SENSITIVITY AND SPECIFICITY OF VISUAL INSPECTION WITH LUGOL’S IODINE S(VILI) IN CERVICAL CANCER.

Introduction: Cervical cancer is the second most common gynecologic cancer worldwide, accounting for 13% of all female cancer in developing countries. Cervical cancer is a disease that can be prevented through both primary prevention and early detection. Pap smear is a screening method which has been used for so long. Hence, one simple diagnostic test namely visual inspection with Lugol 's iodine (VILI) which is based on the ability of the trained healthcare personnel to detect yellow non iodine uptake areas in the cervical transformation zone are currently being evaluated in the experimental setting as potential alternative to cervical cytology. Objective: To determine diagnostic accuracy of visual inspection with Lugol's iodine (VILI) taking histopathology as gold standard among patients of cervical cancer. Subjects and methods: A total of 285 women with early marriage, history of post-coital bleeding, history of post- menopausal bleeding and history of per vaginal discharge were included in study. Women with obvious cervical growth and diagnosed cervical cancer were excluded. I put each patient in the  lithotomy  position and insert Cusco's speculum to visualize cervix. I cleaned the cervix with cotton soaked with normal saline. Now applied Jugol 's iodine, to the cervix normal squamous epithelium contain glycogen and stain.  Conversely premalignant and malignant squamous tissue contain no glycogen and does not stain with iodine. This was schillers test and non-staining areas were schiller positive. For further confirmation I took biopsy from schillers positive area and sent for histopathology. Results: Age range in this study was from 21 to 60 years with mean age of 39.393± 6.66 years and mean duration of disease was 6.031±2.09 months. 43.9% patients were belong to rural area and 56.1% belongs to urban area. 25.6% patients have Family History of cervical cancer. Visual inspection with Lugol's iodine (VILI) diagnosed 43(15.1%) patients and Histopathology diagnosed 15.8% patients with Cervical cancer. Visual inspection with Lugol's iodine (VILI) has shown sensitivity of 86.6%, specificity 98.3%, diagnostic accuracy by 96%, PPV 90.6%, NPV 97.5%, (p=0.000) in diagnosis of Cervical cancer.  Conclusion: My study showed VILI good sensitivity and it can therefore be a suitable potential alternative/adjunctive screening test not only in resource-poor settings but also in well-equipped centers. Keywords: Cervical cancer, Visual inspection with Lugol's iodine, Diagnostic accuracy DOI: 10.7176/JMPB/52-0

Some Differentials in Infant and Child Mortality Risks in Pakistan 1962 - 1986

In Pakistan the history of alternative sampling approaches to collect demographic data for direct and indirect estimation of population parameters extends back for three decades. The sources which provided directly usable statistical data for estimating fertility and mortality rates, are the 1962- 65 Population Growth Estimation (PGE), the 1968- 71 and 1976- 79 Population Grwoth Surveys (PGS), and the 1984- 86 Pakistan Demographic Surveys (PDS). Since these surveys yielded series of data which could be directly used for working out estimates which are in accordance with the conventional concepts, their results are being given a prior consideration in this paper. The second series of demographic surveys in Pakistan consists of the one-time retrospective surveys, which provided data to which indirect techniques could be applied for working out the estimates of fertility and mortality. The three most prominent of such surveys are: the 1975 Pakistan Fertility Surveys (PFS), the 1979-80 Population, Labour Force and Migration Survey (PLM) and the 1984-85 Pakistan Contraceptive Prevalence Survey (PCPS). The objective of this paper is to provide some direct and indirect estimates of infant and child mortality risks from these sources with a view to examining differentials and trends in these estimates

PV Array Driven Adjustable Speed Drive for a Lunar Base Heat Pump

A study of various aspects of Adjustable Speed Drives (ASD) is presented. A summary of the relative merits of different ASD systems presently in vogue is discussed. The advantages of using microcomputer based ASDs is now widely understood and accepted. Of the three most popular drive systems, namely the Induction Motor Drive, Switched Reluctance Motor Drive and Brushless DC Motor Drive, any one may be chosen. The choice would depend on the nature of the application and its requirements. The suitability of the above mentioned drive systems for a photovoltaic array driven ASD for an aerospace application are discussed. The discussion is based on the experience of the authors, various researchers and industry. In chapter 2 a PV array power supply scheme has been proposed, this scheme will have an enhanced reliability in addition to the other known advantages of the case where a stand alone PV array is feeding the heat pump. In chapter 3 the results of computer simulation of PV array driven induction motor drive system have been included. A discussion on these preliminary simulation results have also been included in this chapter. Chapter 4 includes a brief discussion on various control techniques for three phase induction motors. A discussion on different power devices and their various performance characteristics is given in Chapter 5

A system for computerised retinal haemorrhage analysis

Our aim was to develop an objective computerised system for measuring different types of retinal haemorrhages in differing digital images, for use as a research tool. Despite developing various fully automated systems of retinal haemorrhage measurement we ultimately found user interaction to be necessary to achieve satisfactory validity of segmentation, and developed an interactive system of haemorrhage assessment based on this

Statistical Modelling of the Visual Impact of Subretinal Fluid and Associated Features

Introduction: The aim of this study was to develop a statistical model to determine the visual significance of subretinal fluid (SRF) in combination with other constructed optical coherence tomography (OCT) features in patients with wet age-related macular degeneration. Methods: The project used labelled data from 1211 OCTs of patients with neovascular macular degeneration (nAMD) attending the macular treatment centre of Manchester Royal Eye Hospital to build a statistical model to determine vision for any virtual, constructed OCT. A four-dimensional plot was created to represent the visual impact of SRF in OCTs in the context of the associated OCT characteristics of atrophy and subretinal hyperreflective material (SHRM). Results: The plot illustrates that at levels of SRF below 150 µm, the impact of SRF on vision is very low. Increasing the amount of fluid to 200 µm and beyond increases the impact on vision, but only if there is little atrophy or SHRM. Conclusions: This study suggests that levels of SRF up to around 150 µm thickness on OCT have minimal impact on vision. Greater levels of SRF have greater impact on vision, unless associated with significant amounts of atrophy or SHRM, when the additional effect of the SRF on vision remains low