Introduction: Detection of high-risk human papillomavirus (hrHPV) is the most sensitive test for the screening of cervical cancer. Although most high-income countries have adopted this strategy in their screening programme, there are a lot of barriers in low and middle-income countries (LMICs) in setting up this facility for screening. The lessons learned based on this experience can be useful for other LMICs in their first steps to integrate HPV testing into a screening programme.Methods: HPV testing using self-sampling was offered to eligible women residing in one district of Sikkim state. To implement the same, a testing laboratory was set up in the district and the challenges faced are listed. Results:The cost of testing equipment, sampler and cold storage was beyond the budget capping. Setting up of the HPV testing lab accessible to study sites and referral centre was a difficult decision to make. Training the health care providers in their proficiency in triaging and treatment was challenging. Coordinating with community health workers and beneficiaries for effective screening and establishing referral linkages was not easy, as we expected. The cost of transportation, consumables and contingencies was higher due to the difficult terrain. Conclusion:The cost of the equipment and consumables for primary HPV screening can be reduced in bulk purchases through negotiations. Adequate knowledge of the terrain and economic implications of the area of interest is crucial during the budgeting of the programme. Collaborating with the state government, integration with the existing health system and repurposing the available resources are key for success. The barriers faced during implementation are stepping stones for improvement.

A 40-year-old male presented because of generalized weakness, fatigability, and hyperpigmentation with ecchymosis, he was diagnosed to have dietary Vitamin B12 deficiency anemia. The hyperpigmentation and ecchymosis lesions resolved after Vitamin B12 supplementation. Beside hyperpigmented lesion on the skin, the presence of ecchymosis is a very rare manifestation of the disease. Thrombocytopenia in Vitamin B12 deficiency anemia rarely leads to ecchymosis.

AIM: To evaluate the anatomical and visual outcome following removal of intraocular foreign body (IOFB) through pars planavitrectomy.MATERIAL & METHODS: A retrospective analysis of 11 cases of retained posterior segment foreign body that underwent pars planavitrectomy for removal of foreign body during the period of January 2013 to August 2017 was conducted. Demographics of patients, mechanism and details of injury, Snellen best corrected visual acuity, examination results at presentation and after surgery, any diagnostic imaging and surgical procedure were recorded and analysed.RESULTS: Out of eleven eyes of eleven patients (mean age= 25.4}8.6, range 22 50 years; all male) preoperative retinal detachment and endophthalmitis was seen in 27.3% and 36.4% of cases respectively. Eighty-two percent of cases presented within 17 days of sustaining injury. Foreign body size ranged from 2mm to 8 mm and all were magnetic metal. After vitrectomy and removal of foreign body, the number of eyes with vision of hand motion or worse decreased from 72.7% to 27.3%. Similarly 45.5% of eyes gained best corrected postoperative visual acuity of better than 6/60. Anatomical success could be achieved in 81.8% of eyes.CONCLUSION: Anatomical outcome following vitrectomy in eyes with retained posterior segment IOFB in terms of retinal attachment is sufficient; however, visual outcome can be affected by other collateral ocular injuries and their sequelae.Journal of Universal College of Medical Sciences, Vol. 5, No. 2, 2017, Page: 45-48

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In recent years, Internet of Things (IoT) has become an interesting research topic in various fields such as technical, academic, medical and industry. With the growing interest in IoT, security must be taken into consideration as it is one of the main issues of IoT platform, technologies and application. The most important part of secure IoT system is verification and authentication between IoT enabled devices and IoT web servers. This paper presents reviews the research on IoT architecture, various securities issues and challenges that must be taken into consideration and also presents a multi-factor authentication for a new solution to ensure confidentiality, integrity, authentication, authorization and ability to identify heterogeneous devices.