ABSTRACT
Introduction: Thyroid swellings are a common clinical problem. The Bethesda system of FNAC has been used for the past 5-6 decades for the investigation of thyroid lesions. This system helps in categorising thyroid lesions and also suggests possible management. Histopathology is the gold standard for confirming diagnosis. Aims and Objectives: To determine the incidence of thyroid lesions according to age and sex. To compare cytological diagnosis according to the Bethesda system of reporting with histological diagnosis and determine accuracy. Materials and methods: This is a study done over a period of 5 years from January 2016 to December 2020 in the department of pathology in a medical college in a rural area. The number of thyroid aspirations done were 232. Smears were classified as per The Bethesda system. Cytological and histopathological findings were correlated in 50 cases that underwent surgery. Cases with diagnostic discrepancy were reviewed. The sensitivity and specificity, negative predictive value, positive predictive value and diagnostic accuracy values were calculated using standard statistical formulae. Results: The thyroid lesions on cytology in the nondiagnostic, Benign, Atypia of unknown significance, Follicular neoplasia, Suspicious for malignancy and malignant category were 3.4%, 81.89%, 1.72%, 7.7%, 0.8% and 4.3% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy in our study was 78%, 84%, 78%, 87% and 84% respectively Conclusion: The Bethesda system of classification of thyroid lesions on cytology helps in the diagnosis of thyroid lesions and their further management. Histopathological correlation helps in evaluating diagnostic accuracy and helps in quality assurance.
ABSTRACT
A rare mesenchymal neoplasm of the lower female genital tract, fibroepithelial stromal tumor, may be confused with other more aggressive lesions. The appearance in pregnancy may further complicate a normal vaginal delivery and lead to confusion with a more unfavorable diagnosis. Even on histological examination, it is pertinent to rule put other stromal tumors of the region. To avoid overdiagnosis, the pathologist must be aware of the specific histomorphology. We report a case of fibroepithelial stromal polyp in a 32-year-old pregnant woman as an incidental finding during a routine antenatal check-up.
ABSTRACT
Background: Health care in India is a complex amalgam involving various stakeholders. For decades it has been a neglected area with reluctance in increasing the inputs such as finance or infrastructure required to drive this system. Utilization and access to this health system is a key indicator and major determinant of health seeking behaviour.Methods: This community based cross sectional study was conducted from January-February 2016 in, the urban slum located in a metro city using a pretested, semi-structured questionnaire. The data was analyzed using SPSS 22.Results: More than half of the participants preferred to seek treatment from a public health care facility compared to a private. One of the most predominant determining factors on choosing a particular health facility was affordability. Main barriers perceived in utilization of health services were long waiting time at the health facility and expenditure on treatment.Conclusions: The key for ensuring adequate and appropriate utilization of health care services is in having an efficient government health care delivery system which can offer quality and affordable medical care to one and all.