Polysaccharides from shell waste of shellfish and their applications in the cosmeceutical industry: A review.

Shell waste from shellfish processing contains valuable natural polysaccharides, including sulfated polysaccharides, acidic polysaccharides, glycosaminoglycans, chitin and their derivatives. These shellfish waste-derived polysaccharides have numerous functional and biological properties that can be applied in various industries, including the cosmeceutical industry. In keeping with global sustainability and green industry trends, the cosmeceuticals industry is transitioning from petrochemical-based ingredients to natural substitutes. In this context, shell waste-derived polysaccharides and their derivatives can play a major role as natural substitutes for petroleum-based components in various cosmeceutical skincare, hair care, oral care and body care products. This review focuses on the presence of polysaccharides and their derivatives in shell waste and discusses their various cosmeceutical applications in skin care, hair care, sun care, oral care and body care products. This indicates that shell waste utilization will help create a circular economy in which extracted polysaccharides are used to produce green cosmeceutical products.

Optimisation of multigrain seera from sorghum, green gram and finger millet: effect of ingredients on functional, structural and thermal properties.

Seera, is a traditional Indian fermented food, has high carbohydrate and reducing sugar content, however, lacks functional components like antioxidant properties. The present study aims to optimize and evaluate the multigrain seera with added values. The optimization of seera was made using mixture design, with green gram (X1, 15-30%), sorghum (X2, 15-25%) and finger millet (X3, 5-10%) as independent variables. The responses checked were total phenolic content (Y1), protein content (Y2) and overall acceptability (Y3). The optimum run with green gram (25.58%), sorghum (15%) and finger millet (9.41%) resulted in TPC (1.2 ± 0.12 mg GAE/g), protein content (11.40 ± 0.10 g) with overall acceptability (8.32 ± 0.30). The optimized multigrain seera depicted higher fibre (4.23 ± 0.08%), ash (1.90 ± 1.1%) and protein (11.40 ± 0.10%) than the control seera. The rheological properties of seera depicted shear thinning and elastic behaviour. Texture profile analysis showed that cohesiveness (0.415 ± 0.01) increased significantly (along with decreased springiness (0.251). Morphology of seera showed broken and deformed starch granules with few cracks due to fermentation phenomena that leads to superficial corrosion. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-023-05854-5.

Curcumin, its derivatives, and their nanoformulations: Revolutionizing cancer treatment.

Curcumin is a natural compound derived from turmeric and can target malignant tumor molecules involved in cancer propagation. It has potent antioxidant activity, but its effectiveness is limited due to poor absorption and rapid elimination from the body. Various curcumin derivatives have also shown anticancer potential in in-vitro and in-vivo models. Curcumin can target multiple signaling pathways involved in cancer development/progression or induce cancer cell death through apoptosis. In addition, curcumin and its derivatives could also enhance the effectiveness of conventional chemotherapy, radiation therapy and reduce their associated side effects. Lately, nanoparticle-based delivery systems are being developed/explored to overcome the challenges associated with curcumin's delivery, increasing its overall efficacy. The use of an imaging system to track these formulations could also give beneficial information about the bioavailability and distribution of the nano-curcumin complex. In conclusion, curcumin holds significant promise in the fight against cancer, especially in its nanoform, and could provide precise delivery to cancer cells without affecting normal healthy cells.

MicroRNA-541-3p alters lipoproteins to reduce atherosclerosis by degrading Znf101 and Casz1 transcription factors.

High apoB-containing low-density lipoproteins (LDL) and low apoA1-containing high-density lipoproteins (HDL) are associated with atherosclerosis. In search of a molecular regulator that could simultaneously and reciprocally control both LDL and HDL levels, we screened a microRNA (miR) library using human hepatoma Huh-7 cells. We identified miR-541-3p that both decreases apoB and increases apoA1 expression by inducing mRNA degradation of two different transcription factors, Znf101 and Casz1. Znf101 enhances apoB expression while Casz1 represses apoA1 expression. The hepatic knockdown of orthologous Zfp961 and Casz1 genes in mice altered plasma lipoproteins and reduced atherosclerosis without causing hepatic lipid accumulation, most likely by lowering hepatic triglyceride production, increasing HDL cholesterol efflux capacity, and reducing lipogenesis. Notably, human genetic variants in the MIR541, ZNF101, and CASZ1 loci are significantly associated with plasma lipids and lipoprotein levels. This study identifies miR-541-3p and Znf101/Casz1 as potential therapeutic agent and targets, respectively, to reduce plasma lipoproteins and atherosclerosis without causing liver steatosis.

Marine-Derived Compounds Applied in Cardiovascular Diseases: Submerged Medicinal Industry.

Cardiovascular diseases (CVDs) are among the most impactful illnesses globally. Currently, the available therapeutic option has several side effects, including hypotension, bradycardia, arrhythmia, and alteration in different ion concentrations. Recently, bioactive compounds from natural sources, including plants, microorganisms, and marine creatures, have gained a lot of interest. Marine sources serve as reservoirs for new bioactive metabolites with various pharmacological activities. The marine-derived compound such as omega-3 acid ethyl esters, xyloketal B, asperlin, and saringosterol showed promising results in several CVDs. The present review focuses on marine-derived compounds' cardioprotective potential for hypertension, ischemic heart disease, myocardial infarction, and atherosclerosis. In addition to therapeutic alternatives, the current use of marine-derived components, the future trajectory, and restrictions are also reviewed.

Efficacy and Safety of Temporary in situ Stenting of Ahmed Glaucoma Valve in Eyes with High Risk of Hypotony.

Introduction and Objective: To describe a novel technique for providing external ligation of the Ahmed glaucoma valve (AGV) to prevent hypotony in eyes at high risk with a 4/0 nylon stent suture and report outcomes compared to ligation with an absorbable vicryl suture and no ligation in terms of efficacy and safety. Methods: This was a retrospective cohort study investigating the efficacy and safety of in situ stenting compared to an absorbable ligature and the standard care, in high risk eyes, of hypotony. It included 116 patients; 34 in Group A (ligation + stent), 27 in Group B (ligation - stent), and 55 in Group C (no ligation). Results: The mean age (in years) of the participants was 53.94±19.01 in Group A, 44.85±29.92 in Group B and 52.62±24.47 in Group C, 59% (n = 20), 63% (n = 17) and 60% (n = 33) were males, respectively. The follow-up period was at least 6 months (Group A: 9.1±4.2 months, Group B: 9.6±3.4 months and Group C: 10.2±6.4 months). The mean baseline Snellen VA (LogMAR) was 1.82±1.34, 1.30±0.98 and 1.34±1.07 and the mean baseline IOP was 32.50±9.48, 28.22±7.12 and 28.33±10.63 mmHg, in Groups A, B and C, respectively. The failure rates, by the Kaplan Meier Survival curve, were higher 27.3% in Group C (no ligation) compared to 20.6% in Group A (ligation + stent) and 18.5% in Group B (ligation - stent) yet not found to be statistically significant (p = 0.4; log rank test). There was lower hypotony 2.9% in Group A and lower complications 25.9% in Group B but no statistical significance was found amongst the groups. Conclusion: In conclusion, temporary nylon in situ stenting of AGV had lower rates of hypotony. Furthermore, lower failure and complication rates were observed in vicryl only ligated AGV, then nylon in situ stented AGV and lastly in standard AGV controls.

A preliminary comparison of the Aravind aurolab drainage implant with the Baerveldt glaucoma implant: A matched case-control study.

PURPOSE: The Aurolab® aqueous drainage implant is a low-cost alternative to the Baerveldt glaucoma implant. The aim of this study was to test the hypothesis that the two implants are comparable in terms of surgical success and safety. METHODS: We conducted a retrospective case-control study of Aurolab aqueous drainage implant done at our institution from May 2015 and May 2017. Twenty-five consecutive patients who received an Aurolab aqueous drainage implant were matched by age and diagnosis to patients who received a Baerveldt glaucoma implant. Data were collected pre-operative and post-operative visits, including visual acuity and intraocular pressure, number of medications, and complications. Surgical success was defined as intraocular pressure between 5 and 21 mmHg with a minimum 20% reduction from baseline, without loss of light perception or the need for further glaucoma surgery. Cox regression analysis was used to predict factors associated with surgical success. RESULTS: The median (interquartile range, IQR) intraocular pressure at 1 year was 16.0 (8.0) mmHg for the Baerveldt glaucoma implant and 13.0 (8.0) mmHg for the Aurolab aqueous drainage implant, p = 0.38. Success (mean ± SE) at 1 year for the intraocular pressure >21-mmHg failure criterion was 65% ± 15% for the Baerveldt glaucoma implant and 79% ± 11% for the Aurolab aqueous drainage implant (p = 0.80). The frequency of complications listed was similar for the two groups (Fisher's exact p = 0.71). In the Cox regression, the type of implant was not found to be associated with surgical success. CONCLUSIONS: Our preliminary results suggest that the Aurolab aqueous drainage implant is comparable to the Baerveldt glaucoma implant. Further long-term data in a larger population are needed to confirm these findings.

Long-term outcomes of the Ahmed glaucoma valve surgery in childhood glaucoma.

PURPOSE: To report the rates of success of Ahmed glaucoma valve (AGV) surgery in early childhood glaucoma and factors associated with success. METHODS: Children with primary congenital or early childhood secondary glaucoma who underwent AGV surgery over a 10-year period (one eye per child) at a single institution were identified. Surgical failure was defined as having one or more of the following: intraocular pressure of >21 mm Hg 3 months postoperatively, reoperation for glaucoma, and vision loss to no light perception. RESULTS: A total of 178 patients were identified (median age, 5.8 ± 5.5 years): 125 with primary congenital and 53 with secondary childhood glaucoma. The success rate at 1 year was 92% (95% CI, 88%-96%); at 5 years, 64% (95% CI, 55%-73%); and at 10 years, 36% (95% CI, 25%-52%). Younger age at baseline (P = 0.003) and secondary childhood glaucoma (P = 0.045) were associated with lower success. CONCLUSIONS: The AGV is associated with high short-term success in children with primary congenital glaucoma, but the 10-year success rates are poor. Younger age and secondary childhood glaucoma may be associated with a more refractory outcome.

Incidence and outcome of suprachoroidal hemorrhage associated with pediatric glaucoma surgery.

PURPOSE: To report the incidence and outcomes of suprachoroidal hemorrhage (SCH) associated with pediatric glaucoma surgery. METHOD: The medical records of pediatric patients (<18 years of age) who had undergone glaucoma surgery and developed SCH from June 2014 to September 2017 were reviewed retrospectively. In all cases, the SCH was suspected clinically and was confirmed by B-scan ultrasound. Baseline characteristics, intraoperative details (including surgery type), and subsequent and final outcomes were extracted from the records. RESULTS: Of 2,656 glaucoma surgeries during the study period, 17 cases of SCH were documented, for an overall incidence of 0.64%. Of the 17 cases, 16 occurred postoperatively, and 1 was noted intraoperatively. By surgery type, the incidence of SCH was highest for trabeculectomy (4/121), followed by glaucoma drainage device surgery (6/463), deep sclerectomy (6/851), and transcleral cyclophotocoagulation (1/542). Four children had received prior transcleral cyclophotocoagulation, and 5 of the children were aphakic at the time of the glaucoma surgery. At a mean final follow-up of 1.71 ± 1.08 years), visual acuity in the affected eye was 20/50 or better in 3 children, between 20/50 and 20/200 in 5 children, and counting fingers or worse in 9 children. CONCLUSIONS: In our study cohort, the overall incidence of SCH associated with glaucoma surgery was 0.64%. Further study of risk factors for SCH associated with glaucoma surgery in children is needed.

Comparison of surgical outcomes between sulcus and anterior chamber implanted glaucoma drainage devices.

PURPOSE: This retrospective case-control cross-sectional study compared the outcomes of sulcus placement of glaucoma drainage devices (GDD) versus traditional anterior chamber (AC) to test the hypothesis that sulcus placement results in fewer complications whilst maintaining similar efficacy. METHODS: This study included 45 patients in the sulcus group and 60 patients in the anterior chamber (AC) group who had undergone surgery from January 2014 to December 2017. Data were collected on pre-operative demographics, operative details and post-operative intraocular pressure and complications. The IOP, number of medications and complications between the two groups was compared. A P value of <5% was considered statistically significant. RESULTS: The sulcus group had significantly lower overall complications compared to the AC group with a comparable IOP decrease between groups. There were significantly lower rates of hyphaema in the sulcus (3 cases) compared to AC group (17 cases) (P < 0.05). Severe or late complications (implant exposure, corneal decompensation, endophthalmitis, poor vision, choroidal hemorrhage and cornea edema) were significantly lower in the sulcus group [2 eyes; 4.4%] compared to the AC group [13 eyes; 21.7%] (P < 0.05). The sulcus group required fewer medications during the follow-up period. CONCLUSION: Sulcus implantation of GDD resulted in less postoperative hyphaema and severe complications compared to AC implantation. Our findings concur with the literature that sulcus implantation is safe and effective for controlling IOP for various types of glaucoma. The long-term effects of endothelial cell loss for sulcus versus AC implantation require further evaluation.

Glaucoma Patch Graft Surgery Utilizing Corneas Augmented with Collagen Cross-linking.

PURPOSE: Glaucoma drainage device surgery (GDDS) has gained popularity, with outcomes equivalent to trabeculectomy. Erosion of the tube through the overlying conjunctiva may occur in 5%-10% of eyes. Donor corneal tissue has been used as a patch graft for GDDS. MATERIALS AND METHODS: This was a prospective proof of concept study in 10 patients undergoing GDDS. From patients undergoing endothelial keratoplasty, the donor tissue (approximately 300 µ in thickness) was placed epithelial side down in a well and was allowed to soak in riboflavin solution (VibeX, Avedro, Waltham, MA, USA) for 15 min. This anterior corneal lenticule received 8 mW/cm2 ultraviolet (UV) irradiation applied for 15 min (total energy of 7.2 J/cm2). Each lenticule was then bisected and utilized for the two study participants. The tissue was sutured over the tube during the GDDS and then was covered with recipient conjunctiva as per the usual technique. Representative graft tissues were fixed and examined to determine the depth of cross-linking effect. The patients were followed for 1 year. RESULTS: Histology revealed no apparent demarcation line in the cross-linked grafts; this supported a full-thickness cross-linking treatment effect. There were no intra- or postoperative complications attributed to the graft tissue. No patient developed erosion or exposure of the tube during the 1-year follow-up. CONCLUSIONS: UV-riboflavin cross-linking of the corneal tissue patch graft material appears to be a safe modification when used in GDDS and warrants ongoing study. This method of patch graft can replace other costy methods used with GDD.

Risk Factors for Glaucoma Drainage Device Exposure in a Middle-Eastern Population.

PRéCIS:: In this case-control study, female sex, and older age were risk factors for tube exposure; risk was related to the number of prior ocular surgeries and scleral patch graft (compared with pericardial graft) was found to protect against exposure. PURPOSE: Identification of potential risk factors for glaucoma drainage device (GDD) exposure may help to prevent this potentially blinding complication. The purpose of this study was to evaluate the possible risk factors for GDD exposure in a tertiary eye care center in the Middle-East. METHODS: A retrospective case-control study was undertaken for a 7-year period (2008 to 2015 inclusive). All patients who presented with a GDD incident exposure were identified and were compared with a similar number of controls (without exposure) identified during the same period. Demographic factors, past ocular history, treatment, and surgical technique were recorded for both groups. Bivariate and multivariable analyses were used to identify possible risk factors for tube exposure. RESULTS: A total of 836 patients underwent GDD surgery during this time period and 53 patients were identified with exposure, giving a cumulative incident exposure rate of 6.3% (0.9% per year). Bivariate analysis showed that the median age of cases (51 years) was similar to controls (53 years) (P=0.95), while there was a greater proportion of women with exposure (49%) compared with the control group (28%) with a statistically significant difference (P=0.028). The number of previous surgeries (3.77±2.1) was significantly higher (P=0.018) in the exposure group (4.25±2.0) compared with controls (3.3±2.0). With each unit increase in the number of previous surgeries, the odds of exposure significantly increased by 1.29 (95% confidence interval, 1.05-1.57). In the multivariable regression, female sex (P=0.006) and older age (P=0.025) were significant risk factors and use of a scleral patch (P=0.02) graft potentially protective. CONCLUSIONS: Previous surgery, female sex, and older age are potential risk factors identified in our study. The use of scleral patch graft is potentially protective against GDD extrusion. Further study is needed to elucidate the reasons for these causative and protective factors.

The effect of uterine artery ligation in patients with central placenta pevia: a randomized controlled trial.

BACKGROUND: Placenta previa is major obstetric surgical risk as it is associated with higher percentage of intraoperative and postpartum hemorrhage (PPH), increased requirement of blood transfusion and further surgical procedures. The current study aimed to evaluate uterine artery ligation prior to uterine incision as a procedure to minimize blood loss during cesarean section in patients with central placenta previa. METHODS: One hundred and four patients diagnosed with central placenta previa antenatally and planned to have elective caesarean section were recruited from the antenatal clinic at Minia Maternity University hospital. Patients were randomly allocated into either ligation group or control group. RESULTS: Both groups were similar regarding demographic features and preoperative risk factors for bleeding. The intraoperative blood loss was significantly lower in the ligation group as compared with the control group (569.3 ± 202.1 mL vs. 805.1 ± 224.5 mL respectively, p = 0.002). There was a significant increase in the requirement for blood transfusion in the control group as compared with the ligation group (786 ± 83 mL vs. 755 ± 56 mL respectively, p = 0.03) Three cases in the control group required further surgical interventions to control intraoperative bleeding, while no cases in the ligation required further surgical techniques and that was statistically significant (p = 0.001). CONCLUSION: Uterine artery ligation prior to uterine incision may be a helpful procedure to minimize intraoperative and postpartum blood loss in cases with central placenta previa. TRIAL REGISTRATION: Retrospectively registered in ClinicalTrials.gov Identifier: NCT02002026 - December 8, 2013.

Mechanisms underlying the protective effect of montelukast in prevention of endometrial hyperplasia in female rats.

OBJECTIVE: To study the possible protective role of montelukast in endometrial hyperplesia (EH) rat model, induced by estradiol valerate (EV). METHODS/MATERIALS: Thirty six female albino Wistar rats were classified into 7 groups: normal control, EV (2 mg/kg/day, p.o.), montelukast (10 mg/kg/day, p.o.), montelukast (1 mg/kg/day, p.o.) + EV (2 mg/kg/day, p.o.), montelukast (10 mg/kg/day, p.o.) + EV (2 mg/kg/day, p.o.), montelukast (20 mg/kg/day, p.o.) + EV (2 mg/kg/day, p.o.) groups. Uterine malondialdehyde (MDA), superoxide dismutase (SOD), total nitrites (NO) and serum total antioxidant capacity (TAC) were determined. Uterine, serum total cholesterol, high density lipoprotein (HDL) and tumor necrosis factor (TNF)-α were measured. Histopathological examination of the uterine tissue was also done. In addition, immunohistochemistry was done using Phosphatase and tensin homolog (PTEN) and inducible nitric oxide synthase (iNOS) antibodies. RESULTS: Our results showed that montelukast in dose dependant manner improves oxidative stress, lipids profile and TNF α which were affected by EV. Moreover, immunohistochemical examination revealed that montelukast markedly reduced iNOS expression, while expression of PTEN was markedly enhanced, as compared to EV group. The protective effects of montelukast were also verified histopathologically. CONCLUSIONS: Montelukast in dose dependant manner provided biochemical and histo-pathological improvement in EV induced EH, through its anti-inflammatory, antioxidant activity and inhibition of iNOS expression with induction of PTEN expression.

The effect of a short animated educational video on knowledge among glaucoma patients.

PURPOSE: To evaluate the effectiveness of an educational video in increasing knowledge among glaucoma patients and to determine the factors that may influence a patient's level of knowledge. PATIENTS AND METHODS: This was a pre-post intervention study on adult glaucoma patients attending the outpatient service at King Khaled Eye Specialist Hospital. The intervention tested was a short educational video that was edited specifically for this study. All patients completed a pre-video and post-video knowledge questionnaire; moreover, sociodemographic and clinical characteristics were obtained. RESULTS: The total number of patients included was 196. The mean age of patients was 55.7±15.5 years. Overall, 55.1% were males, 29.6% were illiterate, 85.2% resided in an urban area, 62.8% had a low income, and 41.8% were unemployed. The mean pre-intervention knowledge score was 6 out of 17, and the post-intervention score was 11.1 (P≤0.001). Predictors of a poor knowledge score were old age (>60 years), female sex, illiteracy, rural residence, low income, unemployment, and a negative family history of glaucoma. CONCLUSION: The evaluated video intervention was effective in a short-term increase in knowledge among glaucoma patients. This tool may serve as an alternative to traditional educational methods.

Hysteroscopic adhesiolysis: efficacy and safety.

OBJECTIVE: To evaluate the efficacy and safety of hysteroscopic adhesiolysis in patients with intrauterine adhesions (IUAs). SETTING: Minia Maternity University Hospital, Egypt. DESIGN: Prospective cohort study. PATIENTS: This study included 61 patients presented with infertility (primary or secondary) or recurrent pregnancy losses caused by IUAs. INTERVENTION(S): The adhesions were divided by semi-rigid scissors introduced under direct vision through hysteroscopy. Three months later, second-look hysteroscopy was performed. PRIMARY OUTCOME PARAMETERS: Primary outcome parameters were reproductive parameters (pregnancy rate, duration of pregnancies, life births rate, time lag between the intervention and diagnosis of pregnancy). SECONDARY OUTCOME PARAMETERS: Secondary outcome parameters were the changes in post-operative menstrual pattern, number and duration of intervention and type of intra- and post-operative complications. RESULT(S): Pregnancy rate changed from 18 to 65.5 %, while live birth rate improved from 14.7 to 36 %. The mean time until the first conception was 10.2 months (range 2-60 months) after the operation. There was significant negative correlation between the degree of IUAs and the improvement in reproductive performance. Hysteroscopic adhesiolysis significantly improved menstrual pattern in 60.7 % of patients complaining of hypomenorrhea or amenorrhea. (p = 0.0017). The average operative time was 29 ± 10.2 (10-52) min and the hospital stay was 12.5 ± 2.1 (9-24) h. Uterine perforation occurred on 3 (4.9 %), and cervical laceration occurred in one case (1.6 %). CONCLUSION(S): Hysteroscopic adhesiolysis of IUAs is safe and effective in terms of reproductive outcome. The outcome is significantly affected by degree of intrauterine adhesions rather than the main complaint before the procedure.

Evaluation of cervical biopsies guided by visual inspection with acetic acid.

OBJECTIVE: To evaluate the accuracy of visual inspection with acetic acid (VIA) in determining the site, the size, and the number of cervical biopsies in patients with positive cervical cytology. METHODS: This study included 486 patients with positive cervical cytology who presented to the Gynaecological Oncology Unit of Minia Maternity University Hospital, Egypt, in the period between January 2008 and September 2011. Visual inspection with acetic acid was done for all patients. They were classified into 2 groups according to the results of VIA. Group 1 included VIA-negative women, whereas group 2 included VIA-positive women. All patients were reexamined with colposcopy to prove or disprove the presence of lesions. Cervical biopsies were taken from patients with positive VIA or colposcopically confirmed lesions using punch biopsy forceps. Biopsies were sent for histologic examination. RESULTS: In group 1, 100 patients were VIA-negative, 66 of them were histopathologically free, whereas 34 patients had positive biopsy results. Group 2 included 386 patients: 31 were histologically free, 239 had cervical intraepithelial neoplasia (CIN) 1, whereas 116 had CIN 2 or worse. CONCLUSIONS: Visual inspection with acetic acid is a good test for aiding the diagnosis of CIN and may be helpful in determining the site, the size, and the number of biopsies in patients with positive cytologic results. Instead of colposcopy, VIA can be used in developing countries where colposcopic services are not available.

Prevalence of cervical intraepithelial neoplasia (CIN) in patients attending Minia Maternity University Hospital.

BACKGROUND: Cervical cancer is the second most common cancer of the genital tract. Wide use of screening programs can help in prevention of cervical cancer. OBJECTIVE: To screen and evaluate the prevalence of cervical intraepithelial neoplasia (CIN) by visualization of the cervix after application of 5 % acetic acid (VIA) in Minia Maternity University Hospital. PATIENTS AND METHODS: The study included 3,600 women from outpatient clinics of Minia Maternity University Hospital. They were screened for cervical cancer with the use of visual inspection of the cervix after application of 5 % acetic acid (VIA). Positive cases were subjected to colposcopy after referral to the colposcopy unit in the same hospital. Colposcopy-guided biopsies were done for colposcopic positive patients. One hundred and twenty women with negative VIA as control were randomly examined with colposcopy to evaluate the effectiveness of the test used, and no cases experienced cervical lesion. RESULTS: The prevalence was 5.8 % for cervical lesions, 1.4 % for HPV infection alone, 3.3, 0.84 and 0.27 % for CIN I, CIN II and CIN III, respectively. The prevalence of CIN II or higher was 1.11 % (40/3,600). CONCLUSIONS: Prevalence of CIN in the study population was 138 out of 1,800 cases (7.7 %). Pre-invasive high-grade lesions represent 1.3 % in participant women. VIA can be used in national programs for cervical cancer screening.