A study of cytopathological pattern of cervical papanicolaou smear examination in women between 20 - 75 years of age group

INTRODUCTION: Cervical cancers are the most common form of cancer encountered in Indian women. Studies from India had reported HIV positive women are 10-11 times more prone for cervical carcinomas than HIV negative women with a recent rise in incidence observed. India started a free antiretroviral therapy (ART) program in 2004 with services extended to rural General Hospitals. Cancer cervix can be diagnosed at a preinvasive stage with repeatative papanicolaou smear (cytological screening) and can be readily preventable. AIM: Our aim is to determine the prevalence of PAP smear abnormalities among HIV infected women from rural areas coming for ART initiation and the relationship between immunological status and smear abnormalities. METHODS: As per the Indian National ART program all HIV positive women of reproductive age should undergo PAP smear examination before initiation of ART. All consenting women >18 years of age with history of penetrative vaginal intercourse undergo PAP smear examination. In this observational cohort from 25th June 2011 to 15th January 2012 conducted in Melur ART centre and the cytological reports and the patient clinical and immunological status data was analyzed by using SPSS 17 version. RESULTS: 102 PAP smears were obtained and classified according to Bethesda classification. Five patients (4.90%) were abnormal. Squamous cell carcinoma was observed in 1 (0.98%) patient with a CD4 count of 580 cells/mm3. High squamous intraepithelial lesions were observed in 2 patients (1.96%) with CD4 counts of 208 & 633 cells/mm3 respectively. Low squamous intraepithelial lesion were observed in 2 patients (1.96%) with CD4 counts of 50 and 385 respectively cells/mm3. Immunological status (CD4 count) correlated with grade of the initial lesion (p=0.10). All the patients with PAP smear abnormalities were referred to Madurai Medical College Hospital for further treatment and follow-up. CONCLUSION: In our observational study increasing cytological abnormalities in the HIV Infected women were noted. Accordingly, all ART centre and HIV treatment programs should institute comprehensive reproductive health care services for this high-risk groups, including routine Papanicolaou smear screening

Download Full-text

Pattern of epithelial cell abnormality in Pap smear: A clinicopathological and demographic correlation

CytoJournal ◽

10.4103/1742-6413.80527 ◽

2011 ◽

Vol 8 ◽

pp. 8 ◽

Cited By ~ 10

Author(s):

Urmila Banik ◽

Pradip Bhattacharjee ◽

Shahab Uddin Ahamad ◽

Zillur Rahman

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Epithelial Cell ◽

Developing Country ◽

Cervical Cancer Screening ◽

Pap Smear ◽

Age Group ◽

Smear Examination ◽

Group A ◽

Malignant Lesions

Background: In the low resource settings of a developing country, a conventional Papanicolaou (Pap) test is the mainstay screening system for cervical cancer. In order to counsel women and to organize a public health system for cervical cancer screening by Pap smear examination, it is imperative to know the pattern of premalignant and malignant lesions. This study was undertaken to find out the prevalence of an abnormal Pap smear, in a tertiary hospital of a developing country, and to carry out a clinicopathological and demographical analysis for establishing the pattern of epithelial cell abnormality in a Pap smear. Materials and Methods: A cross-sectional descriptive study was carried out in a total of 1699 patients who underwent Pap smear examination. The prevalence of epithelial cell abnormality in the Pap smear was calculated in proportions / percentages. Specimen adequacy and reporting was assessed according to the revised Bethesda system. Results: Among the total of 1699 patients who had their Pap smear done, 139 (8.18%) revealed epithelial cell abnormality. Altogether 26 smears revealed high-grade lesions and malignancy, most of which were found to be in women belonging to the 30 – 39 and ≥ 45 age group. A total of 75 (53.96%) women were in the 20 – 44 age group and 64 (46.04%) were in the ≥ 45 age group. A bimodal age distribution was detected in the epithelial cell abnormality, with the bulk being diagnosed in patients aged 45 or above. Overall one-third of the patients with an abnormal Pap smear result showed healthy cervix in per vaginal examination. Conclusions: A raised prevalence of epithelial cell abnormality reflects the lack of awareness about cervical cancer screening. Women aged 45 or above harbor the bulk of premalignant and malignant lesions in the Pap smear, signifying that these women are among the under users of cytological screening.

Download Full-text

Trainable Children Can Learn Adjectives, Polars, and Prepositions!

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.0803.181 ◽

1977 ◽

Vol 8 (3) ◽

pp. 181-187 ◽

Cited By ~ 1

Author(s):

Marlys Mitchell ◽

Carolyn Evans ◽

John Bernard

Keyword(s):

Mentally Retarded ◽

Chronological Age ◽

Age Group ◽

Achievement Gains ◽

Active Involvement ◽

Mentally Retarded Children ◽

Locative Prepositions ◽

Major Factors ◽

Trainable Mentally Retarded

Twelve trainable mentally retarded children were given six weeks of instruction in the use of adjectives, polars, and locative prepositions. Specially prepared Language Master cards constituted the program. Posttests indicated that children in the older chronological age group earned significantly higher scores than those in the younger group. Children in the younger group made significant increases in scores, particularly in learning prepositions. A multisensory approach and active involvement in learning appeared to be major factors in achievement gains.

Download Full-text