Comparison of In Vivo Study of Co-Polarized and Cross-Polarized Fluorescence Spectroscopy to Co-Minus Cross-Polarized Fluorescence Spectroscopy to Diagnose Precancerous Cervical Lesions by Handheld Probe.

Background: In 2020, the number of new cases of cervix uteri was 604,127, i.e., 3.1% of all cancers, and the number of deaths was 341,831 (3.3%) among both sexes. In vivo fluorescence spectroscopy is an emerging optical technology that offers promise for the diagnosis of disease & has the capability to quickly, noninvasively and quantitatively probe the biochemical and morphological changes that occur as tissue becomes dysplastic. Materials and Method: A cross-sectional observational study was conducted from December 2019 to September 2021 in the OBGY Department, UISEMH, in collaboration with optical imaging laboratory, BIOPHOTONICS, IIT Kanpur. A fabricated in-house fluorescence spectroscope consisting of a laser diode (405 nm) as light source and a miniature spectrometer is used to detect fluorescence signal from the sample. Patient's cervix was examined in the OPD, using an optical handheld probe, which functions on the principle of polarized fluorescence spectroscopy. The tissues were examined and classified on the basis of varying patterns of polarized spectroscopy (co-polarized, cross-polarized and co-minus cross-polarized light). The results were compared with that of cytological, colposcopy and histopathological findings and on various demographic variables. Results and Conclusion: In vivo handheld probe based on polarized fluorescence spectroscopy is an excellent screening technique. Co- and cross- polarized light has shown enhanced accuracy. Accuracy of co-minus cross-polarized light is poor. It is fast, noninvasive and quantitative and, with further developments, has the potential to become a regular screening tool in future.

Seroprevalence and risk factors for hepatitis B virus infection among general population in Northern India.

BACKGROUND: Infection with hepatitis-B virus has been a significant cause of morbidity claiming more than a million lives every year. Epidemiological data reveals that there are 360 million carriers of hepatitis-B virus throughout the globe and 78% of the world populations' hail from Asia. Though several studies from Indian sub-continent have provided an estimate of the prevalence of this viral infection, there exist only few studies, which reflect the status in the general population. AIM: The present study was designed to investigate the prevalence of hepatitis-B infection in North Indian general population. METHODS: The study population comprised of 20,000 healthy blood donors who were screened for hepatitis-B surface antigen (HBsAg) status using third generation ELISA kit. Seroprevalence rate of seropositive donors was calculated and stratified by age, sex and blood groups. Statistical analysis was performed using tests of proportions, chi-square and confidence interval. RESULTS: The study showed that out of 20,000 donors, 450 (2.25%) were HBsAg positive (95% confidence interval (CI), 2.0445-2.4554). Higher prevalence of HbsAg was found among males (440/19235) than females (10/765). The age specific prevalence rose from 1.78% (108/6058) in donors aged 19-25 years to a maximum of 3.03% (96/3161) in donors aged 35-45 years and decreased in older age groups. The peaks were detected in male donors aged 35-45 years and in females aged 25-35 years. Rh-negative blood group donors (21/873) and Rh-positive group donors (429/19127) had almost equivalent prevalence rates of HBsAg. HBsAg was more prevalent in blood group B donors (174/7426) and less prevalent in AB blood group donors (38/2032). CONCLUSION: It was found that variables including gender and age were significantly associated with HBsAg positivity. HBsAg positivity in our population was statistically not associated with ABO blood groups.

Optical Imaging: Future Tool in Detection of Pre-cancerous and Cancerous Lesions of Cervix and Its Comparison to Colposcopy.

OBJECTIVES: To study the diagnostic potential of optical imaging and its comparison with colposcopy, in detecting early cervical dysplasia. METHODS: The study was conducted on 200 patients attending the outdoor of UISE maternity hospital with symptoms suspicious of cervical lesions. All patients were subjected to colposcopy, followed by histo-pathological examination. Out of all HPE, 18 samples each from normal and dysplastic histology were sent to IIT Physics lab, Kanpur for optical imaging. Statistical analysis was done using sensitivity, specificity, PPV, and NPV. Chi square test was applied to calculate p value. RESULTS: In optical imaging, depolarization images had shown significant changes in the epithelium region of the dysplastic tissue as compared to normal one. It is found that the mean value of depolarization power for normal cervix tissues is less than 0.32, while for dysplastic tissues it is greater than 0.32. CONCLUSION: Optical imaging is fast, non-invasive tool with high sensitivity and specificity, comparable to colposcopy (sensitivity 88.9 vs 100 %, specificity 83.3 vs 86.6 %) and thus is useful in both for screening and diagnosis of cervical dysplasia.

Hyperhomocysteinemia as a Risk Factor for IUGR.

OBJECTIVE: To study the role of hyperhomocysteinemia in patients with intrauterine growth retardation. METHOD: 76 patients with intrauterine growth retardation were studied and compared with 50 controls which included pregnant patients without any pregnancy complications. Fasting Plasma homocysteine levels were measured and statistical analysis using tests of significance and logistic regression analysis was performed. Those in the study group were given homocysteine lowering agents for 6 wks and pregnancy outcome was studied. RESULTS: 57.8 % women in the study group were found to have hyperhomocysteinemia. Logistic Regression analysis shows an OR of 2.45 in favor of occurrence of IUGR if homocysteine levels are raised which is statistically significant. Mean plasma homocysteine levels decreased after treatment for 6 wks but this decrease in the case of placebo group is marginal whereas the decrease in the homocysteine levels the treatment group. This implies that treatment has a definitive role in lowering of plasma homocysteine levels. CONCLUSION: The present study shows that hyperhomocysteinemia is associated with IUGR and should be identified as a risk factor as correction favors pregnancy outcome.

Fluorescence spectroscopy: a new approach in cervical cancer.

OBJECTIVE: To study the diagnostic potential of fluorescence spectroscopy and its comparison with different screening methods, including Pap smear and colposcopy, in detecting early cervical neoplasia. METHOD: The study was conducted on patients with gynecological complaints. A full gynecological workup of the patients was done along with Pap smear and colposcopy. Cervical biopsy was done in suspected cases and fresh tissue was sent to IIT for spectroscopy. RESULT: There is a definite increase in NADH fluorescence (67.4 %) and a decrease in collagen fluorescence (74 %) in dysplastic tissues. When epithelial fluorescence and stromal fluorescence are considered together, diagnostic accuracy is increased to 96.5 %. CONCLUSION: The clinical diagnosis of cervical neoplasia by spectroscopic methods is potentially a reliable, fast, and cost-effective alternative to the conventional smear test which needs trained personnel for its interpretation. Research is still continuing to obtain a statistically significant cutoff value from in vitro studies and then use them for in vivo study.

Seroprevalence and risk factors for hepatitis B virus infection among general population in Northern India / Soroprevalência e fatores de risco para infecção pelo vírus da hepatite B na população geral do nordeste da Índia

BACKGROUND: Infection with hepatitis-B virus has been a significant cause of morbidity claiming more than a million lives every year. Epidemiological data reveals that there are 360 million carriers of hepatitis-B virus throughout the globe and 78 percent of the world populations’ hail from Asia. Though several studies from Indian sub-continent have provided an estimate of the prevalence of this viral infection, there exist only few studies, which reflect the status in the general population. AIM: The present study was designed to investigate the prevalence of hepatitis-B infection in North Indian general population. METHODS: The study population comprised of 20,000 healthy blood donors who were screened for hepatitis-B surface antigen (HBsAg) status using third generation ELISA kit. Seroprevalence rate of seropositive donors was calculated and stratified by age, sex and blood groups. Statistical analysis was performed using tests of proportions, chi-square and confidence interval. RESULTS: The study showed that out of 20,000 donors, 450 (2.25 percent) were HBsAg positive (95 percent confidence interval (CI), 2.0445-2.4554). Higher prevalence of HbsAg was found among males (440/19235) than females (10/765). The age specific prevalence rose from 1.78 percent (108/6058) in donors aged 19-25 years to a maximum of 3.03 percent (96/3161) in donors aged 35-45 years and decreased in older age groups. The peaks were detected in male donors aged 35-45 years and in females aged 25-35 years. Rh-negative blood group donors (21/873) and Rh-positive group donors (429/19127) had almost equivalent prevalence rates of HBsAg. HBsAg was more prevalent in blood group B donors (174/7426) and less prevalent in AB blood group donors (38/2032). CONCLUSION: It was found that variables including gender and age were significantly associated with HBsAg positivity. HBsAg positivity in our population was statistically not associated with ABO blood groups.

RACIONAL: A infecção pelo vírus B da hepatite é considerada uma significante causa de morbidade, responsável por mais de 1 milhão de casos, a cada ano. Dados epidemiológicos revelam que existem 360 milhões de portadores de vírus da hepatite B no mundo e 78 por cento da população natural da Ásia. Embora vários estudos realizados na Ásia sub-continental tenham fornecido uma estimativa de prevalência desta infecção viral, existem poucos estudos que avaliam esta condição na população geral. OBJETIVO: Investigar a prevalência da infecção pelo víirus B da hepatite na população geral do nordeste da Índia. MÉTODOS: A população estudada compunha-se de 20.000 doadores de sangue sadios, selecionados através de positividade do antígeno de superfície da hepatite B (HBsAg), utilizando-se o kit ELISA de 3ª geração. A taxa de soroprevalência dos doadores soropositivos foi calculada e estratificada por idade, sexo e grupos sangüíneos. Análise estatística foi obtida usando-se testes de proporções, do qui ao quadrado e intervalo de confiança (CI). RESULTADOS: O estudo revelou que dos 20.000 doadores, 450 (2,25 por cento) eram HBsAg positivos (95 por cento CI 2.0445-2.4554). Prevalência maior de HBsAg foi encontrada em homens (440/19235) do que em mulheres (10/765). A prevalência por faixa etária aumentou de 1,78 por cento (108/6058) em doadores entre 19 a 25 anos, para máximo de 3,03 por cento (96/3161) naqueles entre 35-45 anos e decresceu nos grupos de maior idade. Os picos foram detectados em doadores masculinos de 35-45 anos e em mulheres de 25-35 anos. O grupo de doadores Rh negativo (21/873) e o grupo Rh positivo (4299/19127) mostraram taxas de prevalência de HBsAg quase equivalentes. HBsAg foi mais prevalente no grupo de doadores de tipo sangüíneo B (174/7426) e menos no grupo de tipo sangüíneo AB (38/2032). CONCLUSÃO: Verificou-se que variáveis incluindo gênero e idade foram significantemente associadas à positividade do HBsAg e que esta não foi...