Downstaging of carcinoma cervix: yet to reach the unreached

Background: To know the incidence, presenting symptoms and stages of carcinoma cervix in the patients visiting KIMS, Hubli, Karnataka in the year 2014.Methods: This is a prospective cross-sectional study from January 2014 to December 2014 in Karnataka Institute of Medical Sciences, Karnataka. All patients attending the gynaecological OPD were included in the study. After taking detailed history, patients underwent general physical examination, per speculum and pelvic examination. Patients were divided into 3 groups based on the per speculum and pelvic examination. Group 1 – only PAP smear was taken in women with normal cervix. Group 2 – PAP smear, visual inspection of cervix with acetic acid and biopsy was taken in women with abnormal cervix. Group 3 – only Cervical biopsy was taken and clinical staging was done in women with a suspicious cervix.Results: Total of 8053 patients were screened and examined for carcinoma cervix. A total of 14(0.17%) preinvasive lesions and 85(1.05%) invasive lesions were detected. Out of 85 invasive lesions, the most common pathology was squamous cell carcinomas in 78 (91.76%) patients, adenocarcinomas in 6 (7.05%) patients and adenosquamous carcinoma in 1(1.17%) patient. The most common symptoms of carcinoma cervix were WDPV- 48 (56.4%), Irregular vaginal bleeding- 19 (22.3%), postmenopausal bleeding- 10 (11.7%) and in advanced cases, VVF – 5 (0.05%), RVF- 1 (0.01%) and Uraemia - 2 (0.02%). Most of the patients examined were having disease in stage III -51 (60%) cases, stage IV – 26 (30.58%) cases, stage I -5 (5.8%) cases and stage II – 3 (3.52%) cases.Conclusions: Approximately one in every 100 patients examined in OPD, turned out to be a case of carcinoma cervix, out of which more than 90% patients were diagnosed to be in advanced stage. This huge burden of cases raises the question about screening of carcinoma cervix in rural areas, which needs to be improved. Hence lot has to be done than said, so that screening program of cancer cervix reaches the unreached

Chondroid syringoma of the philtral dimple

A chondroid syringoma (CS) is an exceedingly rare mixed tumor of the skin. These tumors are relatively common in the head and neck area. Occurrence of these tumors in the philtrum is rare, with only two documented cases in English literature to the best of our knowledge. This paper presents a case of CS of the philtral dimple with aesthetically excellent philtrum reconstruction

Downstaging of carcinoma cervix: yet to reach the unreached

Background: To know the incidence, presenting symptoms and stages of carcinoma cervix in the patients visiting KIMS, Hubli, Karnataka in the year 2014.Methods: This is a prospective cross-sectional study from January 2014 to December 2014 in Karnataka Institute of Medical Sciences, Karnataka. All patients attending the gynaecological OPD were included in the study. After taking detailed history, patients underwent general physical examination, per speculum and pelvic examination. Patients were divided into 3 groups based on the per speculum and pelvic examination. Group 1 – only PAP smear was taken in women with normal cervix. Group 2 – PAP smear, visual inspection of cervix with acetic acid and biopsy was taken in women with abnormal cervix. Group 3 – only Cervical biopsy was taken and clinical staging was done in women with a suspicious cervix.Results: Total of 8053 patients were screened and examined for carcinoma cervix. A total of 14(0.17%) preinvasive lesions and 85(1.05%) invasive lesions were detected. Out of 85 invasive lesions, the most common pathology was squamous cell carcinomas in 78 (91.76%) patients, adenocarcinomas in 6 (7.05%) patients and adenosquamous carcinoma in 1(1.17%) patient. The most common symptoms of carcinoma cervix were WDPV- 48 (56.4%), Irregular vaginal bleeding- 19 (22.3%), postmenopausal bleeding- 10 (11.7%) and in advanced cases, VVF – 5 (0.05%), RVF- 1 (0.01%) and Uraemia - 2 (0.02%). Most of the patients examined were having disease in stage III -51 (60%) cases, stage IV – 26 (30.58%) cases, stage I -5 (5.8%) cases and stage II – 3 (3.52%) cases.Conclusions: Approximately one in every 100 patients examined in OPD, turned out to be a case of carcinoma cervix, out of which more than 90% patients were diagnosed to be in advanced stage. This huge burden of cases raises the question about screening of carcinoma cervix in rural areas, which needs to be improved. Hence lot has to be done than said, so that screening program of cancer cervix reaches the unreached

Radiological impact of oral bisphosphonate use on polyostotic Paget's disease of bone over a 2 year period

Paget's disease of bone is a disorder of osteoclasts which hampers the physiological process of bone remodeling. It is the most common metabolic orthopedic disease in the Caucasian populace; we report the diagnosis of Paget's disease of bone in a South-Asian male in his early 50s with a history of gastrointestinal symptoms, weight loss and back pain. An alkaline phosphatase level of 1104 IU/L was noted. A 3-phase bone scan showed noncontiguous heterogenous nuclear uptake. After exhaustive evaluation, the patient was diagnosed with Paget's disease of bone. Despite the disease activity being mitigated by alendronate and monitored by ALP levels within normal range per protocol, the patient had compression fractures of the vertebrae requiring early reinitiation of oral bisphosphonates. This raised doubts about the efficacy of metabolic marker-based management in Paget's disease of bone