevention.
HPV Infections, Cervical Dysplasia and the HPV Vaccine; What will the future ...Summit Health
This document discusses HPV infections, cervical dysplasia, and the HPV vaccine. It provides information on HPV epidemiology, risk factors for cervical cancer, pathogenesis and progression of HPV infection to cervical dysplasia and cancer. Screening recommendations and management of abnormal Pap smears and cervical dysplasia are summarized. The history and development of HPV vaccines including Gardasil and Cervarix are briefly outlined.
Mrs. Payne is a 45-year-old female presenting for her annual exam. She has not had a visit in over 5 years. The nurse practitioner will interview her, update her medical history, and perform a physical exam. Recommendations will address Mrs. Payne's smoking, weight, lack of exercise, and osteoporosis prevention. The practitioner will educate her on menopause, nutrition, physical activity, weight loss, smoking cessation, and cancer screenings. Mrs. Payne will schedule follow ups to review labs and monitor her progress.
Asccp management guidelines august 2014 ppt. Dr. Sharda Jain /Dr Jyoti Agarw...Lifecare Centre
Updated Consensus
American society of Colpscopy & cervical pathology
Guidelines 2014for Managing forAbnormal Cervical Cancer Screening Test and Cancer Precursors
Dr. Sharda Jain /Dr Jyoti Agarwal / dr. Jyoti Bhasker
The document discusses the Female Cancer Foundation and its efforts to eliminate cervical cancer worldwide. It notes that cervical cancer is the second most common cancer in women globally, with over 500,000 new cases diagnosed each year, primarily in developing countries. The Foundation aims to increase awareness, provide screening and treatment, and train local healthcare workers in developing countries using low-cost methods. Its goal is to work with partners and volunteers towards a world without cervical cancer.
The document discusses cervical cancer screening alternatives for developing world contexts. It reviews cervical cancer incidence, risk factors, and the limitations of Pap screening in low-resource areas. The document proposes visual inspection with acetic acid (VIA) as a screening alternative that has shown favorable results compared to cytology in other studies. It describes how to perform VIA screening and the next steps needed to develop a cervical cancer screening program in Santa Lucia, Honduras.
This study evaluated the performance of five clinical decision rules for identifying low bone mineral density (BMD) in 174 postmenopausal African American women. The decision rules had sensitivities between 65.57-83.61% and specificities between 53.85-78.85% for identifying women with low BMD. Positive predictive values ranged from 80.95-87.91% and negative predictive values ranged from 48.44-58.33%. The study found that the decision rules showed some usefulness in identifying low BMD in this population but that more research is needed to establish appropriate cut-points for African American women.
The utility-visual-inspection-with-acetic-acid-cervical-cancer-screening-ecoa...Amarlasreeja
Cervical cancer is potentially preventable but still remains a leading cause of cancer mortality in in developing countries like Nigeria. Cytology-based screening programmers are difficult to maintain in these countries.
3.Edward A. Sickles_Surveillance Imaging for Probably Benign Findings: Benefi...Wanfang Radiology
This document summarizes evidence on mammographic surveillance of probably benign breast lesions. Key points include:
- Studies have found positive predictive values of 0.1-11.2% for probably benign lesions identified on mammography and followed with serial imaging.
- Cancers detected through surveillance tend to be nonpalpable, early-stage lesions with favorable prognosis despite interval growth.
- Serial imaging can help identify cancers earlier through detection of interval change in probably benign lesions over time.
This document discusses cancer screening guidelines for several common cancers. It recommends screening for breast cancer with annual mammograms and clinical exams starting at age 40, and beginning earlier or including MRI for those at high risk. Cervical cancer screening should begin at age 21 with Pap tests every 3 years or co-testing with HPV every 5 years. Colorectal cancer screening options include colonoscopy every 10 years, sigmoidoscopy every 5 years, or annual fecal tests. Genetic screening is recommended for those with a family history suggesting inherited cancer risk. Lung cancer screening with low-dose CT is advised for high-risk smokers aged 55-74. Prostate cancer screening involves PSA testing and DRE for men aged 50-69
Human papiloma virus and its association to Cervical Cancer
HPV in Saudi Arabia .
Currently I am working in Arar Central Hospital, in Arar city
In Saudi Arabia.
Please do not hesitate to contact us if you require any further information.
Alsultany@hotmail.com
This document summarizes primary and secondary prevention strategies for cervical cancer in Saudi Arabia. It begins with epidemiological data showing cervical cancer rates are lower in Saudi Arabia than worldwide but there is currently no organized screening program. It then reviews the role of HPV in causing cervical cancer and limitations of traditional Pap smear screening including sensitivity. The document discusses how HPV testing may improve screening through use as a primary test or to triage abnormal Pap results. Large clinical trials show HPV testing is more sensitive for detecting cervical precancers. The document concludes by stating vaccination could provide active primary prevention against HPV types that cause cervical cancer.
HPV infection and anal dysplasia in Vancouver: findings from the ManCount Survey.CBRC
This document summarizes preliminary findings from the ManCount Survey regarding HPV infection and anal dysplasia in gay and bisexual men in Vancouver. Rectal swabs were self-collected by 252 survey participants. The results found that 38% tested negative for HPV and 47% tested positive for high-risk HPV types. Abnormal anal cytology results were found in 11% (high-grade) and 19% (low-grade). The next steps will analyze these preliminary medical findings together with behavioral data to inform policies around HPV vaccination and anal pap screening for men who have sex with men.
The international federation for cervical pathology and colposcopy courseTariq Mohammed
This document provides an agenda and speaker information for a 3-day international colposcopy workshop taking place in Jeddah, Saudi Arabia from January 12-14, 2014. The workshop will focus on cervical cancer prevention, advances in understanding HPV, and management of lower genital tract diseases. It will include lectures, hands-on training, and case reviews led by experts from Europe, Canada, and Saudi Arabia. The goal is to train participants and raise awareness of cervical cancer screening and prevention methods.
The document discusses HPV vaccine recommendations and current issues. It provides an overview of HPV vaccine licensure and recommendations, safety data showing the vaccines are very safe, and low national and state HPV vaccination rates, especially for certain populations. Rates in Indiana are among the lowest in the US. It recommends new strategies are needed to increase HPV vaccine acceptance and reduce disparities.
This document summarizes a panel discussion on HPV vaccination in India. Some key points:
- Cervical cancer is a major problem in India, with over 122,000 new cases and 67,000 deaths annually.
- HPV is the primary cause of cervical cancer. Vaccination induces high antibody levels to protect against HPV types 16 and 18, which cause 70% of cervical cancers.
- The best age for vaccination is 11-12 years, before sexual debut. Catch-up vaccination is recommended through age 26.
- Common side effects of HPV vaccination are mild and temporary. Rare severe allergic reactions may occur.
- Vaccination is recommended even for sexually active women and women in monogamous relationships to
Screening for premalignant cervical lesions in Egypt is important given the high incidence of cervical cancer. Visual inspection with acetic acid (VIA) is recommended for screening in developing countries due to its low cost, simplicity, and ability to provide immediate results and treatment. Mansoura University experience found VIA to be a sensitive screening method, detecting cervical lesions. While a positive VIA does not always indicate cancer, it allows for low-cost screening and identification of suspicious lesions requiring further evaluation or treatment.
Dr. nisreen cervical cancer screening in park hayatTariq Mohammed
The document discusses cervical cancer prevalence, incidence, and mortality worldwide and in Saudi Arabia. It notes that cervical cancer is the second leading cause of cancer death in women globally, with over 500,000 new cases and 288,000 deaths annually. In Saudi Arabia specifically, the incidence is very low at 1.9 cases per 100,000 women, accounting for 152 new cases and 55 deaths annually. However, little is known about HPV prevalence and transmission patterns in the country. The challenges in addressing cervical cancer in Saudi Arabia include understanding HPV and abnormal cytology prevalence, sexual practices, implementing screening programs, determining vaccine cost-effectiveness, and ensuring quality screening and colposcopy.
The document summarizes the 2013 guidelines for cervical cancer screening in average-risk women. It recommends that screening should begin at age 21 with conventional or liquid-based cytology every 3 years. From ages 30-65, it is acceptable to continue cytology alone every 3 years, but preferred is co-testing with cytology and HPV testing every 5 years. Screening should stop at age 65 for women with adequate negative prior screening or after total hysterectomy with no history of precancerous lesions. The guidelines do not recommend annual screening or primary HPV testing alone for screening.
Dept. of Health cervical cancer fogsi_ screening test npcdcs_dept. of genera...drdduttaM
This document discusses screening methods for cervical cancer. It begins by defining screening as universal testing of at-risk populations regardless of risk factors. For cervical cancer, screening is suitable because it has a long precancerous phase and simple, non-invasive tests are available. The document then discusses various screening methods including conventional cytology (Pap smear), liquid-based cytology, visual inspection with acetic acid (VIA), HPV DNA testing, and triage tools. It notes that while Pap smears have been effective, alternative strategies like VIA are needed in India due to lack of infrastructure. VIA is described as an inexpensive, simple test that allows for immediate results and screening of large numbers of women.
HPV infection, cervical abnormalities, and cancer in HIV-infected women in Mu...Dr.Samsuddin Khan
Background: HIV-infected women are at a higher risk of cervical intraepithelial neoplasia (CIN) and cancer than women in the general population, partly due to a high prevalence of persistent human papillomavirus (HPV) infection. The aim of the study was to assess the burden of HPV infection, cervical abnormalities, and cervical cancer among a cohort of HIV-infected women as part of a routine screening in an urban overpopulated slum setting in Mumbai, India.
Methods: From May 2010 to October 2010, Médecins Sans Frontières and Tata Memorial Hospital Mumbai offered routine annual Pap smears and HPV DNA testing of women attending an antiretroviral therapy (ART) clinic and a 12-month follow-up. Women with abnormal test results were offered cervical biopsy and treatment, including treatment for sexually transmitted infections (STIs).
Results: Ninety-five women were screened. Median age was 38 years (IQR: 33–41); median nadir CD4-count 143 cells/µL (IQR: 79–270); and median time on ART 23 months (IQR:10–41). HPV DNA was detected in 30/94 women (32%), and 18/94 (19%) showed either low-grade or high-grade squamous intraepithelial lesions (LSIL/HSIL) on Pap smear. Overall, >50% had cervical inflammatory reactions including STIs. Of the 43 women with a cervical biopsy, eight (8.4%) had CIN-1, five (5.3%) CIN-2, and two (2.1%) carcinoma in situ. All but one had HPV DNA detected (risk ratio: 11, 95% confidence interval: 3.3–34). By October 2011, 56 women had completed the 12-month follow-up and had been rescreened. No new cases of HPV infection/LSIL/HSIL were detected.
Conclusion: The high prevalence of HPV infection, STIs, and cervical lesions among women attending an ART clinic demonstrates a need for routine screening. Simple, one-stop screening strategies are needed. The optimal screening interval, especially when resources are limited, needs to be determined.
Cervical Cancer Vaccine - Do we need it in IndiaGaurav Gupta
The document discusses cervical cancer and the HPV virus. It provides epidemiological data on cervical cancer in India, describing it as the most common cancer in Indian women. It explains the link between HPV infection and cervical cancer, noting that HPV vaccination can prevent most cervical cancers. The document discusses two approved HPV vaccines, Gardasil and Cervarix, comparing their efficacy, safety and immune responses elicited. It recommends HPV vaccination as an important strategy for cervical cancer prevention.
HPV Infections, Cervical Dysplasia and the HPV Vaccine; What will the future ...Summit Health
This document discusses HPV infections, cervical dysplasia, and the HPV vaccine. It provides information on HPV epidemiology, risk factors for cervical cancer, pathogenesis and progression of HPV infection to cervical dysplasia and cancer. Screening recommendations and management of abnormal Pap smears and cervical dysplasia are summarized. The history and development of HPV vaccines including Gardasil and Cervarix are briefly outlined.
Mrs. Payne is a 45-year-old female presenting for her annual exam. She has not had a visit in over 5 years. The nurse practitioner will interview her, update her medical history, and perform a physical exam. Recommendations will address Mrs. Payne's smoking, weight, lack of exercise, and osteoporosis prevention. The practitioner will educate her on menopause, nutrition, physical activity, weight loss, smoking cessation, and cancer screenings. Mrs. Payne will schedule follow ups to review labs and monitor her progress.
Asccp management guidelines august 2014 ppt. Dr. Sharda Jain /Dr Jyoti Agarw...Lifecare Centre
Updated Consensus
American society of Colpscopy & cervical pathology
Guidelines 2014for Managing forAbnormal Cervical Cancer Screening Test and Cancer Precursors
Dr. Sharda Jain /Dr Jyoti Agarwal / dr. Jyoti Bhasker
The document discusses the Female Cancer Foundation and its efforts to eliminate cervical cancer worldwide. It notes that cervical cancer is the second most common cancer in women globally, with over 500,000 new cases diagnosed each year, primarily in developing countries. The Foundation aims to increase awareness, provide screening and treatment, and train local healthcare workers in developing countries using low-cost methods. Its goal is to work with partners and volunteers towards a world without cervical cancer.
The document discusses cervical cancer screening alternatives for developing world contexts. It reviews cervical cancer incidence, risk factors, and the limitations of Pap screening in low-resource areas. The document proposes visual inspection with acetic acid (VIA) as a screening alternative that has shown favorable results compared to cytology in other studies. It describes how to perform VIA screening and the next steps needed to develop a cervical cancer screening program in Santa Lucia, Honduras.
This study evaluated the performance of five clinical decision rules for identifying low bone mineral density (BMD) in 174 postmenopausal African American women. The decision rules had sensitivities between 65.57-83.61% and specificities between 53.85-78.85% for identifying women with low BMD. Positive predictive values ranged from 80.95-87.91% and negative predictive values ranged from 48.44-58.33%. The study found that the decision rules showed some usefulness in identifying low BMD in this population but that more research is needed to establish appropriate cut-points for African American women.
The utility-visual-inspection-with-acetic-acid-cervical-cancer-screening-ecoa...Amarlasreeja
Cervical cancer is potentially preventable but still remains a leading cause of cancer mortality in in developing countries like Nigeria. Cytology-based screening programmers are difficult to maintain in these countries.
3.Edward A. Sickles_Surveillance Imaging for Probably Benign Findings: Benefi...Wanfang Radiology
This document summarizes evidence on mammographic surveillance of probably benign breast lesions. Key points include:
- Studies have found positive predictive values of 0.1-11.2% for probably benign lesions identified on mammography and followed with serial imaging.
- Cancers detected through surveillance tend to be nonpalpable, early-stage lesions with favorable prognosis despite interval growth.
- Serial imaging can help identify cancers earlier through detection of interval change in probably benign lesions over time.
This document discusses cancer screening guidelines for several common cancers. It recommends screening for breast cancer with annual mammograms and clinical exams starting at age 40, and beginning earlier or including MRI for those at high risk. Cervical cancer screening should begin at age 21 with Pap tests every 3 years or co-testing with HPV every 5 years. Colorectal cancer screening options include colonoscopy every 10 years, sigmoidoscopy every 5 years, or annual fecal tests. Genetic screening is recommended for those with a family history suggesting inherited cancer risk. Lung cancer screening with low-dose CT is advised for high-risk smokers aged 55-74. Prostate cancer screening involves PSA testing and DRE for men aged 50-69
Human papiloma virus and its association to Cervical Cancer
HPV in Saudi Arabia .
Currently I am working in Arar Central Hospital, in Arar city
In Saudi Arabia.
Please do not hesitate to contact us if you require any further information.
Alsultany@hotmail.com
This document summarizes primary and secondary prevention strategies for cervical cancer in Saudi Arabia. It begins with epidemiological data showing cervical cancer rates are lower in Saudi Arabia than worldwide but there is currently no organized screening program. It then reviews the role of HPV in causing cervical cancer and limitations of traditional Pap smear screening including sensitivity. The document discusses how HPV testing may improve screening through use as a primary test or to triage abnormal Pap results. Large clinical trials show HPV testing is more sensitive for detecting cervical precancers. The document concludes by stating vaccination could provide active primary prevention against HPV types that cause cervical cancer.
HPV infection and anal dysplasia in Vancouver: findings from the ManCount Survey.CBRC
This document summarizes preliminary findings from the ManCount Survey regarding HPV infection and anal dysplasia in gay and bisexual men in Vancouver. Rectal swabs were self-collected by 252 survey participants. The results found that 38% tested negative for HPV and 47% tested positive for high-risk HPV types. Abnormal anal cytology results were found in 11% (high-grade) and 19% (low-grade). The next steps will analyze these preliminary medical findings together with behavioral data to inform policies around HPV vaccination and anal pap screening for men who have sex with men.
This document provides an overview of cervical cancer and HPV. It discusses that HPV is the underlying cause of cervical cancer and describes the natural history of HPV infection. HPV is very common and usually clears without symptoms, but sometimes causes pre-cancerous cervical changes that can develop into invasive cancer if left untreated. Screening guidelines and new HPV vaccines are aimed at preventing cervical cancer by detecting and treating pre-cancerous cells or protecting against HPV infection. Regular Pap screening allows most pre-cancer to be detected and treated before it develops into invasive cancer.
Voluntary medical male circumcision vs hiv prevention...evidence.Adeniji Victory
Voluntary Medical Male circumcision has been proven to be an evidence based route of HIV prevention . Its also envisaged that the cost of HIV treatment in the next ten year can be reduced by tenth fraction with an elaborate VMMC performed in two years.
The uptake of VMMC is still not impressive in sub-saharan Africa.
This slides present the evidence for the efficiency of VMMC in HIV prevention.
Cervical screening , present past crown plaza final copyBasalama Ali
This document discusses cervical cancer screening and prevention. It provides the following key points:
1. Cervical cancer is the 2nd most common cancer in women worldwide, with an estimated 530,000 new cases and 274,000 deaths annually, most occurring in developing countries.
2. Incidence of cervical cancer is low in Saudi Arabia but it remains the 8th most common cancer in women, with 241 new cases and 84 deaths estimated annually.
3. Infection with human papillomavirus (HPV) is the most significant risk factor for cervical cancer. Worldwide nearly 100% of cervical cancer cases are HPV-positive.
4. Screening is important for secondary cervical cancer prevention.
Cervical cancer is caused by human papillomavirus (HPV) infection and is preventable through vaccination and screening. Screening via the Pap test can detect precancerous changes in the cervix so that treatment can prevent the development of cancer. Getting regular Pap tests beginning at age 21 or within three years of becoming sexually active can help prevent cervical cancer, as can vaccination against HPV.
Cervical cancer is caused by human papillomavirus (HPV) infection and develops slowly over time. Screening through regular Pap tests can detect precancerous changes in the cervix so they can be treated before cancer develops. Most cervical cancers are preventable with vaccination against HPV and appropriate screening. Screening guidelines recommend annual Pap tests beginning at age 21 and can be less frequent or stop at age 70 if previous results have been normal. Abnormal results may require further tests like colposcopy and HPV testing and possible treatment of precancerous lesions.
Screening modalities like the Pap test and HPV test can help detect abnormal or precancerous cervical cells. The Pap test screens for cell changes and is recommended starting at age 21 and every 3 years. The HPV test screens specifically for the human papillomavirus, which can cause cell changes. For women over 30, both tests may be used. Certain groups like those without insurance can access free screening services. While screening is important, both false positives and false negatives can occur with the Pap test. Multiple organizations provide guidelines around cervical cancer screening.
Screening modalities like the Pap test and HPV test can help detect abnormal or precancerous cervical cells. The Pap test screens for cell changes and is recommended starting at age 21 and every 3 years. The HPV test screens specifically for the human papillomavirus, which can cause cell changes. For women over 30, both tests may be used. Certain groups are at higher risk for cervical cancer, including those with lower incomes or HIV/AIDS. While screening can help detect cell changes, both tests can produce false positives or negatives, so guidelines recommend less frequent screening to avoid unnecessary procedures. Treatment options depend on age and test results but aim to remove visible warts or abnormal cells.
Cervical cancer screening guidelines 2013 on 7th septLifecare Centre
The document summarizes the 2013 guidelines for cervical cancer screening in the United States. The key points are:
1. Screening should begin at age 21 with cytology alone every 3 years until age 30.
2. From ages 30-65, co-testing with cytology and HPV testing every 5 years is the preferred method. Cytology alone every 3 years is acceptable.
3. Screening can stop at age 65 for women with adequate negative prior screening and no history of CIN2 or worse. Screening after a hysterectomy also depends on whether the cervix was removed.
Mission SAY No to Cervical Cancer With HPV Vaccination DR. SHARDA JAIN S...Lifecare Centre
1. Cervical cancer is a major health issue in India, accounting for 23% of new cervical cancer cases and 25% of cervical cancer deaths worldwide.
2. Human papillomavirus (HPV) infection causes cervical cancer, with vaccination providing 98-100% efficacy against HPV types.
3. Screening and vaccination can help prevent cervical cancer, but coverage in India remains low due to cost and lack of national programs.
Welcoming remarks by Dr Osborne E Nyandiva on Symposium: Cervical cancer and its prevention
Co-Presenter Dr Giama. We are happy to present to you this very crucial discussion on Cancer.
Cervical cancer is a type of cancer that develops in a woman's cervix (the entrance to the womb from the vagina).
Cancer of the cervix often has no symptoms in its early stages. If you do have symptoms, the most common is unusual vaginal bleeding, which can occur after sex, in between periods or after the menopause.
CERVICAL-CANCER-introduction, screening and preventionssuser002e70
This document provides an introduction to cervical cancer, including:
- Cervical cancer is a major public health problem, with over 660,000 new cases and 350,000 deaths globally each year. India accounts for 20% of new cases.
- HPV infection is the main cause, with types 16 and 18 associated with over 80% of cancers.
- Screening through Pap smear cytology, VIA, or HPV testing and vaccination can help prevent cervical cancer by identifying and treating precancerous lesions.
- Barriers to controlling cervical cancer include lack of screening infrastructure, funding, awareness, and trained healthcare workers.
The cervical cancer overview with key stats around the world and in Nepal.
Discussion on the sensitivity and specificity of different cervical cancer screening techniques.
Screening modalities like the Pap test and HPV test can help detect abnormal or precancerous cervical cells. The Pap test screens for cell changes and is recommended starting at age 21 and every 3 years. The HPV test screens specifically for the human papillomavirus, which can cause cell changes. For women over 30, both tests may be used. Certain groups like those without insurance can access free screening services. While screening is important, both false positives and false negatives can occur with the Pap test. Multiple organizations provide guidelines around cervical cancer screening.
Screening modalities like the Pap test and HPV test can help detect abnormal or precancerous cervical cells. The Pap test screens for cell changes and is recommended starting at age 21 and every 3 years. The HPV test screens specifically for the human papillomavirus, which can cause cell changes. For women over 30, both tests may be used. Certain groups like those without insurance can access free screening services. While screening is important, both false positives and false negatives can occur with the Pap test. Multiple organizations provide guidelines around cervical cancer screening.
Screening modalities like the Pap test and HPV test can help detect abnormal cervical cells that could become cervical cancer if left untreated. The Pap test screens for cell changes and is recommended starting at age 21 and every 3 years. The HPV test screens specifically for the human papillomavirus that can cause cell changes, and is often used along with the Pap test for women over 30. Certain groups like low-income women may be able to access free screening services. While screening helps detect cervical cancer early, tests can sometimes provide false positives or negatives, so guidelines recommend less frequent screening to avoid unnecessary procedures. Factors like multiple sex partners or smoking can increase cervical cancer risk for some populations.
Dr nisreen anfnan cervical cancer in saudi arabia last versionTariq Mohammed
The document discusses cervical cancer in Saudi Arabia. It finds that incidence of cervical cancer is low in Saudi Arabia, ranking 11th among cancers in females, with 152 new cases and 55 deaths per year. HPV is detected in 31.6-5.6% of women in Saudi Arabia. Nearly all cervical cancer cases (92.9-100%) are associated with HPV infection, most commonly HPV 16 and 18. The document calls for a nationwide cervical cancer screening program in Saudi Arabia, as the actual reasons for low incidence are unknown without screening. It proposes a screening program using HPV testing to screen women ages 30-65 every 5 years until age 65.
Similar to Male Circumcision Research Into Policy Final Sahara Dec 09 2009 (20)
Male Circumcision Research Into Policy Final S A H A R A Dec 09 2009Nicholas Jacobs
Male circumcision has been shown to reduce HIV infection risk in men by 50-60%. Three randomized controlled trials in Africa found circumcision reduced HIV risk. WHO and UNAIDS recommend countries with high HIV prevalence and low circumcision rates consider scaling up circumcision services. In South Africa, circumcision services have been piloted and national guidelines are being developed. Modeling predicts circumcision scale-up could significantly reduce HIV prevalence over time if uptake is high. Ensuring services are gender-sensitive, communicate partial efficacy, and promote safer sex practices will be important for effectiveness.
This document summarizes a study on the impact of HIV-related sickness on migration patterns in Southern Africa. The study found that when individuals in cities like Johannesburg become too sick to work due to HIV, most will return home (68% of men, 58% of women). If someone back home becomes sick with HIV/AIDS, men are more likely to send money home while women are more likely to return home to provide physical and emotional care. The study highlights the importance of networks of care in explaining migration patterns and challenges the assumption that migration is solely for better access to health services.
This document summarizes a workshop on developing evidence on vulnerabilities of men who have sex with men (MSM) and gays in sub-Saharan Africa to support HIV/AIDS advocacy and policy. It discusses the diverse socio-political landscapes across 22 countries, where some criminalize homosexuality while others have more tolerant cultures. While many LGBT communities and organizations exist, they often operate secretly due to oppression. The document analyzes factors like laws, stigma, risky sex practices, and inclusion of MSM in national HIV strategies. It concludes that building solidarity through research-informed advocacy, capacity building, and combating prevention could help address challenges faced by sexual minorities.
1. Uganda saw a dramatic decline in HIV prevalence from 21.1% in 1991 to 9.1% in 1998 through large-scale behavioral changes, equivalent to a 75% effective vaccine.
2. The biggest factor was a substantial decline in sexual partners, with 48% of men and women reporting sticking to one partner.
3. The changes were driven by community and political efforts reinforcing each other through messaging focused on risk avoidance, open discussion of HIV/AIDS, and promoting care for infected individuals and orphans.
This document discusses a study on the reasons young people in rural KwaZulu-Natal, South Africa undergo virginity testing. It provides background on virginity testing as a traditional practice and its revival. The study aims to understand perceptions of virginity testing from the perspectives of adolescents, particularly reasons for undergoing tests. It reviews literature discussing views both supporting and opposing virginity testing and implications for sexual health.
01 Monica Do Santos Healing The Dragon S A H A R ANicholas Jacobs
This document discusses interventions for heroin use disorders and reducing HIV transmission. It summarizes findings from previous studies that found many intravenous drug users in Africa do not properly clean or dispose of needles, increasing HIV risk. The objectives are to compare views of long-term former heroin users and specialists on effective interventions and improve programs. Semi-structured interviews were conducted with 40 former users and 10 specialists. Preliminary findings from the first study on former users are presented on their demographics and drug use histories.
05 Lawrence Osano Is Wife Inheritance An Impediment In H I VNicholas Jacobs
This document discusses how certain cultural practices in the Luo ethnic community in Kenya can act as impediments to controlling and preventing the spread of HIV/AIDS. It focuses on the practices of wife inheritance, polygamy, and "Chira" (a curse). Wife inheritance traditionally ensured continuity of the family line but now young men often claim widows for pleasure without concern for infection status. Polygamy allowed men to have many wives and sons, but spreading infection. "Chira" involved a ritual with a widow's body that could also spread disease. Male dominance prevents women from refusing unprotected sex or inheritance. The document calls for respecting traditions but adding education to address modern challenges like HIV/AIDS.
The document discusses strategies for reducing HIV risk among young people in South Africa. It argues that limited opportunities in education, employment, and entrepreneurship fuel the HIV epidemic by constraining choices and creating a perception of scant opportunity. The proposed strategies aim to change this perception by developing a mindset of seeking opportunity, building skills to negotiate pressures, and finding new links to opportunities through programs, peer networks, and media campaigns. The goal is reducing risk by empowering personal initiative to respond to circumstances.
This document outlines a research study on vulnerabilities of men who have sex with men (MSM) and gays in Eastern and Southern Africa. The study aims to develop an evidence base to advocate for more inclusive HIV/AIDS policies and programming. It involves a desktop literature review, focus group meetings in the region, and an international dialogue. The overall goals are to encourage quality prevention and care for MSM communities and influence policies related to their rights.
Review Of Interventions For Changing BehavioursNicholas Jacobs
This document discusses interventions and strategies for changing HIV-related behaviours. It outlines the theoretical basis for behavioural interventions, target behaviours like unprotected sex that need to be changed, and target groups like adolescents, sex workers, and men who have sex with men. Strategies discussed include counseling, group education sessions, and social events. Examples are given of behavioural interventions conducted in South Africa, including school-based programs, interventions for drug users and those with STIs, and community-based testing initiatives. The conclusion emphasizes the need for sustained, community-level interventions that integrate behavioural strategies into existing programs and services.
The document summarizes research conducted in 9 Southern African countries on multiple and concurrent partnerships (MCPs) as a driver of HIV. Focus groups and interviews found MCPs are common due to sexual dissatisfaction, culture/norms, money/gifts, alcohol, and male dominance. Countries then developed national mass media campaigns promoting safe relationships and challenging MCPs. A regional One Love Southern Africa campaign was also launched with a website, TV drama, radio drama, posters, booklets, and partnerships across countries.
01 Vearey S A H A R A I O M Session 3 Dec 2009Nicholas Jacobs
This document summarizes challenges to common assumptions about migration and health in South Africa. It finds that migrants are often wrongly assumed to travel for healthcare and burden health systems. However, data shows that most migrants seek healthcare after living in South Africa for some time and for reasons other than health. While migrants face barriers to care, their health outcomes on treatment are similar to citizens. The document calls for implementing protective laws and considering health and migration together to address the social determinants of migrant health.
03 N Phaswana Mafuya Perceptions Of Sugar Mommy PracticesNicholas Jacobs
This study explored perceptions of sugar mommy relationships in South Africa through focus groups. There were mixed views on whether these relationships occur and their acceptability. Some saw them as acceptable if due to love, while others saw issues with lack of ethics or promoting youth exploitation. Reasons older women engage in these relationships included sexual fulfillment, domination, procreation, stress relief, and physical attraction to youth. Younger men's reasons included material gain, stress relief, being enticed, rejection by peers, peer influence, beliefs that older women are purer, and that they provide tender loving care and maturity. The study aimed to understand these relationships and perspectives on their occurrence and acceptability.
The document summarizes key discussions from Round Table 7 on using HIV counseling and testing (HTC) as a prevention strategy in Southern Africa. It notes innovative ideas around regional standards for HTC and linking services. Challenges discussed include a lack of evidence on prevention impacts and potential increases in violence if one partner tests positive. Policy implications focus on ensuring quality, accessible HTC services.
The document discusses the Scrutinize social marketing campaign in South Africa, which aims to reduce HIV transmission by promoting partner reduction, condom use, and testing. It describes the campaign's animated adverts ("animerts"), key messages, and accompanying materials. Discussants report the animerts resulting in self-reflection and questioning of personal sexual behaviors. The document raises questions about ensuring the campaign's mass media and interpersonal communication components effectively convey prevention messages at the community level.
The document summarizes research conducted in 9 Southern African countries on multiple and concurrent partnerships (MCPs) as a driver of HIV. Focus groups and interviews found MCPs are common due to sexual dissatisfaction, culture/norms, money/gifts, alcohol, and male dominance. Countries then developed national mass media campaigns promoting safe relationships without MCPs. A regional campaign called "One Love Southern Africa" was also launched with a website, TV drama, radio drama, posters, and partnerships across countries.
This document outlines a research study on vulnerabilities of men who have sex with men (MSM) and gays in Eastern and Southern Africa. The study aims to develop an evidence base to advocate for more inclusive HIV/AIDS policies and programming. It involves a desktop literature review, focus group meetings in the region, and an international dialogue. The overall goals are to encourage quality prevention and care for MSM communities and influence policies related to their rights.
This document summarizes a workshop on developing evidence on vulnerabilities of men who have sex with men (MSM) and gays in sub-Saharan Africa to support HIV/AIDS advocacy and policy. It discusses the diverse socio-political landscapes across 22 countries, where some criminalize homosexuality while others have more tolerant cultures. While many LGBT communities and organizations exist, they often operate secretly due to oppression. The document analyzes factors like laws, stigma, risky sex practices, and inclusion of MSM in national HIV strategies. It concludes that building solidarity through research-informed advocacy, capacity building, and combating prevention could help address challenges faced by sexual minorities.
This document discusses a study on the reasons young people in rural KwaZulu-Natal, South Africa undergo virginity testing. It provides background on virginity testing as a traditional practice and its revival. The problem statement notes that while studies have focused on the debate around banning testing, little research has examined the views of those undergoing testing. The aims of this study are to explore perceptions of testing and the reasons for undergoing it from the perspective of young people.
The document summarizes key discussions from Round Table 7 on using HIV counseling and testing (HTC) as a prevention strategy in Southern Africa. It notes innovative ideas around regional standards for HTC and linking services. Challenges discussed include a lack of evidence on prevention impacts and potential increases in violence if one partner tests positive. Policy implications focus on ensuring quality, accessible HTC services.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Role of Mukta Pishti in the Management of Hyperthyroidism
Male Circumcision Research Into Policy Final Sahara Dec 09 2009
1. Male Circumcision:
Translation of Evidence into Action
Professor Helen Rees
Co-chair of SANAC Programme Implementation Committee
Executive Director, Reproductive Health and HIV Research Unit,
University of Witwatersrand
Honorary Professor: London School of Hygiene & Tropical Medicine
3. In South Africa there
are three new
people infected
For every one
person
commencing
treatment in
2009……..
We will never overcome this epidemic if we only treat patients
4. Why did we consider male circumcision?
Source: UNAIDS 2006 Report on the Global AIDS PandemicIAS Conference Toronto 2006
Beyrer C.
5. Why did we consider male circumcision?
About 30% of males globally are circumcised mainly for
religious, cultural or social reasons
6. We already knew about some health
advantages…..
• Urinary tract infections in • Human Papilloma Virus (HPV)
infants - 63% reduction in
- 12 fold increased risk in circumcised men
uncircumcised boys
• Sexually transmitted • Cervical cancer (HPV) in
infections female partners
• Syphilis (Ulcer) - 2.0 – 5.8 times more
- 1.5-3.0 fold increased risk frequent in women with
in uncircumcised men uncircumcised partners
• Chancroid (Ulcer)
- 2.5 fold increased risk in • Penile cancer (HPV) in men
uncircumcised men - 22 times more frequent in
uncircumcised men
7. There’s been a lot of research…
• 4 ecological studies: Studies that look HIV prevalence is
at associations in large populations lower where
circumcision if
• 35 cross-sectional studies: Studies that higher
look at associations in a population at
one point in time HIV infection
reduced by
• 14 prospective studies: Studies that about 50%
follow up a group of men for a period
of time and observe what happens to HIV infection
them reduced by 50%
or more
9. Randomised controlled trials of male
circumcision to reduce HIV infection
Rakai, Uganda
Gray et. al. (2007)
Lancet; 369: 657 – 66
Kisumu, Kenya
Bailey et. al. (2007)
Lancet; 369: 643 – 56
Orange Farm, South Africa
Auvert et. al. (2005)
Source: 2006 Report on the global AIDS epidemic
PLoS Med; 2 (11): e298
(UNAIDS, May 2006)
10. How were these RCTs designed?
Men are from the Select the population:
same community so Young men at risk of HIV
are likely to behave
in similar ways and
have the same Explain that they might be circumcised
environment now or after 18 months
Divide the men into two groups, half will be circumcised now and half will be
circumcised later.
The researchers and the participants are ‘told’ which group they go into.
Counsel all the men about circumcision and about safer sexual practices
Follow the group up for a year to see who gets HIV infected.
Is it the circumcised men or the uncircumcised men?
11. Results of the three MC trials (RCTs) 2007
Orange Rakai, Kisumu,
Farm Uganda Kenya
Sample size
(Number of men) 3128 4996 2784
Total sero- 69 65 69
conversions
HIV+ MC arm 20 22 22
HIV+ control arm 49 43 47
% reduction in HIV 61% 48% 53%
P < 0.001 P < 0.005 P < 0.005
12. RCT Results of three MC trials (RCTs) 2007
Orange
Farm Rakai Kisumu
Sample size
(Number of men) 3128 4996 2784
Total sero- 69 65 69
conversions
HIV+ MC arm 20 22 22
HIV+ control arm 49 43 47
% reduction in HIV 61% 48% 53%
P < 0.001 P < 0.005 P < 0.005
13. Impact on HIV incidence:
Evidence from observational studies & RCTs
Effect size
Study (95% CI)
Overall 0.42 ( 0.34, 0.52)
High-risk groups 0.29 ( 0.20, 0.42)
General Population 0.56 ( 0.44, 0.71)
South Africa 0.40 ( 0.24, 0.67)
Kenya 0.41 ( 0.24, 0.70)
Uganda 0.49 ( 0.28, 0.86)
.15 .2 .3 .4 .5 1 1.5
Effect size
15. Does it make sense biologically?
Diagram of erect uncircumcised penis with
foreskin retracted
Inner mucosal layer of inner foreskin is exposed
McCoombe & Short, AIDS 2006 20:1491-1495
17. Acceptable in sub-Saharan Africa ?
2006: review of 13 acceptability studies
in 9 sub-Saharan countries:
Uncircumcised men for themselves: 65% (29-87%)
Women (for their partners): 69% (47-79%)
Men for their son: 71% (50-90%)
Women for their son: 81% (70-90%)
Westercamp et al. AIDS Behav. 2006 Oct.
.
18. Acceptability of MC from 13 African studies
The percentage of men and women who agreed with the following statements:
Not surprising: Zulus, Twanas …
19. Some curved balls:
Self reported MC status
• Men asked “Are you circumcised?”
• Physical examination by a male nurse
• 45% of men who said they were circumcised had intact
foreskin
• Possible reasons:
– Confusion between MC and Initiation
– Confusion with words used, vernacular
– Lack of knowledge on what MC is
Orange Farm, Taljard et al 2008
20. HIV (%) and circumcision status
25
PRR=0.93
p=0.73
20
20.2%
18.8%
15
10
5
0
‘’Circumcised’’ Uncircumcised
with foreskin
21. HIV (%) and circumcision status
25
PRR=0.48 p=0.002
20
20.2%
18.8%
15
10
9.5%
5
0
‘’Circumcised’’ ‘’Circumcised’’ Uncircumcised
without foreskin with foreskin
Thus, self reported MC status is a VERY unreliable indicator
22. With all the available data the
scientific world needed no more
convincing
23. The Global Recommendations
WHO/UNAIDS Technical Consultation Male
Circumcision and HIV Prevention: Research
Implications for Policy and Programming, 2007
24. Global Recommendations
• Countries with high prevalence (>15%), generalized
heterosexual HIV epidemics and low rates of MC
should consider urgently scaling up access to MC
services
• 13 countries identified: Botswana, Kenya, Lesotho,
Malawi, Mozambique, Namibia, Rwanda, South
Africa, Swaziland, Tanzania, Uganda, Zambia and
Zimbabwe
• Consider ethics, communication, culture, health
systems, funding, gender, comprehensive prevention
strategies
25. UN Support Actions
The UN partners joint work plan on male circumcision
assists countries to make evidence-based policy and
programme decisions to improve the availability,
accessibility and safety of male circumcision and
reproductive health services as an integral
component of comprehensive HIV prevention
strategies.
26. UN Operational Guidance for MC Scale-up
1. Leadership and 6. Quality assurance and
partnership improvement
2. Situation analysis 7. Human resource
development
3. Advocacy
8. Commodity security
4. Enabling policy and 9. Social change
regulatory environment communication
5. Strategy and operational 10. Monitoring and evaluation
plan
28. Activities for Male Circumcision for HIV Prevention,
2009
Tanzania, Malawi
Situation analysis, pilot Kenya: national guidance &
service sites strategy, situation analysis,
guidelines, training, Quality
Rwanda advocacy Assurance guide, expanded service
campaign, situation delivery, communication & advocacy
assessment under development, M&E, research
underway, services in
military Uganda
Situation analysis, policy
Lesotho: advocacy, development, Comms draft
situation analysis, policy
development, draft Zambia: Situation analysis,
strategy & comms trainings, policy, strategy &
Implementation plan, service
Namibia: delivery
Champions visit,
advocacy, DMPPT,draft Botswana: Situation analysis,
policy, strategy, training DMPPT,policy, strategy, training,
and QA planned, M&E, communications and QA
communications plan
Swaziland
South Africa Policy approved, situation analysis,
Situation analysis strategy & Implementation plan,
underway, draft leg/regulatory assessment, trainings,
guidelines QA, M&E draft, comms draft
29. Snapshot of countries’ progress 2009
Situation Policy & Training Quality Service delivery
Leadership I II
Analysis Reg I Training II Assur M&E
Botswana
Kenya
Lesotho
Malawi
Mozambique
Namibia
Rwanda
South Africa
Swaziland
Tanzania
Uganda
Zambia
Zimbabwe
31. What's been happening in South Africa?
Leadership and
civil society
concerns 2008
MC raised in
RCT Studies SANAC, 2008
available, 2007
Action taken
MC raised in in SANAC,
SANAC, 2007 2009
Pietermaritzburg SANAC plenary Commitment to
Orange Farm agreed to
pilot 2007 pilot 2009 public sector scale
develop public
onwards onwards up in 2010?
sector guidelines
Lack of political
support SANAC reinvigorated by SANAC
political and civil society indecisiveness
SANAC reinvigorated by about policy versus
civil society leadership leadership
guidelines
32. What's been happening in South Africa?
Leadership and
civil society
concerns 2008
MC raised in
Studies available, SANAC, 2008
2007
MC raised in Action taken
SANAC, in SANAC,
2007 2009
Orange Pietermaritzburg SANAC plenary Commitment to
Farm pilot pilot 2009 agreed to public sector scale
develop public
2007 onwards up in 2010?
onwards sector guidelines
Lack of political
support SANAC reinvigorated by SANAC
political and civil society indecisiveness
SANAC reinvigorated by about policy versus
civil society leadership leadership
guidelines
33. What's been happening in South Africa?
Leadership and
civil society
concerns 2008
MC raised in
Studies available, SANAC, 2008
2007
MC raised in Action taken
SANAC, in SANAC,
2007 2009
Orange Pietermaritzburg 2009 SANAC Commitment to
Farm pilot pilot 2009 plenary agreed public sector scale
to develop public
2007 onwards up in 2010?
onwards sector guidelines
Lack of political
support SANAC reinvigorated by SANAC
SANAC reinvigorated by civil political and civil society indecisiveness
society leadership leadership about policy versus
guidelines
34. South Africa Score Card
Leadership and partnership Quality assurance
Researchers, civil society, and now and improvement
politicians, traditional leader &
practitioners Human resource
Situation analysis development
Being completed Commodity security
Advocacy
Social change
Researchers, treatment activist
communication
Enabling policy and regulatory
environment Monitoring and
Being explored evaluation
Strategy and operational plan
Plan not policy being developed
36. Modeling the Impact of MC on HIV Prevalence
& Incidence
Williams 2006
• 100% uptake of MC could avert 2.0 million new infections and
0.3 million deaths over ten years in sub-Saharan Africa
• Could avert 5.7 million new infections over 20 years
Nagelkerke 2007
• 50% uptake of circumcision over 10 years would reduce
prevalence from 18% to 8% over 30 years in Nyanza Province,
Kenya
Mesesan 2006
• 50% uptake of MC could avert 32,000 – 53,000 new infections in
Soweto, SA over 20 yrs.
• HIV Prevalence would decline from 23% to 14%
39. Male Circumcision Service Planning
Modelling circumcision
Services in the public
sector in Hillbrow, Inner
City Johannesburg
40. Alternative scenarios for Hillbrow
• Only 19% of the target population need to be interested to operate
one theatre at full capacity for five years
• With five theatres instead of one:
– 54,704 surgeries could be performed in the 5 years, resulting in
81% coverage
• Performing operations for 10 hours a day instead of 5 hours:
– Would achieve coverage of 37% up from 19%
• If Professional Nurses performed the surgery in lieu of doctors:
– The procedure would be 12% less costly
42. Joburg Circumcision Model Outputs
• Survey showed 80% men interested in MC
• This would mean over 67,000 males could
request MC services in Hillbrow over 5 yrs
• If there is 19% uptake of MC of those men
interested this will require one full-time
MC theatre to run at full capacity for 5
years doing 2500 surgeries per year
• The services will require 1.0 full time
equivalent doctor, 1.77 FTE staff nurses,
1.22 FTE counsellors and 0.23 non health
care workers
44. Recommendations from SANAC
plenary
These recommendations were developed from
two national consultations involving all SANAC
sectors and SANAC government departments and
consultations by sectors: traditional leaders,
NGOs, PLWHA, women, children, men……..
45. Importance of male sexual health package
• MC should be introduced to adolescents and young
men as part of a comprehensive sexual health
package that could include: HCT, STI treatment, safer
sex messaging, condoms, alcohol counselling
• HIV testing should be offered prior to MC but should
not be a prerequisite for MC.
46. Communication strategy
• Community messaging outlining what MC offers,
and discouraging unsafe MC services
• Messages must be clear
– Partial efficacy (only 60% effective)
– Sustaining safer Sexual practices
– Delay sexual debut
– Alcohol abuse
– Changing gender norms
– ‘Male Morality’ e.g. respect of women
• Appropriate media for the disabled
47. MC programmes must be gender sensitive
• Messaging must target women as partners &
mothers of sons
• Messaging must explain advantages to women of MC
• MC programmes should not pull funds away from
existing programmes targeting women eg PMTCT,
Female condoms
• MC should not further stigmatise HIV+ve women by
blaming them should a circumcised male become
infected
48. MC rollout in health services
• More than 3 million young men are
uncircumcised in SA
• Design programmes with reference to
demonstration projects underway e.g. Orange
Farm 8000 MCs in 18 months
• Beware of creating demand for MC without
services being able to respond
49. Costing and Research
• Modelling and costing should be undertaken
to assess affordability, impact and cost-
effectiveness (WHO model available)
• Sustainable funding required
• Research agenda ongoing
50. Take home messages in South Africa
• Policy or guidelines?
• Address traditional male circumcision within a policy?
• Speed in implementing medical male circumcision
programme within an sexual health package as part of SRH
service provision
• Communication strategy informing communities of MC and
HIV prevention data in sexual health context and discourage
unsafe MC practices
• Ongoing consultations with Houses of Traditional Leaders and
traditional practitioners, private sector, other sectors
51. Conclusion
• We have a highly effective intervention
• We must implement this speedily with
ongoing stakeholder consultations
“If this was a pretty drug in nice packaging….”
52. Thank you
Acknowledgments
All the men and women who participated in the
many studies
Dirk Taljard, Orange Farm
Kim Dickson, WHO,
François Venter, RHRU
AND
SOUTH AFRICA