INTRODUCTIONCervical cancer in India ranks as the 2 nd most frequent cancer among women and the 2 nd most frequent cancer among women between 15 and 44 years of age. Current estimates indicate that in india every year 122844 women are diagnosed with cervical cancer and 67477 die from the disease, while in united states, incidence rate is 12042 an death rate is 4074.1 85% of cervical cancer cases that are diagnosed annually worldwide are found in developing countries.2 India bears 18% of the burden of invasive cancer cervix in the world and 80-85% of cases are detected in stage III/IV. 3 The most common histologic type of cervical cancer is squamous, and the relative and absolute incidence of adenocarcinoma is increasing; both histologies are caused by HPV infection. 4 The initiating lesion of cervical cancer is cervical dysplasia, which means abnormal maturation. In most patients it spontaneously regresses back but over a period of 10 to 20 years has the potential to convert into cervical cancer.5 Cervical dysplasia, also referred as cervical ABSTRACT Background: Cervical cancer in India ranks as the 2 nd most frequent cancer among women and the 2 nd most frequent cancer among women between 15 and 44 years of age. Invasive carcinoma of cervix is preventable as it is associated with pre-invasive stage which occurs 10-15 years prior to it, thus permitting early detection by screening and leading to effective treatment and thereby reducing mortality rate with greater impact on lives saved. Objectives were to correlate the findings of Pap smear with colposcopy in evaluation of all symptomatic women; and to assess the utility of colposcopy in detecting the premalignant and malignant lesions of cervix. Methods: This was a prospective observational study of 200 symptomatic women attending the Gynecology OPD of Umaid Hospital Dr. S. N. Medical College Jodhpur, Rajasthan, India from February 2015 to October 2016. Evaluation of all symptomatic women done with Pap smear, colposcopy and biopsy in selected cases and findings were noted. Results: Commonest complaint was white discharge per vaginum in 58.5% followed by pelvic pain in 24% women. 8% women had abnormal pap smear findings with 4% of women had ASCUS, 0.5% had ASC-H, 3% had LSIL and 0.5% had HSIL,73% had inflammatory and 19% with normal smear. 38.5% had abnormal colposcopy with maximum 28% women had acetowhite lesions. Sensitivity of pap smear was 44.44% while sensitivity of colposcopy was 88.88%. Conclusions: Pap smear had poor sensitivity as compared to colposcopy. Hence simultaneous use of colposcopy has shown to increase in the rate of carcinoma cervix detection in symptomatic women.
Brenner tumor of the ovary is very rare, mostly benign, small, and unilateral. Malignant brenner tumor is much rarer. Malignant brenner tumor of ovary closely resembles the transitional cell carcinoma of ovary. These tumors are believed to arise from urothelial metaplasia of ovarian surface epithelium. However the latter has a worse prognosis. Here we present a case of Brenner tumor of ovary in a postmenopausal woman treated surgically and its features are briefly discussed.
Background: Morbidly adherent placenta, a grave complication of pregnancy is becoming an emerging cause of increased maternal morbidity and mortality. Objectives of present study are to evaluate the etiopathogenesis of MAP, its clinical mode of presentation and maternal and fetal outcome with the aim to reduce maternal morbidity and mortality.Methods: It was a retrospective and prospective study at Umaid Hospital, attached to Dr. S.N. Medical College, Jodhpur in which data of patients with clinical diagnosis of MAP were reviewed from October 2014 to January 2016.Results: In this study of 10 cases of morbidly adherent placenta of Umaid hospital from October-2014 to January 2016 were studied, it was found that the mean age of presentation was 30.2 year. 60% cases were unbooked and 40% cases were booked with regular ANC visit. 60% cases presented with bleeding per vagina as a chief complaint and 30% cases were admitted for elective LSCS. 60% cases were already diagnosed case of placenta praevia. 90% cases had a history of previous LSCS. 80% cases were given BT intraoperatively and postoperatively. 60% cases underwent caesarean hysterectomy, 80% cases were shifted to ICU, and there was one maternal death.Conclusions: The incidence of MAP is increasing due to higher cesarean section (C/S) rate. Antenatal diagnosis via USG and color-doppler imaging, preoperative counseling, planning and multidisciplinary approach is necessary to reduce morbidity and mortality associated with MAP.
Background: Radiocontrast media are used extensively nowadays to visualize internal organs. Currently, non-ionic iodinated contrast media are used which are generally considered to be safe but some adverse reactions have been reported. Thus, the present study was carried out to analyze the nature and incidence of adverse drug reactions (ADRs) to radiographic contrast media in a teaching hospital. Methods:An observational study carried out for a period of six months in a teaching hospital. Contrast media induced adverse reactions were analyzed in terms of affected organs, rate, causality assessment, severity and preventability. The treatment and outcomes of adverse events were also recorded. Naranjo Probability Scale was used to evaluate the relationship between the contrast agent used and the suspected ADR. The severity of the suspected ADRs was determined using Hartwig Scale and preventability was assessed using modified Schumock and Thornton criterion. Results:A total of 15 suspected ADRs occurred in 11 patients with an incidence of 1.4%. It included 5 (45.4%) males and 6 (54.5%) females (p < 05). The highest percentage (72.7 %) of ADRs was seen in adult patients, the mean age being 40.8 years. Vomiting (33.3%) was the most common ADR noted followed by severe nausea and rashes. 64.7 % of ADRs were categorized as probable and 35.3 % were possible. Adverse reactions required treatment in 46.6% patients. There was no fatality reported. Conclusion:The reactions observed were mild to moderate in severity and occurred within 30 minutes of the administration of the contrast.
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