scholarly journals Spectrum of epithelial abnormalities on papanicolaou smear in postmenopausal women

2021 ◽  
Vol 6 (2) ◽  
pp. 97-102
Author(s):  
Sonu Bansal ◽  
Chandrakanta ◽  
Harendra Kumar ◽  
Urvashi Verma
Keyword(s):  
Abdominal Pain ◽  
Postmenopausal Women ◽  
Coming Out ◽  
Gold Standard ◽  
Pap Smear ◽  
Clinical Symptoms ◽  
Lower Abdominal Pain ◽  
Premalignant Lesions ◽  
Normal Cytology ◽  
Bethesda System

The Papanicolaou (Pap) smear was introduced in 1941, became the standard screening test for cervical cancer and premalignant lesions, and is being used globally. To estimate the frequency of various epithelial abnormalities on Pap smear in postmenopausal women and assess their relation with parity, clinical symptoms and per speculum findings. Prospective Pap procedure was done on 400 postmenopausal women from November 2017 to June 2019 and smears were stained and cytological interpretation was made according to the 2014 Bethesda system.Out of 97.5% satisfactory smears, 17.9%, 26.2% and 55.9% were diagnosed as of epithelial abnormalities, normal cytology and inflammatory and other benign conditions respectively. ASCUS-mean age was 45.18 years and parity of 3. Patients were either asymptomatic or presented with white discharge. Incidence among epithelial abnormalities was 31.5% with overall incidence of 5.6%. LSIL- mean age was 48.11 years and parity of 4 and presented with white discharge and lower abdominal pain. Incidence was 37.2% among epithelial abnormalities with overall incidence of 6.7%. HSIL- mean age was 58.78 years with parity of >/=5, presented with white discharge and lower abdominal pain. Incidence among epithelial abnormalities was 27% with overall incidence of 4.8%. SCC -mean age was 58.6 years and parity of >/=5, presented with white discharge, postmenopausal bleed and something coming out of p/v. Incidence was 4.2% among epithelial abnormalities with overall incidence of 0.8%. Pap smear is a simple, cheap, safe and gold standard diagnostic tool for screening postmenopausal women.

scholarly journals LAPAROSCOPY;

2012 ◽  
Vol 19 (01) ◽  
pp. 033-039
Author(s):  
NAZIA MUSSARAT ◽  
SIAMA QURESHI ◽  
AWAIS SHUJA ◽  
Mehnaaz Roohi
Keyword(s):  
Abdominal Pain ◽  
Gold Standard ◽  
Open Surgery ◽  
Diagnostic Laparoscopy ◽  
Data Entry ◽  
Lower Abdominal Pain ◽  
Descriptive Study ◽  
Lower Abdomen ◽  
Patient Case ◽  
Polycystic Ovarian Disease

Introduction: Diagnostic Laparoscopy is considered to be the gold standard for the evaluation of the pelvis and is considered asafe procedure. Diagnostic Laparoscopy is a technique in the routine investigation and treatment of infertility as well as other gynecologicalproblems. Objectives: To determine, Laparoscopic findings in different gynecological conditions, different causes of infertility andcomplications of laparoscopy Design: Retrospective, descriptive study. Material And Methods: We reviewed case records of all patients whounderwent laparoscopy for their different Gynecological problems. Data were collected from patient case records in a data entry sheet Results:In our study a total of Thirty patients under went laparoscopy for investigation of different gynecological problems. There were 17 patients whohave primary infertility and 6 have secondary infertility while 7 presented with Lower abdominal pain. In our study the leading cause of primaryinfertility was Polycystic Ovarian Disease(29%).Other causes were bilateral tubal blockade (23.53 %) ,17% has PID and fibroid uteri, While onepatients shown Endometriosis as well as one patient had no obvious pathology.(5.88 %).On laparoscopic examination of secondaryinfertility 50% shown Tubal blocked while 16.67 shown Fibroid uterus and PID.One patient had normal pelvic findings(16.67). Regardingpatients presented with pain lower abdomen 57.15% has ovarian cyst,28.58% has Ectopic pregnancy while one case(14.29%) had hetrotropicpregnancy. In 24 patients had no complication and recovery was smooth. laparoscopy had to be converted into Laparotomy due to significanthemorrhage in two patient and wound infection was observed in two patients. One patient presented with post operative fever and onepresented with abdominal pain. Conclusions: Laparoscopy is a valuable diagnostic tool for females in different gynecological problems. Thebenefit of the laparoscopy to open surgery include less pain, less scarring, less disability and quicker recovery.

scholarly journals Evaluation of cervicovaginal smear results at postmenopausal period

2016 ◽  
Vol 2 (1) ◽  
Author(s):  
Sefa Kelekci ◽  
Emre Destegül ◽  
Servet Gençdal ◽  
Emre Ekmekçi ◽  
Hüseyin Aydoğmuş ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Pap Smear ◽  
Premalignant Lesions ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Screening Programs ◽  
Postmenopausal Period ◽  
Pap Smear Screening ◽  
Intraepithelial Lesion

<p>This study evaluates the statistical analysis of cervicovaginal smear results at postmenopausal period accompanied by literature. Cervicovaginal smear results of 894 postmenopausal women were evaluated retrospectively according to the 2001 Bethesda system (BS) in Adana Numune Training and Research Hospital of Obstetrics and Gynecology Clinic from 2007–2010. The study found, normal results on 287 patients (32.1%), benign findings on 556 patients (62.2%), abnormal epithelial cell changes on 48 patients (5.36%) and malignant changes on 3 patients (0.33%). The abnormal epithelial changes were observed to be atypical cells of undetermined significance (ASC-US) for 22 patients (2.46%), <a href="http://medical-dictionary.thefreedictionary.com/high-grade+squamous+intraepithelial+lesion">low-grade squamous intraepithelial lesion</a> (LSIL) for 11 patients (1.23%), <a href="http://medical-dictionary.thefreedictionary.com/high-grade+squamous+intraepithelial+lesion">high-grade squamous intraepithelial lesion</a> (HSIL) for 7 patients (0.78%), findings that cannot exclude a high-grade squamous intraepithelial lesion (ASC-H) for 6 patients (0.55%) and atypical glandular cells-not otherwise specified (AGC-NOS) for 2 patients (0.22%). Malignant results were 2 squamous cell carcinomas (SCC) (0.22%) and 1 adenocarcinoma (ACC) (0.11%). Cervical cancer screening programs should be expanded and Pap smear screening should be applied to all postmenopausal women. The longer time span involved from premalignant lesions to cancer improves our chance for the diagnosis and treatment. As the incidence of invasive cancer increases in menopausal period, gynecological smear examination and regular check-up are crucial. A high rate of abnormalities of epithelial cells was detected in this study.</p><p> </p>

scholarly journals Clinico-pathological and etiological evaluation of acute appendicitis and assessment of significance of laboratory and ultrasonography examination as an ancillary aid to clinical diagnosis

2019 ◽  
Vol 6 (6) ◽  
pp. 1954
Author(s):  
Sailendra Nath Paul ◽  
Dilip Kumar Das
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Scoring System ◽  
Clinical Symptoms ◽  
Lower Abdominal Pain ◽  
Complication Rates ◽  
Alvarado Score ◽  
Negative Appendicectomy ◽  
Operative Findings

Background: Timely diagnosis and intervention of acute appendicitis reduces morbidity and mortality associated with the disease condition. The study aimed to evaluate the etiology of acute appendicitis, to analyze the sensitivity of modified Alvarado scoring system and radiology in the diagnosis of acute appendicitis and to correlate the observations of laboratory tests, operative findings with the histopathological report of specimen of appendix.Methods: This was a prospective study done on 100 patients with clinical symptoms of acute right lower abdominal pain suggestive of appendicular origin during the period from February 2015 to January 2016 in the department of surgery thorough clinical assessment, laboratory investigations, ultrasound findings as were done for all patients. After confirming the diagnosis of AA the patients had operative intervention and specimens were sent for histopathological study.Results: Male preponderance was seen in the study. Majority of them belongs to 21 to 30 years age group (50%). Faecolith was the most common etiological factor observed (58%). Abdominal pain (100%) was the most common clinical symptom. Alvarado score had sensitivity of 95.74% and specificity of 66.67% in diagnosing AA. In correlation to histopathological findings, ultrasonography findings showed 100% positive visualization rate in all 71 cases. Elevated ESR (94%) had high diagnostic accuracy as confirmed by HPE finding (96.81%) which is statistically significant (p<0.000).Conclusions: Alvarado scoring system, elevated ESR levels and USG findings of the appendix can be considered as adjuncts to clinically diagnose the AA, to improve the diagnostic accuracy thereby consequently the rate of negative appendicectomy can be reduced and thus decreases the complication rates.

scholarly journals A study on cervical cancer screening using pap smear in urban area in state of Meghalaya, India

2018 ◽  
Vol 7 (8) ◽  
pp. 3113
Author(s):  
Priti Mishra ◽  
Ragini Thapa ◽  
Arvind Kumar Dinkar
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Invasive Cervical Cancer ◽  
Pap Test ◽  
Military Hospital ◽  
Normal Cytology ◽  
Pap Smear Test ◽  
Common Cancer ◽  
Bethesda System ◽  
Preinvasive Lesion

Background: Cancer cervix is fourth most common cancer in world second most common in India. The objective of the study is to identify abnormal pap smear cytology in women undergoing the test.Methods: This retrospective study conducted in 200 women attending gynae OPD of Military Hospital, Shillong, Meghalaya, India between January 2016 to December 2017. Pap smear test was done, and classification was done as per Bethesda system 2014.Results: 105 women had normal cytology findings and 23 had abnormal cytology.Conclusions: Cervical cancer is the most common cancer for which screening is done. If pap smear is done every 3 years as per the guidelines mortality due to cervical cancer can be reduced. Every woman should undergo pap test at least once in her life before the age of 45 years. Timely screening of preinvasive lesion allows prevention from invasive cervical cancer.

scholarly journals Uterine Lipoleiomyoma: A Report of Two Cases

2017 ◽  
Vol 7 ◽  
pp. 26 ◽  
Author(s):  
Haji Mohammed Nazir ◽  
Sankesh Mehta ◽  
CR Seena ◽  
N Kulasekaran
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Abdominal Pain ◽  
Magnetic Resonance ◽  
Postmenopausal Women ◽  
Crucial Role ◽  
Imaging Modality ◽  
Lower Abdominal Pain ◽  
Resonance Imaging ◽  
Pelvic Tumors

We report two cases of uterine lipoleiomyoma in postmenopausal women of ages 52 and 55 years, who presented with complaints of leukorrhea and lower abdominal pain, respectively. Lipoleiomyoma is a rare benign variant of leiomyoma, having an incidence of 0.03%–0.2%. These are benign pelvic tumors which are usually asymptomatic and commonly occur in obese postmenopausal women. However, they can occasionally present with typical leiomyoma symptoms. Imaging plays a crucial role in the diagnosis of benign pelvic tumors. Ultrasonography is the first imaging modality for diagnosis of pelvic tumors in females. Computed tomography and magnetic resonance imaging are specific in demonstrating the uterine origin and fat component.

scholarly journals Herlyn-Werner-Wunderlich Syndrome: Comparison of Two Cases

2020 ◽  
Vol 17 (19) ◽  
pp. 7173
Author(s):  
Mateusz Kozłowski ◽  
Katarzyna Nowak ◽  
Dominika Boboryko ◽  
Sebastian Kwiatkowski ◽  
Aneta Cymbaluk-Płoska
Keyword(s):  
Abdominal Pain ◽  
Clinical Symptoms ◽  
Transvaginal Ultrasound ◽  
Lower Abdominal Pain ◽  
Clinical Situation ◽  
Uterus Didelphys ◽  
History Of ◽  
Rare Malformation ◽  
Obstructed Hemivagina

Background: Herlyn-Werner-Wunderlich Syndrome is a rare malformation syndrome characterized by uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis. Symptoms appear most often after menarche and are secondary to hematocolpos. We compare clinical symptoms, diagnosis and treatment of two patients, a 13-year-old and a 17-year-old. Case report: Despite the non-uniform clinical symptoms, it should be noted that in both patients, the 13-year-old and the 17-year-old, hematocolpos, which was probably the cause of lower abdominal pain, was diagnosed with ultrasound. The diagnosis was complemented by laparoscopy, which determined the diagnosis of malformation of uterus didelphys with obstructed hemivagina. The patients had a history of kidney agenesis, which, after gynecological diagnosis, turned out to be ipsilateral. In the 13-year-old, agenesis was diagnosed by uroscintigraphy, while in the 17-year-old it was diagnosed by urography. Incision and drainage of the residual vagina was performed in the course of therapeutic management. In both cases, the clinical situation required a repeated widening of the orifice. Conclusions: Lower abdominal pain accompanying hematocolpos suggested Herlyn-Werner-Wunderlich Syndrome (HWWS) as the cause of symptoms. 3D transvaginal ultrasound enabled the determination of a congenital uterine defect with high probability, although inconclusive cases required confirmation by laparoscopy. Incision of the blocked vagina and drainage of hematocolpos were the key components of treatment. The treatment of HWWS is a multi-step process.

scholarly journals Torquálódott méhfüggelék laparoszkópos ellátása a 32. terhességi héten

2021 ◽  
Vol 162 (35) ◽  
pp. 1418-1421
Author(s):  
Márió Attila Vincze ◽  
Gábor Németh ◽  
Tibor Novák
Keyword(s):  
Abdominal Pain ◽  
Clinical Symptoms ◽  
Operative Procedure ◽  
Lower Abdominal Pain ◽  
Pregnant Patient ◽  
Adnexal Torsion ◽  
Maternal Complications ◽  
Increased Risk ◽  
The University ◽  
In Pregnancy

Összefoglaló. Terhességben az élettani és anatómiai változások miatt bizonyos patológiás szervi eltérések nem specifikus tünettannal járhatnak. A várandósság alatt fellépő hasi panaszok esetén lényeges felállítani a gyors és pontos diagnózist, a minél korábbi adekvát terápia érdekében. A klinikai tünetek hátterében többek között állhatnak szülészeti betegségek, illetve appendicitis, megnagyobbodott ovariumcysta, nephrolithiasis vagy diverticulitis is. Esetismertetésünkben egy 32 hetes gravida ellátását prezentáljuk, aki jobb alhasi panaszok miatt jelentkezett a Szegedi Tudományegyetem Szülészeti és Nőgyógyászati Klinikáján. A magzati paraméterek megfelelőek voltak. A klinikai vizsgálatok appendicitis gyanúját vetették fel, mely miatt laparoszkópia történt. Torquálódott jobb oldali tuba uterina miatt jobb oldali salpingectomiát végeztünk, az appendix kóros elváltozása nem igazolódott. Magzati, illetve anyai szövődmény a posztoperatív szakban nem volt. A további terhesgondozás során szövődményt nem észleltünk, majd a betöltött 40. terhességi héten hüvelyi úton egészséges újszülött született. A méhfüggelék megcsavarodásának operatív megoldása laparoszkópos úton alkalmazható módszernek tekinthető terhességben is. Az adnexcsavarodás ritka sürgősségi nőgyógyászati kórképnek számít, bár szakirodalmi adatok alapján az adnexum torsiójának rizikója fokozott lehet a terhesség korai szakaszában, kiváltképp asszisztált reprodukciós technikák alkalmazása esetén. Várandósság alatt hirtelen jelentkező alhasi panaszok esetén az anamnesztikus adatok tükrében, a klinikai vizsgálatok során szükséges az adnextorsio lehetőségére is gondolni. Orv Hetil. 2021; 162(35): 1418–1421. Summary. Due to physiological and anatomical changes in pregnancy, certain pathological organ abnormalities may be associated with non-specific symptoms. In the case of abdominal complaints during pregnancy, it is important to make a quick and accurate diagnosis to apply an early adequate therapy. The cause of the clinical symptoms can be obstetrical diseases, appendicitis, large ovarial cyst, rarely nephrolithiasis or diverticulitis. Through our case study, we present the treatment of a 32-week gravida. Examination of the pregnant patient occured at the Department of Obstetrics and Gynecology of the University of Szeged due to right lower abdominal pain. The fetal parameters were satisfactory. We assumed appendicitis, so after proper preparation laparoscopy was performed. Salpingectomy was performed because of torqued right fallopian tube and no pathological changes were detected on the appendix. In the postoperative period, there were no fetal or maternal complications. During further care of pregnancy, there were no complications and a healthy newborn was born by vaginal delivery at the 40th week of gestation. The operative procedure of adnexal rotation by laparoscopy can be considered as an applicable method even in pregnancy. Adnexal torsion is a rare emergency gynecological disease, although literature data suggest an increased risk in early pregnancy, especially in the case of assisted reproductive technology. In the case of sudden abdominal pain during pregnancy, in the light of anamnestic data, it is recommended to consider the possibility of adnexal torsion, too. Orv Hetil. 2021; 162(35): 1418–1421.

scholarly journals Clinical Data Mining Related to the Japanese Kampo Concept “Hie” (Oversensitivity to Coldness) in Men and Pre- and Postmenopausal Women

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
H. Tokunaga ◽  
K. Munakata ◽  
K. Katayama ◽  
R. Yamaguchi ◽  
S. Imoto ◽  
...  
Keyword(s):  
Data Mining ◽  
Abdominal Pain ◽  
Postmenopausal Women ◽  
Hot Flashes ◽  
Lower Abdominal Pain ◽  
Classification And Regression Tree ◽  
University Hospital ◽  
Kampo Medicine ◽  
Data Mining Technique ◽  
Cart Analysis

“Hie” is a subjective oversensitivity to cold and a condition experienced in 60% of Japanese citizens. The condition ofhiehas not been documented in Western medicine. However, in Kampo medicine,hieis an important target of treatment, because it has been considered one of the sources of all kinds of diseases. This study aimed to clarify the symptoms and findings associated withhieand contribute to increased precision inhiediagnosis. During 2005-2006, data from interviews of 1691 patients during their initial visit to the Kampo Clinic of Keio University Hospital were analyzed using a classification and regression tree (CART) analysis, a data mining technique. Symptoms and findings characteristic of each group are follows as, postmenopausal women: fatigability, absence of lower abdominal pain, and absence of hot flashes of feet: women with menstruation: leg swelling, knee pain, and abdominal pain; men: insomnia, leg weakness, and absence of excess saliva. From the perspective of Kampo medicine the result suggested that the feature ofhiecondition in postmenopausal women, women with menstruation, and men is statistically different.

scholarly journals Colposcopic evaluation of unhealthy cervix and it’s correlation with Papanicolau smear in cervical cancer screening

2017 ◽  
Vol 6 (11) ◽  
pp. 4959
Author(s):  
Vijay Y. Kalyankar ◽  
Bhakti V. Kalyankar ◽  
Shriniwas N. Gadappa ◽  
Supriya Kute
Keyword(s):  
Sensitivity And Specificity ◽  
Gold Standard ◽  
Pap Smear ◽  
Final Diagnosis ◽  
Premalignant Lesions ◽  
Cancer Cervix ◽  
Medical College ◽  
Naked Eye ◽  
Eye Examination ◽  
Suspected Lesion

Background: In present study colposcopic evaluation of unhealthy cervix was donr and it’s correlation with Papanicolau smear in screening of Cancer cervix. Objective of present study was to critically evaluate the sensitivity and specificity of PAP smear with that of Colposcopy in screening of Cancer Cervix in women with unhealthy cervix.Methods: 100 women with clinically unhealthy cervix on naked eye examination and / or abnormal symptoms attending Gynaecology Out patient department in 2 years period were subjected to PAP smear, Colposcopy, biopsies under Colposcopic guidance and findings correlated with Histopatholgy at Govt. Medical college, Aurangabad, Maharashtra. India. The sensitivity and specificity of PAP smear with that of Colposcopy in screening of Cancer Cervix was evaluated.Results: Both PAP smear and Colposcopy can be reliably used to screen women with premalignant lesions of Cancer cervix.Conclusions: Colposcopy is a better tool for diagnosis of precursors of Cancer Cervix than PAP Smear and Histopathology of suspected lesion remains the gold standard for final diagnosis.

scholarly journals A comparative study of Pap smear and colposcopy guided biopsy in the evaluation of unhealthy cervix

2020 ◽  
Vol 9 (6) ◽  
pp. 2305
Author(s):  
Meenakshi Venkatesh ◽  
Ushadevi .
Keyword(s):  
Comparative Study ◽  
Cervical Carcinoma ◽  
Pap Smear ◽  
Early Stage ◽  
Lower Abdominal Pain ◽  
Premalignant Lesions ◽  
P Value ◽  
Carcinoma Cervix ◽  
Indian Women ◽  
Post Menopausal

Background: Cancer of cervix ranks as the third common malignancy in females worldwide. In developing countries like India, carcinoma cervix is the second commonest malignancy affecting females. In India, every year 1,26,000 new cases are identified and 67,477 deaths occur due to cervical carcinoma. Cervical carcinoma affects women of age 15-44 years and disease peaks at 55-66 years. On average, Indian women have a 2.5% risk of developing carcinoma cervix. It was estimated worldwide that every 5th woman, who suffer from cervical cancer belongs to India.Methods: A comparative study which included 110 married women of age 20 to 65 years. Women who presented with white discharge, lower abdominal pain, post coital bleeding and post-menopausal bleeding were subjected to Pap smear and colposcopy guided biopsy.Results: A total 53.6% women had inflammatory smear, followed by 34.5% women with normal Pap smear, 0.1% women had bacterial vaginosis, 6.4% women had LSIL and 4.5% women had HSIL. Authors found that 63.6% women had chronic cervicitis. 15.4% had chronic endo papillary cervicitis, 13.6% had CIN 1, 5.4% women had CIN 2 and 1.8% women had squamous cell carcinoma. Association of Pap smear with histopathology is statistically significant (p value <0.001).Conclusions: Pap smear can be used as screening test for detecting premalignant lesions of cervix. Colposcopy guided cervix biopsy has got better specificity than Pap smear, so all symptomatic women should be subjected to colposcopy guided cervix biopsy to detect carcinoma at early stage.

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