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Objective: To assess the feasibility of smartphone-based colposcopy for cervical cancer screening, when utilized by the community healthcare workers of rural Vietnam. Methods: Women in community villages of rural Vietnam were enrolled for a cervical cancer screening project. Cervical images were obtained by pre-trained community healthcare workers using a portable, upcycled smartphone-based colposcopy (Samsung Galaxy Note 20). Images were taken before and after the visualization after acetic acid (VIA) and concomitant Papanicolaou smear was done when feasible. Images were later reviewed independently by 2 experienced gynecologists. Image quality and kappa statistics were assessed for the measurement of agreement in VIA findings. Results: Among 476 women screened, images of 177 cases obtained between July and August 2020 were analyzed. The median age of women was 43 years (range 20-63). The entire cervix was visible in 86.4% and unsatisfactory colposcopy findings were 16.4%. The kappa statistic for interobserver reliability was 0.61 for VIA positivity, indicating substantial agreement. Image clarity was rated from 1 to 5 (1=very poor, 5=excellent), with 77.3% assessed as 'average' and above. The reasons for the image quality to be rated average or less were poor image focus (15.3%), inadequate squamocolumnar junction visibility (18%), obscuring of the transformation zone due to blood (11.3%), discharge (14.7%), or artifacts such as intrauterine device or polyps (5.1%). Conclusion: The usage of smartphone-based colposcopy was feasible with an adequate agreement between the VIA assessment based on the captured images when performed by pre-trained healthcare workers in low-resource settings. [ABSTRACT FROM AUTHOR]

Stevens-Johnson syndrome (SJS) and its severe variant, toxic epidermal necrolysis (TEN), are acute inflammatory vesiculobullous reactions of the skin and mucous membranes. Cold medicines including non-steroidal anti-inflammatory drugs and multi-ingredient cold medications are reported to be important inciting drugs. Recently, we reported that cold medicine related SJS/TEN (CM-SJS/TEN) with severe mucosal involvement including severe ocular surface complications (SOC) is associated with HLA-A*02:06 and HLA-B*44:03 in the Japanese. In this study, to determine whether HLA-B*44:03 is a common risk factor for CM-SJS/TEN with SOC in different ethnic groups we used samples from Indian, Brazilian, and Korean patients with CM-SJS/TEN with SOC, and investigated the association between CM-SJS/TEN with SOC and HLA-B*44:03 and/or HLA-A*02:06. We found that HLA-B*44:03 was significantly associated with CM-SJS/TEN with SOC in the Indian and Brazilian but not the Korean population, and that HLA-A* 02:06 might be weakly associated in the Korean- but not the Indian and Brazilian population. [ABSTRACT FROM AUTHOR]