ABSTRACT
Background: With no systematic national screening programme, the rates of cervical epithelial cell abnormalities as reported by various studies range from 1.32% to 25% in India. Majority are epithelial squamous cell abnormalities that include atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL). Worldwide incidence of adenocarcinoma and its precursors have increased over past few decades. Objectives were to study the clinical and cervical cytological profile among women attending camps in rural areas of Thrissur district of Kerala.Methods: A cross sectional study was conducted in 214 women in the 25-65 years age group who attended cancer screening camps in rural areas of Thrissur district. Papanicolaou (Pap) smear was done using standard technique and reported using latest Bethesda classification. Pap smear results were considered as abnormal when the report was ASCUS, atypical glandular cells of undetermined significance, LSIL, high grade squamous intraepithelial lesion or invasive lesion.Results: Of all the smears, 41.6% were negative for intraepithelial lesion or malignancy. Inflammatory smears (nonspecific and specific infection associated) were seen in 57%. Glandular cell abnormality was found in 1.4% and these women were in 31-50 years age group. Among patients with glandular cell abnormality most common symptom was discharge per vaginum.Conclusions: The results of this study may be a pointer to an increase in glandular cytological abnormalities in our population and needs further large-scale studies to confirm. Current screening methods of Pap smear alone may not be adequate to pick up these lesions.
ABSTRACT
Background: With the rising incidence of Maternal deaths due to suicide as evident from reports of Kerala state confidential review of maternal deaths, there is a felt need for screening for depression in study antenatal population. Though there have been various screening tools used, a simplified tool validated in study population was not used in study antenatal women till now. The objective of this study was to estimate the prevalence of depression among antenatal women admitted in the department of obstetrics and gynecology, Government Medical College, Thrissur and also to study the risk factors associated with depression in the study population.Methods: A questionnaire based cross sectional observational study was conducted among 100 antenatal women in their third trimester. PHQ-9 questionnaire was used to screen for depression and the information regarding risk factors was collected from the patient, her caregivers and from clinical records. Data analysis was done using EPI-INFO/SPSS software.Results: Prevalence of depression among hospitalized mothers: 53%. Most cases (70%) had: mild depression (PHQ Score: 5-9). Only very few (2%) of them had severe depression (PHQ score: more than 20). 9% had: moderately severe depression (PHQ score: 15-19). 19% had: moderate depression (PHQ score: 10-14). Statistically significant risk factors identified in this study were fetal gender preference, anxiety about labour process, anxiety about labour pain, anxiety about making the baby a part of their life and anxiety about baby’s health.Conclusions: The prevalence of depression among hospitalized mothers using PHQ-9 scale is high (53%). Screening for depression was found to be feasible and can be made a part of routine antenatal care so that appropriate interventions can be provided to improve maternal mental health and thereby prevent the maternal mortality occurring due to suicides.