Advanced Mobile Medical Van for Cancer Screening: Solar-Powered with Digital Display for Breast, Cervical and Oral

Abstract

ABSTRACT Our Invention “Advanced Mobile Medical Van for Cancer Screening: Solar-Powered with Digital Display for Breast, Cervical and Oral” is a conducted 290 cervical cancer screening outreach clinics in the MSU. Screening was performed by trained nurses/ health care providers using visual inspection with 5% acetic acid (VIA). Screen positive women when eligible were treated by thermal ablation during the same sitting. Women with large lesions not eligible for treatment with thermal ablation were referred for colposcopy and treatment.A total of 10, 925 women were screened between Nov 2016 and June 2019 in 290 outreach clinics in the MSU. The overall screen positivity was 6.6% (95% CI 6.1, 7.0) with a declining trend over time. A total of 304/717 (42.4%, 95% CI 38.7, 46.1) women received treatment with thermal ablation. About 3.6% (11/304) reported minor side effects and 1.6% (5/304) reported lower abdominal pain and all of them subsided after treatment. Among the 413 women who were advised colposcopy, only 84 (20.33%) women underwent the procedure. Of these 84 women, 64 (76.19%) had normal colposcopy/ histopathology, 7 (8.33%) had CIN1, 2 (2.38%) had CIN 2, 9 (10.71%) had CIN 3 disease and 2 (2.38%) women were diagnosed with invasive cancer.MSUs are useful for providing cervical cancer screening services, using the ‘screen and treat’ strategy. Thermal ablation is safe in the field clinics. Additional efforts are needed to improve the compliance for referral of those with large lesions requiring additional visits.

Specification

Description:FIELD OF THE INVENTION
Our invention is related to advance Mobile Medical Van for Cancer Screening: Solar-Powered with Digital Display for Breast, Cervical and Oral.

BACKGROUND OF THE INVENTION
Cervical cancer is the fourth most common cancer among women). In 2018, the age-standardised incidence of cervical cancer was 13.1 per 100 000 women globally). Cervical cancer is a major public health problem especially among women from the low- and middle-income countries.

India accounts to about a fifth of the global burden of cervical cancer and has contributed 97 000 cases and 60 000 deaths in 2018. Screening and vaccination are two powerful tools that are currently available for preventing cervical cancer and have the potential to practically eliminate cervical cancer.

Vaccination of adolescent girls is very promising especially in the countries that do not have screening programs in place. However, cervical cancer screening remains the only option to prevent cervical cancer for unvaccinated adult women.

SUMMARY OF THE INVENTION
Prayas's Ethics Committee has exempted program analysis of these data. Cervical cancer screening using VIA and immediate treatment using thermal ablation was provided in the MSU customized to provide the services. The MSU was designed with the front compartment for the sitting arrangement for staff and storage underneath.

An elongated compartment at the back was designed with an examination bed, light source for visual examination, a wall-mounted clock visible to the nurse while performing VIA, a platform to keep material/ instruments for screening and treatment, sitting and storage area and a small wash basin with a foot operated tap. The list of material carried in the vehicle is listed.

The vehicle was also fitted with a generator (900 VA) for providing electricity for the light source, fans, air-conditioner and treatment with thermal ablation. We initially used wisest coagulator (Germany) and then LigerTM (UT, USA) battery-operated coagulator for thermal ablation.

BRIEF DESCRIPTION OF THE DIAGRAM

Fig.1.2: Advanced Mobile Medical Van for Cancer Screening: Solar-Powered with Digital Display for Breast, Cervical and Oral.

DESCRIPTION OF THE INVENTION
Women with large lesions, not eligible for ablation were referred to the clinic where they underwent colposcopy, directed biopsy if needed and ablative treatment or loop electro-excision procedure (LEEP) aka large loop excision of transformation zone (LLETZ).
LEEP was performed under local anaesthesia at our clinic. Women diagnosed with invasive cancer or women with extensive lesions probably requiring a cold knife conization or LEEP under general anaesthesia were referred appropriately.
Biomedical waste was collected in 3 different plastic containers/ dustbins (one each for used specula, cotton sticks and gloves) lined with disposable plastic bags. These plastic bags were sent to the programme clinic for further processing after tying the plastic bags appropriately.
At the clinic, plastic bags containing cotton sticks and gloves were disposed of as per the local biomedical waste disposal guidelines and used specula were disinfected in 0.5% sodium hypochlorite solution for 20 minutes prior to washing with soap and water and autoclaving.
A total of 10, 925 women were screened between Nov 2016 and June 2019 in 290 outreach clinics in the MSU. The overall screen positivity was 6.6% (95% CI 6.1, 7.0) with a declining trend over time.
A total of 304/717 (42.4%, 95% CI 38.7, 46.1) women received treatment with thermal ablation. About 3.6% (11/304) reported minor side effects and 1.6% (5/304) reported lower abdominal pain and all of them subsided after treatment.
Among the 413 women who were advised colposcopy, only 84 (20.33%) women underwent the procedure. Of these 84 women, 64 (76.19%) had normal colposcopy/ histopathology, 7 (8.33%) had CIN1, 2 (2.38%) had CIN 2, 9 (10.71%) had CIN 3 disease and 2 (2.38%) women were diagnosed with invasive cancer.

 
, Claims:WE CLAIMS

1. Our Invention "Advanced Mobile Medical Van for Cancer Screening: Solar-Powered with Digital Display for Breast, Cervical and Oral" is a conducted 290 cervical cancer screening outreach clinics in the MSU. Screening was performed by trained nurses/ health care providers using visual inspection with 5% acetic acid (VIA). Screen positive women when eligible were treated by thermal ablation during the same sitting. Women with large lesions not eligible for treatment with thermal ablation were referred for colposcopy and treatment. A total of 10, 925 women were screened between Nov 2016 and June 2019 in 290 outreach clinics in the MSU. The overall screen positivity was 6.6% (95% CI 6.1, 7.0) with a declining trend over time. A total of 304/717 (42.4%, 95% CI 38.7, 46.1) women received treatment with thermal ablation. About 3.6% (11/304) reported minor side effects and 1.6% (5/304) reported lower abdominal pain and all of them subsided after treatment. Among the 413 women who were advised colposcopy, only 84 (20.33%) women underwent the procedure. Of these 84 women, 64 (76.19%) had normal colposcopy/ histopathology, 7 (8.33%) had CIN1, 2 (2.38%) had CIN 2, 9 (10.71%) had CIN 3 disease and 2 (2.38%) women were diagnosed with invasive cancer. MSUs are useful for providing cervical cancer screening services, using the 'screen and treat' strategy. Thermal ablation is safe in the field clinics. Additional efforts are needed to improve the compliance for referral of those with large lesions requiring additional visits.
2. According to claim1# the invention is to a "Advanced Mobile Medical Van for Cancer Screening: Solar-Powered with Digital Display for Breast, Cervical and Oral" is a conducted 290 cervical cancer screening outreach clinics in the MSU.
3. According to claim1,2# the invention is to a Screening was performed by trained nurses/ health care providers using visual inspection with 5% acetic acid (VIA). Screen positive women when eligible were treated by thermal ablation during the same sitting. Women with large lesions not eligible for treatment with thermal ablation were referred for colposcopy and treatment. A total of 10, 925 women were screened between Nov 2016 and June 2019 in 290 outreach clinics in the MSU.
4. According to claim1, 3,4# the invention is to a overall screen positivity was 6.6% (95% CI 6.1, 7.0) with a declining trend over time. A total of 304/717 (42.4%, 95% CI 38.7, 46.1) women received treatment with thermal ablation. About 3.6% (11/304) reported minor side effects and 1.6% (5/304) reported lower abdominal pain and all of them subsided after treatment. Among the 413 women who were advised colposcopy, only 84 (20.33%) women underwent the procedure.
5. According to claim1, 3, 4# the invention is to a 84 women, 64 (76.19%) had normal colposcopy/ histopathology, 7 (8.33%) had CIN1, 2 (2.38%) had CIN 2, 9 (10.71%) had CIN 3 disease and 2 (2.38%) women were diagnosed with invasive cancer.
6. According to claim1, 3, 4,5# the invention is to a MSUs are useful for providing cervical cancer screening services, using the 'screen and treat' strategy. Thermal ablation is safe in the field clinics. Additional efforts are needed to improve the compliance for referral of those with large lesions requiring additional visits.

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