scholarly journals Evaluation of cervical erosion in symptomatic women

2020 ◽  
Vol 9 (5) ◽  
pp. 2035
Author(s):  
Sindhu C. Guptha
Keyword(s):  
Pap Smear ◽  
Obstetrics And Gynecology ◽  
Prospective Clinical Study ◽  
Diagnostic Efficacy ◽  
Speculum Examination ◽  
Guided Biopsy ◽  
Menstrual Irregularities ◽  
One Year ◽  
Sensitivity Specificity ◽  
Premalignant Conditions

Background: The objective of this study was evaluation of symptomatic women with cervical erosion.Methods: Prospective clinical study done in the department of obstetrics and gynecology, VIMS, Ballari for one-year period from June 2016 to May 2017. All patients with symptoms of white discharge, post coital bleeding and menstrual irregularities were examined by per speculum examination and all those who had cervical erosion (112 Patients) were included in the study. Pap smear and colposcopy were done in all subjects. Colposcopic guided biopsy was done in women with abnormal findings on colposcopy. Histological prediction of colposcopic findings was done according to the Reid’s modified colposcopic index. The result of the biopsy was correlated with the predicted histology of the Reid’s modified colposcopic index and statistical analysis done to calculate diagnostic efficacy of colposcopy in the evaluation of symptomatic women with cervical erosion.Results: Out of the 112 patients, 5.35% (6/112) had abnormal Pap smear. All patients underwent colposcopy and colposcopic guided biopsy, 11.6% (13/112) had abnormal colposcopic findings. Histopathology confirmed CIN I in 6.25% (7/112) and CIN II in 1.78% (2/112) patients. The sensitivity, specificity, PPV, NPV and accuracy of PAP smear was found to be 22.22%, 96.11%, 33.33%, 93.39% and 90.17%. The above values for colposcopy were found to be 88.89%, 95.15%, 61.54%, 98.99% and 94.64%.Conclusions: Colposcopy should be done in all symptomatic patients with cervical erosion as it is a good diagnostic tool for premalignant conditions of the cervix and correlates well with histopathological findings.

scholarly journals Colposcopic evaluation of cervical erosion in symptomatic women

2017 ◽  
Vol 6 (6) ◽  
pp. 2207 ◽  
Author(s):  
Pooja Patil ◽  
Priyanka Sharma
Keyword(s):  
Diagnostic Tool ◽  
Pap Smear ◽  
Carcinoma Cervix ◽  
Histopathological Findings ◽  
Speculum Examination ◽  
Cin Iii ◽  
Pruritus Vulvae ◽  
Guided Biopsy ◽  
Menstrual Irregularities

Background: This study was carried out to find the colposcopic findings in the symptomatic patients with cervical erosion and correlate the findings with cytology and histopathology.Methods: All the patients coming to gynaecological OPD with symptoms of white discharge, pruritus vulvae, menstrual irregularities were examined by per speculum examination and all those who had cervical erosion were included in the study and pap smear and colposcopy both were done in all subjects. The colposcopic guided biopsy was done in women with abnormal findings on colposcopy (50 women) and reports were compared. Abnormal colposcopic findings were graded according to Reid’s colposcopic index (RCI).Results: Majority of patients came with the complaint of white discharge per vaginum (55%).Out of 120 patients, 85 women (70.9%) had inflammatory pap smear and 35 women (29.1%)had abnormal pap smear. All patients underwent colposcopic examination and out of 120 patients, 67(55.8%) showed normal colposcopic findings and 50 women (41.6%) had abnormal colposcopic finding and biopsy was taken. 3 women had unsatisfactory colposcopy. Histopathology confirmed 24 (48%) women with CIN I and 12 (24%) CIN II and 6 (12%) CIN III and 2 (4%) women with carcinoma cervix. The colposcopy findings and histopathology correlated in 88%.Conclusions: Colposcopy should be prescribed to all symptomatic patients with cervical erosion as it is a good diagnostic tool for pre-malignant conditions of cervix and correlates well with histopathological findings.

scholarly journals Evaluation of women with postcoital bleeding by clinical examination, papsmear, colposcopy and histopathology of cervix

2018 ◽  
Vol 7 (6) ◽  
pp. 2184
Author(s):  
Srilakshmi Yarlagadda ◽  
Rangarao Diddi ◽  
Prasuna J. L. Narra
Keyword(s):  
Cervical Cancer ◽  
Clinical Examination ◽  
Predictive Value ◽  
Screening Test ◽  
Pap Smear ◽  
Medical Sciences ◽  
Cervical Lesions ◽  
Guided Biopsy ◽  
Sensitivity Specificity ◽  
Postcoital Bleeding

Background: Postcoital bleeding refers to spotting or bleeding per vagina that occurs after intercourse and is not related to menstruation. Although there are multiple benign etiologies to this complaint, the most serious cause of postcoital bleeding is cervical cancer (3-5.5%). Cervical cancer is the most common and preventable genital cancer of women. It has a long premalignant phase and with an ideal screening test with good sensitivity and specificity, we can diagnose and treat premalignant cervical lesions, preventing cervical cancer. The present study is aimed to evaluate the women with postcoital bleeding by clinical examination, pap smear, colposcopy and guided biopsy to detect premalignant cervical lesions and carcinoma cervix.Methods: This was a prospective and retrospective study conducted from April, 2016 to March, 2018 for a period of 24 months in the Department of Obstetrics and Gynaecology on 100 women with postcoital bleeding at Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation (Dr. PSIMS&RF). After clinical examination, these women were subjected to pap smear, colposcopy and guided biopsy. The findings were correlated with histopathology of cervix. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of both papsmear and colposcopy were calculated.Results: Sensitivity of papsmear was 71.42%, specificity-86.20%, PPV-78.95%, NPV-80.64% and accuracy-80%. Sensitivity of colposcopy was 90.47%, specificity-89.65%, PPV-86.36%, NPV-92.85% and accuracy-90%.          Conclusions: These results establish colposcopy as an effective screening test for carcinoma cervix. Histopathology of suspected cervical lesion in colposcopy remains the gold standard for definitive diagnosis.

Diagnostic performance of different cholangioscopes in patients with biliary strictures: a systematic review

Endoscopy ◽  
2020 ◽  
Vol 52 (03) ◽  
pp. 174-185 ◽  
Author(s):  
Santi Kulpatcharapong ◽  
Rapat Pittayanon ◽  
Stephen J. Kerr ◽  
Rungsun Rerknimitr
Keyword(s):  
Diagnostic Yield ◽  
Technical Success ◽  
Biliary Strictures ◽  
Diagnostic Efficacy ◽  
Technical Success Rate ◽  
Guided Biopsy ◽  
Language Restriction ◽  
Single Operator ◽  
Malignant Biliary Stricture ◽  
Sensitivity Specificity

Abstract Background Cholangioscopy provides direct intraductual imaging, which can enhance diagnostic efficacy during endoscopic retrograde cholangiopancreatography in patients with biliary strictures. This study aimed to review the diagnostic yield of different cholangioscopes for the diagnosis of malignant biliary stricture (MBS). Methods A comprehensive literature review was performed. Full papers of prospective studies using any type of peroral cholangioscope (POC) were included without language restriction. The primary outcomes were sensitivity, specificity, and accuracy of various POCs to diagnose MBS. Results Data from 20 published articles, involving 1141 patients, were extracted. Overall sensitivities of POCs for diagnosing MBS were higher for the diagnosis made under visual impression compared with those from cholangioscopy-guided biopsy (67 % – 100 % vs. 38 % – 100 %), whereas the overall specificities were generally high and comparable (73 % – 100 % vs. 75 % – 100 %). Newer video cholangioscopes (digital single-operator POC [digital SOC], direct POC) with the exception of video dual-operator mother – baby POC (video DOC), provided better sensitivity of cholangioscopy-guided biopsy compared with fiberoptic scopes (digital SOC 80 % – 85 %, direct POC 80 % – 100 %, video DOC 38 % – 100 %, and fiberoptic SOC 49 % – 100 %, respectively). Among these video cholangioscopes, the digital SOC provided the highest technical success rate, at 100 %. Conclusions POCs enhanced the diagnostic yield for diagnosis of MBS. Compared with fiberoptic POCs that only provide good image impression, the digital SOC and direct POC were good at both image impression and cholangioscopy-guided biopsy to diagnose MBS. To ensure high technical success for MBS diagnosis, the digital SOC is a good option.

Sequential Screening with Cytology and Colposcopy in Detection of Cervical Neoplasia

2009 ◽  
Vol 1 (3) ◽  
pp. 45-48 ◽  
Author(s):  
BR Desai ◽  
PR Malur ◽  
Dalal Anita ◽  
Durdi Geeta ◽  
Sherigar Bhavana ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Pap Smear ◽  
Cross Sectional Study ◽  
Diagnostic Efficacy ◽  
Cross Sectional ◽  
Sequential Screening ◽  
Sensitivity Specificity

ABSTRACT Background Pap smear is the most commonly used screening test for cervical cancer, however it has disadvantage of having low sensitivity. Colposcopy has higher sensitivity as compared to Pap smear but low specificity. Sequential screening with both Pap smear and colposcopy can overcome these problems. Aim The study was aimed to find out the diagnostic efficacy of both Pap smear and colposcopy. It was also intended to find out the advantages of sequential use of Pap smear and colposcopy in screening for cervical cancer. Design It was a cross-sectional study conducted in colposcopy clinic of KLE's Dr. Prabhakar Kore Hospital and MRC, Belgaum from November 2006 to September 2008. Material and methods A total of 190 patients with complaints of postcoital bleeding, intermenstrual bleeding, postmenopausal bleeding, persistent vaginal discharge or those found to have an unhealthy cervix on per speculum examination were included in the study. In all the 190 cases Pap smear, colposcopic evaluation and colposcopic directed biopsy were performed. Statistical analysis Sensitivity, specificity, positive predictive value, negative predictive value of both Pap smear and colposcopy were calculated with histopathology as a gold standard, keeping LSIL as a disease threshold for test positivity. Results Pap smear was positive in 14.21% (27/190) cases, colposcopy was positive in 37.89% (72/190) cases. Biopsy confirmed LSIL and higher lesions in 31.57% cases. The sensitivity, specificity, positive predictive value and negative predictive value of Pap smear were 41.66%, 96.92%, 86.21% and 78.26% respectively and 80%, 81.54%, 66.66% and 89.83% respectively for colposcopy. Combined colposcopy and Pap smear could accurately diagnose 53/60 biopsy confirmed cases of LSIL and higher lesions with an accuracy of 88.33%. Conclusion Sequential use of Pap smear and colposcopy in screening for cervical cancer increases the accuracy of the test.

scholarly journals DIAGNOSTIC EFFICIENCY OF LIQUID BASED CYTOLOGY COMPARED WITH CONVENTIONAL PAP.

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Pammy Pravina ◽  
Rita Sinha
Keyword(s):  
Vaginal Discharge ◽  
Analytical Study ◽  
Pap Smear ◽  
Diagnostic Efficiency ◽  
Age Group ◽  
Diagnostic Efficacy ◽  
Medical College ◽  
Study Population ◽  
Liquid Based Cytology ◽  
Sensitivity Specificity

Aim: Diagnostic efficiency of liquid based cytology compared with conventional pap Methods: The present analytical study entitled was conducted in the Department of Obstetrics and Gynecology, Nalanda Medical College and Hospital, Patna, Bihar, India over the period of 1 year. The study includes total 100 subjects. Results: Mean age of the study population was 39.12 years. Majority belongs to 30-40 years of age group. Vaginal discharge was the major problem reported by the study subjects. There were statistically significant differences of satisfactory/unsatisfactory rate and Diagnostic efficacy i.e. sensitivity and specificity of LBC is greater than CPS for evaluation of cervical cytology. Conclusions: the present study concluded that LBC may improve the sample's quality, reduce the number of unsatisfactory smear and increases the diagnostic efficacy in comparison to CPS. Keywords: Cervical cancer, Conventional pap smear, Liquid-based cytology, Sensitivity, Specificity.

scholarly journals Effectiveness of a Selective Etching Technique in Reducing White Spots Formation around Lingual Brackets: A Prospective Cohort Clinical Study

Coatings ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 572
Author(s):  
Domenico Dalessandri ◽  
Marino Bindi ◽  
Francesca Massetti ◽  
Gaetano Isola ◽  
Marco Migliorati ◽  
...  
Keyword(s):  
Clinical Study ◽  
Difficulty Level ◽  
Prospective Clinical Study ◽  
White Spot Lesions ◽  
Etching Technique ◽  
White Spots ◽  
Accumulation Index ◽  
One Year ◽  
Lingual Brackets ◽  
And Control

The risk of developing white spot lesions (WSLs) after orthodontic treatment with lingual brackets is generally considered lower than with labial ones, even if plaque accumulation is frequently higher due to the increased difficulty level in oral hygiene maintenance. In this prospective clinical study, selective enamel etching technique effectiveness in reducing plaque accumulation and WSLs was tested. Thirty patients were bonded with a split-mouth approach: two randomly selected opposite quadrants were used as the test sides, using customized plastic etching guides, and the other two as control sides, applying traditional direct etching methods. The plaque presence around the braces was recorded after 1, 3, 6, and 12 months according to a lingual plaque accumulation index (LPAI), as was the presence of WSLs. PAI measured values were significantly higher in the control sides during the observation period. Test and control sides differed significantly for new WSL onset only after 12 months of treatment. Therefore, the present research demonstrated that this guided enamel etching technique allowed for significant reduction in plaque accumulation around the lingual brackets and reduced onset of white spots after one year of treatment.

scholarly journals Usefulness of sialic acid for diagnosis of sepsis in critically ill patients: a retrospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Bo Yao ◽  
Wen-juan Liu ◽  
Di Liu ◽  
Jin-yan Xing ◽  
Li-juan Zhang
Keyword(s):  
Sialic Acid ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Incomplete Data ◽  
Acid Level ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Diagnostic Efficacy ◽  
Receiver Operating Characteristic Curves ◽  
Sensitivity Specificity

Abstract Background Early diagnosis of sepsis is very important. It is necessary to find effective and adequate biomarkers in order to diagnose sepsis. In this study, we compared the value of sialic acid and procalcitonin for diagnosing sepsis. Methods Newly admitted intensive care unit patients were enrolled from January 2019 to June 2019. We retrospectively collected patient data, including presence of sepsis or not, procalcitonin level and sialic acid level. Receiver operating characteristic curves for the ability of sialic acid, procalcitonin and combination of sialic acid and procalcitonin to diagnose sepsis were carried out. Results A total of 644 patients were admitted to our department from January 2019 to June 2019. The incomplete data were found in 147 patients. Finally, 497 patients data were analyzed. The sensitivity, specificity and area under the curve for the diagnosis of sepsis with sialic acid, procalcitonin and combination of sialic acid and procalcitonin were 64.2, 78.3%, 0.763; 67.9, 84.0%, 0.816 and 75.2, 84.6%, 0.854. Moreover, sialic acid had good values for diagnosing septic patients with viral infection, with 87.5% sensitivity, 82.2% specificity, and 0.882 the area under the curve. Conclusions Compared to procalcitonin, sialic acid had a lower diagnostic efficacy for diagnosing sepsis in critically ill patients. However, the combination of sialic acid and procalcitonin had a higher diagnostic efficacy for sepsis. Moreover, sialic acid had good value for diagnosing virus-induced sepsis.

scholarly journals The role of magnetic resonance cholangiopancreatography and diffusion-weighted imaging for the differential diagnosis of obstructive biliary disorders

2017 ◽  
Vol 21 (1) ◽  
Author(s):  
Zeynep Cetiner-Alpay ◽  
Fatma Kulali ◽  
Aslihan Semiz-Oysu ◽  
Yasar Bukte ◽  
Kamil Ozdil
Keyword(s):  
Magnetic Resonance ◽  
Sensitivity And Specificity ◽  
Gold Standard ◽  
Diffusion Weighted Imaging ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Malignant Tumours ◽  
Diagnostic Efficacy ◽  
Diffusion Weighted ◽  
Sensitivity Specificity ◽  
And Diffusion

Background: Although endoscopic retrograde cholangiopancreatography (ERCP) is accepted as the gold standard, there is a place for magnetic resonance cholangiopancreatography (MRCP) and diffusion-weighted imaging (DWI) in the diagnosis of obstructive biliary disorders.Aim: To compare the findings of MRCP with ERCP in patients with obstructive biliary disorders and to investigate the diagnostic efficacy of MRCP combined with DWI.Study design: Retrospective, analytic, cross-sectional study.Methods: The MRCP images of 126 patients who underwent both MRCP and ERCP owing to biliary obstruction were reviewed. Nine patients were excluded because of incomplete diagnostic workup or a long period (>3 months) between MRCP and ERCP. Ninety-two patients underwent DWI, which was also evaluated. The sensitivity, specificity and accuracy of MRCP and DWI were analysed.Results: The sensitivity, specificity and accuracy of MRCP according to ERCP results as the gold standard was 97%, 71% and 93% for assessment of biliary dilatation; 100%, 94.7% and 97.5% for the diagnosis of choledocholithiasis; 93.7%, 100% and 99% for the identification of benign strictures; 100%, 100% and 100% for the diagnosis of malignant tumours; and 100%, 100% and 100% for the detection of complicated hydatid cysts; respectively. The sensitivity and specificity of DWI for the diagnosis of malignant tumour was 100%. In the detection of choledocholithiasis, the sensitivity and specificity of DWI was 70.8% and 100%.Conclusions: MRCP is an alternative, non-invasive, diagnostic modality, comparable with ERCP for the evaluation of pancreaticobiliary diseases. DWI can be helpful for diagnosis of choledocholithiasis and tumours.

scholarly journals Full in-Office Guided Surgery with Open Selective Tooth-Supported Templates: A Prospective Clinical Study on 20 Patients

2018 ◽  
Vol 15 (11) ◽  
pp. 2361 ◽  
Author(s):  
Francesco Mangano ◽  
Uli Hauschild ◽  
Oleg Admakin
Keyword(s):  
Clinical Study ◽  
Low Cost ◽  
Prospective Clinical Study ◽  
3D Printer ◽  
Guided Surgery ◽  
Operative Complications ◽  
Edentulous Patients ◽  
One Year ◽  
Single Crowns ◽  
Surgical Templates

Background: Guided implant surgery appears to have several benefits, such as the possibility of inserting flapless implants in a prosthetically driven manner, avoiding dangerous anatomical structures. However, to date, only a few surgeons routinely use guided surgery in partially edentulous patients. Aim: To present the results obtained with tooth-supported surgical templates characterized by an innovative open design with selective support, and manufactured via a full in-office procedure with a low-cost desktop 3D printer. Methods: Over a two-year period (2016–2018), all partially edentulous patients with one to three missing teeth (in maxilla and/or mandible), referred to a private dental practice for restoration with dental implants, were considered for inclusion in this prospective clinical study. An intraoral scanner (CS 3600®, Carestream Dental) and cone beam computed tomography (CS 9300®, Carestream Dental) were used to acquire the 3D information on the patients. Guided surgery software (SMOP®, Swissmeda) was used to plan the surgeries and to design open, selective, tooth-supported templates that were fabricated with a stereolithographic (SLA) desktop 3D printer (XFAB2000®, DWS). Guided implant surgeries were performed and patients were followed for a period of one year. The study outcomes were fit and stability of surgical templates, duration (time) of surgery, intra and post-operative complications, and implant stability and survival. Results: Twenty (20) partially edentulous patients (9 males, 11 females; mean age 54.4 ± 9.4 years) were included in the study; 28 open, selective, tooth-supported templates were designed with the aim of inserting 38 implants. Among the surgical templates, 24 had optimal fit and stability, three had optimal fit and sufficient stability, and only one had inadequate fit and unsatisfactory stability and was therefore not suitable for clinical use. The average time of the intervention was 15.7 ± 5.2 min per template. No intra-operative complications were reported, but one implant was not stable at placement and had to be removed. In total, 36 implants were restored with 10 two-unit fixed partial prostheses and 16 single crowns. All implants were successfully functioning at one year, even if, in two single crowns, minor prosthetic complications (abutment screw loosening) occurred. Conclusions: Full in-office guided surgery with open, selective, tooth-supported templates seem to represent a clinically predictable surgical procedure to restore partially edentulous patients. Further studies are needed to confirm these positive outcomes.

scholarly journals Value and Diagnostic Efficacy of Fetal Morphology Assessment Using Ultrasound in A Poor-Resource Setting

Diagnostics ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 109 ◽  
Author(s):  
Ukweh ◽  
Ugbem ◽  
Okeke ◽  
Ekpo
Keyword(s):  
Predictive Value ◽  
Performance Metrics ◽  
Area Under The Curve ◽  
Youden Index ◽  
Likelihood Ratios ◽  
Diagnostic Efficacy ◽  
Predictive Values ◽  
Resource Setting ◽  
Post Test ◽  
Sensitivity Specificity

Background: Ultrasound is operator-dependent, and its value and efficacy in fetal morphology assessment in a low-resource setting is poorly understood. We assessed the value and efficacy of fetal morphology ultrasound assessment in a Nigerian setting. Materials and Methods: We surveyed fetal morphology ultrasound performed across five facilities and followed-up each fetus to ascertain the outcome. Fetuses were surveyed in the second trimester (18th–22nd weeks) using the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) guideline. Clinical and surgical reports were used as references to assess the diagnostic efficacy of ultrasound in livebirths, and autopsy reports to confirm anomalies in terminated pregnancies, spontaneous abortions, intrauterine fetal deaths, and still births. We calculated sensitivity, specificity, positive and negative predictive values, Area under the curve (AUC), Youden index, likelihood ratios, and post-test probabilities. Results: In total, 6520 fetuses of women aged 15–46 years (mean = 31.7 years) were surveyed. The overall sensitivity, specificity, and AUC were 77.1 (95% CI: 68–84.6), 99.5 (95% CI: 99.3–99.7), and 88.3 (95% CI: 83.7–92.2), respectively. Other performance metrics were: positive predictive value, 72.4 (95% CI: 64.7–79.0), negative predictive value, 99.6 (95% CI: 99.5–99.7), and Youden index (77.1%). Abnormality prevalence was 1.67% (95% CI: 1.37–2.01), and the positive and negative likelihood ratios were 254 (95% CI: 107.7–221.4) and 0.23 (95% CI: 0.16–0.33), respectively. The post-test probability for positive test was 72% (95% CI: 65–79). Conclusion: Fetal morphology assessment is valuable in a poor economics setting, however, the variation in the diagnostic efficacy across facilities and the limitations associated with the detection of circulatory system anomalies need to be addressed.

Sign in / Sign up

Export Citation Format

Share Document