scholarly journals Correlation of clinical and ultrasonographic features with histopathology in post-menopausal bleeding

2020 ◽  
Vol 9 (7) ◽  
pp. 2817
Author(s):  
Meenakshi Vempalli ◽  
Lopamudra B. John ◽  
G. Chandana
Keyword(s):  
Predictive Value ◽  
Histopathological Examination ◽  
Endometrial Thickness ◽  
Tertiary Care ◽  
Statistical Correlation ◽  
Clinical Findings ◽  
Postmenopausal Bleeding ◽  
Tertiary Care Centre ◽  
Post Menopausal ◽  
Sensitivity Specificity

Background: Postmenopausal bleeding is generally regarded as an ominous alarm of genital pathologies which requires a thorough evaluation clinically and pathologically to exclude carcinoma as the cause and ensure a benign pathology. This study aims at finding out whether clinical diagnosis and ultrasonographic features can be reliable parameters for the diagnosis of causes and whether the findings correspond with histopathology reports.Methods: This observational study was conducted in a tertiary care centre in Pondicherry between January 2018 to August 2019. 114 women were enrolled for whom detailed history taking and clinical examination was done. All the patients were subjected to transvaginal ultrasonography. Patients with clinically visible lesions on cervix and vulva were subjected to biopsy and the rest underwent fractional curettage and the sample was sent for histopathological examination. Finally, histopathology report was compared with clinical and ultrasonographic findings.Results: With endometrial thickness cut off of 4 mm, the sensitivity, specificity, positive predictive value and negative predictive value in predicting malignancy by ultrasonography were 100%, 12.3%, 4.5% and 100%. Histopathology showed atrophic endometrium (43.8%), endometrial hyperplasia (8%), endometrial polyp (7.9%) and endometrial carcinoma (3%). Clinical and ultrasonographic findings did not show any statistical correlation with histopathology.Conclusions: Authors conclude that clinical findings and ultrasonographic features do not correlate with histopathology in cases of postmenopausal bleeding for which atrophic endometrium was the commonest etiology. However, ultrasound should be done routinely before endometrial sampling as the sensitivity for predicting malignancy was 100% for endometrial thickness cut off of 4 mm.

scholarly journals A study of the pattern of non-venereal genital dermatoses in male patients at a Tertiary Care Centre from Hadoti region of Rajasthan, India

2021 ◽  
Vol 12 (e) ◽  
pp. e87-e87
Author(s):  
Asha Nyat ◽  
Arti Singh ◽  
Alpana Mohta ◽  
Ramesh Kumar Kushwaha ◽  
Devanshi Gupta ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Tertiary Care ◽  
Clinical Findings ◽  
Venereal Diseases ◽  
Fixed Drug Eruption ◽  
Tertiary Care Centre ◽  
Diagnostic Dilemma ◽  
Correct Treatment ◽  
Male Patients ◽  
Epidemiological Profile

Background: Non venereological diseases of genitalia can be a diagnostic dilemma to a dermatologist and also a cause of considerable concern to the patient because they tend to get misdiagnosed with venereal diseases. Aims: To study the pattern and clinico-epidemiological profile of non-venereal dermatoses of male genitalia in Hadoti region of Rajasthan. Materials and Methods: We conducted this prospective, descriptive study in 250 male patients with non venereal dermatoses in Rajasthan from January 2015 to July 2016. The demographic profile and clinical findings of the patients were recorded and appropriate investigations and histopathological examination were done as and when required. Cases having venereal diseases were excluded from the study by clinical examination, serological and microbiological tests for venereal diseases. Results: The age of the patients ranged between one to 70 years, with mean age being 27.1 years. The most common dermatosis was nodular scabies 54 (21.6%) followed by sebocystoma multiplex 24 (9.6%), fixed drug eruption 19 (7.6%), tinea genitalis 17 (6.8%) and genital psoriasis 14 (5.6%) cases. Conclusion: This study highlights the importance of diagnosing non-venereal dermatoses for both correct treatment of the patient as well as to alleviate the anxiety associated with venereophobia and cancer phobia.

scholarly journals Evaluation of endometrial causes of postmenopausal bleeding with it's correlation with endometrial thickness and hysteroscopy findings and endometrial tissue histopathology

2020 ◽  
Vol 9 (7) ◽  
pp. 2940
Author(s):  
Saurabh V. Bhangale ◽  
Shailja Sharma ◽  
Asmita Patil ◽  
Beena Kumari
Keyword(s):  
Diagnostic Accuracy ◽  
Endometrial Carcinoma ◽  
Predictive Value ◽  
Histopathological Examination ◽  
Endometrial Thickness ◽  
Endometrial Tissue ◽  
Transvaginal Sonography ◽  
Histopathological Diagnosis ◽  
Postmenopausal Bleeding ◽  
Dilation And Curettage

Background: Postmenopausal bleeding (PMB)accounts for 5% of gynecology visit. All with unexpected uterine bleeding should be evaluated for endometrial carcinoma since this potentially lethal disease is the cause of bleeding in approximately 10 percent patients (range 1 to 25 percent, depending upon risk factors). The aim of the study was to evaluate endometrial causes of postmenopausal bleeding (PMB) with it's correlation with endometrial thickness (ET)and hysteroscopy findings and endometrial tissue histopathology.Methods: A total 50 consecutive cases of PMB fulfilling the inclusion and exclusion criteria and giving informed consent were selected. Each patient was subjected to transvaginal sonography (TVS) in which uterus, adnexa and endometrial thickness (ET) was assessed. Then hysteroscopy and/or dilation and curettage was scheduled at subsequent visit. Endometrial sample was sent for histopathological examination. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy was calculated for ET by TVS and hysteroscopy findings, considering histopathological diagnosis as the gold standard.Results: Most common endometrial cause of PMB was atrophic endometrium (44%). The other causes were endometrial carcinoma (18%), endometrial hyperplasia (18%), endometrial polyp (12%), endometritis (4%), and leiomyoma (4%). The diagnostic accuracy of ET by TVS at a cut-off point of 5 mm was 94% with sensitivity 89.3%, specificity 100%, PPV 100% and NPV 88%. The diagnostic accuracy of hysteroscopy was 98% with sensitivity 96.4%, specificity 100%, PPV 100% and NPV 95.7%.Conclusions: Being relatively cheap, easily accessible, non-invasive, TVS with ET measurement should first line investigation in the evaluation of women with postmenopausal bleeding with suspected endometrial pathology. Although hysteroscopy is more specific and sensitive, in poor resource settings it should be limited to cases with ill-defined endometrial lining, recurrent/ persistent bleeding and cases with endometrial thickness greater than 5 mm irrespective of endometrial echotexture.

scholarly journals Comparing WHO C-Model generated C-Section probabilities to actual delivery outcomes in a tertiary care centre

2017 ◽  
Vol 7 (1) ◽  
pp. 229
Author(s):  
Amita Ray ◽  
Arun Gopi ◽  
Sujoy Ray
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Vaginal Delivery ◽  
Predictive Value ◽  
Model Comparison ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Tertiary Care Centre ◽  
High Positive Predictive Value ◽  
Sensitivity Specificity

Background: A model which takes into account several relevant factors and gives the probability of C-Section in a woman would have the advantage of preparing for such an event. The identification of women at high risk of C-Section (>50% risk) would provide the opportunity for understanding risks involved in pursuing a vaginal delivery whereas if the risk of C-Section was less (<50%) it would prove useful in counselling for a vaginal delivery. We used the WHO C-Model with the aim to find the predictability of this model in our facility and the overuse of C-section in the 10 Robson’s Groups.Methods: A retrospective observational study in which all women who gave birth at our hospital from June 2016 to May 2017 were included and C-Section probability was calculated using the C-Model. Comparison with the actual mode of delivery was done to find the sensitivity, specificity, positive and negative predictive value of the model and the overuse of C-Section in the Robson’s Groups.Results: Out of the 314 C-Sections done only 45 women had a >50% probability, giving the model a sensitivity of 14.33%, specificity of 98.8%, positive predictive value of 90% and negative predictive value of 60.56%. Robson’s Groups 5 and 3 demonstrated the greatest overuse of C-Sections.Conclusions: The WHO Model when applied to this centre showed a high positive predictive value for C-Sections but the negative predictive value or the ability to correctly predict a vaginal delivery was much less.

scholarly journals Endometrial assessment by transvaginal ultrasonography and correlation with histopathology among post menopausal women

2020 ◽  
Vol 10 (1) ◽  
pp. 1613-1617
Author(s):  
Hari Kishor Shrestha ◽  
Ram Chandra Adhikari ◽  
Khadga Bahadur Shrestha
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasonography ◽  
Menopausal Women ◽  
History Of ◽  
Post Menopausal ◽  
Sensitivity Specificity ◽  
Age Range

Background: Transvaginal ultrasonography has increased the reliability of imaging diagnosis of women with endometrial pathologies and this technique has become widely used to evaluate endometrial thickness in women with postmenopausal bleeding. Materials and methods: 359 women presenting with history of at least three months amenorrhea were undergone transvaginal ultrasonography with measurement of endometrial thickness and uterine size. Endometrial biopsies were taken in 69 cases (19.2%) only. Results: The median age of patients was 53 years with the age range of 42 years to 81 years. Abdominal pain was the commonest symptoms followed by backache. 3/69 cases with histopathological diagnoses had normal sized uterus, while 66 cases had bulky (>6.0 cm) uterus. 58/69 cases showed > 5 mm thick endometrium and the endometrium was abnormal in 31/69 cases. The sensitivity, specificity, positive predictive value and negative predictive value of transvaginal ultrasonography to detect abnormal endometrium were 91.2%, 22.9%, 53.4% and 72.7% respectively. The sensitivity, specificity, positive predictive value and negative predictive value of transvaginal ultrasonography to detect endometrial hyperplasia and carcinoma were 100%, 17.5%, 10.3% and 100% respectively. Conclusions: Transvaginal sonographic evaluation of endometrial thickness and uterine size is useful for exclusion of endometrial pathology and to avoid unnecessary invasive surgical procedures.

scholarly journals DIAGNOSTIC ACCURACY OF SALINE HYSTEROSONOGRAPHY IN DETECTING ENDOMETRIAL HYPERPLASIA IN PATIENTS WITH POST MENOPAUSAL BLEEDING

2020 ◽  
Vol 11 (2) ◽  
pp. 1-8
Author(s):  
Benish Yousuf ◽  
Hira Ambreen ◽  
Tahira Mariam ◽  
Abdul Raouf ◽  
Ambreen Yaseen ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Endometrial Hyperplasia ◽  
Foley Catheter ◽  
High Sensitivity ◽  
Cost Effective ◽  
Postmenopausal Bleeding ◽  
Cost Effective Method ◽  
Post Menopausal ◽  
Sensitivity Specificity

BACKGROUND & OBJECTIVE: Saline hysterosonography is a simple and cost-effective method with high sensitivity to detect uterine abnormalities causing postmenopausal bleeding. The objective of this study was to evaluate the diagnostic accuracy of saline hysterosonography in detecting endometrial hyperplasia in women with postmenopausal bleeding by taking histopathology as a gold standard. METHODOLOGY: A hundred and twenty (120) cases were enrolled from the outpatient and inpatient department of obstetrics and gynecology. Proper history and relevant examination of the patient was done. Then preparations were made for the procedure. The patient was counseled and the technique explained to her. Then Foley catheter no 12 was passed in cervix and sonography was done while instilling normal saline through a cervical catheter and scan pictures were frozen and results were given by expert gynecologist of Allied Hospital, Faisalabad. Histopathology specimen was sent to the pathology lab. RESULTS: Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of saline hysterosonography in detecting endometrial hyperplasia was recorded as 96.15%,91,49%,75.76%,98.85%, and 92.5% respectively. CONCLUSION: Saline hysterosonography has high sensitivity to detect uterine hyperplasia. It can be used as a cost effective alternative to hysteroscopy in many units in Pakistan.

scholarly journals ANA immunofluorescence versus profile-how well they perform in autoimmune diseases: an analysis of their clinical utility in a tertiary care centre

2018 ◽  
Vol 6 (9) ◽  
pp. 3140
Author(s):  
Velammal Petchiappan ◽  
Adityan Guhan ◽  
Sumitra Selvam ◽  
V. N. Nagaprabu
Keyword(s):  
Positive Predictive Value ◽  
Autoimmune Diseases ◽  
Predictive Value ◽  
Tertiary Care ◽  
Immunofluorescence Assay ◽  
Tertiary Care Centre ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Individual Disease ◽  
Better Than

Background: While Immunofluorescence assay remains the gold standard for the detection of ANA, Immunoprofile by ELISA is being increasingly utilized in view of easy availability and quick results. The study was done to find out whether ANA profile results are comparable with IFA.Methods: About 100 patients who had undergone both immunofluorescence and Immunoprofile were included. Immunofluorescence correlation with profile and their correlation with the disease were analyzed; sensitivity, specificity and predictive values were calculated.Results: ANA was positive in 78% by immunofluorescence; 73% by ANA profile. 22 patients in whom ANA IFA was negative were picked up by ANA profile. 27 patients who were not detected by ANA profile were tested positive by IFA. ANA testing by immuno profile had a sensitivity of 65% with a positive predictive value of 69% when compared with IFA. Immunofluorescence pattern and ANA profile correlated with the diagnosed disease in 63% and 49% respectively. Immunofluorescence pattern correlated with the ANA profile in only 35% of the study subjects. On correlation with the disease, ANA profile scored less compared to ANA-IFA with a sensitivity and specificity of 46% each; positive predictive value of 59%; negative predictive value of 33%. On analysis of individual disease, ANA profile is as good as IFA in SLE and scleroderma in terms of sensitivity. In Sjogren’s syndrome and MCTD, specificity and positive predictive value of ANA profile is high.Conclusions: ANA IFA performs better than immunoprofile in the diagnosis of autoimmune diseases.

scholarly journals Clinicopathological and Radiological Profile of Multinodular Goitre – A Prospective Study

2021 ◽  
Vol 29 (2) ◽  
pp. 164-168
Author(s):  
Koustav Mondal ◽  
Chiranjib Das
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Histopathological Diagnosis ◽  
Care Hospital ◽  
Multinodular Goitre ◽  
Sensitivity Specificity

Introduction Multinodular goitre (MNG) is defined as multiple palpable distinct nodules in the enlarged thyroid gland. MNG can harbour malignancy in 1-10% cases. We undertook the present study to correlate the clinical, radiological and cytological features of MNG with that of final histopathological diagnosis. Materials and Methods A prospective cohort study was done in a tertiary care hospital in northern part of West Bengal from January 2018 to December 2019. Patients aged between 12 years and 75 years, presenting with MNG on clinical examination, were included in the study. We compared the pre-operative ultrasonography (USG) of neck and fine needle aspiration cytology (FNAC) reports with post-operative histopathological examination (HPE) report. Results Among 100 patients 80 were female and 20 were male. Most patients were in 41-50 years age group. For detection of malignancy in MNG, USG had 40% sensitivity, 97.78% specificity, 66.67% positive predictive value (PPV), 93.62% negative predictive value (NPV), and 92% diagnostic accuracy. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of FNAC for detection of malignancy in MNG were 20%, 93.33%, 25%, 91.3% and 86% respectively. When USG features were combined with FNAC features non-diagnostic result decreased from 6% to 2% and diagnostic accuracy for detecting malignancy in MNG increased from 86% to 90%. Conclusion USG and FNAC are complementary to each other in the diagnostic workup of MNG. USG guided FNAC is still better for reaching final diagnosis and exclusion of malignancy.

scholarly journals A Clinicopathological study of uterine cervical lesions in a Tertiary Care Centre

2020 ◽  
Vol 11 (4) ◽  
pp. 5860-5866
Author(s):  
Sujata Kumbhar ◽  
Sujata Kanetkar ◽  
Avinash Mane ◽  
Akanksha Gore
Keyword(s):  
Predictive Value ◽  
Pap Smear ◽  
Early Stage ◽  
Tertiary Care ◽  
Screening Method ◽  
Pap Test ◽  
Cervical Lesions ◽  
Tertiary Care Centre ◽  
Sensitivity Specificity ◽  
Histopathological Results

Pap test is a simple yet effective screening method to detect cervical cancer in its early stage, and thus it helps to reduce morbidity and mortality from cancer. A total of 430 cases were studied after taking ethical clearance. The cytological diagnoses were made by Cytopathologist using Bethesda 2014 system for categorization of cervical smears. Cytological results were correlated with clinical features and histopathological results wherever biopsy was available. The total of the 430 cases studied 24 (5.58%) were inadequate to report, excluding these, of the total 406 cases 260 (64.04%) cases were symptomatic, and 146 (35.96%) were asymptomatic. Cytologic diagnoses were NILM –normal- 140 (55.23%)with a mean age of 38.48 years, NILM- inflammatory 128 (47.76%) with a mean age of 35.96 years, ASC-US 36 (8.86%) with a mean age of 36.69 years, ASC-H 18 (4.43%) with a mean age of 45 years, LSIL 42 (10.34%) with a mean age of 41.90, HSIL 22 (5.42%) with a mean age of 51.22 years, and invasive cancer 20 (4.92%) with a mean age of 61.8 years. Sensitivity, specificity, and positive predictive value, negative predictive value and accuracy of Pap test were 89.79%, 95.34%, and 95.65%, 89.13% and 83.33% respectively. Pap smear test is a simple, rapid, economical, still practical screening test to detect cervical intraepithelial lesions and cancer.

A prospective observational study on the effectiveness of risk of malignancy index score (RMI 3) in a tertiary care centre in Eastern India

2020 ◽  
Vol 11 (5) ◽  
pp. 54-60
Author(s):  
Apurba Mandal ◽  
Shibram Chattopadhyay ◽  
Sushanta Mondal ◽  
Arunava Biswas
Keyword(s):  
Ovarian Cancer ◽  
Adnexal Mass ◽  
Malignant Tumors ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Ca 125 ◽  
Tertiary Care Centre ◽  
Gynecology And Obstetrics ◽  
Risk Of Malignancy ◽  
Malignant Lesions

Background: Adnexal mass is a common presentation in today’s gynecological practice. The incidence of ovarian cancer is increasing day by day and diagnosis is often difficult to be made pre operatively with inadequate surgical exploration is a regular occurrence. Aims and Objectives: To assess and validate the importance of RMI-3 score as pre-operative diagnostic tool of differentiating benign from malignant adnexal mass for starting first line therapy of ovarian cancer and to find out the incidences of ovarian malignancy among study population. Material and Methods: The study was conducted in the Department of Gynecology and Obstetrics on (n=115) patients attending GOPD and indoor with adnexal mass fulfilling the inclusion and exclusion criteria using purposive sampling technique. All the selected cases underwent ultrasonography and serum CA- 125 level estimation necessary for calculating RMI score. A score of >200 was taken as suggestive of malignancy and confirmatory diagnosis was performed by histopathological examination obtained from staging laparotomy of adnexal mass. The individual scores were then correlated with final outcomes with statistical analyses. Results: The study revealed benign ovarian tumors are more under 50 years (78.46%) and patients with normal BMI are diagnosed with maximum of malignancy (n = 28). History of tubal ligation carried less risk of malignancy (p<0.0001). Histologically malignant tumors found mostly in 71.4% postmenopausal group whereas 94.1% benign pathology were present in perimenopausal group and there is no association found between parity and histopathology (p=0.058). Bilateral (p=0.013), multilocular (p=0.000) tumors with solid areas (p<0.0001) and thick papillary projections (p<0.0001) had statistically significant association with malignant lesions. RMI score (>200) had more efficacy than serum CA-125 level (>46) in differentiating malignant lesions from benign one in terms of specificity (96% vs 83.87%) and positive predictive value (95% vs 79.17%). Conclusions: RMI-3 score is a simple, reliable and effective tool in differentiating benign from malignant adnexal masses thereby help in quick referral and management of cases with increase chances of survival of the patients.

HISTOPATHOLOGICAL EVALUATION OF WHO CLASSIFIED MULTIBACILLARY LEPROSY CASES IN A TERTIARY CARE CENTRE, SOUTH KERALA

2021 ◽  
pp. 32-34
Author(s):  
Anita Sanker ◽  
G Nandakumar ◽  
Swapna Balkrishnan
Keyword(s):  
Immune Response ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Newly Diagnosed ◽  
Epithelioid Cells ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Leprosy Patients ◽  
Epidermal Atrophy ◽  
Multibacillary Leprosy

There are signicant differences in the histopathology of leprosy lesions which is inuenced by the host immune response to Mycobacterium leprae. Objective - To nd the histopathological changes in newly diagnosed multibacillary leprosy(MB) cases registered in the skin department Government Medical College, Thiruvananthapuram. Method- skin biopsy performed in 40 multibacillary leprosy cases and histopathological ndings were evaluated. 70% showed epidermal atrophy. Granulomas, composed of sheets of foamy macro Results- phages, lymphocytes and epithelioid cells, were seen in 21 cases & twenty two cases were AFB positive. Eight cases each were lepromatous, borderline tuberculoid, mid boderline, borderline lepromatous types. Conclusion- Presence of 60% cases of borderline leprosy indicates the unstable immune response in leprosy patients. Majority were either borderline lepromatous or lepromatous showing the infective nature of multibacillary leprosy. Histopathological examination with Fite- Foroco staining is a crucial method and the gold standard for accurate diagnosis and typing of leprosy.

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