Comparison between Visual Inspection of Cervix and Cytology Based Screening Procedures in Bangladesh

Nessa, Ashrafun,Nahar, Khadiza Nurun,Begum, Shirin Akhter,Anwary, Shahin Ara,Hossain, Fawzia,Nahar, Khairun Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.12

Background: Cervical cancer continues to be a major problem in Bangladesh with approximately 18,000 new cases annually of which over 10,000 women die from it. Visual inspection of the cervix after 3-5% acetic acid (VIA) application is a simple and easy to learn method for cervical cancer screening, although cytology-based screening is more often applied in developed countries where it has successfully reduced the prevalence of cervical cancer. Objective: To compare the efficacy of VIA and cytology-based primary methods for cervical cancer screening in Bangladesh. Materials and Methods: This hospital based comparative study was conducted at the VIA centre and Colposcopy Clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU) from October 2008 to October 2010. Results: Among 650 women, 74 (11.4%) were VIA+ve and 8 (1.2%) had abnormalities in their Pap smear reports. During colposcopy, 38 (7.7%) women had different grades of CIN and 4 (0.6%) had cervical cancer. The gold standard histology findings proved 20 women had CIN I, 14 had CIN II/II and 4 had cervical cancer. Among the 38 histology diagnosed abnormalities, VIA test could identify 30 abnormalities including two cervical cancers. However, Pap smear could detect only 8 cases of histological abnormalities (2 low grade and 6 had high grade lesion) and it missed all the cervical cancer cases. The sensitivity and specificity of VIA were 88.9% and 52.1%. The positive predictive value (PPV) and negative predictive value (NPV) were 41.0%, and 92.6% respectively. Moreover, the sensitivity, specificity, PPV and NPV of Pap smear were 33.3%, 95.8%, 75.0% and 79.3%, respectively. Conclusions: VIA test should be used as the primary screening tool even with its low sensitivity and specificity in low resource countries like Bangladesh. False positive results may be greater, but overtreatment can be minimized by colposcopy evaluation of the VIA positive women.

Role of the HPV DNA Test in Follow-up of Treated Cervical Intraepithelial Neoplasia in Bangladesh

Nessa, Ashrafun,Rashid, Mohammad Harun Ur,Jahan, Munira,Ferdous, Noor-E,Nahar, Pervin Akhter Shamsun,Chowdhury, Afroza Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.19

Background: Cervical cancer is a major public health problem in Bangladesh. Persistence of high risk human papillomavirus (HRHPV) influences the progression of the disease, with an important role in followup for cervical intraepithelial neoplasia (CIN). Objective: To establish application of high risk HPV DNA test in the follow-up of women after treatment of CIN. Materials and Methods: This cross-sectional and hospital based study was carried out among 145 CIN treated women during the previous six months to three years at the colposcopy clinic of Bangabandhu Sheikh Mujib Medical University, Dhaka, between January 2011 and June 2012. Pap smear and HPV samples were collected and colposcopy was performed to find out the persistence of the disease. Cervical samples obtained were tested for HPV DNA using the Hybrid Capture II (HC-II) test. A cervical biopsy was collected whenever necessary. The results were compared to assess the efficacy of different methods during follow up such as Pap smear, HPV test and colposcopy. Results: Mean age of the recruited women (n=145) was 33.6 (${\pm}7.6$), mean age of marriage was 16.8 (${\pm}2.9$) and mean age of 1st delivery was 18.8 (${\pm}3.5$) years. More than half had high grade CIN before treatment and 115 (79.3%) women were managed by LEEP and 20.7% were managed by cold coagulation. Among the 145 treated women, 139 were negative for HPV DNA and six of them (4.1%) were HPV positive. Sensitivity of Pap smear (40.0) and HPV DNA test (40.0) was poor, but specificity was quite satisfactory (>93.0) for all the tests. Conclusions: The high risk HPV DNA test can be an effective method of identifying residual disease. It can be added to colposcopy and this should be applied to all treated women attending for their first or second post-treatment follow-up visit at 6 months to one year, irrespective of the grade of treated CIN.

Role of Print and Audiovisual Media in Cervical Cancer Prevention in Bangladesh

Nessa, Ashrafun,Hussain, Muhammad Anwar,Ur Rashid, Mohammad Harun,Akhter, Nargis,Roy, Joya Shree,Afroz, Romena Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.5

Background: Visual inspection of cervix with acetic acid (VIA) is offered at 252 centers in 64 districts of Bangladesh. VIA+ve women are managed at colposcopy clinics of Bangabandhu Sheikh Mujib Medical University (BSMMU) and 14 Medical College Hospitals (MCHs). This research work has been supported by 'UICC Cancer Prevention Campaign' programme. Objectives: This study explored the role of print materials and electronic media to improve cervical cancer screening in the present socio-cultural context of Bangladesh. Methods: This study was performed from January to August 2011 at two upazilas of Bangladesh (Singair with screening facility and Sonargaon without screening facility). Data were collected by focus group discussion (FGD) with women, husbands and community people before and after intervention. Information on cervical cancer screening and VIA camps was disseminated using advertisement through local cable line of the television, microphone announcement, service providers and leaflet throughout the week prior to a VIA camp. Three-day VIA camps were organized at the upazila health complex (UHC) of both upazilas. Quantitative data was gathered from women at the camps on source of information on VIA and the best method of awareness creation. Results: The population was aware of "cancer" and a notable number knew about cervical cancer. Baseline awareness on prevention and VIA was low and it was negligible where screening services were unavailable. Awareness was increased fourfold in both upazilas after interventions and half of the women and the majority of the community people became aware of screening and available facilities. Cable line advertisement (25.5%), microphone announcement (21.4%), and discussion sessions (20.4%) were effective for awareness creation on VIA. Television was mentioned as the best method (37.4%) of awareness creation. Conclusion: Television should be used for nation-wide awareness creation. For local awareness creation, cable line advertisement, microphone announcements and health education at Uthan Baithaks/ EPI sessions can easily be adopted by the government.

Trade openness and working poverty: empirical evidences from developing countries

Nessa Hazera-Tun-,Imai Katsushi S. 경희대학교 글로벌 통상·금융연구원 2023 International Trade, Politics and Development Vol.7 No.2

Existence of working poverty reduces the effectiveness of the strategy of “increasing employment to reduce poverty”. Developed countries are already concerned about it but insufficient attention has been made by developing countries. Focusing on developing countries this study identifies (1) the effects of trade openness (TO) on working poverty and (2) whether the working poverty trap exists or not in developing countries. Both objectives are also analyzed for three subsamples of low income, lower-middle income and upper-middle income developing countries.Panel data for 98 developing countries over the period of 2000–2016 have been collected for the study. Fixed effect and GMM methods are applied for static and dynamic analysis, respectively.The study finds that TO significantly reduces working poverty rate (WPR) (mainly driven up by upper-middle income developing countries). The positive association between WPR with its previous year's rate proves the existence of working poverty trap.The study's outcome is subject to selected time, countries and methods. Future research should use more improve methods and should identify the channels through which TO could affect working poverty.Middle income and upper-middle income developing countries should increase TO to reduce the working poverty. Low income developing countries that have the highest working poverty should search the way to derive beneficial effects of trade on working poverty.Working poverty is not only a developed country issue rather it is a global phenomenon. Hence, it is expected that the study will raise the social consciousness about this phenomenon in developing countries too.The study fulfills the gaps of identifying the effects of TO on working poverty and existence of in-work poverty trap in developing countries.

Performance Analysis of Dual-Hop Cooperative Transmission with Best Relay Selection in a Rayleigh Fading Channel

Ahasanun Nessa,Wooyong Lee,Yongsun Kim,Kyung Sup Kwak 한국통신학회 2009 韓國通信學會論文誌 Vol.34 No.7

Performance Analysis Of Two-Hop Cooperative MINO Transmission with No Channel State Information

Ahasanun Nessa,Zhao Chengshi,MD Huamaum Kabir,Kyung Sup Kwak 한국통신학회 2008 한국통신학회 학술대회논문집 Vol.2008 No.7

Will she-won’t she: determinants of complementary and alternative medicines use among female rheumatoid arthritis patients

Swati Alok,Samrun Nessa,Sai Sruthi Tata,A. Sajeli Begum 경희대학교 융합한의과학연구소 2023 Oriental Pharmacy and Experimental Medicine Vol.23 No.1

Rheumatoid Arthritis (RA) is one of the most prevalent chronic inflammatory diseases targeting mainly the synovium or cellular lining of bone joints. The first line therapies employed for RA often fail to offer satisfactory efficacy and therefore many patients opt for complementary and alternative medicines (CAM). The present study aimed to assess the type and extent of CAM usage among RA patients visiting rheumatology clinics taking into account the socio-demographic profile and perception of the RA patients towards CAM usage. A descriptive cross-sectional questionnaire-based study was conducted in the top Rheumatology clinics of Hyderabad, Telangana with 200 RA female patients and the obtained data were analysed using logistic regression. Survey revealed that more than 54% of the respondents used some form of CAM and 45% of the patients were reluctant to reveal the use of CAM to their allopathic clinicians. The results showed that patients with basic education (school/undergraduate) used CAM with a probability of 4.622 compared to an illiterate. It was found that patients experiencing moderate sensory pain had a probability of 31.176 to use CAM than the ones with no sensory pain. A significant relationship between depression and CAM usage was found which revealed CAM usage with a probability of 3.43 compared to patients with no depression. Comorbidities like hypertension, diabetes, thyroid, etc. discouraged CAM usage. CAM is preferred at the initial stage of pain among RA patients but as the pain reaches higher levels patients opt for allopathy or allopathy along with CAM for synergistic or faster relief.

Doppler Shift Minimization Using Transmitter Diversity Techmique

Md.Humaun Kabir,S M Riazul Islam,Ahasanun Nessa,Kyung Sup Kwak 한국통신학회 2008 한국통신학회 학술대회논문집 Vol.2008 No.7

유전 알고리즘을 이용한 Cognitive Radio MB-OFDM UWB 시스템의 성능 분석

김태훈(Kim Tae Hun),한동완(Han Dong wan),네사(Nessa),곽경섭(Kwak kyung sup) 한국통신학회 2007 한국통신학회 학술대회논문집 Vol.2007 No.7

Multi-epitope vaccine against drug-resistant strains of Mycobacterium tuberculosis: a proteome-wide subtraction and immunoinformatics approach

Md Tahsin Khan,Araf Mahmud,Md. Muzahidul Islam,Mst. Sayedatun Nessa Sumaia,Zeaur Rahim,Kamrul Islam,Asif Iqbal Korea Genome Organization 2023 Genomics & informatics Vol.21 No.3

Mycobacterium tuberculosis (Mtb) is the causative agent of tuberculosis, one of the most deadly infections in humans. The emergence of multidrug-resistant and extensively drug-resistant Mtb strains presents a global challenge. Mtb has shown resistance to many frontline antibiotics, including rifampicin, kanamycin, isoniazid, and capreomycin. The only licensed vaccine, Bacille Calmette-Guerin, does not efficiently protect against adult pulmonary tuberculosis. Therefore, it is urgently necessary to develop new vaccines to prevent infections caused by these strains. We used a subtractive proteomics approach on 23 virulent Mtb strains and identified a conserved membrane protein (MmpL4, NP_214964.1) as both a potential drug target and vaccine candidate. MmpL4 is a non-homologous essential protein in the host and is involved in the pathogen-specific pathway. Furthermore, MmpL4 shows no homology with anti-targets and has limited homology to human gut microflora, potentially reducing the likelihood of adverse effects and cross-reactivity if therapeutics specific to this protein are developed. Subsequently, we constructed a highly soluble, safe, antigenic, and stable multi-subunit vaccine from the MmpL4 protein using immunoinformatics. Molecular dynamics simulations revealed the stability of the vaccine-bound Tolllike receptor-4 complex on a nanosecond scale, and immune simulations indicated strong primary and secondary immune responses in the host. Therefore, our study identifies a new target that could expedite the design of effective therapeutics, and the designed vaccine should be validated. Future directions include an extensive molecular interaction analysis, in silico cloning, wet-lab experiments, and evaluation and comparison of the designed candidate as both a DNA vaccine and protein vaccine.