ABSTRACT
Background: Abnormal uterine bleeding is one of the most frequent problems in life of an adult female. Accurate analysis of endometrium & localization of intrauterine lesion is the goal to effective management & better outcome of problem. Aims & Objective: To evaluate various histopathological features in D & C and/or hysterectomy in patients presenting with abnormal uterine bleeding and to find the efficacy of D & C as a better, cost effective and minimally invasive tool for screening in patients with AUB. Materials and Methods: The present study was conducted in Department of Pathology, tertiary care hospital, Ahmedabad, Gujarat, India over a period of one and half years. A total 320 patients aged 20 years & above, presenting with AUB were included. Endometrial samples were analysed, histopathological changes identified and classified. Results: Age of patients ranged from 21 to 70 years mean age being 42.6 ± 6.9 years, maximum patients (53.4%) belonged to 41-50 years of age group. Most common histopathological pattern was normal cyclical endometrium (47.3%) followed by endometrial hyperplasia (42.9%). Endometrial hyperplasia was most common (57.1%) in perimenopausal age group (41-50 years). The diagnostic accuracy of D &C was found to be 93.4%; amongst all histopathological patterns it was maximum for complex hyperplasia (typical and atypical) and simple atypical hyperplasia. Conclusion: Endometrial causes of AUB are age related therefore it is specially recommended in women of perimenopausal age group to rule out preneoplastic and neoplastic etiology. D & C is an accurate, minimally invasive outdoor procedure for detecting endometrial pathology especially hyperplasia.
ABSTRACT
Background & objectives: Microalbuminuria has been described as an early sign of vascular damage in certain high risk goups such as diabetes, hypertension & family history of cardiovascular renal disease. In diabetes mellitus the prognostic value of microalbuminuria as a marker of early nephropathy and increased cardiovascular risk has been well established. The aim of this study is to establish the prevalence of microalbuminuria in nondiabetic essential hypertensive patients and its relation with target organ damage. Material and Methods: 100 non diabetic essential hypertensive patients attending OPD as well as admitted in the tertiary care hospital of Jamnagar were included in this study. They underwent detailed clinical examination. A single early morning urine sample was used to measure microalbuminuria by Micral test strip and urine creatinine was measured to establish albumin creatinine ratio. Results: The age of patients selected for study varied from 35 to 76 years; mean age being 51.5 years. 52% were males and mean duration of hypertension was 3.9 +/- 3.9 yrs. Microalbuminuria was found in 46% of the patients and showed significant association with male gender (p=0.001), age (p<0.05) & target organ damage in any form (p<0.05). Interpretation and conclusion: Measuring urinary albumin excretion (UAE), a simple, low cost and readily available test, can be regarded as a cost effective way to identify nondiabetic essential hypertensives at high risk and can thus help to prevent the development of complications by aggressive treatment to get down to target blood pressure.