scholarly journals ENDOMETRIAL CARCINOMA

2015 ◽  
Vol 22 (10) ◽  
pp. 1256-1261
Author(s):  
Shazia Majid Khan ◽  
Farhat Yasmeen ◽  
Abida Riaz

Background: Bleeding from the reproductive tract in women is a naturallyoccurring event, generally the result of menstruation and childbirth, and is not associated with ableeding disorder in most cases. Dysfunctional uterine bleeding is the most common reason forwomen to undergo an interventional gynecologic procedure. The major task of the clinician is toexclude endometrial carcinoma in women and to identify organic pathology in order to manageit effectively. Objective. To determine the incidence of endometrial carcinoma in women withabnormal uterine bleeding. Study Design: Cross sectional study. Setting. Department ofObstetrics and Gynecology, Sheikh Zayed Hospital, Rahim Yar Khan. Duration of study: Sixmonths (16th February 2013 to 15th August 2013). Material and method: One hundred andsixteen women with complaint of abnormal uterine bleeding, meeting the inclusion criteria wereselected. All the patients were undergone endometrial sampling and assessment of endometrialthickness was done which was confirmed by endometrial biopsy to evaluate endometrialpathologies. The collected data was noted on pre-designed proforma. Results: The mean agewas 42.07 years. According to parity, 56 women (48.2%) have 1-4 parity, 48 women (41.4%)have 5-8 parity and 12 women (10.4%) have 9-14 parity. The mean duration of dysfunctionaluterine bleeding was 14.64±7.87 months. Six women (5.2%) have endometrial carcinoma while110 women (94.8%) have no endometrial carcinoma. Conclusion: This study thus proved thatin our setup the incidence of endometrial carcinoma is very high. So every patient with abnormaluterine bleeding should undergo endometrial biopsy to rule out endometrial carcinoma.

2020 ◽  
Vol 15 (1) ◽  
pp. 50-54
Author(s):  
Sapna Chauhan ◽  
Krishnapriya Radhakrishnan

Aims: To study the association of clinical profile of patients with Abnormal Uterine Bleeding with the different endometrial histopathological patterns Methods: A retrospective cross-sectional study was done in the department of Obstetrics and Gynaecology at a hospital in Karnataka, India from January 2017 to January 2019. Medical records were reviewed for all the cases of abnormal uterine bleeding who underwent endometrial biopsy. Results: There were 148 records of endometrial biopsies; >55% were in 41-50 years age group; 28% had postmenopausal bleeding; and 28% presented with menorrhagia. Menorrhagia and menometrorrhagia were equally common under 50 years of age. The various physiological patterns of endometrium (proliferative, secretory & menstruating endometrium) were noted in more than half the cases (51%). Proliferative endometrium was in 37%, followed by hyperplasia without atypia in 22% and only 3% showed malignancy; all of whom were in the postmenopausal group. Even in women with post menopausal bleeding, proliferative pattern was the commonest (33%), followed by atrophic endometrium and malignancy. Atypical hyperplasia was found to be most commonly associated with post menopausal bleeding. Conclusions: Both physiological and non physiological endometrial patterns were seen almost equally among the AUB cases. The knowledge of endometrial pattern in a case of AUB helps to decide a plan of management. Endometrial sampling plays a very important role in management of AUB, especially in the age group of more than 40 yrs; i.e, the peri and post-menopausal age groups, where incidence of malignant or pre malignant conditions was noted to be the highest. Key words: abnormal uterine bleeding, endometrial cancer, endometrial sampling, hyperplasia


Author(s):  
Jovita Deepthy John ◽  
Vimala Damodaran ◽  
Shankar Radhakrishnan

Background: Thyroid disorders are 10 times more common in women than men.1 Menstrual disturbances usually accompany clinical alterations in thyroid function and every clinician would have encountered altered menstrual pattern among women suffering from either hypo or hyper thyroidism. A high serum prolactin level can distrurb the follicular maturation and corpus luteum function, and leads to inhibition of normal pulsatile secretion of gonadotrophin-releasing hormone in hypothalamus resulting in anovulation. The aim of the study was to assess the thyroid and the prolactin levels among the women with abnormal uterine bleeding and to evaluate the association between them by comparing with normal females.Methods: A cross sectional study was conducted for a period of one year between Jan 2016 and December 2016 in our institution at the gynaecology OPD. Patients in the age group of 15 to 45 with the complaints of abnormal uterine bleeding and with the ultrasound findings showing normal uterus and ovary were included in the study. Hundred age and sex matched controls without any complaints of abnormal uterine bleeding in the age group of 15 – 45 years were also included in the study. Free T3, Free T4, TSH and prolactin estimation was done by chemiluminescent immunoassay for both the patients and the controls.Results: The mean TSH levels among the cases were much higher than that of the controls and the difference in the levels found to be statistically significant. Similarly, hyperprolactinemia was found in 18 cases when compared to 2 cases in controls and the mean prolactin levels were higher in cases. The serum prolactin levels and the serum TSH levels showed a perfect positive correlation which indicates that as the TSH level increases prolactin levels also increases with the R value >0.5.Conclusions: Early detection of hypothyroidism in such subjects saves the patient from recurrent curettage and at times hysterectomy. The financial implications of screening for prolactin/thyroid hormone abnormalities will have to be evaluated before a general recommendation can be made.


2021 ◽  
pp. 29-32
Author(s):  
Zothansung Joute ◽  
Telen Thangkhojam Kom ◽  
Phirthangmoi Fimate ◽  
Rajesh Singh Laishram

Objective: To assess the diagnostic accuracy of preoperative curettage biopsy samples and to correlate the ndings with post hysterectomy curettage samples for different endometrial pathologies. Methods: This cross-sectional study was conducted from October 2012 to September 2014 in the Department of Pathology in collaboration with the Department of Obstetrics and Gynaecology, Regional Institute of Medical Sciences, Imphal, Manipur. Approval from institutional ethical committee was taken before starting the study. Specimens of all perimenopausal women with abnormal uterine bleeding (AUB) who underwent endometrial biopsy and subsequent hysterectomy were studied in the Department of Pathology. Results: A total of 50 cases of clinically diagnosed patients with abnormal uterine bleeding were studied. Preoperative Endometrial curettage biopsy was followed By curettage post-hysterectomy. Biopsy ndings were correlated with post-hysterectomy curettage ndings. The age group of the patients range from 37 years to 53 years with maximum number of cases in the range of 45 to 50 years (38%). Proliferative endometrium was the most common pattern (56%) obtained by endometrial curettage biopsy as well as in post hysterectomy curettage followed by secretory endometrium. Statistical analysis of endometrial biopsy study of 48 cases showed that it has a high Sensitivity (100%), Negative predicted value (100%), Specicity (97.44%) and Positive predicted value (90.91%). The Accuracy of the test was 98%. Conclusions: While endometrial curettage biopsy using uterine curette is not the gold standard for diagnosing endometrial pathologies in AUB, it is an important diagnostic tool in the investigation for assessment of endometrium as it has few advantages.


2017 ◽  
Vol 15 (2) ◽  
pp. 26-31
Author(s):  
Sharmila Parajuli ◽  
Binita Thapa

Introduction: Abnormal uterine bleeding is a common sign of a number of different uterine disorders ranging from dysfunctional (non organic) abnormalities or complications of pregnancy to organic lesions such as polyps, hyperplasia or carcinoma. Methods: This is a retrospective study conducted at Hospital of 2nd author during a period of 5 years (Jan 2008-Dec 2013).  Histopathology records were retrieved and searched for cases of abnormal uterine bleeding. Relevant histopathological findings and clinical data were recorded and analyzed. The aim of the study was to determine the causes for abnormal uterine bleeding in women presenting to the hospital and to compare the histopathological findings at various age groups.Results: The age of patients ranged from 17 to 71 years with an average of 43 years. The most common cause of uterine bleeding was found to be proliferative phase endometrium; that were 649 cases (56.43%). Out of the pathological causes, the most common cause was found to be endometrial hyperplasia- 44 cases (3.82%). Endometrial carcinoma was found to be more common in the elderly postmenopausal women. A total of 6 cases (0.5%) of endometrial carcinoma were present.Conclusion: Endometrial hyperplasias and malignancies are common in increasing age group, especially in perimenopausal and postmenopausal women. So, a thorough work-up and diagnostic endometrial biopsy is therefore mandatory without delay in these patients to rule out malignancies. 


2020 ◽  
Vol 27 (09) ◽  
pp. 1862-1866
Author(s):  
Muhammad Nasir Ali ◽  
Muhammad Khalid Chishti ◽  
Kashif Siddiq ◽  
Muhammad Hamayun Hameed ◽  
Muhammad Tayyab Waheed ◽  
...  

Objectives: To determine the failure of DHS (dynamic hip screw) in terms of lag screw cutout. Study Design: Hospital Based Cross Sectional study. Setting: BVH and Civil Hospital Bahawalpur. Period: From 2013 to 2018. Material & Methods: 273 patients of both genders with age more than 50 years having stable intertrochanteric fractures were included in this study. With the help of C arm, the best possible anatomical reduction and rigid internal fixation was done with 135 degree DHS. Lag screw position and TAD determined on first postoperative day on radiographs (Anteroposterior & Lateral). Failure of fixation was determined on the radiographs during follow up. Lag screw cut-out was the projection of the screw from the femoral head by more than 1mm. Results: The mean age of the patients was 68.6 years (50-88). There were 132 (51.1 %) males and 126 (48.8%) females. Overall lag screw cutout rate was 11.2%. 21(30.8%) had screw cutout while 47 (69.1%) healed successfully among 68 patients with TAD ≥ 25mm. On the other hand 8(4.2%) had screw cutout while 182 (95.7%) healed successfully among 190 patients with TAD < 25mm. Middle middle and inferior middle position had highest success rate (˃ 92%) while inferior posterior position had highest cutout rate (36.2%). Among different age categories high failure rate (17.8%) seen in patients more than 70 years. Conclusion: The incidence of lag screw cutout is 11.2 % and risk of cutout can be minimized by placing lag screw in middle middle or inferior middle position and keeping the TAD < 25mm. More attention during follow up should be paid to patients with age ˃ 70 years.


2016 ◽  
Vol 06 (02) ◽  
pp. 014-016
Author(s):  
Mamta Choudhary

Abstract Background: Reproductive tract infections form one of the major burdens of disease in developing countries. Most of the women suffer from leucorrhoea and do not present themselves for seeking medical treatment in early stage as the women has poor understanding regarding leucorrhoea. Objectives: To assess the knowledge of females regarding leucorrhoea. Study Design: Cross- sectional study. Materials and Methods: The study involved collection of information regarding knowledge of females about leucorrhoeausingmultiple-choice questionnaire. Two hundred and fifty females residing in Model Town, Ludhiana were recruited in the study by using convenient sampling. Results: The result revealed that only 20% of subjects had good level of knowledge, and 80% subject had poor level of knowledge regarding leucorrhoea. The mean knowledge score regarding leucorrhoea among subjects was 19 with a standard deviation of 3.94. The highest mean knowledge score of 19.5 + 4.69 was in the age group of >35 years.


2016 ◽  
Vol 6 (12) ◽  
pp. 1018-1020
Author(s):  
S Subedi ◽  
B Banerjee ◽  
C Manisha

Background: Thyroid hormones play a key role in the menstrual and reproductive function of women .It is recognized universally that menstrual disturbances may accompany clinical alteration in thyroid function and every clinician has encountered altered menstrual pattern among women suffering from thyroid disorders. The aim of this study was to find the incidence of thyroid disorders in Dysfunctional uterine bleeding and its correlation with menstrual patterns.Materials and Methods: A hospital based cross-sectional study including 75 cases with dysfunctional uterine bleeding attending the OPD of Nobel Medical College, where incidence of thyroid disorder was evaluated along with its correlation with menstrual patterns and histopathology.Results: The incidence of Gynecological OPD attendance due to abnormal uterine bleeding was 3%.and the incidence of thyroid dysfunction was 10.6% with hypothyroidism being the commonest. (9.3%). The commonest menstrual pattern found was menorrhagia/polymenorrhoea in 8 percent.Conclusion: Prevalence of hypothyroidism was more common in DUB. Thus every woman with menstrual irregularities should undergo thyroid assessment and this will ultimately avoid unnecessary intervention like misuse of hormonal treatment and hysterectomy.


Author(s):  
Hema K. R. ◽  
Girish B. L. ◽  
Dhananjaya B. S. ◽  
Riyaj Ahmad Kalaburgi

Background: Abnormal uterine bleeding (AUB) is one of the commonest presentations encountered in gynecological outpatient department. Menstruation is also regulated by many mechanisms, including thyroid hormone. So, for definitive management of AUB, it becomes imperative to assess thyroid status in those with abnormal uterine bleeding.Methods: Cross sectional study was conducted on all woman attending to OPD at Sri Siddhartha Medical College, Tumukuru, with complaints of abnormal uterine bleeding (AUB). Thyroid test was done for those who were eligible under inclusion criteria. Incidence of thyroid disorders among AUB and type of abnormal menstrual pattern associated with specific type of thyroid dysfunction were noted in this study.Results: Total of 522 presented with AUB. AUB was most common among woman age >40 years at 49.23% (257 of total 522 cases). AUB was more common in Multipara at 61.49% (321 of 522 cases). Menorrhagia was commonest pattern in AUB accounting for 51.34% (268 of 522cases). Thyroid dysfunction was present in 12.27% (64 of 522) of cases with AUB. Among them hypothyroid was most common accounting for 8.81% (46 of 522 cases). Hyperthyroidism was present in 3.44% (18 of 522 cases). Menorrhagia was most common pattern in Hypothyroidism at 65.21% (30 of 46 cases, followed by polymenorrhea at 17.39% (8 of 46 cases). Oligomenorrhea was most common in hyperthyroid group at 55.54% (10 of 18 cases) closely followed by hypomenorrhea at 44.44% (8 of 18 cases).Conclusions: Abnormal uterine bleeding (AUB) is one of the commonest gynecological complaint at gynecological OPD.  Thyroid dysfunction is noted consistently in cases of AUB. So, evaluation of thyroid profile should be part of evaluation of AUB, especially during perimenopause.


Author(s):  
Sunitha Mary Mathew ◽  
Pramod Thomas

Background: Abnormal uterine bleeding is one of the most common problem encountered in gynaecology clinics. Assessment of endometrial pathology is recommended to rule out malignancy and premalignant conditions. Endometrial sampling can be done by Pipelle biopsy in outpatient units as well as by conventional dilatation and curettage in an operation theatre setup. Our study aims to find out the efficacy of office endometrial biopsy in terms of its sample adequacy, diagnostic accuracy and patient acceptability.Methods: 120 women presenting with abnormal uterine bleeding were included. A detailed history along with clinical examination findings are entered in the proforma. Ultrasound scan was done for all of them to identify pelvic pathology and endometrial thickness. Endometrial sampling was then done with Pipelle without anaesthesia. Histopathology reports are collected and sample adequacy and pattern were analysed. Patients are subsequently followed up for a period up to one year. Those who underwent hysterectomy are analysed for the endometrial pathology in hysterectomy specimen which is used as gold standard and compared with Pipelle endometrial sampling histopathology.Results: Sample adequacy for Pipelle biopsy was found to be 96%. Diagnostic accuracy for atypical hyperplasia and adenocarcinoma is 92.5% and 94% respectively. In hysterectomy specimens, carcinoma endometrium coexisted with atypical hyperplasia in 40% of cases with atypical hyperplasia in pipelle biopsy report.Conclusions: Thus, Pipelle endometrial biopsy is a cost-effective method for endometrial sampling except for focal lesions.


2021 ◽  
Vol 28 (04) ◽  
pp. 548-551
Author(s):  
Maria Saleem ◽  
Asim Khurshid ◽  
Amna Wajdan ◽  
Muhammad Salman Zafar

Objectives: To analyze the clinical profile, etiologies and outcome of seriously ill patients admitted in Pediatric Intensive Care Unit (PICU). Study Design: Cross Sectional study. Setting: PICU of Nishtar Medical Hospital, Multan, Pakistan. Period: January 2018 to December 2018. Material & Methods: During the study period, a total of 150 children, aged 1 to 12 years, with better prognosis and post-surgical cases requiring intensive care were registered. Age, gender, cause for hospitalization (clinical, surgical or emergency), length of PICU stay, diagnosis and outcome were recorded for all patients. Results: During the year of the study, 83 (55.3%) children were noted to be male. The mean age was 56.9+12.5 months. Mechanical ventilation was done in 62 (41.3%) patients. Major indications for admission to the PICU were respiratory disorders (21.5%), followed by sepsis (11.4%) and meningitis (8.1%). Majority, 80 (53.3%) patients improved and were shifted to ward and later discharged while 27 (18.0%) expired. Conclusion: Most of the children admitted in the PICU were male, aged below 5 years. Most common indication for admission in the PICU were respiratory disorders followed by sepsis and meningitis.


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