Diagnostic approach to Perimenopausal bleeding by Pipelle or Dilatation and Curettage

Hormonal Contraception ◽

High Specificity ◽

Sample Collection ◽

Dilation And Curettage ◽

Specificity And Sensitivity

Perimenopausal bleeding, is a very common problem, which is an alarming symptom for both; women and their doctors because of the rising fears of cellular changes or tumor of endometrium. In our study we tried to prove that collecting endometrial samples using the outpatient method of Pipelle is as effective as collecting the endometrial samples in the traditional method of Dilation and Curettage (DandC) in operation theatre which necessitates general anesthesia. Ninety four patients more than 40 years old were included in the study, all of them were complaining of abnormal uterine bleeding (pregnant ladies and ladies using hormonal contraception were excluded from the study) and endometrial samples were collected first in outpatient clinic using the Pipelle and labelled as A samples and secondly in the theatre under general anesthesia by dilatation and curettage and labelled as B samples, all samples were sent for histopathology without informing the pathologist about the method of sample collection and patients past medical history. Then, the reports of histopathological examination were compared between Pipelle and DandC samples (group A and group B). From the results we can conclude that samples of endometrium using Pipelle could replace the traditional method of DandC, with high specificity and sensitivity in detecting endometrial carcinoma and endometrial hyperplasia.

Study of endometrial histopathology in women with abnormal uterine bleeding

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170442 ◽

2017 ◽

Vol 6 (3) ◽

pp. 824

Author(s):

Ushadevi Gopalan ◽

Sathiyakala Rajendiran ◽

Karnaboopathy Ranganathan

Keyword(s):

Tertiary Care ◽

Endometrial Biopsy ◽

Uterine Bleeding ◽

Age Group ◽

Proliferative Endometrium ◽

A Prospective Study ◽

Secretory Endometrium

Background: Abnormal uterine bleeding is a major gynaecological problem accounting for 33% of Gynaec outpatients. The cause of the bleeding is established in only 50-60% of the cases. The aim of this study was to evaluate the various histopathological patterns in the endometrial biopsy of patients presenting with abnormal uterine bleeding and to determine the specific pathology in the different age groups.Methods: This was a prospective study done in a tertiary care teaching hospital for a period of 2 years. Total of 905 patients with abnormal uterine bleeding were included in the study and they were subjected to a Dilatation and Curettage. Histopathological examination of the endometrial biopsy was done and the various histopathological patterns identified and classified.Results: The age of patients ranged from 24-74 years. 54.7% were in the age group 40-49 years followed by 23.4% in the age group 30-39 years. The most frequent findings were proliferative findings in 47.3% followed by secretory endometrium in 16.1 % patients. Proliferative endometrium was more common in the age group 40-49 years as also disordered proliferation, secretory endometrium, cystoglandular hyperplasia and endometrial hyperplasia.Conclusions: Endometrial curettings and biopsy is an important diagnostic procedure for assessing all cases of abnormal uterine bleeding and to plan for successful management.

DIAGNOSTIC HYSTEROSCOPY IN ABNORMAL UTERINE BLEEDING & IT'S HISTOPATHOLOGIC CORRELATION: OUR EXPERIENCE

Journal of Health and Allied Sciences NU ◽

10.1055/s-0040-1703646 ◽

2013 ◽

Vol 03 (02) ◽

pp. 013-017

Author(s):

Neetha Nandan ◽

Lakshmi Manjeera ◽

Supriya Rai ◽

Mangala Gowri

Keyword(s):

Endometrial Hyperplasia ◽

Uterine Bleeding ◽

Histopathological Diagnosis ◽

Normal Endometrium ◽

The Past ◽

Medical Academy ◽

Diagnostic Hysteroscopy

Abstract Aims & objectives: 1) To study the accuracy of hysteroscopy in evaluation of abnormal uterine bleeding in perimenopausal and postmenopausal women. 2) To correlate hysteroscopic findings with histopathologic results. Materials and methods: It is a retrospective study done in the department of OBG at K. S.Hegde Medical Academy, Mangalore. All patients who underwent diagnostic hysteroscopy for abnormal uterine bleeding in the past 6 years were included in this study. Patients underwent clinical and sonographical evaluation. Following hysteroscopic evaluation, patients had undergone dilatation and curettage and endometrial curetting were sent for histopathological examination (HPE). The correlation between findings on hysteroscopy & HPE were tabulated. Results: On hysteroscopy, endometrium was classified as suggestive of normal, hyperplasia, atrophic, polyp, fibroid, cancer. Histopathological diagnosis was taken as gold standard to determine the efficacy of hysteroscopy in diagnosing endometrial pathologies. Out of 175 patients, 108 patients were diagnosed to have endometrial hyperplasia on hysteroscopy, however only 53 confirmed to have on histopathologically. Similarly 25 patients were said to have normal findings on hysteroscopy but by histopathology 85 were having normal endometrium. Hysteroscopy was highly specific for diagnosis of polyp (95.9%), cancer (100.0%), and atrophy (96. 9%), normal endometrium (92.2%) but low specificity for diagnosing hyperplasia (48.4%). The sensitivity of hysteroscopy in diagnosing polyp and endometrial hyperplasia were 100% and 84.9% respectively but it was low in case of cancer (16.7%) and normal endometrium (21.2%). Conclusion: Hysteroscopy is a highly accurate diagnostic tool in diagnosing intrauterine lesions like endometrial polyp and submucous fibroid. In fact, it was also found to be highly specific in conditions like endometrial cancer, polyp, atrophic and normal endometrium.

A prospective study of comparison between transvaginal sonogram and histopathological examination in perimenopausal women with abnormal uterine bleeding

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20194609 ◽

2019 ◽

Vol 8 (11) ◽

pp. 4233

Author(s):

P. Rishma Priyanka ◽

C. Rama Mani ◽

A. Yamuna

Keyword(s):

Endometrial Thickness ◽

Uterine Cavity ◽

Uterine Bleeding ◽

Transvaginal Sonography ◽

Main Concern ◽

Perimenopausal Women ◽

Histopathological Report

Background: Abnormal uterine bleeding is one of the most frequently encountered conditions in gynaecology practice and forms about 10% of all gynaecological admissions, the main concern in perimenopausal bleeding is that the bleeding could be the only external manifestation of many hidden serious pathologies of uterine-cavity. The objective of this study was to compare the results of transvaginal sonography (TVS) and drug and cosmetic (D and C) with histopathological examination (HPE) report of hysterectomy specimen in perimenopausal women with AUB.Methods: A prospective comparative study where 100 perimenopausal women with AUB were subjected to TVS then D and C and then the results were compared with histopathological report of the hysterectomized specimen.Results: With an endometrial thickness less than or equal to 15 mm the histopathology report is normal endometrium. When the endometrial thickness more than or equal to 15 mm the histopathology report is hyperplasia or carcinoma. Findings of TVS correlated well with histopathological report after hysterectomy. 14 cases of adenomyosis, 16 cases of myomatous polyp, and 6 cases of endometrial polyp missed by dilatation and curettage.Conclusions: TVS is a simple, non-invasive test to indirectly visualize the endometrial cavity and is useful as a first step diagnostic procedure in the evaluation of perimenopausal bleeding. Dilatation and curettage lags in detecting adenomyosis, endometrial and myomatous polyps, When TVS combined with dilatation and curettage, it can supplement the shortcomings of dilatation and curettage.

Role of pipelle versus dilatation and curettage in tissue diagnosis abnormal uterine bleeding

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20203497 ◽

2020 ◽

Vol 8 (9) ◽

pp. 3223

Author(s):

Markad Swapnil Balaram ◽

Roopa R. Shinde ◽

C. Suresh Babu ◽

Hamid Mubashar Mohamed Mubasher ◽

Ranoji Vijaysing Shinde

Keyword(s):

Tissue Sample ◽

Endometrial Thickness ◽

Diagnostic Value ◽

Uterine Bleeding ◽

Medical College ◽

Post Menopausal

Background: Menstrual irregularities and abnormal heavy menstruation account for up to 26-35% of women attending Gynecological outpatient Department. Abnormal Uterine Bleeding (AUB), it is more common at extremes of age endometrial hyperplasia occurs in 5-10% of patients with post-menopausal bleeding out of which atypical hyperplasia has 26-32 % risk of having malignancy in future. Therefore, endometrial sampling for histopathology is important in the assessment of abnormal uterine bleeding is mandatory. Our study was conductive to know the effectiveness of pipelle type devices, versus Dilatation and curettage in obtaining quality endometrial tissue for histopathological examination.Methods: The study was undertaken in Department of obstetrics and gynaecology along with department of Pathology at Rajarshi Chhatrapati Shahu Maharaj, government medical college, Kolhapur after getting approval from the Hospital Committee on Clinical Research and Ethical Committee of the institution, during the period from October 2016 to March 2017 (six months). Total number of subjects included in study is Hundred after taking into consideration of inclusion and exclusion criteria.Results: The ease of doing procedure was much easier as compared to D&C and the Tissue sample obtained for histopathological examination were as par D&C. It was concluded that histopathology report was available in 92 of the 100 pipelle samples and 93 of 100 D&C samples. It was also, observed that increased endometrial thickness was not always associated with adequate tissue diagnosis.Conclusions: Pipelle is simple, affordable, patient friendly can be easily performed with minimal training, which can be performed in Outpatient Gynaecological Department. The diagnostic value and positive predictive value of Pipelle is at par with conventional D&C. So, pipelle can be recommended for all perimenopausal patients with AUB to rule out various, premalignant and malignant conditions of the endometrium.

Antibody Mediated Immunity to SARS-CoV-2 and Human Coronaviruses: Multiplex Beads Assay and Volumetric Absorptive Microsampling to Generate Immune Repertoire Cartography

Frontiers in Immunology ◽

10.3389/fimmu.2021.696370 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jiong Wang ◽

Dongmei Li ◽

Qian Zhou ◽

Alexander Wiltse ◽

Martin S. Zand

Keyword(s):

Critical Role ◽

High Specificity ◽

Scaling Analysis ◽

Sample Collection ◽

Highly Pathogenic ◽

Blood Samples ◽

Volumetric Absorptive Microsampling

Coefficients Of Variation ◽

Human Coronaviruses ◽

The COVID-19 pandemic is caused by SARS-CoV-2, a novel zoonotic coronavirus. Emerging evidence indicates that preexisting humoral immunity against other seasonal human coronaviruses (HCoVs) plays a critical role in the specific antibody response to SARS-CoV-2. However, current work to assess the effects of preexisting and cross-reactive anti-HCoVs antibodies has been limited. To address this issue, we have adapted our previously reported multiplex assay to simultaneously and quantitatively measure anti-HCoV antibodies. The full mPlex-CoV panel covers the spike (S) and nucleocapsid (N) proteins of three highly pathogenic HCoVs (SARS-CoV-1, SARS-CoV-2, MERS) and four human seasonal strains (OC43, HKU1, NL63, 229E). Combining this assay with volumetric absorptive microsampling (VAMS), we measured the anti-HCoV IgG, IgA, and IgM antibodies in fingerstick blood samples. The results demonstrate that the mPlex-CoV assay has high specificity and sensitivity. It can detect strain-specific anti-HCoV antibodies down to 0.1 ng/ml with 4 log assay range and with low intra- and inter-assay coefficients of variation (%CV). We also estimate multiple strain HCoVs IgG, IgA and IgM concentration in VAMS samples in three categories of subjects: pre-COVID-19 (n=21), post-COVID-19 convalescents (n=19), and COVID-19 vaccine recipients (n=14). Using metric multidimensional scaling (MDS) analysis, HCoVs IgG concentrations in fingerstick blood samples were well separated between the pre-COVID-19, post-COVID-19 convalescents, and COVID-19 vaccine recipients. In addition, we demonstrate how multi-dimensional scaling analysis can be used to visualize IgG mediated antibody immunity against multiple human coronaviruses. We conclude that the combination of VAMS and the mPlex-Cov assay is well suited to performing remote study sample collection under pandemic conditions to monitor HCoVs antibody responses in population studies.

Prospective Application of Aptamer-based Assays and Therapeutics in Bloodstream Infections

Mini-Reviews in Medicinal Chemistry ◽

10.2174/1389557520666200212105813 ◽

2020 ◽

Vol 20 (10) ◽

pp. 831-840

Author(s):

Weibin Li

Keyword(s):

Pathogenic Bacteria ◽

Genetic Diagnosis ◽

Bloodstream Infections ◽

High Specificity ◽

Peptide Sequence ◽

High Morbidity ◽

Prospective Application ◽

Small Molecule Therapeutics

Sepsis is still a severe health problem worldwide with high morbidity and mortality. Blood bacterial culture remains the gold standard for the detection of pathogenic bacteria in bloodstream infections, but it is time-consuming, and both the sophisticated equipment and well-trained personnel are required. Immunoassays and genetic diagnosis are expensive and limited to specificity and sensitivity. Aptamers are single-stranded deoxyribonucleic acid (ssDNA) and ribonucleic acid (RNA) oligonucleotide or peptide sequence generated in vitro based on the binding affinity of aptamer-target by a process known as Systematic Evolution of Ligands by Exponential Enrichment (SELEX). By taking several advantages over monoclonal antibodies and other conventional small-molecule therapeutics, such as high specificity and affinity, negligible batch-to-batch variation, flexible modification and production, thermal stability, low immunogenicity and lack of toxicity, aptamers are presently becoming promising novel diagnostic and therapeutic agents. This review describes the prospective application of aptamerbased laboratory diagnostic assays and therapeutics for pathogenic bacteria and toxins in bloodstream infections.

SARS-CoV-2 specific antibody and neutralization assays reveal the wide range of the humoral immune response to virus

Communications Biology ◽

10.1038/s42003-021-01649-6 ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Mikail Dogan ◽

Lina Kozhaya ◽

Lindsey Placek ◽

Courtney Gunter ◽

Mesut Yigit ◽

...

Keyword(s):

Specific Antibody ◽

Neutralizing Antibodies ◽

Vaccine Development ◽

High Specificity ◽

Spike Protein ◽

Humoral Immune ◽

Wide Range ◽

Specific Igg ◽

Negative Controls

AbstractDevelopment of antibody protection during SARS-CoV-2 infection is a pressing question for public health and for vaccine development. We developed highly sensitive SARS-CoV-2-specific antibody and neutralization assays. SARS-CoV-2 Spike protein or Nucleocapsid protein specific IgG antibodies at titers more than 1:100,000 were detectable in all PCR+ subjects (n = 115) and were absent in the negative controls. Other isotype antibodies (IgA, IgG1-4) were also detected. SARS-CoV-2 neutralization was determined in COVID-19 and convalescent plasma at up to 10,000-fold dilution, using Spike protein pseudotyped lentiviruses, which were also blocked by neutralizing antibodies (NAbs). Hospitalized patients had up to 3000-fold higher antibody and neutralization titers compared to outpatients or convalescent plasma donors. Interestingly, some COVID-19 patients also possessed NAbs against SARS-CoV Spike protein pseudovirus. Together these results demonstrate the high specificity and sensitivity of our assays, which may impact understanding the quality or duration of the antibody response during COVID-19 and in determining the effectiveness of potential vaccines.

Highly Sensitive Fluorescent Detection of Acetylcholine Based on the Enhanced Peroxidase-Like Activity of Histidine Coated Magnetic Nanoparticles

Nanomaterials ◽

10.3390/nano11051207 ◽

2021 ◽

Vol 11 (5) ◽

pp. 1207

Author(s):

Hong Jae Cheon ◽

Quynh Huong Nguyen ◽

Moon Il Kim

Keyword(s):

Magnetic Nanoparticles ◽

High Sensitivity ◽

High Specificity ◽

Choline Oxidase ◽

Fluorescent Detection ◽

One Pot ◽

Site Structure ◽

Highly Sensitive ◽

Peroxidase Mimics

Inspired by the active site structure of natural horseradish peroxidase having iron as a pivotal element with coordinated histidine residues, we have developed histidine coated magnetic nanoparticles (His@MNPs) with relatively uniform and small sizes (less than 10 nm) through one-pot heat treatment. In comparison to pristine MNPs and other amino acid coated MNPs, His@MNPs exhibited a considerably enhanced peroxidase-imitating activity, approaching 10-fold higher in catalytic reactions. With the high activity, His@MNPs then were exploited to detect the important neurotransmitter acetylcholine. By coupling choline oxidase and acetylcholine esterase with His@MNPs as peroxidase mimics, target choline and acetylcholine were successfully detected via fluorescent mode with high specificity and sensitivity with the limits of detection down to 200 and 100 nM, respectively. The diagnostic capability of the method is demonstrated by analyzing acetylcholine in human blood serum. This study thus demonstrates the potential of utilizing His@MNPs as peroxidase-mimicking nanozymes for detecting important biological and clinical targets with high sensitivity and reliability.

Histopathological Analysis of Endometrial Biopsy in Gandaki Medical College Teaching Hospital, Pokhara, Nepal

Journal of Gandaki Medical College-Nepal ◽

10.3126/jgmcn.v12i1.22608 ◽

2019 ◽

Vol 12 (1) ◽

pp. 25-30

Author(s):

B Parajuli ◽

G Pun ◽

S Ranabhat ◽

S Poudel

Keyword(s):

Hydatidiform Mole ◽

College Teaching ◽

Histopathological Diagnosis ◽

Age Group ◽

Medical College ◽

Partial Mole ◽

Proliferative Endometrium ◽

The Common

Objective: To study the spectrum of histopathological diagnosis of endometrial lesions and their distribution according to age. Methods: All the endometrium samples obtained by the procedure of dilatation and curettage and hysterectomy sent for histopathological examination at Pathology Department of Gandaki Medical College Teaching Hospital, Pokhara, Nepal. The study duration was total 12 months ranging from July 2016 to June 2017. All the endometrial samples were processed, sectioned at 4 - 6 μm and stained with routine H & E stain. Patient’s data including age, sex, procedure of the biopsy taken and histopathological diagnosis were noted. A pathologist, using Olympus microscope, reported the slides. Cases were reviewed by a second pathologist whenever necessary. Results: A total of 128 cases were studied. The most common histopathological diagnosis was proliferative endometrium (28.9%) followed by disorder proliferative endometrium (15.65%). Most of the patients were in age group 36 - 45 years comprising 32.03%. Hydatidiform mole comprised of 7.03% and among Hydatidiform mole, partial mole was more common. Dilatation and curettage (82.8%) was the common procedure in compare to hysterectomy for the evaluation of endometrial lesions. Conclusions: In this study, we observed a variety of endometrial lesions. Most of them are benign; among benign, proliferative endometrium was the common histopathological diagnosis followed by disorder proliferative endometrium. Most common presenting age group was found to be at 36 - 45 years. In evaluation of hydatidiform mole, partial mole was more frequent in compare to complete mole. Conventional dilatation and curettage is the preferred method in developing countries with limited resource to screen endometrial lesion and therefore biopsy should be sent for histopathological examination. Thus histopathological examination of routinely stained hematoxylin and eosin is readily available and widely accepted standard technique for evaluation of the endometrial lesions.

Serum MicroRNA Signature as a Diagnostic and Therapeutic Marker in Patients with Psoriatic Arthritis

The Journal of Rheumatology ◽

10.3899/jrheum.190602 ◽

2020 ◽

Vol 47 (12) ◽

pp. 1760-1767

Author(s):

Sarah M. Wade ◽

Trudy McGarry ◽

Siobhan C. Wade ◽

Ursula Fearon ◽

Douglas J. Veale

Keyword(s):

Psoriatic Arthritis ◽

Characteristic Curve ◽

High Specificity ◽

Serum Samples ◽

Rna Molecules ◽

Serum Mirna ◽

Serum Microrna ◽

European League Against Rheumatism ◽

Noninvasive Markers

ObjectiveMicroRNA (miRNA) are small endogenous regulatory RNA molecules that have emerged as potential therapeutic targets and biomarkers in autoimmunity. Here, we investigated serum miRNA levels in patients with psoriatic arthritis (PsA) and further assessed a serum miRNA signature in therapeutic responder versus nonresponder PsA patients.MethodsSerum samples were collected from healthy controls (HC; n = 20) and PsA patients (n = 31), and clinical demographics were obtained. To examine circulatory miRNA in serum from HC and PsA patients, a focused immunology miRNA panel was analyzed utilizing a miRNA Fireplex assay (FirePlex Bioworks Inc.). MiRNA expression was further assessed in responders versus nonresponders according to the European League Against Rheumatism response criteria.ResultsSix miRNA (miR-221-3p, miR-130a-3p, miR-146a-5p, miR-151-5p, miR-26a-5p, and miR-21-5p) were significantly higher in PsA compared to HC (all P < 0.05), with high specificity and sensitivity determined by receiver-operating characteristic curve analysis. Analysis of responder versus nonresponders demonstrated higher baseline levels of miR-221-3p, miR-130a-3p, miR-146a-5p, miR-151-5p, and miR-26a-5p were associated with therapeutic response.ConclusionThis study identified a 6-serum microRNA signature that could be attractive candidates as noninvasive markers for PsA and may help to elucidate the disease pathogenesis.