A Novel Model for Papillomavirus-Mediated Anal Disease and Cancer Using the Mouse Papillomavirus

We show, for the first time, that MmuPV1 infection is sufficient to efficiently mediate high-grade squamous intraepithelial lesions in the anal tract of mice using the NSG immunocompromised strain and that MmuPV1, in combination with the chemical carcinogen DMBA, has carcinogenic potential. We further show that MmuPV1 is able to persist for up to 6 months in the anal tract of FVB/NJ mice irradiated with UVB and contributes to high-grade disease and cancer in an immunocompetent strain.

A COMPARATIVE CLINICAL STUDY ON THE EFFICACY OF APAMARGA AND PALASHA PRATISARANEEYA KSHARA IN ARSHAS

Ever since the evolution of the species Homo sapiens, anal problems have been a source of constant anxiety. Contrarily there seems to be an increasing incidence of the commonest of all anal disease, i.e. Arshas, a kind of disease which is very unkind towards mankind. Ayurvedic literatures have described Arshas as Mahagada and can be compared to Haemorrhoids in modern medicine. The various therapies show that there is no universally acceptable technique in the management of Haemorrhoids and also these have many side effects and demerits. Pratisaraneeya Kshara the alkaline group of medicinal substances has been emphasized throughout the classical literature for Arshas, as a substitute for surgical procedure and can be used safely in patients who are afraid of surgery, old and weak also. This work includes preparation of Apamarga and Palasha Pratisaraneeya Ksharas; evaluation of the efficacy of Apamarga and Palasha Pratisaraneeya Kshara and comparing the results in the management of Arshas. The effects of Apamarga Pratisaraneeya Kshara and Palasha Pratisaraneeya Kshara were evaluated clinically in 30 patients, 15 in each group randomly divided. The study concluded that in patients suffering from Arshas both Apamarga Pratisaraneeya Kshara and Palasha Pratisaraneeya Kshara showed statistically highly significant results (p < 0.001) in terms of the improvement in Mass per rectum, Pain and Size of pilemass and 80% of the patients treated with Apamarga Pratisaraneeya Kshara got complete remission from the disease, while with Palasha Pratisaraneeya Kshara 46.7% patients showed complete remission. Though there won’t many differences statistically, the comparison of individual criteria ‘s percentage and the relief obtained, Apamarga Pratisaraneeya Kshara showed an upper hand in managing the Arshas.

Human Papillomavirus–Associated Anogenital Pathology in Females With HPV-Positive Oropharyngeal Squamous Cell Carcinoma

We sought to determine the incidence and location of human papillomavirus (HPV)–associated anogenital disease in women with HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) via a retrospective cohort study with prospective contact to update history at Mayo Clinic in Rochester, Minnesota. Females undergoing treatment for nonmetastatic HPV-positive OPSCC from 2011 to 2019 were identified. Clinical history and outcomes were abstracted from medical records. Patients without documented anogenital history were contacted, consented, and administered a survey, and external records were requested and reviewed. Seventeen of 46 patients (37.0%) had a history of anogenital HPV-associated disease, and 16 of 17 (94.1%) required procedures to diagnose or treat HPV lesions. The cervix was the most common site (16/17, 94.1%). Procedures included colposcopy (n = 6), cervical excision (n = 3), cryotherapy (n = 4), and hysterectomy (n = 3). One case of fatal cervical carcinoma was noted, diagnosed 1 year following OPSCC. Three of 17 (17.6%) had HPV-related vulvovaginal disease, and 1 of 17 had anal disease. Patients with a history of HPV-positive OPSCC may be at elevated risk for HPV-associated anogenital disease.

P611 Provision of care for pregnant women with IBD in the UK - the current landscape

Background inflammatory bowel disease (IBD) results in increased rates of negative pregnancy outcomes; particularly in poorly controlled disease. We aimed to describe the current landscape of provision of antenatal care for women with IBD in the UK. Methods This cross-sectional study collected data on service set-up, on principles of care pre, during, and after pregnancy and on perceived responsibilities of clinicians. An online survey was distributed to all gastroenterology units in the UK. Results Data were provided for 97 of 273 IBD units. Pre-pregnancy counselling was not available in 7%, offered routinely (39%), or on request (54%) but predominantly (91%) in an ad-hoc fashion rather than in a dedicated set-up. Ninety-two per cent of units provided a nominated gastroenterology consultant during pregnancy. In 86% of this was the patient’s usual consultant rather than a consultant with expertise in pregnancy (14%). Combined clinics with obstetricians and gastroenterologists were offered in 14% of units only, but more often in academic rather than district hospitals (24% vs. 7%; p = 0.043) Otherwise, communication with obstetrics was ‘as and when required’ in 51% of cases. Patients were reviewed either every trimester (55%), monthly (15%) or ‘only when required’ (30%). The majority of respondents thought gastroenterologists should be involved in decisions regarding routine vaccinations (70%), breastfeeding (80%), folic acid dosage (61%), and VTE prophylaxis (53%). Sixty-five per cent of participants thought that gastroenterologists should be involved in decision-making regarding the delivery method. Regarding IBD indications for elective caesarean section, 94% of participants recommended these for active peri-anal disease, 30% for previous but healed peri-anal disease, 56% for ileo-anal pouch and 20% for previous abdominal and/or pelvic surgery. Conclusion In a nationwide survey on the provision of antenatal IBD care we found considerable variation in all aspects of service provision, particularly the availability of expertise and specialist services. We have detected areas of poor care (review only when required, communication ad-hoc only, poor provision of dedicated pre-pregnancy counselling). A significant minority of IBD units also felt that they do not need to provide input into areas such as VTE prophylaxis, delivery method and folic acid dosing. IBD indications for caesarean section seem to be poorly understood by a sizable minority. A basic framework to inform service set-up, and better education on the available clinical guidance for clinicians, is required to ensure consistent identification and review of patients and high-quality care.