Background: Marked advancements in molecular technology and better understanding of the natural history of Human Papillomavirus (HPV) have significantly contributed to the introduction of molecular biomarkers in cervical cancer screening in recent years. The detection of highly sensitive HPV DNA and the highly specific HPV E6/E7 mRNA are now widely utilized in developed countries for cervical cancer screening. Among these, the HPV E6/ E7 mRNA test is considered more specific for identifying precancerous cervical lesions. Objective: To evaluate the effectiveness of the HPV E6/E7 mRNA test as a triage tool for screening of cervical cancer in primary screen positive women by VIA (visual inspection with acetic acid) or Pap smear (cytology) or HPV DNA test. Methods: This cross-sectional observational study was conducted in the colposcopy clinic of the National Centre for Cervical & Breast Cancer Screening & Training, Bangladesh Medical University (BMU) in collaboration with the Department of Virology, BMU, Dhaka, Bangladesh, from October 2023 to September 2024. This study included 150 women by consecutive sampling who tested positive on any primary cervical cancer screening method (VIA/Cytology/HPV DNA) and were referred to the colposcopy clinic of BMU. After collecting cervical sample from each enrolled subject, colposcopy and colposcopy directed biopsy was performed. HPV E6/E7 mRNA test was performed on cervical sample in virology department of BMU. Presence of E6/E7 mRNA predicts the precancerous & early invasive lesion. Colposcopy reported normal or precancerous lesion (CIN 1, 2, 3). Finally, histopathology on biopsy material confirmed it as normal (e.g cervicitis) or precancerous (CIN 1, 2, 3) or cancerous (e.g invasive carcinoma or carcinoma in situ). All data were processed and analysed using 26 version of SPSS. Diagnostic efficacy of HPV E6/E7 mRNA and colposcopy for detection of pre-cancerous/ cancerous cervical lesion were calculated taking histopathology as gold standard. Results: The majority of participants were aged 30–39 years (45.3%) and multiparous (87.3%). Colposcopy revealed cervical intraepithelial neoplasia 1 (CIN I) in 60% of cases, while histopathology showed chronic cervicitis (54.67%) and CIN I (30.67%) as the most common findings. HPV E6/E7 mRNA was overexpressed in 15% of cases. Among E6/E7 mRNA-positive patients, 78.3% had biopsy-confirmed precancerous and cancerous lesions, compared to 39.37% in the mRNA-negative group. The E6/E7 mRNA test showed high specificity (93.9%), high PPV (78.3%) and overall accuracy 63.3% for detecting precancerous and early invasive lesions, with low sensitivity of 26.5%. Colposcopy showed higher sensitivity (94.12%) but very low specificity (8.54%) and low accuracy (47.33%) in this regard. Compared to colposcopy; the E6/E7 mRNA test provided more reliable diagnostic accuracy (63.3% vs 47.33%) for detecting precancerous and early invasive lesions of cervix. Conclusion: The findings obtained from the study, emphasize the importance of integrating HPV E6/E7 mRNA molecular testing into routine cervical cancer screening programs as a triage test due to its high specificity, PPV and accuracy compared to colposcopy for identifying clinically significant precancerous and early invasive lesions of cervix. Therefore, the HPV E6/E7 mRNA test may serve as an effective triage tool before doing colposcopy for identifying clinically significant precancerous cervical lesions and contributing to the prevention of cervical cancer. Thus it also can minimize colposcopy referral and over treatment. Bangladesh Medical Res Counc Bull 2025;51(3): 123-130
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Theoretically, ownership of property connotes among other things, ‘‘the right to use, perhaps to abuse save in so far as no damage or harm is caused to the adjoining owners of land or neighborhood”. [1] Ownership of property further connotes right to exclusive possession and the unfettered right to alienate, develop or transfer such property or right in it when it is desired. This poser supports the maxim of cuiusestsolum, eiusestusqueadcoelum et ad inferos It arises with respect to a given property. Just like Petroleum Act and Nigeria Constitution, the Mineral Act handed over solid minerals to the government of the federation. Ebonyi State is one of the States in the South Eastern Nigeria with enormous solid minerals. However, Mineral Act took a different dimension in approach of exploration and development of the solid minerals thus, giving local community and local government vis-à-vis the immediate landowners some recognitions or participatory roles in negotiation of leases. But prospective miners must get approvals from Ministry of Mines and Steel Development through its Mining Cadastre Office and not through State Department of Mineral Development. Development and sustainability of state economy through the development of non-oil resources across the nation is hampered due to the uncharitable stance of section 44 (3) of the Constitution of Nigeria. Thus, the ‘sacrosanct’ of this proviso makes the state’s right to develop or participation solely on the collection of tolls and land taxes and not rights of developing the minerals per se to boost the independence of state’s economic stand. In this article, the writer is considering the above legal issues and how best states with non-oil minerals can develop them to reduce their dependency on federal monthly allocation. It is also aimed to exploring in-depth, principles or theorems that may be best applied in formulating State’s non-oil mineral policies, legislations, proven system integration and reforms in solid mineral management in Nigeria to building a sustainable economic development in Ebonyi State Nigeria. The author will have a quick look at Ebonyi State agricultural prowess and make recommendations. This work adopts a doctrinal methodological approach where relevant primary and secondary data will be required. Keywords: Solid minerals, Resources, Non-Oil and Gas, Sustainability, Diversification, Economy, Revenue, Development, Ebonyi State, DOI: 10.7176/JLPG/134-05 Publication date: July 31 st 2023 [1] I. A. Uwmezulike, ABC of Contemporary Land Law in Nigeria (Revised and Enlarged Edition), (Snaap Press Nigeria Ltd 2013) at p 14. See also the Nigerian Supreme Court decision on Ashiru v Olukoya (2006) 11 NWLR PT 991 P. 1.
