Pap smear: Are we choosing wisely? An observational study of clinicopathologic variables of patients undergoing Pap smear examination

Abstract: Background: Cervical cancer is a major cause of mortality in women. Pap smear is a screening test used in the screening of cervical cancer. There are well defined guidelines regarding its use. It should be offered to all sexually active women between the ages of 30-65 years, irrespective of whether or not they are symptomatic. Moreover, those women who have undergone hysterectomy for reasons other than cervical cancer or precancerous lesions, do not require this test. Materials and methods: We undertook an observational study to describe the age, presenting complaint, previous history of hysterectomy and reason for hysterectomy in women undergoing Pap smear testing in a private super speciality hospital in Central India in the past 3 years. Objectives: The objective of this study was to examine how closely the aforementioned guidelines were being followed, so as to deduce how wisely were we choosing the women to whom the test was being offered. Results: This study found that a significant proportion of tests were being offered to women who did not need them. And more importantly, we were missing the opportunity to screen women who presented with non gynaecologic complaints in our hospital. Conclusion: Hence we present the findings of this study to reassert the role of Pap smear as a screening test, the primary goal of which is to identify high grade precancerous lesions of the cervix; and to sensitizesensitise specialist physicians other than gynaecologists to offer Pap smear to women presenting with complaints unrelated to the genitourinary tract: so that we can choose wisely as to who should and who should not get the test

To study the serum C-reactive protein level and its correlation with prognostic variables in stable COPD patients

Introduction: C-reactive protein is a stable and excellent biomarker of systemic inflammation which is easy to measure. COPD is an inflammatory disorder of lung with widespread Systemic manifestations and associated Systemic inflammatory response. C-reactive protein levels are increased in COPD patients. Present study investigated C-reactive protein level in stable COPD patients and its relation with clinically important outcome variable, exercise capacity. Method: Study included 56 stable COPD patients with mild to moderate severity in age group 40-70 years and 56 nonsmoking controls in the same age group. Clinical and physiological characteristics were determined and C-reactive protein levels were measured. Result: This study confirms the finding of higher C-reactive protein levels in smoker COPD patients (4.9 vs 4.0 mg-L-1) as compared to nonsmoker COPD patients. It also confirms that level of C-reactive protein in ex-smoker COPD population remains significantly higher than nonsmoker control group (4.9±0.5 vs 3.1mg/l). Conclusion: C-reactive protein level was strongly associated and correlated with 6 minute walk distance, FEV1 and GOLD stages, so C-reactive protein level can indirectly reflect prognosis of COPD patient and his exercise capacity. We recommend that measurement of C-reactive protein levels may be a useful tool to predict the prognosis and patient outcome in COPD patients. It also provides strong argument to develop therapies aimed at decreasing inflammation independent of smoking cessation