Background: Endometrial aspiration biopsy is one of the primary steps in diagnostic evaluation of a women presenting with suspected endometrial pathology. The aim of present study was to compare specimen adequacy, ease of doing the procedure, patient comfort and cost effectiveness in office endometrial sampling by endosampler vs Karman cannula number 4.Methods: This was a prospective comparative study where 102 patients were included. In 50% of patients, endosampler was used and Karman cannula was used in the rest. All procedures were noted, analysed and done in outpatient department and various parameters like specimen adequacy, pain score, ease of doing the procedure were analysed and compared in both groups.Results: The mean age of the patients was 37.1(±10) years with comparable distribution in the two groups. The parity was comparable in both groups. Authors further analysed the data on the basis of operator experience. The mean score of ease of insertion based on the experience of residents of < 2 years and > 2 years was 3.1±1.48; 4.0±1.96 and 3.5±1.5; 3.7±2 in endosampler and Karman cannula group respectively. This difference was significant in the endosampler group (P: <0.001). The difference in pain score in two groups was not significant. The specimen obtained was adequate in 32 (62.7 %) patients of the endosampler group and in 39 (76.4 %) patients of the Karman cannula group. (p-0.07). Endosampler is five times costlier than Karman cannula.Conclusions: Karman cannula is a good and cost-effective sampling device for endometrial biopsy.
Background: Leiomyomas are benign tumors of smooth muscle cells commonly encountered in women of reproductive age group. Aim of this study was to conduct a histopathological study of leiomyomas in hysterectomy specimens and to correlate them with clinical findings.Methods: A prospective study was done on 130 hysterectomy specimens clinically diagnosed as leiomyoma. The specimens were subjected to histopathological examination.Results: In this study, the most common age group was 31-50 years (87.69%). Most common complaint was menorrhagia (51.54%). In endometrium, the most common histopathological diagnosis was proliferative phase (46.15%) followed by endometrial hyperplasia (19.23%). The most common secondary change was hyalinization and the most common site was intramural (62.9%).Conclusions: Hysterectomy is a commonly performed procedure in the management of uterine leiomyomas. The ultimate diagnosis and prognosis depends on the histopathological examination; therefore, every operated specimen must be subjected to histopathology.
Background: Valproate-induced pancreatitis is an idiosyncratic reaction of the drug, commonly seen in the paediatric age group, between 1 week to 8 years of starting the drug. Case: The authors present a case report of a 61-year-old patient who presented with acute pancreatitis. All common causes were ruled out. The patient had a significant treatment history of taking valproate for bipolar disorder for 12 years. The patient was resuscitated with intravenous fluids and analgesics. Sodium valproate was stopped. The patient was monitored to detect early symptoms of systemic inflammatory response syndrome or any organ dysfunction or failure. The patient was sent to the ward after 4 days. The patient had a good outcome due to early diagnosis and resuscitation. Conclusion: Acute pancreatitis is a rare and potentially fatal complication in patients on valproate. After ruling out other common causes, a detailed medical and treatment history can lead to the diagnosis of this entity. Healthcare providers should be vigilant about the early signs and symptoms of pancreatitis, including acute abdomen, vomiting, and raised serum amylase and lipase.
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