ABSTRACT
Background: Postmenopausal bleeding is generally regarded as an ominous alarm of genital pathologies which requires a thorough evaluation clinically and pathologically to exclude carcinoma as the cause and ensure a benign pathology. This study aims at finding out whether clinical diagnosis and ultrasonographic features can be reliable parameters for the diagnosis of causes and whether the findings correspond with histopathology reports.Methods: This observational study was conducted in a tertiary care centre in Pondicherry between January 2018 to August 2019. 114 women were enrolled for whom detailed history taking and clinical examination was done. All the patients were subjected to transvaginal ultrasonography. Patients with clinically visible lesions on cervix and vulva were subjected to biopsy and the rest underwent fractional curettage and the sample was sent for histopathological examination. Finally, histopathology report was compared with clinical and ultrasonographic findings.Results: With endometrial thickness cut off of 4 mm, the sensitivity, specificity, positive predictive value and negative predictive value in predicting malignancy by ultrasonography were 100%, 12.3%, 4.5% and 100%. Histopathology showed atrophic endometrium (43.8%), endometrial hyperplasia (8%), endometrial polyp (7.9%) and endometrial carcinoma (3%). Clinical and ultrasonographic findings did not show any statistical correlation with histopathology.Conclusions: Authors conclude that clinical findings and ultrasonographic features do not correlate with histopathology in cases of postmenopausal bleeding for which atrophic endometrium was the commonest etiology. However, ultrasound should be done routinely before endometrial sampling as the sensitivity for predicting malignancy was 100% for endometrial thickness cut off of 4 mm.
ABSTRACT
Background: The percentage of elderly is growing rapidly worldwide. They are at a risk of malnutrition due to physiological, psychological, social, dietary and environmental factors.The present study was conducted to find the malnourished elderly in the community. The aims and objectives of the study were to evaluate the nutritional status of elderly using Mini Nutritional Assessment (MNA) scales; to evaluate the dietary consumption in terms of total calories and protein intake; to assess the factors associated with the malnutrition; to educate regarding nutritional importance in elderly.Methods: A community based cross-sectional study was conducted among the geriatric population (n=117) in rural Mangaluru using convenient sampling technique. After obtaining oral consent, mini nutritional assessment scale was used and socio-demography was collected. Total screening score of 14 and assessment score of 16 were summed up to get the total assessment score of 30 to determine the person’s nutritional status.Results: Majority (60.6%) of the study population was females and 39.4% were males. 53% population were Muslims and 51% belonged to nuclear family. According to MNA scale, 54 (46.7%) were at risk of malnutrition, 17 (14.5%) were suffering from malnutrition and rest 46 (39.3%) had normal nutritional status. There was a significant correlation of MNA score with BMI.Conclusions: The results suggest that MNA is a useful tool in the identification of elderly at risk of malnutrition. Due to the high prevalence of elderly who were malnourished or at the risk of malnutrition, a more detailed evaluation, regular follow up and dietary intervention is required.