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ABSTRACT: OBJECTIVE:: To evaluate accurate, affordable and feasible method to screen and treat HIV infected women so that cervical cancer can be prevented among them. DESIGN:: A cross sectional study was conducted in India in which eligible HIV infected women underwent VIA, VILI, cytology, HPV testing and colposcopy. METHODS:: We screened women with cytology, HPV testing, VIA and VILI. All screened women had colposcopy and women with colposcopic abnormalities had directed biopsies. Women with suspected CIN on colposcopy were treated with cold coagulation or loop excision. Sensitivity, specificity, and predictive values of the screening tests were calculated. RESULTS:: Among 1128 women screened, 55 (4.9%) had CIN2-3 lesions. Sensitivity for VIA, VILI, cytology at ASCUS threshold and HPV testing was 83.6%, 89.1%, 63.3%, 94.6% and specificity was 88.8, 89.3%, 94.5% and 77.4%, respectively in detecting CIN 2/3 lesions. Cytology had significantly lower sensitivity and higher specificity than VIA, VILI and HPV testing. Sequential testing with VIA/VILI, HPV testing/VIA, HPV testing/VILI, and HPV testing/VIA/VILI had more balanced sensitivity and specificity than the single tests. Cold coagulation was well tolerated and cured 80% of CIN2-3 based on preliminary results at 6-month to 1-year follow-up periods. CONCLUSIONS:: Sequential testing with VIA and VILI is the most feasible screening approach for cervical cancer screening in HIV-infected women in low-resource countries. When HPV testing becomes feasible and affordable, HPV testing followed by VIA/VILI may be considered.
AIDS (London, England) 10/2012; · 4.91 Impact Factor
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ABSTRACT: Literature reports examining the association of bone mineral density (BMD) and socioeconomic status suggest of an inconclusive relation.
We studied 58 and 54 women (mean age 49.5 ± 7.2 years) from upper socioeconomic class (USC) and lower socioeconomic class (LSC), respectively, for their BMD at lumber spine and total femur by Lunar DPX-PRO dual-energy X-ray absorptiometry. Socioeconomic, lifestyle and biochemical data were collected.
Percent prevalence of osteoporosis in USC women was 12% and 0% at lumber spine and total femur, respectively, while it was 33% and 11%, respectively, in LSC women. When the mean BMD values were adjusted for the effect of body mass index, protein and calcium intake, physical activity, and sunlight exposure, only the total femoral BMD of USC premenopausal women was significantly greater.
Our data suggest that bone health of our LSC women was poor possibly due to the influence of socioeconomic and lifestyle factors.
Endocrine Research 01/2012; 37(1):25-34. · 0.97 Impact Factor
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International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 07/2011; 114(1):82-3. · 1.41 Impact Factor
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ABSTRACT: To assess the prevalence and the relative importance of risk factors for low bone mass in Indian pre- and post-menopausal women.
Data were collected on anthropometry and lifestyle factors in apparently healthy 80 pre- and 92 post-menopausal (40-75 years) women. Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry. Fasting blood samples were analysed for Parathyroid hormone, vitamin D, calcium and zinc.
BMD at all three sites was significantly lower in post-menopausal than the pre-menopausal women (p < 0.001). Prevalence of osteoporosis was highest at the lumbar spine (25.8%) in post-menopausal women, while prevalence of osteopenia was high in pre-menopausal women (44.3%). Vitamin D deficiency was seen in 54.5% pre and 41.8% post-menopausal women and significant correlation of serum 25(OH)D levels (r = 0.16) was obtained only for total hip Z-score (p < 0.05). Correlation between sun index and lumbar spine BMD was marginally significant (r = 0.14, p = 0.07). Generalised linear models revealed that after adjusting for age, weight and height, percent decrease of 2.1-4.5% in BMD may be attributed to menopause.
Age, weight, height, menopause, low intakes of calcium and low 25(OH)D along with poor sunlight exposure are the major factors contributing to bone loss in Indian women above 40 years of age.
Gynecological Endocrinology 12/2010; 26(12):909-17. · 1.58 Impact Factor
