Efficacy of colposcopy technique with Pap smear and histology in screening of cervical lesions

Background: In India the most common genital cancer among women is carcinoma of the cervix (80%). The objective of the study is analysis of efficacy of colposcopy technique with Pap smear and histology in screening of cervical lesions.Methods: Patients above 18 years of age with varied parity and socioeconomic status attending out-patient clinics were studied for correlation between cytology, colposcopy and colposcopically directed biopsy for a one year period.Results: In cytology and colposcopic directed biopsy sensitivity is 81%, specificity is 95%, false positive is 4.9%, false negative is 18% and accuracy is 92%. In colposcopy and directed biopsy sensitivity is 94%, specificity is 91%, false positive is 7.4%, false negative is 5.8% and accuracy is 92.85%. Colposcopy helps to reduce false negative cases seen in cytology.Conclusions: In our study overall incidence of CIN was 19, among them CIN1 in 9%, CIN2 in 4%, CIN3 in 4% and malignancy in 2% cases. Higher sensitivity in colposcopy and directed biopsy 94%, higher specificity 95% in cytology as compared to colposcopy. This emphasizes the use of all 3 methods Papincolaou cytology, colposcopy and histology is complementary to each other and helps to reduce false negative cases

Contraceptive awareness in post-natal patients in KIMS, Bangalore

Background: Family planning can avert more than 30% of maternal deaths and 10% of child mortality if couples spaced their pregnancies more than two years apart. India was the first country in the world to launch the family planning programme in 1951. There exists a KAP gap i.e.  a gap between knowledge, attitude, and practices regarding contraception. Healthcare workers have an important role to play to acknowledge the importance and right concept of contraception among married couples. This study aimed to assess the knowledge, awareness, and perception of contraception among postnatal women.Methods: A questionnaire-based study was conducted among postnatal inpatients and outpatients from September 2021 to November 2021. All postnatal patients in this hospital, willing to participate in the study, after a thorough written informed consent, patients were given pre decided questions for answering. Answers were noted, counselling was done.Results:  Out of 200 women, 97% of the women were aware of at least 1 contraceptive method, the highest being of female sterilization (91%). The 22% of women have used contraception before. The 78% of women had never used contraception before, main reason was that they wanted to conceive (46%) followed by fear of side effects (29%). Regarding willingness to use the contraception after counselling, female sterilization (32%) was the preferred method followed by copper-T (22%). The most common source of information was by relatives was 33%.Conclusions: There is a large gap between the awareness and practice of contraception. Proper education of both partners, increasing female literacy, socio economic upliftment, effective health care system is needed. After delivery, during immediate postpartum period, maximum women wish for contraception Hence these women can be served by family planning services before discharge from hospital to ensure the acceptance of contraceptive practices among them. This would curb unwanted pregnancies and its future consequences

Study of the serum uric acid level as a prognostic indicator in hypertensive disorders of pregnancy

Background: Abnormal uric acid levels in patients with preeclampsia and eclampsia affect both maternal and fetal outcome negatively. This study was done to know the alterations in these serum levels in comparison to normal pregnancy and also among various hypertensive disorders of pregnancies.Methods: Maternal serum uric acid levels were compared among cases and controls in relation to disease severity, mode of delivery, maternal outcome.Results: In group A (cases), 10 patients had raised uric acid levels, of which 5 were severe preeclampsia, 3 were eclampsia and 2 cases of chronic hypertension superimposed preeclampsia. P value is 0.001 (highly significant). Also serum uric acid is significantly elevated in hypertensive disorders of pregnancy compared with controls with a P value of 0.001.Conclusions: Significant correlation was observed between maternal serum uric acid, disease severity and maternal outcome. Our study concludes that uric acid can be considered as a sensitive prognostic indicator of severity in hypertensive disorders of pregnancy