Background: Cervical cancer is a major contributor to mortality and morbidity in women. Naked eye visual screening (NE test) and Pap test are commonly used for cervical cancer screening. Both tests have inherent limitations like low sensitivity (Pap test) and subjectivity in interpretation, lack of permanent record and overestimation (NE test). Here, Smart Scope ® visual screening test (SS test) was compared with NE and Pap tests. Smart Scope ® is a small, hand-held device that captures cervical images attached to a tablet to store data. Objective: To compare SS test with Pap and NE tests. Study Design: This prospective observational study was conducted at a tertiary care hospital in India, over 16 months. A total of 509 women in the age group of 25 to 65 years were included in the study as per the inclusion criteria. All the participants underwent Pap test, NE test and SS test. Screen positives on any one test were advised colposcopy and biopsy. Results: Out of 154 screen-positive women, 49 visited for follow-up colposcopy-guided biopsy. Nine incidental biopsies of screen-negative women were included in the data. Thus, statistical analysis was carried out based on 58 available histopathology results. Out of 58 biopsies, 8 were normal, 30 were benign lesions, 18 were precancerous and 2 were cancerous lesions. SS test was found to have a sensitivity and NPV of 100% each, PPV of 45.4% and a specificity of 36.8%. Sensitivity and specificity of NE test was 90% and 39.5% respectively, PPV was 43.9% and NPV was 88.2%. Pap smear had a sensitivity of 25% and specificity of 84.2%, PPV of 45.5% and NPV of 68.08%. Conclusion: SS test has great potential to be a primary screening test in low-resource settings due to its better sensitivity and NPV as compared to NE and Pap tests.
Background: Menstrual abnormalities are a major gynaecological problem faced by adolescent girls leading to morbidity that may have an adverse effect on their school attendance. The objective of the study was to determine prevalence of menstrual disorders in girls aged 10-19 years and to study their treatment-seeking behaviour. Methods: We conducted a cross-sectional study on 592 girls in the age group of 10 to 19 years attending schools in Pune city during January 2016 to December 2016. Permission was sought from school authorities. Girls 10-17 years were included after obtaining parental consent. For 18 and 19 year olds, informed consent was taken from the girls themselves. Demographic information, height, weight and characteristics of menstrual period were noted. Results: Majority girls (36%) were in age group 12.1-14 years. Most prevalent menstrual disorder was painful menses reported by 70% of girls, followed by heavy menstrual bleeding (46%) and cycle irregularity (22%). All menstrual disorders were most commonly prevalent in the age group of 14.1 to 16 years. Proportion of girls visiting a doctor and taking medications for painful menses was 26.7% and 16.5% respectively, for heavy menstrual bleeding was 25.7% and 16.5% respectively and for cycle irregularity was 33% and 16.5% respectively. No association was found between mother's education and treatment seeking behaviour for menstrual disorders. Conclusions: In spite of high prevalence of menstrual disorders, only a minority of the adolescents seek expert advice. This underscores the need for creating awareness among girls, mothers and teachers and developing a screening tool to identify girls who could benefit by further investigation and follow-up.
Objectives: -To study cervical cytology in women with abnormal cervical findings on visual inspection. Methods:-Descriptive analytical study was conducted in Department of Gynecology & Obstetrics, Bharati Vidyapeeth Medical College, Pune, India.1600 women from Gynecology OPD having abnormal cervical findings on visual inspection were included in study. These women were subjected for Pap smear. Results: -Inflammatory changes were seen in 47.75% and precancerous lesions seen in 9.56% patients. Out of which LSIL was seen in 6.75% and HSIL was (CIN II & CIN III) in 2.81% of patients. In present study mean age for CIN was 38.13 ± 9.03 years. Malignant lesions were detected in 0.56% of patients, maximum in age group 41-45 years. Conclusion: -Women with abnormal cervical findings on visual inspection should be subjected to Pap smear to detect the disease in precancerous stage & to lower the mortality & morbidity.
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