Trend of Human Papillomavirus Genotypes in Cervical Neoplasia Observed in a Newly Developing Township in Yangon, Myanmar

Persistent infection with oncogenic types of human papillomavirus (HPV) is the most important risk factor associated with cervical cancer. This study detected the oncogenic HPV genotypes in cervical neoplasia in relation to clinicopathological findings using a cross-sectional descriptive method in 2011 and 2012. Cervical swabs and colposcopy-directed cervical biopsy tissues were collected from 108 women (median age 45 years;range 20-78) showing cervical cytological changes at Sanpya General Hospital, Yangon, Myanmar. HPV DNA testing and genotyping were performed by polymerase chain reaction and restriction fragment length polymorphism. HPV was identified in women with cervical intraepithelial neoplasia (CIN) 1 (44.4%), CIN2 (63.2%), CIN3 (70.6%), and squamous cell carcinoma (SCC) (74.1%). The association between cervical neoplasia and HPV positivity was highly significant (p＝0.008). Most patients infected with HPV were between 40-49 years of age, and the youngest were in the 20- to 29-year-old age group. The most common genotype was HPV 16 (65.6%) with the following distribution:70% in CIN1, 41.7% in CIN2, 91.7% in CIN3, and 60% in SCC. HPV-31 was the second-most frequent (21.9%):30% in CIN1, 33.3% in CIN2, 8.3% in CIN3, and 15% in SCC. The third-most frequent-genotype was HPV-18 (7.8%):8.3% in CIN1, and 20% in SCC. Another genotype was HPV-58 (4.7%):16.7% in CIN1 and 5% in SCC. The majority of CIN/SCC cases were associated with HPV genotypes 16, 31, 18, and 58. If oncogenic HPV genotypes are positive, the possibility of cervical neoplasia can be predicted. Knowledge of the HPV genotypes distribution can predict the effectiveness of the currently used HPV vaccine

In vitro Evaluation of PEGylated-Mucin Matrix as Carrier for Oral Delivery of Metformin Hydrochloride

Purpose: To formulate metformin hydrochloride-loaded PEGylated-mucin microparticles and evaluate their in vitro properties.Method: Three different formulations of metformin hydrochloride (MTH) (PEG-M1, PEG-M2 and PEGM3) were prepared using PEGylation method. PEG-8000 and snail mucin, in a ratio of 1:3, were PEGylated together using solvent interaction principle. Loading of MTH into the matrix was by diffusion method and the microparticles characterized for particle size, zeta potential, polydispersity index, stability and in vitro release in phosphate buffer (pH 7.4).Results: Maximum yield and encapsulation were 97 and 87 % respectively. Zeta potential was -37.7, - 42.3 and -46.2 mV for PEG-M1, PEG-M2 and PEG-M3 with a corresponding polydispersity index (PDI) of 0.320, 0.374 and 0.398, respectively. Particles size was 85, 115, and 145 μm for PEG-M1, PEG-M2 and PEG-M3, respectively, and they showed a unimodal distribution. Drug release was biphasic and exhibited controlled release pattern with maximum release of 92 % in 18 h compared to 81 % in 6 h for the conventional formulation.Conclusion: Extended release metformin hydrochloride formulations were successfully developed using PEGylated mucin matrices.Keywords: Drug delivery, Extended release, Polyethylene glycol, Mucin PEGylation, Encapsulation, Zeta potential, Polydispersity inde

Prevalence of High-Risk Human Papillomavirus (HR-HPV) Infection among Women with Normal and Abnormal Cervical Cytology in Myanmar

This study aimed to determine the prevalence of normal and abnormal cervical cytology in women who attended the cervical cancer screening clinic of the Department of Medical Research in Lower Myanmar, and to determine the proportion of high-risk (HR) human papillomavirus (HPV) infection and HPV genotypes in women with normal and abnormal cervical cytology. A total of 1,771 women were screened from 2010 to 2011. Among them, 762 women (43.0%) had a normal smear, and 866 (48.9%) and 87 (4.9%) were diagnosed with inflammatory smears and atypical squamous cells of undetermined significance (ASCUS), respectively. Diagnoses of low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL) numbered 42 (2.3%) and 11 (0.6%) respectively. Three cases of squamous cell carcinoma (SCC) (0.2%) were detected. Cervical swabs were collected from 96 women with abnormal cervical cytology and 20 with normal cytology. HR-HPV DNA testing was performed by polymerase chain reaction (PCR) with pU1M/pU2R primers. HR-HPV were identified in 35.5% (22/62) of inflammatory smears, 60% (6/10) of ASCUS, 86.7% (13/15) of LSIL, 50% (3/6) of HSIL, 100% (3/3) of SCC and 5% (1/20) of normal cytology. In PCR-positive cases, HPV genotyping was analyzed by the cleaved amplification polymorphism method. The most prevalent HPV genotypes were HPV-16 (60.4%) followed by HPV-31 (14.6%), HPV-18 (12.5%) and HPV-58 (12.5%). Women with abnormal cervical cytology were 10 times more likely to be HR-HPV positive than those with normal cytology (p＝0.0001). This study suggests that the implementation of a cervical cytology screening program and routine vaccination against HPV in preadolescent and adolescent groups are needed to reduce the burden of HPV-associated cervical cancer

Decoupling Techniques for Coupled PDE Models in Fluid Dynamics

We review decoupling techniques for coupled PDE models in fluid dynamics. In particular, we are interested in the coupled models for fluid flow interacting with porous media flow and the fluid structure interaction (FSI) models. For coupled models for fluid flow interacting with porous media flow, we present decoupled preconditioning techniques, two-level and multilevel methods, Newton-type linearization-based two-level and multilevel algorithms, and partitioned time-stepping methods. The main theory and some numerical experiments are given to illustrate the effectiveness and efficiency of these methods. For the FSI models, partitioned time-stepping algorithms and a multirate time-stepping algorithm are carefully studied and analyzed. Numerical experiments are presented to highlight the advantages of these methods

Challenges and Frugal Remedies for Lowering Facility Based Neonatal Mortality and Morbidity: A Comparative Study

Millennium development goal target on infant mortality (MDG4) by 2015 would not be realised in some low-resource countries. This was in part due to unsustainable high-tech ideas that have been poorly executed. Prudent but high impact techniques could have been synthesised in these countries. A collaborative outreach was initiated to devise frugal measures that could reduce neonatal deaths in Nigeria. Prevailing issues of concern that could militate against neonatal survival within care centres were identified and remedies were proffered. These included application of (i) recycled incubator technology (RIT) as a measure of providing affordable incubator sufficiency, (ii) facility-based research groups, (iii) elective training courses for clinicians/nurses, (iv) independent local artisans on spare parts production, (v) power-banking and apnoea-monitoring schemes, and (v) 1/2 yearly failure-preventive maintenance and auditing system. Through a retrospective data analyses 4 outreach centres and one control were assessed. Average neonatal mortality of centres reduced from 254/1000 to 114/1000 whilst control remained at 250/1000. There was higher relative influx of incubator-dependent-neonates at outreach centres. It was found that 43% of mortality occurred within 48 hours of presentation (d48) and up to 92% of d48 were of very-low birth parameters. The RIT and associated concerns remedies have demonstrated the vital signs of efficiency that would have guaranteed MDG4 neonatal component in Nigeria

A collaborative healthcare framework for shared healthcare plan with ambient intelligence

The fast propagation of the Internet of Things (IoT) devices has driven to the development of collaborative healthcare frameworks to support the next generation healthcare industry for quality medical healthcare. This paper presents a generalized collaborative framework named collaborative shared healthcare plan (CSHCP) for cognitive health and fitness assessment of people using ambient intelligent application and machine learning techniques. CSHCP provides support for daily physical activity recognition, monitoring, assessment and generate a shared healthcare plan based on collaboration among different stakeholders: doctors, patient guardians, as well as close community circles. The proposed framework shows promising outcomes compared to the existing studies. Furthermore, the proposed framework enhances team communication, coordination, long-term plan management of healthcare information to provide a more efficient and reliable shared healthcare plans to people