ABSTRACT
"To evaluate the usefulness of PCR in diagnosing genital tuberculosis in female infertility and its sensitivity,specificity, positive predictive value, negative predictive value and its edge over other diagnostic modalitieslike histopathological examination and culture. This study included 100 infertile women who met the inclusionand exclusion criteria. After a detailed history, clinical examination and investigations, endometrial curettingswere taken in premenstrual phase and sent for culture, histopathological examination and PCR. Afterevaluation the results were compared individually with each other or in combination to see the positive pickup percentage and their sensitivity and specificity. We found 4% cases positive for tuberculosis on culturefor Mycobacterium tuberculosis, 7% of cases positive histopathologicaly and 15% cases on PCR evaluation.The sensitivity for diagnosing this disease was found highest in PCR (100%) followed by histopathologicalexamination (75%). Culture had the least sensitivity of 42.85%. PCR represents a rapid and sensitivemethod for identification of Mycobacterium DNA in female genital tuberculosis. Culture and histopathologyhave low sensitivity compared to PCR. Therefore, when the clinical suspicion is high and culture andhistopathology is negative, PCR is the method of choice for identifying the infection."
ABSTRACT
We compared Transvaginal Sonography (TVS) with histopathological results of the dilatation and curettage biopsies in 50 women with postmenopausal bleeding attending Gynaecology out-patient department of SMGS hospital, Jammu. These women underwent TVS followed by histopathological examination of endometrium. Endometrial lesions detected by histopathology in these women were: hormonal effects (proliferative and secretary endometrium) in 5 (10%), endometrial polyps in 4 (8%), endometritis in 2 (4%), endometrial hyperplasia in 9 (18%) and endometrial carcinoma in 5 (10%). A total of 21 (42%) showed atrophic endometrium and in 4 (8%) women, sample was insufficient. On TVS, 24 (48%) women had endometrial thickness (ET) < 5 mm and 26 (52%) women had ET > 5 mm. At a cut-off limit of > 5 mm for endometrial thickness indicating pathologic endometrium, the sensitivity and specificity of TVS was 100% and 80% respectively and a predictive value as a positive test, as a negative test and accuracy was 76.9%, 100% and 89% respectively. This study shows that TVS allows detection of endometrial pathology in vast majority of women and it is relatively easy, cheap, non-invasive and does not require anesthesia. It can be used as the first diagnostic step in the investigations of women with postmenopausal bleeding.
ABSTRACT
Fetal Kidney Length (FKL) is most accurate single parameter for estimating GA than other biometric indices in late 2nd and 3rd trimester and could be easily incorporated into the models for estimating GA. We evaluated role of FKL in estimation of gestational age (GA) in late 2nd & 3rd trimester. A total of 98 pregnant women with singleton pregnancy underwent serial biometric & FKL measurements ultrasonographically at 24, 28, 32, 36 and 38 weeks of gestation. These measurements were used to date the pregnancies relative to dating by last menstrual period. Linear regression models for estimation of GA were derived from the biometric indices and FKL. New models were constructed by combining different biometric indices and kidney length in various combinations. Comparison of accuracy in prediction of GA was made between individual parameters and these models to obtain best individual parameter and the best model in prediction of gestational age. Left FKL was slightly, but significantly longer than right FKL at each gestational period observed in the study. Standard error of prediction of GA was least for FKL (±8.56 days), closely followed by femur length (±8.9 days) and maximum for abdominal circumference (±11.72 days). The best model in estimating GA included all the five variables (femur length, FKL, biparietal diameter, head and abdominal circumference) with a standard error of ±7.41 days. FKL is the most accurate single parameter for estimating GA than other biometric indices in late 2nd and 3rd trimester and could be easily incorporated into the models for estimating GA.