ABSTRACT
Background & objectives: Staging of cervical carcinoma is done clinically using International Federation of obstetrics and Gynecology (FIGO) guidelines. It is based on physical examination findings and also includes results of biopsy, endoscopy and conventional radiological tests like chest radiograph, intravenous urography and barium enema. These conventional radiological investigations have largely been replaced by computed tomography (CT) and magnetic resonance imaging (MRI) at present. FIGOo staging system does not consider CT and MRI mandatory; however, use of these modalities are encouraged. tThis prospective study was conducted to determine the role of CT in staging work up in women diagnosed with cervical carcinoma. Methods: Fifty three women diagnosed with cervical carcinoma were evaluated with contrast enhanced CT scan of abdomen and pelvis. CT scan images were especially evaluated to determine tumour size, invasion of parmetrium, pelvic walls, rectum, urinary bladder and ureters, pelvic or retroperitoneal lymphadenopathy and distant metastases. CT findings were associated with clinical findings and staging, including findings from cystoscopy and sigmoidoscopy. Results: There was a poor agreement between clinical and CT staging of cervical carcinoma. Primary tumour was demonstrated on CT in 36 (70%) of 53 patients. CT underestimated the parametrial, vaginal and pelvic wall invasion when compared with physical examination. CT overestimated the urinary bladder and rectal invasion when compared with cysto-sigmoidoscopy, however, CT had 100 per cent negative predictive value (NPV) to exclude bladder and rectal involvement. CT detection of lymph node enlargement and lung metastases influenced the management. Interpretation & conclusions: Our findings show that CT scan does not reliably correlate with clinical FIGOo staging of cervical cancer. However, it can detect urinary obstruction as well as nodal or distant metastases and thus improves the clinical FIGOo staging
ABSTRACT
The effect of crude proteinase inhibitor extracts from seeds of different crop plants (black gram, chickpea, chickling vetch, finger millet, French bean, green gram, horse gram, lentil, pea and soybean) on the insecticidal activity of B. thuringiensis var. kurstaki HD-1 was investigated against neonate larvae of H. armigera by diet incorporation method. The larval mortality due to crude proteinase inhibitors alone (5% seed weight equivalent) ranged from 4.1 to 19.1%; the maximum mortality with finger millet and the minimum with pea var. DDR-23. A mixture of B. thuringiensis var. kurstaki HD-1 (10 ppm) and proteinase inhibitor (5% seed weight equivalent) was synergistic in larval mortality with respect to proteinase inhibitors of pea var. DMR-16, chickling vetch var. RLK-1098 and B101-212, lentil var. ILL-8095 and L-4076, soybean var. PK-1042, PK-416 and Pusa-22, chickpea var. Pusa-413, French bean (Chitra) and black gram; and antagonistic with respect to those of finger millet, horse gram and kidney bean. The larval growth reduction with crude proteinase inhibitors alone ranged from 17.9 to 53.1%; the maximum growth reduction with soybean var. PK-1042 and minimum with lentil var. L-4076. A mixture of B. thuringiensis var. kurstaki and proteinase inhibitor was synergistic in growth reduction with respect to proteinase inhibitors of lentil var. ILL-8095, and L-4626 and antagonistic with respect to that of finger millet. The midgut proteinase inhibition with crude seed extracts (3.3% seed weight equivalent) ranged from 9.3 to 60.9% and was negatively correlated with larval mortality. These results showed that interactive effect of B. thuringiensis var. kurstaki HD-1 and proteinase inhibitors in the larvae of H. armigera depended upon the quality and quantity of proteinase inhibitors, which vary widely in different plants.