ABSTRACT
Aim: The aim of this study is to evaluate oral submucous fibrosis (OSMF) by clinical and histopathological examination, and compare the results with those from ultrasonographic technique. Materials and Methods: 30 clinically diagnosed OSMF patients were subjected to both ultrasonographic and histopathological evaluation before treatment. Later, only ultrasonographical examination was done during 4 th and 8 th week of treatment. Prognosis of the lesion for the treatment was evaluated. Peak systolic velocity (PSV) of blood in the lesional area was statistically analyzed. 10 normal individuals without any mucosal lesions were considered as the control group. Results: In normal individuals, ultrasonography delineates normal mucosa with uniform fine mottled appearance with interspersed hypoechoic areas. Color Doppler and spectral Doppler depicts uniform distribution of blood vessels and normal peak systolic velocity of blood respectively. All OSMF patients were diagnosed upon clinical and histopathological examination. Clinical examination revealed 14 individuals with unilateral palpable fibrotic bands and 16 individuals with bilateral fibrotic bands whereas, ultrasonographic evaluation revealed 6 individuals with unilateral fibrotic bands and 24 individuals were with bilateral fibrotic bands, which was statistically significant. Ultrasonography demonstrated number, length and thickness of the fibrotic bands. Color Doppler and spectral Doppler showed decreased vascularity and PSV in lesional area. Prognosis evaluation revealed 25 cases of good prognosis and 5 cases were showed poor prognosis. Wilcoxon Signed Ranks Test revealed no significant difference of PSV was seen in poor prognosis patients. Conclusion: Ultrasonography is a non-invasive diagnostic tool for OSMF. It could be a better diagnostic tool compared to clinical and histopathological examination.
Subject(s)
Adult , Blood Flow Velocity/physiology , Blood Vessels/diagnostic imaging , Dexamethasone/administration & dosage , Dexamethasone/analogs & derivatives , Dexamethasone/therapeutic use , Drug Combinations , Fibrosis , Follow-Up Studies , Glucocorticoids/administration & dosage , Glucocorticoids/therapeutic use , Humans , Hyaluronoglucosaminidase/administration & dosage , Hyaluronoglucosaminidase/therapeutic use , Injections, Intralesional , Mouth Mucosa/blood supply , Oral Submucous Fibrosis/drug therapy , Oral Submucous Fibrosis/pathology , Oral Submucous Fibrosis/diagnostic imaging , Prognosis , Pulsatile Flow/physiology , Treatment Outcome , Ultrasonography, Doppler , Ultrasonography, Doppler, Color , Ultrasonography, Doppler, Duplex , Young AdultABSTRACT
Audit in medicine is a well tried means of assessing the quality of practice by using acceptable measures of outcome. Audit in maternal and child health has been limited to fatal outcomes such as maternal and perinatal deaths. The outcome of audit is of interest to the providers, the health authorities and the consumers. The utility of audit lies in effective use of data to improve quality of service. Quality control of instruments and education of junior staff are some other benefits of audit. The limitations of manpower, money, means, fear of litigation and above all dislike of clinicians for handling data are hurdles in the way of effective audit. The concept of 'Standard Primipara' and 'Total Fetal Wastage' are likely to add new dimension to perinatal audit.
Subject(s)
Child Health Services/standards , Female , Humans , Infant, Newborn , Maternal Health Services/standards , Medical Audit/methods , Outcome Assessment, Health Care , Pregnancy , Pregnancy Outcome , Quality Assurance, Health CareABSTRACT
Nine cases of tubal carcinoma were found in a period of 20 years in JIPMER Hospital among approximately 9,000 gynaecological malignancies. Most patients were diagnosed as malignant ovarian tumour, but two cases presented unusually, one as Meig's syndrome and another as acute hemoperitoneum. This often stressed symptom of amber discharge or hydrops tubae profluens could not be elicited in any patient. All the patients underwent surgical treatment and radiotherapy or chemotherapy. The period of follow up ranged from two months to four and half years.