Cervical screening with Luviva machine for early detection of cervical dysplasia: experience from Ekiti state, Nigeria

Background: Cervical cancer is a preventable and potentially curable cancer when detected early, yet it continues to be among the leading causes of cancer death in developing countries. Screening for cervical dysplasia is critical for early detection in order to reverse this trend. Several traditional screening methods such as pap smear test, HPV-DNA screening test, visual inspection with acetic acid or lugol iodine are in vogue with different specificity and sensitivity. LuViva advanced cervical scan is a new automated screening tool that has great promise for the detection of the disease in itsearliest form both in developing and developed countries.Objective: This study was designed to describe our experience with the use of LuViva advanced cervical scan as a primary screening tool for cervical dysplasia.Method: This is a descriptive cross-sectional study, whose data was obtained from the free health screening for civil servants in Ekiti State conducted between 11th and 21st February, 2014. Screening for Cervical dysplasia was conducted using the LuViva advanced cervical scan for women 40 years old and above. The result was automatically recorded and transferred to an Excel sheet for analysis.Result: A total sum of 254 patients was screened during the study period. Only one patient had a prior pap smear done. The automated self-reporting LuViva scan presented the result of the benign changes on the cervix as low risk in 143 patients (56.3%), moderate risk in 52 patients  15%) and high risk in 59 patients (11.5%). The machine further classified the dysplastic changes of the low, moderate and high risk categories as Atypical glandular cell (AGC), Atypical glandular cell favouring neoplasia (AGC-FN), Atypical g l a n d u l a r c e l l o f u n d e t e r m i n e d significance(AG-US), Atypical squamous cell of undetermined significance (ASC-US), Atypical squamous cell where high grade cannot be excluded (ASC-H) and Low grade squamous Intraepithelial lesion (LSIL). The proportion of moderate and high risk AGC (31.2%) was just slightly lower than the moderate and high risk of ASC-US (35.2%) while a higher percentage of43.9% in low grade squamous intraepithelial lesion was recorded among the patients.Conclusion: Our experience suggests that there is a place for the use of luViva scan in the primary screening for cervical dysplasia and there is a correlation between LuViva scan high risk result and histological diagnosis of cervical dysplasia.Keywords: Cervical screening, cervical dysplasia, civil servants, LuViva Scan, Ekiti State Nigeri

Intra aortic balloon pump: literature review of risk factors related to complications of the intraaortic balloon pump

The increasing use of the intra aortic balloon pump is attributed to the relatively easy percutaneous insertion and the low threshold of use over the past few years, especially in elderly patients with multi-vessel diseases and an affected ejection fraction

Concurrent Oral 1 - Therapy of rheumatic disease: OP4. Effectiveness of Rituximab in Rheumatoid Arthritis: Results from the British Society for Rheumatology Biologics Register (BSRBR)

Background: Rituximab (RTX) in combination with methotrexate (MTX) has been licensed since 2006 for the management of severe active rheumatoid arthritis (RA) in patients who have failed at least one anti-tumour necrosis factor (anti-TNF) therapy. Published clinical trials have demonstrated the efficacy of RTX in improving both clinical symptoms and patients' physical function. This study aimed to assess the effectiveness of RTX in RA patients treated in routine clinical practice by examining clinical and patient reported outcomes six months after receiving a first course of RTX. Methods: The analysis involved 550 RA patients registered with the BSRBR, who were starting RTX and were followed up for at least 6 months. Change in Disease Activity Score (DAS28) and European League Against Rheumatism (EULAR) response were used to assess the clinical response while change in Health Assessment Questionnaire (HAQ) score was used to assess the physical function of the patients 6 months after starting RTX. The change in DAS28 and HAQ was compared between seronegative and seropositive patients and anti-TNF naïve patients versus anti-TNF failures. The response was also compared between patients receiving RTX in combination with MTX, other non-biologic disease modifying anti-rheumatic drugs (nbDMARDs) or no nbDMARDs. Results: The mean (s.d.) age of the cohort was 59 (12) years and 78% of the patients were females. The patients had a mean (s.d.) of 15 (10) years of disease duration. 16% were biologic naïve while 84% were anti-TNF failures. 32% of the patients were seronegative and 68% were seropositive. The mean (95% CI) DAS28 at baseline was 6.2 (6.1, 6.3) which decreased to 4.8 (4.7, 4.9) at 6 months of follow up. 16% were EULAR good responders, 43% were moderate responders and 41% were non responders. The mean (95% CI) change in HAQ was −0.1 (−0.2, −0.1) (Table 1). The mean change in DAS28 was similar in seropositive and seronegative patients (p = 0.18) while the anti-TNF naïve patients showed a greater reduction in DAS28 scores than anti-TNF failures (p = 0.05). Patients receiving RTX in combination with MTX showed similar changes in DAS28 and HAQ compared to patients receiving RTX alone or with other nbDMARDs. Conclusions: RTX has proven to be effective in the routine clinical practice. Anti-TNF naïve patients seem to benefit more from RTX treatment than anti-TNF failures. Disclosure statement: The authors have declared no conflicts of interes

Chronic Leg Ulcers in Two Sisters with Sickle Cell Disease

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Comparative Analysis of Association Rule Mining Algorithms in Market Basket Analysis Using Transactional Data

Association rule mining (ARM) is an aspect of data mining that has revolutionized the area of predictive modelling paving way for data mining technique to become the recommended method for business owners to evaluate organizational performance. Market basket analysis (MBA), a useful modeling technique in data mining, is often used to analyze customer buying pattern. Choosing the right ARM algorithm to use in MBA is somewhat difficult, as most algorithms performance is determined by characteristics such as amount of data used, application domain, time variation, and customer’s preferences. Hence this study examines four ARM algorithm used in MBA systems for improved business Decisions. One million, one hundered and twele thousand (1,112,000) transactional data were extracted from Babcock University Superstore. The dataset was induced with Frequent Pattern Growth, Apiori, Association Outliers and Supervised Association Rule ARM algorithms. The outputs were compared using minimum support threshold, confidence level and execution time as metrics. The result showed that The FP Growth has minimum support threshold of 0.011 and confidence level of 0.013, Apriori 0.019 and 0.022, Association outliers 0.026 and 0.294 while Supervised Association Rule has 0.032 and 0.212 respectively. The FP Growth and Apirori ARM algorithms performed better than Association Outliers and Supervised Association Rule when the minimum support and confidence threshold were both set to 0.1. The study concluded by recommending a hybrid ARM algorithm to be used for building MBA Applications. The outcome of this study when adopted by business ventures will lead to improved business decisions thereby helping to achieve customer retention. Keywords: Association rule mining, Business ventures, Data mining, Market basket analysis, Transactional data