Pap smears are used for cytologic screening to reveal abnormalities in the cervical epithelium. Colposcopy enables a closer and more precise examination of the cervix, and is recommended for women for whom there is doubt regarding cervical dysplasia or cancer, in addition to those in whom an HPV infection is suspected and those with atypical squamous cells of undetermined significance [1]. Material taken through biopsy, conization, fractionated curettage, or hysterectomy should undergo histopathologic analysis. Cytodiagnosis has revolutionized the early diagnosis of precancerous conditions; when combined with colposcopy, its accuracy may reach 85%-90% [2].The aim of the present study was to determine the importance of cytology, colposcopy, and histopathology in the prevention of cervical malignancies.The study was carried out at In the absence of an ethics review council in Kosovo, institutional approval was obtained from the Director of the study center. All participants provided written informed consent.The study population comprised 750 women who had been admitted to the clinic for different reasons, and in whom cervical alterations were noted during speculum examination or who showed clinical symptomatology. All participants underwent Pap smears and colposcopy. In cases in which there was uncertainty regarding dysplasia, histopathologic examinations were performed.The majority of women with findings of Pap I-III were 31-40 years of age (Table 1). The fewest women with Pap I were younger than 20 years of age or 51-60 years of age (both 8.3%) ( Table 1). The most common findings among the 187 patients with atypical colposcopic changes were mosaic (36.4%) and leukoplakia (26.7%) (data not shown).None of the patients younger than 20 years of age had atypical epithelial changes.In addition to the material obtained during colposcopy, biopsies were taken from 117 women. Histopathologic analysis of the biopsied tissue revealed different levels of dysplasia in 16.2% of cases, carcinoma in situ in 5.1%, and invasive carcinoma in 2.6%. The highest percentage of atypical epithelium was verified in the context of atypical colposcopy findings: leukoplakia; mosaic; punctuation; and vascular atypia. Of the patients with leukoplakia who underwent biopsy, dysplasia was verified by histopathology in 25.0%; of the women with mosaic dysplasia, the findings were verified by histopathology in 21.4%; of the women with punctuation dysplasia, the results were verified histopathologically in 16.7%; of the patients with vascular atypia, dysplasia was verified histopathologically in 12.5% (Table 2). Atypical epithelium was verified histopathologically only very rarely, when there was either an atypical transformation zone or cervical erosion. There were 6 cases of carcinoma in situ, whereas Table 1 Cytologic results of cervical examination according to age group. aAge, y Pap Total (n = 750) I (n=60) II (n=525) III (n=123) IV (n=38) V (n=4) b 20 5 (8.3) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 5 (0.7)
Pregnancy in a non-communicating rudimentary horn is very difficult to diagnose before it ruptures, leading to life -threatening intraperitoneal hemorrhage. A 22-year-old second gravida patient presented at the Emergency Center of the University Clinical Center of Kosova with a 16-week history of amenorrhea and acute onset of severe abdominal pain. She was resuscitated and taken for an emergency laparotomy under general anesthesia. Intraoperatively, there was a massive hemoperitoneum with a ruptured right rudimentary horn Given their rarity, ruptured rudimentary horn pregnancies are of interest.
Background Preeclampsia is a common complication of pregnancy and a major cause of morbidity and mortality of mothers and babies worldwide. This study aimed to explore what the role of calcium/creatinine ratio is in urine compared with proteinuria and uric acid in predicting preeclampsia. Material/Methods In this prospective case-control study, 200 pregnant women who participated in the study were consecutively divided into 3 groups: a group of 59 women with preeclampsia, 61 women with pregnancy-induced hypertension, and a control group of 80 normotensive pregnant women. A 24-h urine sample was collected for estimation of calcium/creatinine ratio and proteinuria and a blood sample for estimation of uric acid at a gestational age of 24–34 weeks of pregnancy. Results The study found that the sensitivity of proteinuria as a predictor of preeclampsia was 96.6% ( P =0.000) and specificity was 21.3%. The sensitivity of uric acid as a predictor was 96.6% ( P =0.000) and the specificity was 48.8%; whereas for the 24-h urine calcium/creatinine ratio, the sensitivity was 87.9% ( P =0.000) and the specificity 40.7%, which corresponds to a value of 0.105 (cutoff). Women with a calcium/creatinine ratio <0.105 have a higher risk of developing preeclampsia (87.9% confidence interval, P =0.000). Conclusions The role of the calcium/creatinine ratio in urine is inferior to proteinuria and uric acid in predicting preeclampsia.
Worldwide, cervical cancer is the fifth most frequent malignant disease in women, ranking third, after endometrial and ovarian cancer, among malignant diseases of the female genitalia. Sexual activity early in adolescence and promiscuity have been confirmed as risk factors. The aim of this study was to establish the value of cytology, colposcopy, and pathohistology in the prevention of cervical malignancies.:The study population comprised 750 patients hospitalized for different reasons in whom cervical alterations were noted on speculum examination or who showed typical clinical symptomatology, performed at the Obstetric-Gynecologic Clinic in Prishtina, Kosovo during the period between January 2008 and January 2009.The symptomatology of the patients with pathological cervices varied, with 272 of the 750 patients (36.27%) showing clinical symptoms. Atypical epithelial changes, noted during colposcopy, were more frequent in patients 31-40 years of age (60 patients, 32.09%) and 41-50 years of age (59 patients, 31.55%). In addition to material collected during colposcopic examination, biopsy material (direct biopsy) was obtained from 117 patients. Histopathological findings from both sources were noted: 19 cases (16.24%) of cervical dysplasia at different stages, six cases (5.13%) of carcinoma in situ, and three cases (2,56%) of invasive carcinoma.The correct clinical evaluation of cervical epithelial alterations enables a prompt diagnosis and the timely implementation of appropriate therapeutic measures.: colposcopy, cytodiagnosis, cervix.
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