The World Health Organisation estimates that 2 million women undergo some form of female genital mutilation (FGM) annually. Because of increasing migration, clinicians in the UK are increasingly exposed to women who have suffered FGM. Recognising this trend, the RCOG has set standards for guidance of health professionals caring for women with FGM. As yet, no study has assessed levels of knowledge of FGM among relevant health professionals. An anonymous structured questionnaire based on the Royal College of Obstetricians and Gynaecologists' standards was circulated among staff at a University Teaching Hospital. A total of 45 participants completed the questionnaire. Only 40% were familiar with the regulations in the FGM Act of 2003; 58% were unable to list the different categories of FGM; 47% incorrectly thought that caesarean section is the best way of managing FGM if vaginal examination is not possible in the first stage of labour and 54% chose anterior episiotomy as the treatment of choice during the second stage. Our study found that there were significant gaps both in theoretical knowledge and practice.
Objective: Studies have been inconsistent in establishing sex steroids as a risk factor for human papillomavirus (HPV) infections. This study was designed to determine whether cervical oestrogen receptors (as measured by oestrogen receptor transcripts) at the cervix would be associated with cervical HPV infections. Methods: In 175 women, ages 14-44, we tested for the presence of HPV DNA and oestrogen receptors transcripts at the cervix during routine pelvic examinations. All subjects completed a self administered questionnaire regarding sexual and menstrual histories. Results: 40% of the women (n=70) tested positive for HPV at the cervix. Of those women testing positive for HPV, 99% had detectable levels of Oestrogen receptors transcripts (n=69/70). HPV cervical infections were independently associated with presence of Oestrogen receptors transcripts (OR = 39.8, CI=4.4, 361.1) and greater numbers of sexual partners (OR=1.1, CI=1.01, 1.18). Conclusion: Women who expressed higher levels of oestrogen receptors transcripts were significantly more likely to have cervical HPV infection. These results demonstrate that Oestrogen receptors may play an important part in cervical HPV infections.H uman papillomavirus (HPV) is a common genital infection of females, particularly afflicting adolescents and women in their early 20s. Most infections are subclinical and, hence, the exact prevalence is not known. However, when molecular techniques are used to detect the virus, rates have ranged from 11% to 64% for sexually active adolescents and young adults. [1][2][3][4][5][6] This has become important because of HPVs strong link to anogenital cancer, particularly cervical cancer. Although HPV is strongly linked to cervical cancer and its precursor, cervical dysplasia, it is clear that other risk factors are associated with acquisition and retention of the virus and viral associated oncogenesis.7 8 More recently, research has focused on factors influencing HPV persistence at the cervix since those women who have persistent viral infection are at greater risk for developing cervical dysplasia. 6 9 Why some women acquire the infection more easily than others or remain infected is not completely understood.Both clinical and laboratory studies have suggested that sex hormones can be an additional factor in influencing viral infection.10 Oral contraceptives and pregnancy have been shown to represent risk factors for acquisition of HPV and cervical dysplasia, 8 11 12 while pregnancy has also been associated with persistence of HPV infection. 13 14 At a cellular level, oestrogen has been shown to stimulate the transcription of HPV-16 early genes in SiHa cells 15 and HPV-16 DNA immortalised human cervical cells. 16 Additionally, oestradiol has shown to activate the upstream regulatory region of HPV-18 in transgenic mice. 17 This stimulatory effect and subsequent gene activation of HPV by oestrogen is thought to occur as a result of the oestrogen receptor complex that binds to the steroid response element within the virus by an unknown me...
Background: Cervical cancer is the third leading cause of death in Malaysia, and Human Papilloma Virus (HPV) is the principal aetiology that is responsible for its development. This study was aimed to determine the prevalence and distribution of HPV types among different age groups, ethnicity, and areas in Malaysia. Materials and Methods: A total of 764 women aged 20-74 years old within the cities of Johor Bahru, Kuala Lumpur, Ipoh, Penang, and Kota Kinabalu underwent both cervical cytological assessment and HPV DNA analysis. Cervical cytology glass slides were prepared using the liquid base technique (Path TEZT TM). HPV DNA was extracted using TANBead ® Nucleic Acid Extraction Kit (Taiwan Advanced Nonotech Inc.), then the types were further identified using a DR.HPV Genotyping IVD kit. Results: The prevalence of HPV infection was 14.0% (107/764) with high-risk type at 10.7% (82/764) and low-risk type at 3.27% (25/764). The most common high-risk HPV types were HPV-52, 66, 33, 39, and 58 whereas low-risk HPV types were HPV-6, 40, and 81. The majority of HPV infections (80.37%) were detected in women with normal cytology results. The most prevalent HPV type among Chinese is 33 (n=6) followed by 16, 44, 58, 66 and 68 (n=5). Among Malays, HPV 16 and 51 were the two most prevalent types (n=2). The sensitivity of the HPV DNA test compared to cytology was 100% with a specificity of 88.37%. Conclusion: This study revealed that the most common high-risk HPV type among women living in urban areas in Malaysia is HPV 52, unfortunately which is not the type of infection the current HPV vaccine is covered for protection among females. These findings may contribute beneficial information to health care providers for the appropriate use of HPV vaccine in the prevention of cervical cancer in Malaysia.
Pixel value access control (PVAC) was introduced to deliver a secure and simple graphical password method where it requires users to load their image as their password. PVAC extracts the image to obtain a three-octet 8-bits Red-Green-Blue (RGB) value as its password to authenticate a user. The pixel value must be matched with the record stored in the database or otherwise, the user is failed to authenticate. However, users which prefer to store images on cloud storage would unintentionally alter and as well as the pixel value due to media compression and caused faulty pixels. Thus, the K-Means clustering algorithm is adapted to fix the issue where the faulty pixel value would be recognized as having the same pixel value cluster as the original. However, most of K-Means algorithm works were mainly developed for content-based image retrieval (CBIR) which having opposite characteristics from PVAC. Thus, this study was aimed to investigate the crucial criteria of PVAC and its compatibility with the K-Means algorithm for the problem. The theoretical analysis is used for this study where the suitable characteristics of K-Means are analyze based on PVAC requirements. The compliance analysis might become a referencing work for digital image clustering techniques adaptation on security system such as image filtering, image recognition, and object detection since most of image clustering works was focused on less sensitive image retrieval.
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