Recent Advances in Recent Advances in Screening TestsScreening TestsAbraham MallelaAbraham MallelaRoll No : 92Roll No : 92

Guided by Sipra Guided by Sipra MadamMadam

DevelopmentDevelopmentDevelopment of technology Development of technology

Newer methods Newer methods

Faster results Faster results

Accurate AnalysisAccurate Analysis

Lesser PainLesser Pain

Cervical CarcinomaCervical Carcinoma

PAP Smear ACIASPAP Smear ACIASACIASACIAS : Automated Computer : Automated Computer Image Analysis SystemImage Analysis System

Initial Stages of developmentInitial Stages of development

X National Screening X National Screening

High Volume Reference LabsHigh Volume Reference Labs

Improve sensitivity and Improve sensitivity and unsatisfactory specimenunsatisfactory specimen

Breast Breast CancerCancer

Full Field Digital Full Field Digital MammographyMammography

Mammography - Mammary gland Mammography - Mammary gland cancercancer

Previously - Screen Film CassettesPreviously - Screen Film Cassettes

Currently - Digital ImagingCurrently - Digital Imaging

Also Know as : Full Field Digital Also Know as : Full Field Digital MammographyMammography

FFDM FFDM

Colo-rectal CarcinomaColo-rectal Carcinoma

Virtual ColonoscopyVirtual ColonoscopyColorectal CarcinomaColorectal Carcinoma

Traditionally : Anal ProbeTraditionally : Anal Probe

Disadvantages: Disadvantages: Pain, ShynessPain, Shyness

Recent Advances: Recent Advances: Virtual ColonoscopyVirtual Colonoscopy

MRI & CT Scans - 2D & 3D MRI & CT Scans - 2D & 3D ImagesImages

Non - Invasive and Pain freeNon - Invasive and Pain free

Many drawbacksMany drawbacks

Doubtful Diagnostic ValueDoubtful Diagnostic Value

ExpensiveExpensive

Lacks therapeutic actions - Removal of Lacks therapeutic actions - Removal of polyps polyps

TuberculosisTuberculosis

QuantiFERON TB - GoldQuantiFERON TB - GoldTuberculosisTuberculosis

Gold Standard : Mantoux TestGold Standard : Mantoux Test

Many replacements developedMany replacements developed

QuantiFERON TB - GoldQuantiFERON TB - Gold

Blood testBlood test

Measures Immune Measures Immune reactivity to TBreactivity to TB

Chronic DepressionChronic Depression

Beck Depression Beck Depression InventoryInventory

Depression Screening TestDepression Screening Test

21 questions with multiple choice answers21 questions with multiple choice answers

Severity of depressionSeverity of depression

3 versions 3 versions

BDI - 1BDI - 1

BDI - 1ABDI - 1A

BDI - 2BDI - 2

Foetal Foetal AbnormalitiAbnormalitieses

3D Sonography3D SonographyFoetal Abnormalities Screening Foetal Abnormalities Screening tests : Sonography, Alpha Feto tests : Sonography, Alpha Feto Protein Protein

Traditionally : 2D image sonography Traditionally : 2D image sonography

Recent Advances : Real time Recent Advances : Real time 3D 3D SonographySonography

Multiple Sonographs at different Multiple Sonographs at different angelsangels

View abnormalities in a beating heart View abnormalities in a beating heart in realtimein realtime

Diabetes Diabetes

DiabetesDiabetesMost common non-Most common non-communicable diseasecommunicable disease

Prevention: Early detection & Prevention: Early detection & change in life stylechange in life style

Current screening methods: Current screening methods: Questionnaire, urine Questionnaire, urine examination , fasting blood examination , fasting blood sugar, plasma glycogen, HbA1csugar, plasma glycogen, HbA1c

Drawing of BloodDrawing of Blood

Gold Standard for Diagnosis : Oral Glucose Gold Standard for Diagnosis : Oral Glucose Tolerance testTolerance test

Cannot be used as Screening testCannot be used as Screening test

Multiple blood samples & Time Taking Multiple blood samples & Time Taking

Diab - SpotDiab - SpotDeveloped by DiagnOptics LabsDeveloped by DiagnOptics Labs

AGE’sAGE’s : Advanced Glycation EndProducts : Advanced Glycation EndProducts

Important role in development of Important role in development of DiabetesDiabetes

Non Invasive method using Fluorescent Non Invasive method using Fluorescent technique technique

Measures Measures AGE’sAGE’s in tissues in tissues

Combined with age,sex,weight Combined with age,sex,weight - immediate results - immediate results

Screening with SalivaScreening with Saliva

Screening with SalivaScreening with Saliva

Analysis of saliva for Analysis of saliva for various enzymes various enzymes

Can be used for Can be used for many applicationsmany applications

Adrenal Conditions : Adrenal Conditions : Addisons Disease Addisons Disease

Polycystic Ovary Syndrome , Polycystic Ovary Syndrome , Anovulations ,MenopauseAnovulations ,Menopause

Andropause , Hyperstogenic Andropause , Hyperstogenic

Metabolic Disorders : Insulin Resistance, Metabolic Disorders : Insulin Resistance, DiabetesDiabetes

Bengin & Metastatic Neoplasm : Breast Bengin & Metastatic Neoplasm : Breast Cancer , Oral Cancers, Pancreatic CancerCancer , Oral Cancers, Pancreatic Cancer

Allergic Conditions : Food Allergy Allergic Conditions : Food Allergy

Coronary Coronary Heart Heart DiseaseDisease

Coronary Heart DiseaseCoronary Heart DiseaseCurrent Screening Tests : Current Screening Tests : EKG & Exercise Cardiac EKG & Exercise Cardiac Stress Testing ( Stress Testing ( ECSTECST ) )

Unreliable - mitral valve Unreliable - mitral valve stenosis & Inadequate stenosis & Inadequate increase in heart rateincrease in heart rate

Further confirmation - Further confirmation - Angiography Angiography

RadioNucleioside RadioNucleioside Stress Test Stress Test

Invasive screening test Invasive screening test

Radioactive isotope dye Radioactive isotope dye

Gamma CameraGamma Camera

Areas with low blood flow - Areas with low blood flow - Nuclear Cold SpotNuclear Cold Spot

Electron beam Electron beam Computerised Computerised TomographyTomography

Also called as Calcium Also called as Calcium Scoring Scoring

Measures Calcium Deposits Measures Calcium Deposits in Coronary Arteriesin Coronary Arteries

CT ScannersCT Scanners

Urine StripUrine StripDetecting Diabties & Kidney Disease Detecting Diabties & Kidney Disease

Latest Advancements : Automated Urine Strip Latest Advancements : Automated Urine Strip Analyser Analyser

Calcium, blood glucose, bilirubin , urobilirubinq, Calcium, blood glucose, bilirubin , urobilirubinq, ketones , leucocytes creatine, microalbumin, ketones , leucocytes creatine, microalbumin, pH , ascorbic acid and protein all with a single pH , ascorbic acid and protein all with a single sample of urine. sample of urine.

Diabetic RetinopathyDiabetic Retinopathy

30 - degree 30 - degree Stereoscopic Stereoscopic PhotographyPhotographyScreening test for Screening test for Diabetic Retinopathy Diabetic Retinopathy

Traditional methods: Traditional methods: Direct & Indirect Direct & Indirect OphthalmoscopyOphthalmoscopy

Indirect Ophthalmoscopy Indirect Ophthalmoscopy - needs access to health - needs access to health carecare

Where health care not Where health care not developed : Film or developed : Film or digital photographydigital photography

Recent Gold Standard : Recent Gold Standard : 30 - degree 30 - degree stereoscopic stereoscopic photography of the photography of the seven standard fieldsseven standard fields

Expensive & Highly Expensive & Highly trained professionals trained professionals requiredrequired

SyphilisSyphilis

Syphilis Syphilis Traditionally VDRL slide testTraditionally VDRL slide test

Test is difficult to perform Test is difficult to perform

Alternative : Rapid Plasma Alternative : Rapid Plasma Reagin Test ( Reagin Test ( RPRRPR ) )

Effective Screening TestEffective Screening Test

Non - Specific Antibodies Non - Specific Antibodies against T. pallidium against T. pallidium

THANK THANK YOU!!!!YOU!!!!