Comparative study between liquid-based cytology & conventional Pap smear for cytological follow up of treated patients of cancer cervix

Background & objectives: Cancer cervix is one of the most common forms of genital malignancy among Indian women. Recurrence is seen in a significant number of cases. The conventional cervical smear technique has inherent problems and screening and interpretation errors. This study was undertaken to assess the efficacy of liquid-based cytology (LBC) as a method for cytological follow up and detection of recurrence in treated cases of cancer cervix and to compare it with conventional Pap smear technique to find the best screening method for detection of recurrence in these patients. Methods: This cross-sectional study was conducted over a period of one year. Patients attending Gynecology and Radiotherapy outpatient departments for follow up after treatment of cancer cervix were included. Pap smear and LBC were taken in all cases. Colposcopy and biopsy were done for those having epithelial cell abnormality in cytology report. Colposcopy and biopsy were taken as gold standard for diagnosis of cancer cervix recurrence. Results: Ninety four treated patients of carcinoma cervix were studied. The diagnostic accuracy for detection of recurrence of conventional Pap smear was 79.16 per cent, and that of LBC was 97.6 per cent. The difference between the two methods was significant (P<0.001). Interpretation & conclusions: Our findings showed that LBC performed better than the conventional method of cytology to detect recurrence of squamous cell carcinoma. Its sensitivity, specificity as well as accuracy were much higher than conventional method. LBC can be a better method of cytological follow up of post-treated patients of cancer cervix.

Prognostic significance of pre discharge one hour electrocardiographic monitoring in patients recovering from acute myocardial infarction.

During a 15 months period, 97 patients with AMI were monitored continuously at hospital discharge for one hour. The VPCs or no VPC noted during this period of continuous monitoring were correlated with subsequent cardiac events during one year follow up. Patients with complicated VPCs had a significantly higher incidence of cardiac deaths and non-fatal re-infarctions during one year follow up (54.5%) as compared to patients with no VPCs (6.5%) (p less than .001). Patients with higher grades of VPCs had more complicated course (30.3% to 66.7% for Lown Grade II to IV) as compared to 6.5% and 20.8% for grade Lown O and I. Though, the results of this 1 hour continuous monitoring at hospital discharge are not as sensitive as with ambulatory Holter monitoring as is evident from this study where complicated VPCs were detected in 11.4% patients vs. 33% with Holter monitoring, it could be a useful tool in institutions where the facility of Holter monitoring does not exist.