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Introduction/Background Visual Inspection after application of 5% acetic acid (VIA) has been recommended for primary cervical cancer screening in India. The objectives were to develop and validate video based training tool for capacity building of paramedical staff in cancer awareness and screening, thereby reducing expert time requirement and duration of training and to comparatively evaluate performance of HPV Hybrid Capture 2 (HC2) and Cytology as triage tests among VIA screen positive women, thus aiming to reduce referral burden. Methodology Video based tutorials were prepared in 14 modules. These videos included conducting cancer awareness, performing VIA, collecting samples for HPV and Cytology. The paramedical staff were invited for training. The standard training of 12 weeks was reduced to two weeks using new tool. Practical demonstration and micro-teaching was combined with tutorials training on pre-loaded tablets. Community based cervical cancer screening with VIA was conducted among women aged 30–65, residing in Mumbai, India, by trained Primary Health Workers (PHWs). After obtaining informed consent, delivering cancer awareness, participants were offered VIA screening by trained PHWs. All VIA screen positive women underwent Cytology and HPV HC2 and later diagnostic Colposcopy at nodal hospital. Women with positive Colposcopy underwent cervical biopsies. Results Fifty trainees were evaluated with theory and practical evaluation. All trainees found training to be informative, easy to understand and felt confident to deliver cancer awareness, perform VIA and collect samples for HPV and Cytology. 231 VIA positive women underwent Cytology and HPV HC2 test, followed by Colposcopy. Cervical biopsies were obtained in 83 cases. The sensitivity and specificity in detecting ≥ CIN 2 were 77.8 and 92.3 for HC2 and 66.7 and 98.2 for cytology. The false positivity and negativity rates were 7.7 and 22.2 for HC2 and 1.8 and 33.3 for cytology. Conclusion With India now being on roll out mode of cancer control programme, it’s outcome will depend on quality of training that will be imparted to health services staff. The preparation and validation of these indigenously prepared video based tutorials has opened new avenue by which vast majority of paramedical staff could be trained in relatively shorter duration and utilizing least expert time. The study shows that paramedical staff can be trained to collect HPV samples and that HPV HC2 reduces referrals to larger extent and misses fewer cases compared to cytology, thus appearing a better triage test among VIA positive women. Disclosures TMH-IIT Collaborative projects through Tata Trusts and DAE Grants

Introduction/Background Cervical cancer is the second most common cancer among Indian women. The government is now committed to control common cancers. The objectives are to develop and validate video based training tool for capacity building of existing health services staff in cancer awareness and screening activities, to reduce the expert time involved in the training and to reduce the duration of training. Methodology Video based tutorials were prepared in ten modules and three languages by TMH in co-ordination with IIT, Mumbai. The health services staff were invited for the training. The training which was for 12 weeks using standard methods was now planned for two weeks using the new technology. Practical demonstration and micro-teaching of health awareness activities, preparation of dilute acetic acid, lugol’s iodine, inserting speculums, performing VIA and VILI, identifying lesions, disinfection and sterilization procedures were combined with video based theory and demonstrations. The tablets pre-loaded with the video based tutorials were retained with the trainees during the training period. Results The fifty trainees were evaluated with theory and practical evaluation. Majority scored well in the theory exams. Out of twenty marks allocated for practical evaluation 49 (98%) scored above 10 marks. All trainees found the training to be very informative, easy to understand and felt confident to deliver cancer awareness talk and to perform VIA and VILI based screening. Conclusion The outcome of roll out of the cancer control programme will depend on the quality of training imparted to the health services staff. A real-world issue is relieving the health services staff for longer duration for training and the availability of expert time for training. The preparation and validation of these indigenously prepared video based tutorials has opened new avenue by which the vast majority of the health services staff can be trained in relatively shorter duration. Disclosure Funding Support for preparation of videos was through TMH-IIT Collaborative projects through Tata Trusts and for testing the videos through TMH Intramural funds.

Background India has been a Party of the World Health Organization Framework Convention on Tobacco Control since more than a Decade, National Tobacco-Control Program (NTCP), of India is in place. Though there were several tobacco control policies introduced in the country, the production side of tobacco menace, alternative crops to tobacco still need to strengthen further. Current study is based on a mixed methods observations study to explore various perspectives of tobacco farmers on their knowledge/awareness about health and tobacco, alternative crops options, and feasibility issues. Methods A mixed method study conducted to explore the farmers perspectives on tobacco and health, tobacco cultivation and alternative crops. A structured self-administered Quantitative questionnaire used for Tobacco farmers (N=150) of 6 districts, Andhra Pradesh state, India. Qualitative guide was used to conduct Focus Group Discussions (FGDs) for 36 tobacco farmers of 3 districts from Andhra Pradesh and Karnataka state. Results Awareness of tobacco related health hazards are, Tobacco crop is always profitable, previously the crop was profitable, always on losses 8%, 45%, 40%.and 72%% mentioned alternative crops are essential. 88% believed the tobacco causes various diseases, 4% consider the tobacco as a profitable crop rather public health concern. About 4% farmers have cancer patients in the family. About 28% said seek various forms of support from Govt, and 22% ask for financial benefits to quit tobacco cultivation. Only 8% said alternative crops not required. Qualitative findings revealed very interesting factors about why Farmers forced to grow tobacco though they know its deadly crop. Conclusions This shows the role of National tobacco control program must address the alternative crops alongside of efforts to reduce Tobacco consumption. Farmers also addressed tobacco industries monopoly in controlling tobacco price and taking over maximum benefit out of tobacco crop than the farmer.

IntroductionTobacco is the single most preventable cause of deaths globally. India is the second largest consumer and third largest producer of tobacco. A plethora of tobacco products are consumed. India has highest number of oral cancer cases globally and bears one fourth of the global burden.With the smoke free public places legislation being implemented since 2nd October 2008, smoking is prohibited on public transport bus premises in India. Tobacco addiction is common among the commuters, drivers, conductors and other staff of the public transport department.The present study was conducted to understand the knowledge, attitude and practices (KAP) regarding harmful effects of tobacco among the public transport bus staff, to educate them regarding the importance of smoke free legislation and health hazards associated with tobacco use, to support them in tobacco cessation, to conduct oral cancer screening and to assist in the further management.Materials and methodsAround 4000 public transport bus employees in Mumbai were enrolled after explaining the programme and obtaining informed consent. They were interviewed and their KAP regarding tobacco was recorded. The employees were then given detailed health education. They were screened for oral cancers and counseled for tobacco cessation. The screened positive employees were referred for diagnostic evaluation and management.Results4000 public transport bus employees were enrolled. Amongst them 1691 (42.28%) were tobacco users. Smokeless form of tobacco use was dominant, 1561 (92.31%). All 4000 employees participated in oral cancer screening and were enrolled for tobacco cessation counselling. 743 employees were screened positive, 592 complied to referral for diagnostic evaluation and 534 employees were clinically diagnosed with oral pre-cancersConclusionsTobacco use and oral pre-cancers are high among the public transport bus employees in Mumbai. Hence, awareness, oral cavity screening and tobacco cessation counseling should be incorporated within their annual health check-up.

At the present time, the aptitude in contemplation of accessing as well as sharing images has become progressively facile with the Internet allowing people to procure information remotely from anywhere in the entire world. Moreover, there has been also an expansion with regard to the number of the still digital images over the internet for the sake of the fact that a vast number of millions of people are capturing digital photos. Fundamentally, the procedure of digital watermarking can be delineated as a method for embedding information into another signal (a digital signal). In case of digital images, the embedded information can be either visible or hidden from the user. In this project, we will concentrate on imperceptible watermarks. The principal intention of digital watermarks is to provide copyright protection for intellectual property that is in digital format. Typical usage scenarios for watermarking are such as copyright protection and data authentication. In this paper, we describe an imperceptible and a robust DWT digital Image Watermarking algorithm.The algorithm watermarks a given digital image using a Discrete Wavelet Transform. &nbsp