scholarly journals Unsatisfactory rate in liquid-based cervical samples as compared to conventional smears: A study from tertiary care hospital

CytoJournal ◽  
2016 ◽  
Vol 13 ◽  
pp. 14 ◽  
Author(s):  
Nalini Gupta ◽  
Vikrant S. Bhar ◽  
Arvind Rajwanshi ◽  
Vanita Suri
Keyword(s):  
Cell Count ◽  
Pap Smear ◽  
Tertiary Care ◽  
Developed Countries ◽  
Care Hospital ◽  
Sample Collection ◽  
Bethesda System ◽  
Liquid Based Cytology ◽  
The Difference ◽  
The Bethesda System

Background: Developed countries adopted liquid-based cytology (LBC) cervical cytology, partly because of its lower proportions of unsatisfactory (U/S)/inadequate samples. This study was carried out to evaluate effect on the rate of U/S samples after introduction of LBC in our laboratory. Materials and Methods: An audit of U/S cervical samples was performed, which included split samples (n = 1000), only conventional Pap smear (CPS) smears (n = 1000), and only LBC samples (n = 1000). The smears were reviewed by two observers independently, and adequacy for the samples was assessed as per The Bethesda System 2001. The reasons for U/S rate in split samples were categorized into various cytologic and/or technical reasons. Results: U/S rate was far less in only LBC samples (1.2%) as compared to only CPS (10.5%) cases. Cases in the satisfactory but limited category were also less in only LBC (0.4%) as compared to only CPS (3.2%) samples. The main reasons for U/S smears in split samples were low cell count (37.2% in CPS; 58.8% in LBC). The second main reason was low cellularity with excess blood and only excess blood in CPS samples. Conclusion: There was a significant reduction of U/S rate in LBC samples as compared to CPS samples, and the difference was statistically significant. The main cause of U/S samples in LBC was low cellularity indicating a technical fault in sample collection. The main cause of U/S rate in CPS was low cellularity followed by low cellularity with excess blood. Adequate training of sample takers and cytologists for the precise cell count to determine adequacy in smears can be of great help in reducing U/S rate.

scholarly journals A Comparative Study of Manual Liquid-Based Cytology with the Conventional Pap Smear for Cervical Cancer Screening in a Tertiary Care Hospital of Mandya, Karnataka

2021 ◽  
Vol 8 (16) ◽  
pp. 1009-1014
Author(s):  
Manjunath M.R ◽  
Sheetal Sheetal
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Invasive Cervical Cancer ◽  
Tertiary Care ◽  
Human Papillomaviruses ◽  
Care Hospital ◽  
Cancer Cervix ◽  
Hpv Dna ◽  
Bethesda System ◽  
Liquid Based Cytology

BACKGROUND A long pathological process for investigation of precursor lesion squamous intraepithelial lesion (SIL) leads to invasive cervical cancer. This SIL can be detected much earlier before the lesion progresses to invasive cancer. For greater than fifty years, screening for cancer cervix was done by conventional scrape smears and stained by Papanicolaou [Pap] stain but conventional Pap smears (CPAP) have been reported to have low sensitivity. To overcome these drawbacks manual liquid-based cytology [MLBC] was introduced. The objective of this study was to screen females for cervical cancer using CPAP and MLBC techniques and compare the results of these techniques. METHODS Cervical cytology samples were obtained from 120 non-pregnant females through specialised Uprep cytobrush with a detachable head. Thus, obtained samples were first smeared onto a clean glass slide for CPAP smear, and the whole head to cytobrush was dropped into the specialised Uprep liquid preservative medium and processed by using Uprep Cytospin machine to obtain MLBC smears. Both the smears were stained by conventional Pap stain and reported according to 2014 Bethesda system. RESULTS In this study, the CPAP method had a greater number of unsatisfactory smears than that of MLBC method which was statistically significant. MLBC identified more number of intraepithelial lesions when compared to CPAP and MLBC had an increased detection rate [IDR] of 73.68 % over CPAP. CONCLUSIONS Analysis of our results showed that MLBC had more advantages over CPAP. Since the cost effective MLBC has an improved rate of detection of abnormal lesions, MLBC can be used as a routine technique for screening of cancer cervix in India. Also, MLBC offers an important advantage of performing both human papillomaviruses deoxyribonucleic acid (HPV DNA) test and cytological analysis on a single sample. KEYWORDS Cervical Cancer, Conventional Pap Smear, Manual Liquid Based Cytology, Human Papilloma Virus (HPV DNA), Bethesda System

The Bethesda System for reporting thyroid cytopathology: A two year retrospective review in a tertiary care hospital

2016 ◽  
Vol 3 (1) ◽  
pp. 48 ◽  
Author(s):  
Shanmuga Priya Shankar ◽  
K Meenakshisundaram ◽  
V Rajalakshmi ◽  
Satish A Selvakumar ◽  
Bhanumathi Giridharan
Keyword(s):  
Retrospective Review ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Bethesda System ◽  
Thyroid Cytopathology ◽  
The Bethesda System

scholarly journals Comparison of conventional Papanicolaou smear and liquid‑based cytology: a study of cervical cancer screening at a tertiary care center in Bengaluru

2021 ◽  
Vol 10 (8) ◽  
pp. 3106
Author(s):  
Chaitra Krishna ◽  
Savitha Chandraiah ◽  
Chandana Krishna
Keyword(s):  
Cervical Cancer ◽  
Second Generation ◽  
Pap Smear ◽  
Care Center ◽  
Tertiary Care ◽  
Care Hospital ◽  
Cervical Lesions ◽  
Cervical Neoplasm ◽  
Cytological Abnormality ◽  
Liquid Based Cytology

Background: Cervical cancer is the fourth commonest cancer affecting women worldwide and the second most common cancer in women aged 15-44 years. The Papanicolaou (Pap) smear has been the cornerstone of screening for cervical neoplasm for the last 50 years. Liquid-based cytology (LBC) was introduced in mid-1990s as an alternative technique to process cervical samples has many benefits over Pap. A new second generation technique, Liquiprep was introduced after a decade has the advantage of a much lower cost. However, the information available on second generation liquid based cytology is limited. The objective was to look for the efficacy of LBC and to compare it to that of conventional cytology.Methods: This hospital based comparative study was undertaken 100 women who attended gynaecology OPD during 2017 at a tertiary care hospital in Bengaluru. Two cervical smears were simultaneously prepared from each subject, one for Pap smear and another for LBC followed by colposcopy and biopsy.Results: Among the study subjects, 89% of Pap smear analysis and 100% of smears in LBC showed satisfactory smear. Cytological abnormality was detected in 11% and 21% in pap and LBC, respectively. The present study showed higher sensitivity and specificity of 100% and 75% by LBC when compared to Pap smear (55% and 100% respectively).Conclusions: The present study showed that liquid based cytology is better in detecting cervical lesions when compared to conventional smear. 

A qualitative assessment of the diagnosis and management of ventilator-associated pneumonia among critical care clinicians exploring opportunities for diagnostic stewardship

2021 ◽  
pp. 1-7
Author(s):  
Blaine Kenaa ◽  
Lyndsay M. O’Hara ◽  
Mary Elizabeth Richert ◽  
Jessica P. Brown ◽  
Carl Shanholtz ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Qualitative Assessment ◽  
Ventilator Associated Pneumonia ◽  
Care Hospital ◽  
Sample Collection ◽  
Respiratory Sample ◽  
Identification Of Bacteria ◽  
Attending Physicians ◽  
Work Up ◽  
Radiographic Changes

Abstract Background: Prompt diagnosis and intervention for ventilator-associated pneumonia (VAP) is critical but can lead to overdiagnosis and overtreatment. Objectives: We investigated healthcare provider (HCP) perceptions and challenges associated with VAP diagnosis, and we sought to identify opportunities for diagnostic stewardship. Methods: We conducted a qualitative study of 30 HCPs at a tertiary-care hospital. Participants included attending physicians, residents and fellows (trainees), advanced practice providers (APPs), and pharmacists. Interviews were composed of open-ended questions in 4 sections: (1) clinical suspicion and thresholds for respiratory culture ordering, (2) preferences for respiratory sample collection, (3) culture report interpretation, and (4) VAP diagnosis and treatment. Interviews transcripts were analyzed using Nvivo 12 software, and responses were organized into themes. Results: Overall, 10 attending physicians (75%) and 16 trainees (75%) trainees and APPs believed they were overdiagnosing VAP; this response was frequent among HCPs in practice 5–10 years (91%, n = 12). Increased identification of bacteria as a result of frequent respiratory culturing, misinterpretation of culture data, and fear of missing diagnosis were recognized as drivers of overdiagnosis and overtreatment. Although most HCPs rely on clinical and radiographic changes to initiate work-up, the fear of missing a diagnosis leads to sending cultures even in the absence of those changes. Conclusions: HCPs believe that VAP overdiagnosis and overtreatment are common due to fear of missing diagnosis, overculturing, and difficulty distinguishing colonization from infection. Although we identified opportunities for diagnostic stewardship, interventions influencing the ordering of cultures and starting antimicrobials will need to account for strongly held beliefs and ICU practices.

Pap Test Reporting Rates for Conventional Smear and Liquid-Based Cervical Cytology from the Largest Academic Women's Hospital in China: Analysis of 1,248,785 Pap Test Reports

2015 ◽  
Vol 59 (6) ◽  
pp. 445-451 ◽  
Author(s):  
Xiang Tao ◽  
R. Marshall Austin ◽  
Hao Zhang ◽  
Lihong Zhang ◽  
Jianan Xiao ◽  
...  
Keyword(s):  
Cervical Screening ◽  
Pap Test ◽  
Major Change ◽  
Cervical Cytology ◽  
Pap Smears ◽  
Pap Tests ◽  
Bethesda System ◽  
Liquid Based Cytology ◽  
The Bethesda System ◽  
Reporting Rates

Objective: The Obstetrics and Gynecology Hospital of Fudan University (OGHFU) in Shanghai is the largest academic women's hospital in China. Between 2009 and 2014, the use of liquid-based cytology (LBC) significantly increased while gradually adopting the Bethesda System (TBS), and in 2012 local regulations mandated that pathologists replace technicians to sign out Pap tests. Design: A retrospective OGHFU database search documented all Pap test reports between 2009 and 2014 by specimen type, either LBC or conventional Pap smears (CPS), and final reporting category. A total of 1,224,785 Pap reports were analyzed to document variations in Pap test reporting during a period of major change in cervical screening in China. Results: LBC gradually replaced CPS, which declined from over 65% of Pap tests in 2010 to 6.4% in 2014. Of 514,811 Pap reports using the traditional class system, class I (negative) reports accounted for 98.3% of results. With the introduction of TBS reporting, pathologist reviews and substantial replacement of CPS by LBC, the laboratory abnormal Pap test rate increased significantly to almost 5%. Conclusions: Changes in cervical cytology reporting between 2009 and 2014 in China's largest academic women's hospital reflected both increased use of LBC and the introduction of pathologist TBS reporting. Abnormality rates increased significantly and fell within CAP benchmark ranges.

Abstract 14721: Impact of Covid-19 on Cardiology Consultation in Tertiary Care Hospital of a Developing Country

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
ghufran adnan ◽  
Osman Faheem ◽  
Maria Khan ◽  
Pirbhat Shams ◽  
Jamshed Ali
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Reduction Rate ◽  
Care Hospital ◽  
Chi Square ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Drastic Increase ◽  
Chi Square Test ◽  
The Difference

Introduction: COVID-19 pandemic has overwhelmed the healthcare system of Pakistan. There has been observation regarding changes in pattern of patient presentation to emergency department (ED) for all diseases particularly cardiovascular. The aim of the study is to investigate these changes in cardiology consultations and compare pre-COVID-19 and COVID-19 era. Hypothesis: There is a significant difference in cardiology consultations during COVID era as compared to non-COVID era. Method: We collected data retrospectively of consecutive patients who visited emergency department (ED) during March-April 2019 (non-COVID era) and March-April 2020 (COVID era). Comparison has been made to quantify the differences in clinical characteristics, locality, admission, type, number, and reason of Cardiology consults generated. Results: We calculated the difference of 1351 patients between COVID and non-COVID era in terms of cardiology consults generated from Emergency department, using Chi-square test. Out of which 880 (59%) are male with mean age of 61(SD=15). Analysis shows pronounced augmentation in number of comorbidities [Hypertension(6%), Chronic kidney disease (6%), Diabetes (5%)] but there was 36% drop in total cardiology consultations and 43% reduction rate in patient’s ED visit from other cities during COVID era. There was 60% decrease in acute coronary syndrome presentation in COVID era, but fortuitously drastic increase (30%) in type II myocardial injury has been noted. Conclusion: There is a remarkable decline observed in patients presenting with cardiac manifestations during COVID era. Lack in timely care could have a pernicious impact on outcomes, global health care organizations should issue directions to adopt telemedicine services in underprivileged areas to provide timely care to cardiac patients.

scholarly journals Retrospective analysis of the most common cause of rejection of donors for blood donation

2021 ◽  
Vol 8 (3) ◽  
pp. 444
Author(s):  
Garima Vijayvergiya ◽  
Parag Fulzele ◽  
Naveen Vairyamoorthy
Keyword(s):  
Blood Pressure ◽  
Blood Donor ◽  
Blood Donation ◽  
Tertiary Care ◽  
Geographical Area ◽  
Rejection Rate ◽  
Developed Countries ◽  
Care Hospital ◽  
Systemic Examination ◽  
Safe Blood

Background: A significant imbalance in access to safe blood is seen between the developing and developed countries. Donor selection has a pivotal role in preventing transfusion related complications and provide safety to the recipients. In this study, we aimed to find out rate and causes of blood donor rejection in our hospital.  Methods: A retrospective study conducted in a tertiary care hospital involving both the voluntary and replacement donors during the period September 2017 to December 2018. We included all those donors who were considered unfit for blood donation. All those who came for blood donation at our hospital were asked to fill up an enrolment form for a blood donor. A general and systemic examination were done. We calculated the rejection rate, listed the reasons for donor rejection, and analyzed the data.Results: Among 150 rejected blood donors, most were males [129 (86%)], and the rest were females [21 (14%)]. The rejection rate in our study was 3.29%. We found that the rejection rate of donors was different among voluntary and replacement donors. It showed that the most common reason for the temporary rejection of blood donation was low hemoglobin level, followed by abnormal blood pressure.  Conclusions: A vast majority of donors were rejected temporarily [132 (88%)], while the rest of them were rejected permanently [18 (12%)]. Low Hb in females and abnormal blood pressure in males were the commonest causes of blood donor rejection. Many factors affect the similarities and variations between the most typical causes of blood donor rejection, such as geographical area, cultural, socio-economic, and educational factors.  

scholarly journals Turn Around Time for Clinical Biochemistry Laboratory: A Vital and Effective Parameter for Patient Care

2021 ◽  
Author(s):  
Mitul Navinchandra Chhatriwala ◽  
Dharmik Savjibhai Patel ◽  
Divyal Patel ◽  
Hitesh N Shah
Keyword(s):  
Clinical Biochemistry ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sample Collection ◽  
Diagnostic Laboratory ◽  
Cross Sectional ◽  
Entire Interval ◽  
Turn Around Time ◽  
Analytical Errors

Introduction: Clinical laboratories are judged by its validity, reliability, genuineness or authenticity and its timeliness in reports generating. Repetitively, patients and physicians complain about the time taken by the laboratory for the investigation. The total Turn Around Time (TAT) for laboratory tests includes the entire interval from the order of the test to the awareness of the result by the clinicians. The evaluation and improvement of TAT is crucial for the management of laboratory quality and the satisfaction of patients. Aim: To observe the TAT of common biochemical investigations, to identify reasons for increased TAT and to formulate a plan to rectify increased TAT. Materials and Methods: A hospital based cross-sectional study was conducted at the Clinical Biochemistry Section of the Central Diagnostic Laboratory of Tertiary Care Hospital. TAT data from April 2014 to September 2015 were included in the study. The laboratory technicians and the resident doctors of biochemistry recorded the reasons for the delay of those specimens exceeding the TAT. Data were analysed with the help of statistical software Epi Info 7. Results: The total number of samples received in the biochemistry laboratory were 1,85,658. Out of this, Out Patient Department (OPD) samples were 1,35,022 and Intensive Care Unit (ICU) samples were 50,636. Pre-analytical errors were observed in 670 of ICU samples, which was 1.32% of total samples received and it was higher than the post-analytical errors. In the pre-analytical phase, the most common cause was inaccurate procedures of sample collection. Conclusion: This study demonstrates that the main culprit of increased TAT was delay in the sample transportation and Haemolysed samples. TAT minimisation is a constant procedure for any facility. Every laboratory needs to develop a decent approach for reducing the TAT.

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