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Development of a cervical cancer screening program in a slum setting using visual inspection with acetic acid: Analysis of feasibility and cost

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Open Journal of Obstetrics and Gynecology 2012年第2期2卷 140-146页

作者： Leslie S. Bradford Bimalangshu R. Dey Syed Md akram Hussain Sultana Razia Begum Farhat Hussain Sharmina Hoque Annekathryn Goodman ak khan healthcare trust Dhaka Bangladesh Division of Gynecologic Oncology Massachusetts General Hospital Boston USA Division of Hematologic Oncology Massachusetts General Hospital Boston USA

Objective: In Bangladesh, cervical cancer is the second most common cause of cancer deaths in women. Annually, over 50 million women are at risk for cervical cancer, with 17,686 cases diagnosed and 10,362 deaths each year. Visual inspection with acetic acid (VIA) is a well validated tool in low resource areas for identifying cervical lesions. In this pilot study, ak khan Health Care trust (akKHCT), in collaboration with oncologists at Massachusetts General Hospital (LB, BD, AG), launched a VIA cervical cancer-screening program. Methods: A clinic was established in the Korail Slum of Dhaka, a 90-acre slum with over 70,000 inhabitants, in the summer of 2011. From September 17, 2011 to November 1, 2011, ten women living in the Korail Slum were recruited and completed the three-month training program to learn how to do a pelvic examination and to evaluate the cervix using VIA. Three of the ten women performed VIA screening during the study period. Results: 44 patients were recruited and 8 women were identified to have VIA-positive results for a screen-positive rate of 18.2%. Two of the eight women underwent treatment. One woman underwent an excisional procedure for pre-invasive disease in the slum clinic. The other woman had an early invasive cervical cancer and was successfully treated in a local hospital. Conclusion: Our pilot project demonstrates some important factors in developing and implementing a successful screening program. Involving laywomen as healthcare workers provides a strong tie to community, as well as education, economic independence, and empowerment for women who would otherwise occupy a lower social standing in their community. VIA is feasible in the complicated environment of an inner city slum. It was feasible to perform minor excisional procedures to treat pre-invasive cervical disease in the slum clinic.

关键词： Visual Inspection Acetic Acid VIA Cervical Cancer Bangladesh Dhaka Slum Korail Slum

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Use of the reported Edmonton frail scale in the assessment of patients for transcatheter aortic valve replacement： a possible selection tool in very high-risk patients？

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Journal of Geriatric Cardiology 2018年第6期15卷 463-466页

作者： Louis Koizia Sarosh khan Angela Frame Ghada W Mikhail Sayan Sen Neil Ruparelia Geriatric Medicine St Mary's Hospital Praed Street London UK Department of Cardiology Western Sussex Hospitals NHS Foundation Trust West Sussex UK Department of Cardiology lmperial College Healthcare NHS Trust London UK

Transcatheter aortic valve replacement （TAVR） has revolutionised the treatment of patients with aortic stenosis （AS） over the last 15 *** is a well-established procedure for the treatment of patients considered high risk for open surgery. Results from the PARTNER （Placement of AoRTic traNscathetER） trial showed that inoperable patients randomly assigned to TAVR, had a 20% reduction in all-cause mortality, as well as hospitalisation, at one year compared to best medical management.

关键词： Edmonton frail scale Frailty Transcatheter aortic valve replacement

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Imaging of liver cancer

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World Journal of Gastroenterology 2009年第11期15卷 1289-1300页

作者： Ben Ariff Claire R Lloyd Sameer khan Mohamed Shariff Andrew V Thillainayagam Devinder S Bansi Shahid A khan Simon D Taylor-Robinson Adrian KP Lim Department of Imaging Imperial College Healthcare NHS Trust Charing Cross Hospital Campus Fulham Palace Road London W6 8RF United Kingdom Department of Hepatology and Gastroenterology Division of Medicine Imperial College London St Mary's Hospital Campus South Wharf Road London W2 1NY United Kingdom

Improvements in imaging technology allow exploitation of the dual blood supply of the liver to aid in the identif ication and characterisation of both malignant and benign liver lesions. Imaging techniques available include contrast enhanced ultrasound, computed tomography and magnetic resonance imaging. This review discusses the application of several imaging techniques in the diagnosis and staging of both hepatocellular carcinoma and cholangiocarcinoma and outlines certain characteristics of benign liver lesions. The advantages of each imaging technique are highlighted, while underscoring the potential pitfalls and limitations of each imaging modality.

关键词： Hepatic cell carcinoma Cholangiocarcinoma Contrast enhanced ultrasound Computed tomography Magnetic resonance imaging

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Viral hepatitis prevalence in patients with active and latent tuberculosis

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World Journal of Gastroenterology 2015年第29期21卷 8920-8926页

作者： Hesam Ahmadi Nooredinvand David W Connell Mahmoud Asgheddi Mohammed Abdullah Marie O'Donoghue Louise Campbell Melissa I Wickremasinghe Ajit Lalvani Onn Min Kon Shahid A khan Hepatology and Gastroenterology Section Division of Diabetes Endocrinology and MetabolismDepartment of MedicineImperial College London Tuberculosis Service St Mary’s HospitalImperial College Healthcare NHS Trust Liver Unit St Mary’s HospitalImperial College London

AIM: To assess the prevalence of hepatitis B virus(HBV) and hepatitis C virus(HCV) infection and association with drug induced liver injury(DILI) in patients undergoing anti-tuberculosis(TB) ***: Four hundred and twenty nine patients with newly diagnosed TB- either active disease or latent infection- who were due to commence antiTB therapy between September 2008 and May 2011 were included. These patients were prospectively tested for serological markers of HBV, HCV and human immunodeficiency virus(HIV) infections- hepatitis B core antigen(HBc Ag), hepatitis B surface antigen(HBs Ag), hepatitis B e antigen, Ig G and Ig M antibody to HBc Ag(anti-HBc), HCV Ig G antibody and HIV antibody using a combination of enzyme-linked immunosorbent assay, Western blot assay and polymerase chain reaction techniques. Patients were reviewed at least monthly during the TB treatment initiation phase. Liver function tests were measured prior to commencement of antiTB therapy and 2-4 wk later. Liver function tests were also performed at any time the patient had significant nausea, vomiting, rash, or felt non-specifically unwell. Fisher's exact test was used to measure significance in comparisons of proportions between groups. A P value of less than 0.05 was considered statistically ***: Of the 429 patients, 270(62.9%) had active TB disease and 159(37.1%) had latent TB infection. 61(14.2%) patients had isolated anti-HBc positivity, 11(2.6%) were also HBs Ag positive and 7(1.6%) were HCV-antibody positive. 16/270 patients with active TB disease compared to 2/159 patients with latent TB infection had markers of chronic viral hepatitis(HBs Ag or HCV antibody positive; P = 0.023). Similarly the proportion of HBs Ag positive patients were significantly greater in the active vs latent TB infection group(10/43 vs 1/29, P = 0.04). The prevalence of chronic HBV or HCV was significantly higher than the estimated United Kingdom prevalence of 0.3% for each. We found no ass

关键词： Epidemiology Hepatitis B Hepatitis C Tuberculosis Drug induced liver injury

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Global variation in skin injures and skincare practices in extremely preterm infants

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World Journal of Pediatrics 2023年第2期19卷 139-157页

作者： Pranav Jani Umesh Mishra Julia Buchmayer Rajesh Maheshwari Daphne D’Çruz Karen Walker Duygu Gözen Krista Lowe Audrey Wright James Marceau Mihaela Culcer Archana Priyadarshi Adrienne Kirby James EMoore Ju Lee Oei Vibhuti Shah Umesh Vaidya Abdelmoneim Khashana Sunit Godambe Fook Choe Cheah Wen-Hao Zhou Xiao-Jing Hu Muneerah Satardien Faculty of Medicine and Health The University of SydneySydneyNSWAustralia Department of Neonatology Westmead HospitalWestmeadNSW2145Australia Comprehensive Center for Pediatrics Department of Pediatrics and Adolescent MedicineDivision of NeonatologyPediatric Intensive Care and NeuropediatricsMedical University of ViennaViennaAustria Department of Newborn Care Royal Prince Alfred HospitalCamperdownNSWAustralia Council of International Neonatal Nurses BostonMAUSA The George Institute for Global Health SydneyNSWAustralia Sydney Institute for Women Children and Their FamiliesSydneyNSWAustralia Pediatric Nursing Department Florence Nightingale Faculty of Nursingİstanbul University-CerrahpaşaIstanbulTurkey The National Health and Medical Research Council Clinical Trials Centre University of SydneySydneyNSWAustralia Connecticut Children’s Division of Neonatal-Perinatal Medicine Connecticut Children’s Medical CenterHartfordCTUSA UCONN School of Medicine FarmingtonCTUSA The Royal Hospital for Women RandwickNSWAustralia School of Women’s and Children’s Health University of New South WalesRandwickNSWAustralia Department of Paediatrics and Institute of Health Policy Management and EvaluationMount Sinai HospitalTorontoCanada Department of Pediatrics King Edward Memorial HospitalPuneIndia Pediatrics Suez Canal UniversityIsmailiaEgypt Divisional Director for Clinical Governance Women’sChildren’s and Clinical SupportImperial College Healthcare NHS TrustLondonUK Department of Pediatrics Faculty of MedicineUniversiti KebangsaanBangiMalaysia Hospital Canselor Tuanku Muhriz Jalan Yaacob LatifBandar Tun RazakKuala LumpurMalaysia Department of Neonatology and Vice President Children’s Hospital of Fudan UniversityShanghaiChina Vice Director of Nursing Department Children’s Hospital of Fudan UniversityShanghaiChina Department of Paediatrics and Child Health Tygerberg HospitalCape TownSouth Africa University of Stellenbosch Cape TownSouth Africa

Background Globally,are skincare practices and skin injuries in extremely preterm infants comparable?This study describes skin injuries,variation in skincare practices and investigates any association between *** A web-based survey was conducted between February 2019 and August *** skin injuries and describing skincare practices in extremely preterm infants were the main *** association between skin injuries and skincare practices was established using binary multivariable logistic regression adjusted for *** Responses from 848 neonatal intensive care units,representing all geographic regions and income status groups were *** dermatitis(331/840,39%)and medical adhesive-related skin injuries(319/838,38%)were the most common *** a local skincare guideline reduced skin injuries[medical adhesive-related injuries:adjusted odds ratios(aOR)=0.63,95%confidence interval(CI)=0.45–0.88;perineal injuries:aOR=0.66,95%CI=0.45–0.96;local skin infections:OR=0.41,95%CI=0.26–0.65;chemical burns:OR=0.46,95%CI=0.26–0.83;thermal burns:OR=0.51,95%CI=0.27–0.96].Performing skin assessments at least every four hours reduced skin injuries(abrasion:aOR=0.48,95%CI=0.33–0.67;pressure:aOR=0.51,95%CI=0.34–0.78;diaper dermatitis:aOR=0.71,95%CI=0.51–0.99;perineal:aOR=0.52,95%CI=0.36–0.75).Regional and resource settings-based variations in skin injuries and skincare practices were *** Skin injuries were common in extremely preterm *** in practice and improved surveillance appears to reduce the occurrence of these *** evidence regarding optimal practices is needed to reduce skin injuries and minimize practice variations.

关键词： Extremely premature infants Injuries Neonatal intensive care unit Skin care Wounds

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