Online ISSN: 2515-8260

Keywords : PAP smear


PELVIC INFLAMMATORY DISEASE: HOW FREQUENT IT IS AMONG THE WOMEN PRESENTING WITH LOW BACK PAIN

Dr. Vipin Garg, Dr. Parul Trichal, Dr. Vijerdra Damor, Dr. Pradeep Dubey, Dr. Roma Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 656-663

Background: Low backache (LBA) in females is a major public health problem world-wide and treating this condition is also challenging due to its vast differential diagnosis. Pelvic inflammatory disease (PID) is the most frequently encountered condition in females for LBA and if diagnosed and treated early can lead to significant improvement in symptoms of LBA.       Aim: The present study is conducted to determine the incidence of Pelvic inflammatory disease (PID) and its associated risk factors in women with complaints of low back pain (LBP).      Material and Methods: A prospective epidemiological study was done in the department of orthopedics in GRMC Gwalior, M.P. 400 female patients attending OPD with the presenting complaint of LBP were enrolled in our study. Detailed history was taken and thorough examination was done.      Results: Out of 400 patients with LBA, PID was found in 324 (81%) patients. Maximum number (32%) of patients was from the age group of 41- 50 years. Majority of patients (60.7%) were of low socio-economic status, 51.7% females were illiterate, 69% females were overweight  31.8% of patients complained of vaginal discharge were age group of 41-50 years. 37.4% women used oral contraceptive pills and 58.1% females had an intrauterine contraceptive device inserted. Majority of the PID patients (53.4%) showed inflammatory cell on Pap smear
Conclusion: The present study suggests that PID is a major contributing factor in LBP in middle age females.

STUDY AND ANALYSIS OF ONE THOUSAND CERVICAL PAP SMEARS; EXPERIENCE OF A RURAL TERTIARY CARE CENTER IN EASTERN U.P.

Dr. Madhu Kumari Yadav, Dr. Neha Yadav, Dr. Samiksha kumari

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 452-458

Introduction: Cancer is the leading causes of adult deaths worldwide. However there is a marked difference in the distribution of cancer sites across different regions of the world. In contrast to developed countries cervical cancer is a public health problem in developing countries like India. Cervical cancer is the fourth most frequent cancer in women with an estimation of 6.6 percent of all female cancers and representing 3.2 percent of all cancer deaths in women [1]. In India cancer cervix constitutes 14 percent of cancer incidence among women. The standardized death rate is about 6.5 per 100,000 population [2]. Infection with HPV (Human Papilloma Virus) is the primary cause of cancer of cervix and its precursor lesions [3]. Specific high risk HPV types account for about 90% of high grade intraepithelial lesions and cancer. The carcinogenic HPV strains are HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68 [4]. HPV – 16 is the most common HPV found in invasive cancer and in CIN2 & CIN3 [5]. HPV—18 is more specific for invasive tumors [4]. HPV infection usually resolves in 9-15 months in a vast majority of cases [6]. A small minority of women exposed to HPV develop persistent infection and many progress to CIN and frank invasive carcinoma later over 15-20 years [7]. This long latent period provides us the opportunity to prevent the disease and to screen and treat the disease in its pre-malignant phase only.

STUDY OF CERVICAL LESIONS BY PAP SMEAR SCREENING IN 1000 CASES IN A TERTIARY CARE HOSPITAL PUNJAB INDIA

Ninder Kumar, Manmeet Kaur, Mohanvir Kaur

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1744-1752

Background: Cancer of uterine cervix is a leading cause of mortality and morbidity in developing countries including India due to lack of proper screening, especially in the rural and suburban areas. This may be due to dearth of awareness amongst the women of developing countries. Cervical carcinoma is the fourth most common cancer in the world. Developing countries accounted to about 80% of the global burden. This retrospective study was conducted to highlight the importance of Pap smear examination as screening test in differentiating inflammatory, premalignant and malignant lesions.
Materials and Methods: This retrospective study was conducted among 1000 cervical pap smears of women with age group 20 to 75 years coming to the obstetrics and gynaecology department and cytology section of pathology, Government Medical College and Rajindra Hospiatal Patiala. All the smears were reported as per the 2014 Bethesda system.
Results: In Our study, we found 12.1% inadequate smear for reporting, 35% cases NILM including inflammatory smear, 1.7% atrophic, 4.4% ASCUS, 1.5% ASC-H, 0.7% LSIL, 1.4% HSIL and 0.4% cases of squamous cell carcinoma. Although 0.4% is a small fraction, PAP smear is a cost effective, non-invasive screening test for cervical lesions.
Conclusion: Cervical cytology by Pap smear is an important tool for early detection of premalignant and malignant lesions of cervix. Regular Pap smear screening should be conducted in vulnerable age group.
 

STUDY OF SPECTRUM OF CERVICAL LESIONS ON PAP SMEARS AND GYNECOLOGICAL CYTOHISTOLOGIC CORRELATION -WHEREVER FEASIBLE, IN A RURAL TERTIARY TEACHING COLLEGE HOSPITAL

Dr. Ashwini Rege-Gundawar, Dr. Sneha Joshi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3671-3693

Introduction: Cervical carcinoma (Ca Cx) is a high incidence malignancy in India (6–29% of all cancers in women). The Pap smear test is a proven effective measure for reducing cervical carcinoma incidence. Lack of population level screening program in India corresponds with the detection of most cervical lesions at a late stage of disease (stage II or stage III) with consequent high mortality and morbidity. The hospital where this study was conducted offers Pap smear free of cost.
Aims & Objectives:

1.      To study the spectrum of cervical lesions by analyzing the results of Pap smear tests -for a period of one year.
2.      To evaluate clinical utility of Pap smear testing by studying histopathological correlation- wherever feasible, for the same one-year period.

Materials and Methods: Retrospective observational study conducted by retrieving data for 1 year, pertaining to conventional Pap smear tests and related histopathological examination reports.
Results ([1]): Of 808 Pap smear tests done, 788 (97.5%) were satisfactory for evaluation. These were reported using, “The Bethesda system for evaluation of cervical pathology (2014)”. Results were divided into: i) Inflammatory (70.56%), ii) NILM (23.60%), iii) Atrophic (3.42%) and iv) Epithelial cell abnormalities [ECA] (2.41%). The ECAs included ASCUS, LSIL, HSIL and SCC. The inflammatory Pap smears included 28 cases of Trichomonas vaginalis, 7 cases of Yeast, (likely Candida) infection, and 2 cases with presence of blue wool like microorganisms morphologically resembling Actinomyces. Histopathological report association was done for 118 (14.97%) cases. Of these, 112 (94.91%) cases were reported as inflammatory pathology and 6 (5.08%) cases as ECAs. The ECAs included 3 HSILs, 2 LSIL/inflammatory changes and 1 case of SCC. All 118 cases were reported with 100% concurrence rate for cytopathology –histopathology correlation.
Conclusions: 1) Pap smear is a good screening as well as diagnostic test. 2)However more significant yield towards prevention of Ca Cx will be achieved by adding supplemental testing e.g., HPV DNA testing.3) Concentrated efforts need to be made to target screening efforts towards older age group women and also towards follow up and treatment of the Positive Pap smear cases

Outcome of cervical cancer screening using Pap smear test on a target population

Dr. Shruti Bhavi Patil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 122-126

Objective: To evaluate the use of Pap smear screening method for detection of precancerous
lesions.
Methods: Women working in police department and female family members of men working
in police department were screened for Ca cervix. A total of 67 women were recruited for the
study. A clinical examination per speculum and per vaginal examination were performed and
a history taken for all women. A pap smear was used for all women to see for cervical cancer.
The smear was obtained using Ayer’s spatula and spread over a marked glass slide which was
placed in 95% ethyl alcohol and sent to department of Pathology for cytopathological
examination. All data were recorded using a predesigned proforma.
Results: Most women were in age range of 30-50 years. The common complaint was white
discharge per vagina occurring in about 30% of individuals, abdominal pain was in 8.95% of
them, irregular menstrual cycle in 12.78% and 40.29% of them did not have any complaints.
Out of 67 ladies 61 (92.1%) pap smears were taken and 6 were not taken due to post
hysterectomy status or because they were menstruating. The test was negative for malignancy
in 68.6% of individuals and 11% of individuals had inflammatory smear due to infections
with trichomoniasis, bacterial vaginosis or candidiasis. Atypical cells were detected in 2.98%
women and they were advised colposcopy and guided biopsy. 5% of individuals had
unsatisfactory smear due to inadequate sample.
Conclusion: A Pap smear is simple, noninvasive, cost-effective, and easy to perform for
detection of precancerous lesions in a gynecological patient. Awareness about screening in
general population is needed. Women with an abnormal Pap test should undergo a
colposcopy and guided biopsy.

A Prospective Study to Evaluate the PAPSmear and Acetic Acid Test (VIA) as Cervical Cancer Screening Tools with Histopathological Correlation at Tertiary Care Center

Neha Gupta, Ruchi Agrawal, Shweta Agarwal, Suneeta Meena

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1383-1387

Background: Cervical cancer is the second most common cancer among women
globally. There are different methods for control and prevention of cervical cancer
which include conventional cytology (Pap smear), liquid-based cytology, human
papillomavirus (HPV) screening, and vaccination against HPV. The aim of this study to
evaluate the pap smear and acetic acid test as cervical cancer screening tools with
histopathological correlation.
Material & Methods: The present study was carried out in department of pathology at
SMS Medical College, Jaipur, Rajasthan, India for one year period. A total of 150
patients attending the gynecology OPD were enrolled in the study. All the patients in the
study were subjected to colposcopy. The cervix was inspected with the naked eye than
with a colposcope. After taking the Pap smear with Ayre’s spatula and cytobrush and
was evaluated by the Bethesda system and then cervix was washed with normal saline
and visualized, followed by application of 3% acetic acid and visualization by
colposcope. Collected data was statistically analyzed to determine specificity and
sensitivity, PPV, NPV of Pap smear, VIA.
Results: Our study shows that majority of cases were seen in 40-50 years of age
group.Sensitivity of VIA was found to be 90% (versus Pap smear, which had 40%) and
specificity of VIA was 87.85% (versus Pap smear, which had specificity of 96.42%).
Conclusion: PAP smear screening needs good infrastructure, trained manpower to
make & interpret the slides which is not feasible considering the facilities available in
the periphery. However, VIA can be done even by sisters in the remotest place with
minimum facilities & patient is diagnosed.

Pap screening for cervical carcinoma – evolving trends

R.Thiripurasundari, L.Jacqueline, S. Priya

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1320-1330

Cancer has manifested itself as one of the most serious health problems facing humanity today. Cervical cancer is one of the most common types of cancer, and the Papanicolaou (Pap) test, often known as a Pap smear, is the most basic test for cervical screening. It involves the microscopic inspection of cervical cells obtained from the cervix, and it is performed by a physician. In order to achieve this, automated detection and classification of cervical cancer from pap-smear images has become a must just because it allows for accurate, reliable, and rapid investigation of the condition's progression. With an emphasis on the history of pap screening, liquid based cytology, and machine learning for cervical cancer detection in recent research publications, this paper provides a summary of the state of the art as stated in several significant recent information sources. For the first time, an evaluation of image analysis and machine learning applications in the growing trends of cervical cancer diagnosis from pap-smear images over the course of a decade has been published. The survey examines 26 journal papers that were obtained electronically through major scientific databases such as PubMed, Google Scholar, Scopus, IEEE, and Science Direct, which were searched using sets of keywords. The papers were obtained from major scientific databases such as Pubmed, Google Scholar, Scopus, IEEE, and Science Direct. Whenever the Pap test is improved through the use of artificial intelligence, the sensitivity for the detection of cervical pathology is improved as well. The general public should be taught about the Pap smear test with AI, including its purpose and the frequency with which it must be performed, through comprehensive programmes aimed at improving disease management in general.