scholarly journals The Application of Artificial Intelligence-Assisted Colposcopy in a Tertiary Care Hospital within a Cervical Pathology Diagnostic Unit

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 106
Author(s):  
Aleksandra Zimmer-Stelmach ◽  
Jan Zak ◽  
Agata Pawlosek ◽  
Anna Rosner-Tenerowicz ◽  
Joanna Budny-Winska ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Cervical Cancer ◽  
Clinical Assessment ◽  
Gynecological Cancer ◽  
Tertiary Care ◽  
Medical Personnel ◽  
Tertiary Hospital ◽  
Limiting Factor ◽  
Lower Sensitivity ◽  
Care Hospital

The rising global incidence of cervical cancer is estimated to have affected more than 600,000 women, and nearly 350,000 women are predicted to have died from the disease in 2020 alone. Novel advances in cancer prevention, screening, diagnosis and treatment have all but reduced the burden of cervical cancer in developed nations. Unfortunately, cervical cancer is still the number one gynecological cancer globally. A limiting factor in managing cervical cancer globally is access to healthcare systems and trained medical personnel. Any methodology or procedure that may simplify or assist cervical cancer screening is desirable. Herein, we assess the use of artificial intelligence (AI)-assisted colposcopy in a tertiary hospital cervical diagnostic pathology unit. The study group consisted of 48 women (mean age 34) who were referred to the clinic for a routine colposcopy by their gynecologist. Cervical images were taken by an EVA-Visualcheck TM colposcope and run through an AI algorithm that gave real-time binary results of the cervical images as being either normal or abnormal. The primary endpoint of the study assessed the AI algorithm’s ability to correctly identify histopathology results of CIN2+ as being abnormal. A secondary endpoint was a comparison between the AI algorithm and the clinical assessment results. Overall, we saw lower sensitivity of AI (66.7%; 12/18) compared with the clinical assessment (100%; 18/18), and histopathology results as the gold standard. The positive predictive value (PPV) was comparable between AI (42.9%; 12/28) and the clinical assessment (41.8%; 18/43). The specificity, however, was higher in the AI algorithm (46.7%; 14/30) compared to the clinical assessment (16.7%; 5/30). Comparing the congruence between the AI algorithm and histopathology results showed agreement 54.2% of the time and disagreement 45.8% of the time. A trained colposcopist was in agreement 47.9% and disagreement 52.1% of the time. Assessing these results, there is currently no added benefit of using the AI algorithm as a tool of speeding up diagnosis. However, given the steady improvements in the AI field, we believe that AI-assisted colposcopy may be of use in the future.

scholarly journals PAP-Smear Study and its Utility in Cervical Cancer Screening in a Tertiary Care Hospital in Chittagong, Bangladesh

2014 ◽  
Vol 13 (1) ◽  
pp. 17-19 ◽  
Author(s):  
Sabina Yeasmin ◽  
Tahera Begum ◽  
Lutfun Naher Begum ◽  
A.S.M. Mostaque Ahmed ◽  
Babul Osman
Keyword(s):  
Cervical Cancer ◽  
Coming Out ◽  
Dibutyl Phthalate ◽  
Pap Smear ◽  
Gynecological Cancer ◽  
Tertiary Care ◽  
Life Time ◽  
Care Hospital ◽  
Pap Screening ◽  
Epithelial Lesions

Background & Purpose: In developing countries, cervical cancer is the most common gynecological cancer and one of the leading causes of cancer death. Cervical cancers can be prevented through early detection and cervical smear is a sensitive test for it.Materials & Methods: This retrospective study was carried out at Chattagram Maa- Shishu O General Hospital, between July 2012 and June 2013. Total 500 patients were screened having complaints of vaginal discharge, irregular bleeding per vagina, post coital bleeding or something coming out per vagina. History and symptoms along with parity were recorded. Smears were taken by trained Doctor using modified Ayres wooden spatula and plastic endocervical cytobrush which were inserted and rotated 360 over cervix. Both ectocervix and endocervix were sampled. Slides were prepared, labeled, fixed in 95% ethyl alcohol immediately and subsequently stained by pap stain. After staining, slides were mounted with DPX (distren dibutyl phthalate xylene), screened and reported by two Cytopathologist according to The 2001 Bethesda system.Results: Age ranged from 20 to 50 and 50 to75 years with an average age of 37 years. Four hundred sixty five (93%) cases showed inflammatory lesions, 15 (3%) showed atrophy, 8 (1.6%) showed metaplasia and others showed ASCUS, AGUS, LSIL, HSIL, SCC. Eighty percent of all the epithelial abnormalities were found in the age group of 40 years and above. Average age of patients for all the epithelial abnormalities was 49 years.Conclusion: Cervical cancer is one of the most common malignancies in the women of Bangladesh. Pap smear cytology is a useful screening tool to detect pre-invasive cervical epithelial lesions. Based on the findings of this study we recommend at least a single life-time Pap screening cytology of the uterine cervix of all the women aged 40 to 50 years.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i1.19412

Healthcare associated infections caused by non-fermenting Gram negative rods (NFGNR): six years of experience of a tertiary hospital

2013 ◽  
Vol 7 (2) ◽  
pp. 06-12
Author(s):  
Zahidul Hasan ◽  
Md. Kamrul Islam ◽  
Arifa Hossain
Keyword(s):  
Blood Stream Infection ◽  
Tertiary Care ◽  
Blood Stream ◽  
Tertiary Hospital ◽  
Healthcare Associated Infections ◽  
Care Hospital ◽  
Gram Negative ◽  
Acinetobacter Spp ◽  
Tract Infections ◽  
Healthcare Associated

Recently non-fermenting Gram negative rods (NFGNR) are playing an important role in healthcare associated infections. This observational study in a tertiary care hospital of Dhaka city conducted during 01August 2007 to 30 June 2013 found that 34.8% isolated organisms from patients with healthcare associated infections were NFGNR. Majority (74.3 %) of these infections were occurring inside critical care areas. Pseudomonas and Acinetobacter together constituted 79.6% of the total NFGNR whereas Burkholderia cephacia complex (15.4%), Stenotrophomonas (4.3%) and Chryseobacterium species (0.7%) combined constituted remaining 20.4%. Out of total NFGNRs, Pseudomonas was responsible for highest number of catheter associated urinary tract infections (55.6%), ventilator associated pneumonia (46.3%), respiratory tract infection (65.8%) and surgical site infection (70.6%). Blood stream infection was predominantly caused by Burkholderia cephacia complex (33.5%) and Acinetobacter spp. (39.5%). Other than colistin most of the organisms were resistant to antibiotics commonly recommended for NFGNR.DOI: http://dx.doi.org/10.3329/bjmm.v7i2.19326 Bangladesh J Med Microbiol 2013; 07(02): 6-12

scholarly journals Gynecological malignancies at tertiary care hospital, Pakistan: A five-year review

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Tayyiba Wasim ◽  
Javeria Mushtaq ◽  
Ahmad Zunair Wasim ◽  
Gul e Raana
Keyword(s):  
Risk Factors ◽  
Ovarian Cancer ◽  
Cervical Cancer ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Advanced Stage ◽  
Gynecological Malignancy ◽  
Abdominal Symptoms ◽  
Gynecological Malignancies

Background & Objective: Gynecological malignancies are important cause of female morbidity and mortality. They pose significant burden on health resources in low middle-income countries. Data on presentation and risk factors can help in early identification and reduce this burden. Our objective was to evaluate frequency, stage of presentation and risk factors of gynecological malignancies in a tertiary care setting. Methods: It was cross sectional study done in Gynecology Department, Services Institute of Medical Sciences, Services Hospital, Lahore from January 2015- December 2019. The records of the patients were retrospectively reviewed to include all cases of gynecologic malignancies. Demographic information, frequency, risk factors, symptoms, grade and stage of tumor was collected. Results: There were 122 patients diagnosed with gynecological malignancy during the study period. Ovarian cancer was seen in 60 (49.18%) patients followed by cervical cancer in 29(23.7%), endometrial cancer 27(22.1%) and vulva 06(4.9%). Mean age for all cancers was 51±12.7 to 55±9.3 except cervical cancer which was seen in 43±8.9 years. Patients with ovarian cancer had significantly more hypertension and diabetes (p<0.05). Heavy menstrual bleeding and postmenopausal bleeding was significantly seen in patients of endometrial and cervical cancer (p<0.05). Abdominal symptoms of pain, mass and distension were seen in patients with ovarian cancer (p<0.05). Majority patients presented in advanced stage. Among ovarian cancer, 52/60(86.6%) were epithelial in origin while 25(86.2%) cervical cancer and all vulva cancers were squamous cell carcinoma. Conclusion: Ovarian cancer was commonest gynecological malignancy followed by cervical cancer. Late presentation with advanced stage was seen in majority of all cancers. doi: https://doi.org/10.12669/pjms.37.3.3596 How to cite this:Wasim T, Mushtaq J, Wasim AZ, Gul-e-Raana. Gynecological malignancies at tertiary care hospital, Pakistan: A five-year review. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3596 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Gestational Age Specific Postnatal Growth Curves for Singleton Babies in Tertiary Hospital of Western Nepal

2017 ◽  
Vol 56 (207) ◽  
pp. 325-330
Author(s):  
Santosh Pathak ◽  
Nagendra Chaudhary ◽  
Prativa Dhakal ◽  
Shyam Kumar Mahato ◽  
Sandeep Shrestha ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Economic Status ◽  
Tertiary Care ◽  
Growth Curves ◽  
Tertiary Hospital ◽  
Care Hospital ◽  
Cross Sectional ◽  
Intrauterine Growth ◽  
Geographical Regions

Introduction: Measurement of birth weight (BW), crown heel length (CHL), head circumference (HC) and chest circumference used to assess the intrauterine growth of a baby vary with altitude, race, gender, socio economic status, maternal size, and maternal diseases. The study aimed to construct centile charts for BW, CHL and HC for new born at different gestational ages in western Nepal. Methods:  This was a descriptive cross sectional study done over a period of 15 months in a tertiary care hospital of western Nepal. BW, length, HC and CC were measured within 12-24 hours of birth. Gestational age was estimated from first day of last menstrual period, maternal ultrasonology and New Ballard’s scoring system. Microsoft 2007 Excel and SPSS-16 was used for data analysis. Cole’s Lambda Mu Sigma method was used for constructing centile curves. Results: Out of 2000 babies analysed, 1910 samples were used to construct smoothed intrauterine growth curve of BW, CHL, and HC from 33-42 weeks of gestation. 57.35% (1147) were male, mean gestational age was 38.13 ±2.44 weeks, where 21.5% were preterm and 1.7% post term. The means of BW, CHL, HC and CC were 2744.78 gm, 47.80 cm, 33.18 cm, and 30.20 cm with standard deviations of 528.29, 3.124, 1.78, and 2.35 respectively. These data vary as compared to the Kathmandu data, in case of birth weight for 10th and 90th centiles, and at 90th centile in case of length. Conclusions: This necessitates the update in the existing growth charts and develop in different geographical regions of a country.

scholarly journals Pathways to care and diagnostic delay among cervical cancer patients attending a tertiary care hospital in Puducherry: a cross-sectional study

2020 ◽  
Vol 7 (6) ◽  
pp. 2298
Author(s):  
Roshina Sunny ◽  
Sitanshu Sekhar Kar ◽  
Dasari Papa ◽  
Sujiv Akkilagunta ◽  
Jeby Jose Olickal
Keyword(s):  
Cervical Cancer ◽  
Cancer Patients ◽  
Tertiary Care ◽  
Diagnostic Delay ◽  
Cross Sectional Study ◽  
Cancer Center ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Facilities

Background: The high mortality among cervical cancer patients in India can be attributed to presentation at advanced stages. The varied and lengthy pathway taken up to diagnosis could be a major reason for advanced stage at presentation. Hence, we aimed to describe the care pathways and diagnostic delay among cervical cancer patients.Methods: A hospital-based cross-sectional study was conducted among 101 cervical cancer patients attending a cancer clinic at a Regional Cancer Center. The histo-pathologically confirmed cases of cervical cancer, who registered in July to October 2018 were approached. Data were collected through personal interviews using a semi-structured questionnaire. Descriptive statistics were used to describe the number of providers visited and diagnostic delay.Results: The median (range) number of providers visited by the patients up to diagnosis was 2 (1-5). As the first point of care, 14% of participants approached sub-center or primary care facilities, 27% approached secondary care facilities, 49% participants approached tertiary care facilities and 11% came directly to a regional cancer center. Diagnosis was made only in 24% of participants at secondary and tertiary care levels. The median (IQR) number of days to get diagnosed was 66 (30-130) days and three fourth of the patients had a diagnostic delay.Conclusions: The diagnostic delay was higher among patients who consulted multiple providers. Implementing a protocol to be followed at all three levels of health care delivery system may enhance the early diagnosis. 

A CROSS-SECTIONAL STUDY TO ASSESS VACCINATION COVERAGE OF CHILDREN OF AGE GROUP 12 - 23 MONTH RESIDING IN THE FIELD PRACTICE AREA OF TERTIARY HOSPITAL.

2021 ◽  
pp. 28-29
Author(s):  
Jayesh Dhananjay Gosavi ◽  
Deppa H Velankar ◽  
Sumedha M Joshi ◽  
Sumit G Wasnik ◽  
Sudarshan Ramaswamy
Keyword(s):  
Vaccination Coverage ◽  
Tertiary Care ◽  
Immunization Coverage ◽  
Tertiary Hospital ◽  
Cluster Sampling ◽  
Care Hospital ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Group 12

Background:It is estimated that annually more than 89 lakh children in the country do not receive all vaccines that are available under the UIP– the highest number compared with any other country in the world. Objective: This study was carried out to assess vaccination coverage of children of age group 12 - 23 month residing in the eld practice area of tertiary hospital. Material & methods: This was sectional study conducted at eld practice area of tertiary care hospital during January 2017 to July 2018. Study population was children in the age group 12-23 month. As per WHO norm for identication of sample size for vaccination coverage in study area 30 cluster sampling method is preferred. Results: In the study 188 (89.52%) children were Fully Immunized. 22 (10.48%) children were partially immunized and none of the child was non immunized. overall coverage of BCG was 98.5, for PENTA3 was 96.3%, OPV3 was 96.3% and Measles was 89.8%. Conclusion: Overall immunization coverage in the area is good and higher than the national coverage level. There is no signicant difference in the immunization status of Male and Female children.

scholarly journals Utility of GeneXpert in Diagnosis of Multidrug-resistant Extrapulmonary Tuberculosis

2017 ◽  
Vol 03 (02) ◽  
pp. 085-087
Author(s):  
Ankush Chaudhary ◽  
Ketaki Utpat ◽  
Unnati Desai ◽  
Jyotsna Joshi
Keyword(s):  
Lymph Node ◽  
Psoas Abscess ◽  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
False Negative ◽  
Multidrug Resistant ◽  
Nucleic Acid Amplification ◽  
Lower Sensitivity ◽  
Care Hospital ◽  
Gluteal Abscess

ABSTRACT Background: The Xpert Mycobacterium tuberculosis (MTB)/rifampicin (RIF) assay (GeneXpert) is a rapid semi-quantitative nucleic acid amplification test with established role in the diagnosis of pulmonary tuberculosis (PTB) and multidrug-resistant (MDR) PTB. We determined the performance of the GeneXpert assay for the diagnosis of extrapulmonary tuberculosis (EPTB) MDR cases. Aims and objectives: To study the role of GeneXpert in the diagnosis of EPTB MDR. Materials and methods: A retrospective study was conducted over a period of 2 years at a tertiary care hospital after Ethics Committee permission. Data of 44 consecutive patients of diagnosed EPTB MDR were retrieved for GeneXpert and culture drug susceptibility test (DST). Sensitivity of GeneXpert in the diagnosis of EPTB MDR was calculated comparing culture DST results. Results: Various EPTB MDR cases studied were lymph node TB (n = 23) 51%, pleural effusion (n = 14) 32%, central nervous system TB/spinal TB/psoas abscess/gluteal abscess (n = 7) 17%. Sensitivity for GeneXpert was found to be 91.30, 57, 100% respectively. True positive and false negative were 36 and 8 cases respectively. The overall sensitivity of GeneXpert in diagnosing EPTB MDR was 81.80%. The sensitivity among lymph node, pleural effusions, and spinal/psoas abscess/gluteal abscess was 91.30, 57.14, and 100% respectively. Conclusion: GeneXpert sensitivity for the diagnosis of EPTB MDR varied with site of extrapulmonary involvement, with lower sensitivity in pleural fluid as compared with higher sensitivity among lymph node and spine TB. Nevertheless, given the rapid turnaround time and simplicity, it is a useful tool in the diagnosis of EPTB MDR when used in correct clinical context. Subsequent confirmation with culture DST, however, is recommended to diagnose false negatives.

Knowledge and Attitude Regarding Cervical Cancer Screening in Women attending Obstetrics and Gynaecological Opd at Birat Medical College Teaching Hospital

2020 ◽  
Vol 5 (2) ◽  
pp. 1055-1059
Author(s):  
Raj Deb Mahato ◽  
Amit Deo ◽  
Hanoon Pokharel
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Tertiary Care ◽  
Negative Attitude ◽  
College Teaching ◽  
Care Hospital ◽  
Medical College ◽  
The Mean ◽  
Knowledge And Attitude

Introduction: Cervical cancer is the most common Gynaecological cancer in Nepal which is preventable if appropriate screening and prevention measures are employed. Considerable reduction in cervical cancer incidence and cervical cancer related deaths can be achieved by effective screening. However, lack of knowledge and awareness can result in underutilization of the preventive measures.  Objectives: The objective of this study was to assess the knowledge and attitude regarding cervical cancer screening in women visiting Obstetrics and Gynaecology OPD at tertiary care Hospital in Eastern Nepal.  Methodology: A cross-sectional questionnaire-based study was conducted in Obstetrics and Gynaecology outpatient department of Birat Medical College Teaching Hospital from 1 January 2019 to 31 December 2019. Women were enrolled in the study by convenient sampling methods. Structured questionnaire was used to collect the data. The collected data was entered in Microsoft excel and analyzed by using SPSS version 22.  Results: Among 374 participants, the mean age was 31.13 years. More than three fourth (89.6%) of participants were literate. Regarding occupation, 89.8% of participants were housewives, and 82.9 % of participants were married. As per the findings, only 43.27 % of participants i.e. less than the mean, had adequate knowledge of cervical cancer and its screening. 65.50 % of participants had a negative attitude towards cervical cancer screening. Literate participants had good knowledge and positive attitude regarding cervical cancer screening than illiterate participants (P value less than 0.05).  Conclusion Considerable proportions of participants had inadequate knowledge and negative attitude regarding cervical cancer screening in Gynaecological patients visiting tertiary care Hospital in Eastern Nepal.

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