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

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.

Laparoscopy as a diagnostic tool in evaluation of female factors in infertility

Background: Infertility leads to considerable personal suffering and disruption of family life. According to United Nations "Reproductive health is a state of complete physical mental and social well-being and not merely the absence of disease or infirmity in all matters relating to the reproductive system and to its functions and processes". The objective of present study was to find out different causes of female infertility with diagnostic laparoscopy and their comparative frequency in primary and secondary infertility.Methods: It is a prospective study conducted on all infertile women and they underwent diagnostic laparoscopy for primary and secondary infertility during the study period. Couples who had not lived together for at least 12 months, and those with male factor infertility were excluded. Data were collected on a proforma, and analyzed on SPSS package for windows version 10. Frequencies were calculated for laparoscopic findings regarding primary and secondary infertility.Results: Fifty infertile women underwent laparoscopy during the study period, 35 (70%) had primary infertility while 15 (30%) secondary infertility. 10 (28.5%) patients with primary and 3 (20%) patients with secondary infertility had no visible abnormality. The common finding was tubal blockage in 10 (28.5%) and 5 (33.3%) cases of primary and secondary infertility respectively. 9 (25.7%) cases of primary infertility were detected as polycystic ovaries (PCO) and 2 (13.3%) in cases of secondary infertility. Endometriosis was found in 1 case with primary infertility and 2 (13.3%) cases with secondary infertility. Fibroid was found in 3 (8.57%) and 1 (6.6%) cases of primary and secondary infertility respectively.Conclusions: Most common causes responsible for infertility were tubal occlusion and polycystic ovary. Infertile couple should be thoroughly investigated. Laparoscopy in infertility can be used for a definitive diagnosis

A Cross Sectional Study of Feto-Maternal Outcome for Second Stage Cesarean Delivery

Background: Caesarean delivery at full dilation of cervix is associated with increased technical difficulty and feto-maternalcomplications.Objectives: To know the short term maternal and foetal outcome in second stage caesarean deliveries. Material & Methods: Thisis a descriptive, prospective cross-sectional study done at Vani Vilas hospital attached to Bangalore medical college and research institute fromJan 2022 to Dec 2022. Intra operative and immediate post operative complications were collected from case record, mother and new-born were followed during hospital stay till discharge. Data entered in MS excel sheet and analysed using SPSS version 20.0. Descriptive statistics of the explanatory and outcome variables were calculated by mean, standard deviation for quantitative variables, frequency and proportions for qualitative variables. Results: Sample size was 98 women in one year. Mean Age of the sample population is 25.71±3.26 years, 67.3% are primi gravid women. Common methods of extraction included Vertex and Patwardhan method. Extension of hysterotomy incision seen in 20.4%. PPH seen in 16% of women. About 16% of new-borns required NICU admission. One still birth and two neonatal deaths were noted. Conclusions: Second stage caesarean delivery carries increased morbidity both to mother and child. Skill and expertise are required to reduce the complications during second stage caesarean sections