scholarly journals AYURVEDIC MANAGEMENT OF CHRONIC PID ASSOCIATED WITH CERVICAL INTRAEPITHELIAL NEOPLASIA - A CASE REPORT

2021 ◽  
Vol 09 (3) ◽  
pp. 668-673
Author(s):  
Prajitha. P. K ◽  
Gouri Shanker Prasad. T
Keyword(s):  
Cervical Intraepithelial Neoplasia ◽  
Lower Abdominal Pain ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Low Grade ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Back Ache ◽  
Intraepithelial Lesion ◽  
Regional Cancer Centre

Pelvic inflammatory disease (PID) is the inflammatory condition of uterus, and associated structures, which are often sexually transmitted. Human Papilloma Virus (HPV) infection is the most prevalent sexually transmitted infection as well as the most important risk factor for Cervical Intraepithelial Neoplasia (CIN) and Invasive Cervical Carcinoma (ICC). CIN are dysplastic changes taking a long period to progress into true cancer. Currently treatment is not recommended for CIN 1&2 lesions as they are said to regress in some cases. According to Ayurvedic principles, Garbashaya Mukha Sopha, can be managed with Vranaropana-Ojovardhaka drugs. The symptomatic management with anti-inflammatory and immune-modulatory drugs along with Sthanika chikitsa, together gave promising results even in cytological level. A 43-year-old lady presented with thick yellowish discharge per vagina along with lower abdominal pain & low back ache. On examination, hypertrophied and eroded cervix was noticed along with positive cervical motion tenderness. She was sent to Regional Cancer centre, Trivandrum for cytological evaluation, which revealed LSIL (Low grade Squamous Intraepithelial lesion) with Koilocytic atypia. She was managed with oral medication and Sthanika chikitsa and got relieved from symptoms which was consistent even after the follow up period. The cytology revealed negative for intraepithelial lesion or malignancy. Ayurvedic modalities proved to be effective in management of Chronic PID with CIN.

scholarly journals AYURVEDIC MANAGEMENT OF ATROPHIC VAGINITIS WITH CERVICAL INTRAEPITHELIAL NEOPLASIA- A CASE REPORT

2020 ◽  
pp. 69-72
Author(s):  
Giby Thomas ◽  
Lakshmi Devi.R
Keyword(s):  
Case Report ◽  
Cervical Intraepithelial Neoplasia ◽  
Vaginal Discharge ◽  
Symptomatic Relief ◽  
Intraepithelial Neoplasia ◽  
Burning Sensation ◽  
Low Grade ◽  
Atrophic Vaginitis ◽  
Genital Area ◽  
Intraepithelial Lesion

Vaginitis in postmenopausal women is termed as atrophic vaginitis, characterised by vaginal bleeding or spotting, vaginal discharge and discomfort or dryness in vulva. As the symptoms are not usually disclosed by women it may become chronic and can adversely affect the quality of life. In cervical intraepithelial neoplasia the squamous epithelium of cervix is replaced by the cells of varying degree of atypia. Even though CIN1 and CIN2 regress spontaneously, untreated CIN1 and CIN2 lesions may progress to invasive carcinoma. Ayurvedic management for the above conditions focuses on symptomatic relief and improvement of general health and immunity. Oral medication and Sthanika Chikitsa like Kshara Karma and Varthi play vital role in this. A 70 year old lady presented with complaints of burning sensation and itching over genital area. On examination haemorrhagic spots were observed on vaginal walls. She was sent to Early Cancer Detection Centre for cytological screening. The reports showed low grade sqamous intraepithelial lesion. She was managed with oral medications and Sthanika chikitsa. During follow up she was relieved from the symptoms like burning sensation and itching over genital area and vaginal discharge. Bleeding spots on vaginal walls were absent and cytology revealed a negative smear for intraepithelial lesion or malignancy. From this case report it is evidenced that Ayurvedic treatment modality is effective and successful for the management of Atrophic vaginitis with CIN.

scholarly journals Photodynamic Therapy for Low-grade Cervical Intraepithelial Neoplasia (CIN1): A Case Report

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Yinyin Zhang ◽  
Hong Lin ◽  
Huizhen Fan
Keyword(s):  
Photodynamic Therapy ◽  
Cervical Intraepithelial Neoplasia ◽  
Persistent Infection ◽  
Precancerous Lesions ◽  
Irradiation Time ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Cervical Canal ◽  
Low Grade ◽  
Oxygen Inhalation

As a drug-mechanical combination technology, photodynamic (PDT) can achieve accurate and targeted therapy for malignant tumors and benign diseases through the production of reactive oxygen species, oxygen free radicals or singlet oxygen by photosensitizers at specific wavelengths. Compared with traditional surgery, it has the advantages of selective killing, repeatable treatment, preserving target organ function and so on. The purpose of this study was to explore the clinical value of photodynamic therapy in cervical precancerous lesions by taking the patients with low-grade cervical intraepithelial neoplasia (CIN1) with high-risk human papillomavirus (HR-HPV) persistent infection diagnosed by "three-step diagnosis and treatment procedure" as an example. Using HiPorfin as a photosensitizer, photodynamic therapy was performed 48 hours after intravenous drip. Set laser wavelength 630nm, light dose density 137.58J/cm2, transmission efficiency 1.42, output power 2w. 3cm columnar optical fiber was placed around the 2cm in the cervical canal to cover all the lesions, and the irradiation time was 900s (600s in the cervical canal and 300s outside the cervical canal). The patients were given oxygen inhalation for 6 hours after operation, and the patients were observed for itching and other discomfort, and paid attention to avoid light. Photodynamic therapy was performed again in the same way on the second day. After two months of treatment, pathological biopsy showed chronic cervicitis, indicating that the disease had been effectively controlled. Theoretically, although the patient is not the absolute indication of photodynamic therapy (that is, meeting CIN ? or CIN ?, having fertility requirements and not undergoing surgery), this therapy can remove not only the superficial lesions inside and outside the cervix, but also the potential lesions not found under colposcopy. It can also block the persistent infection of HPV by inhibiting the expression of HPV18, E6 and E7mRNA in Hela cells. In combination with Baofukang suppository, it can block HPV infection. Increase the negative conversion rate of cervical HPV and reduce the probability of recurrence after CIN1 cure. For young female patients with persistent HR-HPV infection and fertility requirements, photodynamic therapy is an effective choice for clinical treatment of CIN1.

scholarly journals Association of Human Papillomavirus 31 DNA Load with Risk of Cervical Intraepithelial Neoplasia Grades 2 and 3

2015 ◽  
Vol 53 (11) ◽  
pp. 3451-3457 ◽  
Author(s):  
Xia Liu ◽  
Mark Schiffman ◽  
Ayaka Hulbert ◽  
Zhonghu He ◽  
Zhenping Shen ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Cervical Intraepithelial Neoplasia ◽  
Intraepithelial Neoplasia ◽  
Low Grade ◽  
Random Set ◽  
Squamous Cells ◽  
Viral Loads ◽  
Unit Increase ◽  
Intraepithelial Lesion ◽  
The Difference

The association between human papillomavirus 31 (HPV31) DNA loads and the risk of cervical intraepithelial neoplasia grades 2 and 3 (CIN2–3) was evaluated among women enrolled in the atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL) triage study (ALTS), who were monitored semiannually over 2 years and who had HPV31 infections detected at ≥1 visit. HPV31 DNA loads in the first HPV31-positive samples and in a random set of the last positive samples from women with ≥2 HPV31-positive visits were measured by a real-time PCR assay. CIN2–3 was histologically confirmed at the same time as the first detection of HPV31 for 88 (16.6%) of 530 women. After adjustment for HPV31 lineages, coinfection with other oncogenic types, and the timing of the first positive detection, the odds ratio (OR) per 1-log-unit increase in viral loads for the risk of a concurrent diagnosis of CIN2–3 was 1.5 (95% confidence interval [CI], 1.2 to 1.9). Of 373 women without CIN2–3 at the first positive visit who had ≥1 later visit, 44 had subsequent diagnoses of CIN2–3. The initial viral loads were associated with CIN2–3 diagnosed within 6 months after the first positive visit (adjusted OR, 1.5 [95% CI, 1.0 to 2.4]) but were unrelated to CIN2–3 diagnosed later. For a random set of 49 women who were tested for viral loads at the first and last positive visits, changes in viral loads were upward and downward among women with and without follow-up CIN2–3 diagnoses, respectively, although the difference was not statistically significant. Results suggest that HPV31 DNA load levels at the first positive visit signal a short-term but not long-term risk of CIN2–3.

Adjunctive Human Papillomavirus Testing in the 2-Year Follow-up of Women With Low-Grade Cervical Cytologic Abnormalities: A Randomized Trial and Economic Evaluation

2003 ◽  
Vol 127 (9) ◽  
pp. 1169-1175 ◽  
Author(s):  
Alice Lytwyn ◽  
John W. Sellors ◽  
James B. Mahony ◽  
Dean Daya ◽  
William Chapman ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Cervical Intraepithelial Neoplasia ◽  
Pap Test ◽  
Intraepithelial Neoplasia ◽  
Low Grade ◽  
High Grade ◽  
Hpv Testing ◽  
Squamous Intraepithelial Lesion ◽  
Intraepithelial Lesion

Abstract Context.—Although human papillomavirus (HPV) testing may aid in managing low-grade abnormality on screening cervical cytology, patient compliance with repeat testing programs requires consideration. Objectives.—To determine effectiveness and costs of repeated Papanicolaou (Pap) test and oncogenic HPV testing for detecting cervical intraepithelial neoplasia 2 or 3. Design.—We conducted a randomized controlled trial of combined Pap test and cervical HPV testing by Hybrid Capture 1 test compared with Pap test alone; tests were performed every 6 months for up to 2 years. The study end point was colposcopic examination performed on all women at 2 years, or earlier if an HPV test was positive or if a Pap test showed high-grade squamous intraepithelial lesion. Setting.—Sixty-six community family practices. Participants.—Two hundred fifty-seven women with atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion on screening cervical cytology. Main Outcome Measures.—Detection of histologically confirmed cervical intraepithelial neoplasia 2 or 3, fully allocated costs, and loss to follow-up. Results.—Combined Pap test and HPV testing detected 11 (100%) of 11 cases of cervical intraepithelial neoplasia 2/3, whereas Pap test alone detected 7 (63.6%) of these 11 cases (P = .14); corresponding specificities were 39 (46.4%) of 84 and 45 (71.4%) of 63 (P = .005). The cost-effectiveness ratio was Can $4456 per additional case of high-grade cervical intraepithelial neoplasia. Sixty-nine (26.8%) of the 257 women (24.6% combined group vs 29.1% Pap test only group, P = .41) defaulted from testing or from colposcopy when referred with an abnormal result. Conclusions.—Combined testing was more costly but may detect more cases of cervical intraepithelial neoplasia 2/3 than Pap test alone. However, poor adherence limits usefulness of a management strategy that requires repeated follow-up.

scholarly journals The Epidemiology of Human Papillomavirus Infection and Cervical Cancer

2007 ◽  
Vol 23 (4) ◽  
pp. 213-227 ◽  
Author(s):  
F. Xavier Bosch ◽  
Silvia de Sanjosé
Keyword(s):  
Cervical Cancer ◽  
Invasive Cervical Cancer ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Human Papillomaviruses ◽  
Transmitted Infection ◽  
Hpv Dna ◽  
Sexually Transmitted ◽  
Papillomavirus Infection ◽  
Simplex Virus

Cervical cancer has been recognized as a rare outcome of a common Sexually Transmitted Infection (STI). The etiologic association is restricted to a limited number of viral types of the family of the Human Papillomaviruses (HPVs). The association is causal in nature and under optimal testing systems, HPV DNA can be identified in all specimens of invasive cervical cancer. As a consequence, it has been claimed that HPV infection is a necessary cause of cervical cancer. The evidence is consistent worldwide and implies both the Squamous Cell Carcinomas (SCC), the adenocarcinomas and the vast majority (i.e. > 95%) of the immediate precursors, namely High Grade Squamous Intraepithelial Lesions (HSIL)/Cervical Intraepithelial Neoplasia 3 (CIN3)/Carcinomain situ. Co-factors that modify the risk among HPV DNA positive women include the use of oral contraceptives (OC) for five or more years, smoking, high parity (five or more full term pregnancies) and previous exposure to other sexually transmitted diseases such as Chlamydia Trachomatis (CT) and Herpes Simplex Virus type 2 (HSV-2). Women exposed to the Human Immunodeficiency Virus (HIV) are at high risk for HPV infection, HPV DNA persistency and progression of HPV lesions to cervical cancer.

scholarly journals Triage by PAX1 and ZNF582 methylation in women with cervical intraepithelial neoplasia grade 3: a multicenter case-control study

2022 ◽  
Author(s):  
Kun Fu ◽  
Ming Lei ◽  
Li-Sha Wu ◽  
Jing-Cheng Shi ◽  
Si-Yu Yang ◽  
...  
Keyword(s):  
Cervical Intraepithelial Neoplasia ◽  
Predictive Accuracy ◽  
Screening Method ◽  
Intraepithelial Neoplasia ◽  
Fold Increase ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Intraepithelial Neoplasia Grade ◽  
Intraepithelial Lesion ◽  
Grade 3

Abstract Background The colposcopy-conization inconsistency is common in women with cervical intraepithelial neoplasia grade 3 (CIN3). No adequate method has been reported to identify the final pathology of conization. In this study, we explored the ability of PAX1 and ZNF582 methylation to predict the pathological outcome of conization in advance. Methods This was a multicenter study and included 277 histologically confirmed CIN3 women who underwent cold knife conization (CKC) from January 2019 to December 2020. The methylation levels of PAX1 (PAX1m) and ZNF582 (ZNF582 m) were determined by quantitative methylation specific PCR (qMSP) and expressed in ΔCp. Receiver-operating characteristic (ROC) curves were used to evaluate predictive accuracy. Results The final pathological results in 48 (17.33%) patients were inflammation or low-grade squamous intraepithelial lesion (LSIL), 190 (68.59%) were high grade squamous intraepithelial lesion (HSIL) and 39 (14.08%) were squamous cervical cancer (SCC). PAX1 m and ZNF582 m increased as lesions progressed from inflammation/LSIL, HSIL to SCC. PAX1 and ZNF582 methylation yielded better prediction performance compared to common screening strategies, whether individually or combined. ΔCpZNF582 ≥19.18). A 6.53-fold increase in SCC risk was observed in patients with elevated ZNF582 methylation (ΔCpZNF582 < 7.09). Conclusion DNA Methylation would be an alternative screening method to triage and predict the final outcome of conization of the CIN3 cases.

scholarly journals Integrative and episomal forms of genotype 16 of human papillomavirus in patients with cervical intraepithelial neoplasia and cervical cancer

2016 ◽  
Vol 61 (6) ◽  
pp. 270-274 ◽  
Author(s):  
M. K. Ibragimova ◽  
M. M. Tsyganov ◽  
I. V. Karabut ◽  
O. N. Churuksaeva ◽  
O. N. Shpileva ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Viral Load ◽  
Cervical Intraepithelial Neoplasia ◽  
Intraepithelial Neoplasia ◽  
High Viral Load ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Comprehensive Survey ◽  
Intraepithelial Lesion

The study involved 500 patients with LSIL (low grade squamous intraepithelial lesion), HSIL (high grade squamous intraepithelial lesion), stage I-IV cervical cancer, infected with human papillomavirus (HPV), as well as 235 women without pathological changes in cervical mucosa. The comprehensive survey included colposcopy, cytological and histological analysis, detection and genotyping of high-risk human papillomavirus. Viral load and physical status of HPV16 DNA was evaluated in cases of mono-infection (n = 148). The prevalence of virus-positive cases among the patients with LSIL/NSIL, cervical cancer patients and healthy women was 69.2%, 76.7% and 51.9%, respectively. An association between the severity of disease and high viral load was revealed. The frequency of integrated DNA was strongly increased in patients with a high viral load. The frequency of episomal forms was either reduced or not detecteable in patients with high viral load as compared to patients with low viral load. It is reasonable to suggest that a high HPV16 viral load may cause an increase in the frequency of integration of virus DNA into the cellular/host genome. This suggests that a high HPV16 viral load may be considered as a risk factor for prognosis of cervical intraepithelial neoplasia and cervical cancer.

The main differences between vulvar intraepithelial neoplasia and vulvar intraepithelial lesion

2020 ◽  
Vol 11 (5) ◽  
Author(s):  
Vivian de Oliveira Rodrigues Brum ◽  
Denise Gasparetti Drumond ◽  
Neila Maria de Góis Speck ◽  
Gabriel Duque Pannain ◽  
Giovana Moreira Bordim
Keyword(s):  
Vulvar Cancer ◽  
Gynecological Cancer ◽  
Squamous Carcinoma ◽  
Intraepithelial Neoplasia ◽  
Final Diagnosis ◽  
Hpv Infection ◽  
Vulvar Intraepithelial Neoplasia ◽  
Low Grade ◽  
Intraepithelial Lesion ◽  
The Difference

Vulvar cancer is a recurrent subject in gynecological cancer. Vulvar Intraepithelial Neoplasia is known for being a precursor lesion of vulvar cancer and can be divided in three different subtypes: Low-grade Vulvar Intraepithelial Lesion (vulvar LSI), High-grade Vulvar Intraepithelial Lesion (vulvar HSIL) and Differentiated Vulvar Intraepithelial Neoplasia (dVIN). These subtypes differ in several aspects, and this article aims to present those differences in order to facilitate its treatment and the final diagnosis. The HSIL is the most associated with cronic Human Papilloma Virus (HPV) infection and can be related to other environment factors. As for dVIN, it’s more frequent in post-menopausal women with sclerosis lichen and it has a higher rate of progression to vulvar squamous carcinoma. The difference must be made in order to choose what is the best treatment, once there are various modalities, such as simple excision, CO2 ablation and topical application of imiquimod or fluoracil. This differences is also important for the development of measures that seek specific prevention, such as HPV vaccine for the HSIL and the proper treatment of vulvar conditions for the dVIN.

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