Cervical cytology by pap smear in reproductive population

Background: The present hospital-based study was conducted to study the incidence of various cervical epithelial abnormalities such as infection, dysplasia and early cervical cancer changes in reproductive age population and its correlation with age, parity, socioeconomic status, clinical symptoms and cervical biopsy findings.Methods: A prospective study was conducted in 300 women of reproductive age group. The cervical smear was taken from all patients by means of the scrape technique using the Ayre’s spatula. Pap smear results were considered as positive (abnormal) when they are ASCUS, LSIL, HSIL or Invasive lesion. On persistence of unhealthy cervix/inflammatory smear after a course of antibiotic, direct cervical punch biopsy was taken.Results: Inflammatory smears were seen in 88.0%, ASCUS in 5%, LSIL in 1.4%, HSIL in 0.3% and invasive carcinoma in 0.3% patients. Direct cervical punch biopsy was taken from 13 cases out of 264 with inflammatory smear. Most of these patients had cervicitis (12 cases) while 1 case showed CIN stage 2. All cases of ASCUS and LSIL had infection which showed chronic cervicitis on biopsy. HSIL and Invasive carcinoma showed CIN stage 2 and Carcinoma as their biopsy findings.Conclusions: The Pap smear is a simple, safe, practical and cost-effective method for early detection of cervical cancer and its precursors. In developing countries like India, it is the most logical screening modality although it has a very low sensitivity, but detection rates could be further improved using liquid-based cytology and the use of endocervical cytobrush

Effects of delay in adjuvant chemotherapy on survival in patients undergoing curative resection for rectal cancer and the risk factors associated with delay in chemotherapy

OBJECTIVES : This study is aimed at assessing overall and five year survival in patients who receive chemotherapy within and after 8 weeks of curative rectal cancer resection and to assess the factors causing delay in receiving chemotherapy. METHODS : This is a historical bidirectional cohort study in which consecutive patients who underwent curative rectal cancer surgery in the Department of Surgery 2 at Christian Medical College Vellore from 1st January 2007 and requiring adjuvant chemotherapy were included. The data was collected on the pro formas and through telephonic conversations. Data was analyzed for survival using Kaplan Meier Curve and Cox proportionate Hazard model. Risk factors for delay in chemotherapy will be analyzed using Chi square and Independent sample T test and logistic regression. The optimal cut-off for delay in chemotherapy was calculated using a receiver-operator characteristic (ROC) curve. RESULTS : In our analysis, the majority of patients with stage III rectal cancer had initiated adjuvant chemotherapy within 11 weeks of resection. We observed that patients with abdominoperineal resection had perineal wound infection and dehiscence leading to delayed hospital stay. Mostly delay in chemotherapy initiation was due to prolonged hospital stay secondary to post operative complication. Comorbidities, age and pathological staging did not cause delay in treatment. Even when those factors were taken into account, treatment delay was associated with poorer cancer-specific and overall survival. However, the initiation of chemotherapy within 8 weeks after surgery was not associated with better outcomes. There was no significant difference in overall and disease free survival based on timing of adjuvant chemotherapy

Biopsy-Proven Acute Tubular Necrosis due to Vancomycin Toxicity

Vancomycin (VAN) has been associated with acute kidney injury (AKI) since it has been put into clinical use in the 1950's. Early reports of AKI were likely linked to the impurities of the VAN preparation. With the advent of the more purified forms of VAN, the incidence of AKI related to VAN were limited to acute interstitial nephritis (AIN) or as a potentiating agent to other nephrotoxins such as Aminoglycosides. VAN as the sole etiologic factor for nephrotoxic acute tubular necrosis (ATN) has not been described. Here, we report a case of biopsy-proven ATN resulting from VAN

FORMULATION DEVELOPMENT OF MOUTH DISSOLVING PRINTED FILM OF KETOROLAC AND IN VITRO EVALUATION

Objective: The present research work was carried out to prepare Ketorolac printed Oral Thin Films using a pneumatic pressure printer. In this research, we attempted to prepare a non-contact printing system by using pneumatic pressure-based printer that incorporates printing of active pharmaceutical ingredients onto a medical-grade Orodispersible film for developing personalized medication. Methods: In the present work Ketorolac Trometamol was used as a model drug. Placebo substrate was developed by using cellulosic polymers like HPMC, MCC, Neusilin, and starch to impart paper-like properties that are desirable for printing. It was evaluated for various physicochemical properties like disintegration time, mechanical strength, folding endurance, surface properties, etc. Polymers and plasticizers were evaluated for the development of drug loaded Printing ink. The drug-printed films were characterized for physicochemical properties and in vitro drug dissolution. Results: Various film-forming polymers were evaluated for the development of printing substrates. The F3 substrate had desired mechanical properties i.e. the thickness of 0.157±0.003, the tensile strength of 0.331±0.016, disintegration within 60 seconds, and this substrate also maintained its integrity after the printing of the drug ink. The HPMC-based ink (I4) with polyethylene glycol for modulating flow properties of ink in the concentration of 1.40%w/v was selected among various ink formulations. The drug release from the printed films was 98±1.94% in 1 h. Conclusion: Through this new drug printing technology the limitation of low drug dose loading associated with ink-jet and flexographic printing can be solved by increasing the drug loading ranges from micrograms to milligrams by a single pass of the print head

Correlation of sinonasal polyposis with chronic suppurative otitis media

Background: Aim of the study was to assess correlation of sinonasal polyposis with CSOM. To see the role of lignocaine nebulisation and to compare its role with use of steroids and bronchodilators alone in post bronchoscopy patients. Methods: In the present study, 50 patients of sinonasalpolyposis were subjected to otoscopic, microscopic examination of tympanic membrane findings and tuning fork tests were performed. Pure tone audiometry (PTA) was also done in all patients. High resolution computed tomography (HRCT) of temporal bones and computed tomography (CT) of paranasal sinuses were used to assess otological and sinonasal pathology. Results: Out of 50 patients, males were 26 and females were 24. Age group 11-20 years had 8 males and 8 females, 21-30 years had 5 males and 7 females, 31-40 years had 11 males and 8 females and 41-50 years had 2 males and 1 female. Left side was involved in 6, right in 9 and both sides in 10 patients. Swab cultures revealed pure aerobic isolates in 16, mixed aerobic and anaerobic isolates in 10. Micro-organisms were staphylococcus aureus in 10, Pseudomonas aeruginosa in 6, Streptococcus spp. in 5, Peptostreptococcus in 3 and Bacteroides in 2 cases. The difference was significant (p<0.05). Out of 50 Sinonasal polyp patients, 26 (52%) had CSOM. Type identified was tubotympanic in 12 and atticoantral in 14. There was positive pearsoncorrelation of CSOM with sinonasal polyp (r value of 0.92, p value 0.021). Conclusions: In the present study there was positive correlation of sinonasal polyposis with CSOM. The prevalence rate was 26%. Micro-organisms were Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus spp., Peptostreptococcus and Bacteroides

Sonographic evaluation of normal liver, spleen, and renal parameters in adult population: A multicenter study

Objective: To determine the normal liver, spleen, and renal parameters in adult patients with no comorbidities. Study Design: Cross-sectional study. Place and Duration of Study: Dow Institute of Radiology, Ojha Campus, LEJ Campus, and Al-Mustafa Hospital Karachi, from October 2016 to March 2017. Methodology: A total of 3,136 study participants with more than 16 years of age of either gender underwent ultrasound examination. All individuals with morbid conditions like hypertension (HTN), diabetes mellitus (DM), liver cirrhosis, hydronephrosis, renal cyst, and liver mass were excluded. Ultrasound scan was performed and longitudinal and transverse sections were obtained of both kidneys (in full inspiration), spleen and liver. Results: A significant positive correlation was observed between age and spleen size of the individuals (r=0.053, p=0.012). The correlation of BMI and liver size was also found significantly positive (r=0.237, p \u3c0.001). The correlation of age and kidney size was found significantly negative in between age and right kidney (r=-0.074, p \u3c0.001) and left kidney (r=-0.087, p \u3c0.001). Similarly, the correlation of BMI and renal size was found significantly weak positive between BMI and right kidney (r=0.206, p \u3c0.001) and BMI and left kidney (r=0.227, p \u3c0.001). Conclusion: BMI was found significantly positively correlated with liver size and both kidneys in study participants. Moreover, spleen was found directly and renal size inversely correlated with age of the individuals

Body Dysmorphic Disorder: a Comprehensive Review

DergiPark: 889274tmsjBody dysmorphic disorder is psychiatric morbidity that comes under the spectrum of obsessive-compulsive disorders. Individuals suffering from body dys- morphic disorder are incredibly concerned about their minor or so-called defects to such an extent that their lives may be affected drastically. As a result of continuously thinking about the asserted defect, the individuals end up suffering from major depression, anxiety, and self-harm. Diagnosis of body dysmorphic disorder is based on the Diagnostic and Statistical Manual of Mental Disorders, fifth edition criteria. The management of body dysmorphic disorder consists of psychotherapeutic and pharmacological interventions. Body dysmorphic disorder is a hidden disorder and is often under-reported. It has been linked to muscle dysmorphia, substance abuse, and major depressive disorder. The lack of studies in different countries and populations has made this a topic that requires sub- stantial input from researchers

Assessing the Real-Life Socio-Economic Scenario of Established Slums in Dhaka: The Cases of Korail and Sattola

The research aims to assess the current situation of three primary socio-economic indicators, namely education, health and water availability at the two most established slums of Bangladesh’s capital Dhaka – Korail and Sattola. Surveys, using cluster and then random sampling to target households, and analysis, found that both slums' children's education level was moderate with 52% - 68% and 20% - 28% availing primary and secondary education, respectively; several NGOs had helped to establish brick-and-mortar latrines and disseminate necessary and effective awareness about sanitation; and surveyed slum dwellers were economically strong, with 68% - 70% of the interviewed households' income levels being 10,000 – 15,000 BDT (USD 118 – 178) per month. A comparative analysis with national level statistics also yielded that the conditions in these slums are truly better than previously thought. Primary recommendation includes in-depth monitoring to understand why such large numbers live in slums, even though they can afford better

Assessing the Real-Life Socio-Economic Scenario of Established Slums in Dhaka: The Cases of Korail and Sattola

The research aims to assess the current situation of three primary socio-economic indicators, namely education, health and water availability at the two most established slums of Bangladesh’s capital Dhaka – Korail and Sattola. Surveys, using cluster and then random sampling to target households, and analysis, found that both slums' children's education level was moderate with 52% - 68% and 20% - 28% availing primary and secondary education, respectively; several NGOs had helped to establish brick-and-mortar latrines and disseminate necessary and effective awareness about sanitation; and surveyed slum dwellers were economically strong, with 68% - 70% of the interviewed households' income levels being 10,000 – 15,000 BDT (USD 118 – 178) per month. A comparative analysis with national level statistics also yielded that the conditions in these slums are truly better than previously thought. Primary recommendation includes in-depth monitoring to understand why such large numbers live in slums, even though they can afford better

Primary ovarian pregnancy: early diagnosis still a myth

Primary ovarian pregnancy occurs quite rarely accounting for 1 to 3%. And that too usually in young highly fertile multiparous women using intra uterine device and is associated with rupture very early in the gestation. We present a case where a young primigravida presented with abdominal pain and was diagnosed as ectopic pregnancy and was confirmed intra-operatively and histopathologically as primary ovarian pregnancy, managed with partial ovariectomy