ABSTRACT
Background: Polycystic ovarian syndrome (PCOS) is the most commonly prevalent endocrinopathy of reproductive age women. It is a significant public health issue with reproductive, metabolic and psychological features. Because patients with PCOS are at high risk for developing glucose abnormalities, the early identification of affected patients and institution of life style changes or pharmacological treatment may help reduce the long-term risks associated with PCOS. This study was done to assess the prevalence of glucose abnormalities and to evaluate the efficacy of Fasting blood glucose (FBG) in detecting glucose abnormalities when compared to 2 hrs oral glucose tolerance test (OGTT).Methods: Hospital based cross sectional study carried out in 300 women diagnosed as PCOS according to Rotterdam criteria. In patients diagnosed as PCOS, Fasting Blood Glucose and OGTT were done. OGTT taken as an accurate test and FBG values compared with OGTT values to evaluate the efficacy of FBG. Prevalence of glucose abnormalities and association with age, BMI and clinical features was evaluated.Results: Glucose abnormalities were detected in 69 (23%) women with 2 hours OGTT, but with FBG only in 49 (16.33%) women, around one third of women were missed. Sensitivity of FBG was 71.01% (95% CI 58.84% to 81.31%). Mean age of women with abnormal OGTT (27.99) was significantly higher than the women with normal OGTT (24.7). Mean BMI of women with abnormal OGTT (27.42) was significantly higher than the Mean BMI of women with normal OGTT (23.36).Conclusions: Sensitivity of FBG was low in detecting glucose abnormalities. Increasing age, increase in a BMI, menstrual abnormalities, hirsutism/acne and family history of diabetes appear to have positive linear correlation with prevalence of glucose abnormalities.
ABSTRACT
Background: There are multiple screening methods available for screening cervical cancer with their advantages and disadvantages, researches that compare the sensitivity, specificity, positive and negative predictive values of these tests in a low-cost setting specific to a geographical area is lacking and has to be enhanced. The objective of this study was to determine and compare the agreement, sensitivity, specificity and predictive values of conventional Pap smear cytology, liquid-based cytology and VIA/VILI with cervix biopsy.Methods: This cross sectional study was conducted on women of >35 years of age. Pap smear specimen was collected followed by Liquid Base Cytology (LBC) using cytobrush specimen after which visual inspection with 5% acetic acid (VIA) and visual inspection with Lugol’s Iodine (VILI) procedure was carried out and followed by cervix biopsy. All methods were analyzed for accuracy.Results: Sensitivity was lowest for PAP smear (39.1%, 95% CI 19.18% to 59.1%), followed by VIA VILI (95.7%, 95% CI 87.32% to 100%), and highest for LBC (100.0%). The negative predictive value was lowest for PAP smear (87.4%, 95% CI 81.21% to 93.6%), followed by VIA VILI (99.0%, 95% CI 96.99% to 100.0%) and highest for LBC (100%). The overall diagnostic accuracy was lowest for PAP smear (88.3%) followed by VIA/VILLI (99.2%) and highest for LBC (100%).Conclusions: Treatment decisions based on findings of the PAP smear have to be taken with caution, considering the lower sensitivity. Wherever resources are available more accurate screening methods like liquid-based cytology must be used.