Role of Papinicolaou Smears in the Diagnosis of Premalignant and Malignant Lesions of the Cervix.

Cervical carcinoma is an important cause of morbidity and mortality among women worldwide and has been considered as one of the preventable cancers. Aim: To determine the prevalance of various lesions on cervical cytology and to study the clinicopathologic correlation of conventional Papanicoloau smears for the diagnosis of squamous intraepithelial lesion and invasive carcinoma using the Bethsda system for reporting cervical cytology. Material and method: The study included a retrospective reviewing of conventional cervical smears reported in the Department of pathology, Government medical College, Miraj over a period of six months from January 2012 to June 2012. Results: Epithelial cell abnormalities were found in 3% cases. Atypical squamous cells of undetermined significance (ASCUS) and atypical squamous cell- cannot exclude HSIL(ASC-H) was seen in 3(0.91%) cases each. Squamous intra-epithelial lesion was seen in 6(1.83%), out of which 2(0.61%) had low grade squamous intra-epithelial lesion(LSIL) exhibiting koilocytic atypia and 4(1.22%) had high grade squamous intra-epithelial lesion(HSIL). Invasive squamous cell carcinoma was seen in 4(1.22%) cases. The mean age of patients with LSIL was 43.4 years, and that with HSIL and invasive carcinoma was 53 years and 54 years, respectively. Conclusion: Cervical screening using Pap smear helps to detect premalignant and malignant cervical lesions at an early stage.

Malaria in India: challenges and opportunities.

India contributes about 70% of malaria in the South East Asian Region of WHO. Although annually India reports about two million cases and 1000 deaths attributable to malaria,there is an increasing trend in the proportion of Plasmodium falciparum as the agent. There exists heterogeneity and variability in the risk of malaria transmission between and within the states of the country as many ecotypes/paradigms of malaria have been recognized. The pattern of clinical presentation of severe malaria has also changed and while multi-organ failure is more frequently observed in falciparum malaria, there are reports of vivax malaria presenting with severe manifestations. The high burden populations are ethnic tribes living in the forested pockets of the states like Orissa, Jharkhand, Madhya Pradesh, Chhattisgarh and the North Eastern states which contribute bulk of morbidity and mortality due to malaria in the country. Drug resistance,insecticide resistance,lack of knowledge of actual disease burden along with new paradigms of malaria pose a challenge for malaria control in the country. Considering the existing gaps in reported and estimated morbidity and mortality, need for estimation of true burden of malaria has been stressed. Administrative, financial,technical and operational challenges faced by the national programme have been elucidated. Approaches and priorities that may be helpful in tackling serious issues confronting malaria programme have been outlined.

Gastroenteritis due to Vibrio cholerae El-Tor Ogawa in Dhule.

For V. Cholerae isolation, stool sample is better than rectal swab. Direct oxidase test on stool is easy and reliable. V. cholerae El-Tor Ogawa is predominant type in Dhule area. New phage type T27 was reported. Tetracyclin resistance needs further studies.