ABSTRACT
To identify precursor lesions of cancer cervix and early cancer cervix in married women with primary complaint of leucorrhoea in a tertiary referral centre with reference to effectiveness of screening methods, 100 successive women attending colposcopy clinic with primary complaints of leucorrhoea were selected . All women had speculum examination, Pap smear, vaginal pH, Whiff test, visual inspection of cervix after application of acetic acid (VIA), visual inspection of cervix after application of Lugol's iodine (VIL), colposcopy done. Biopsy was taken when indicated. A total of 63 women were referred. There were 93 menstruating women. The mean age was 34.5 years. Whiff test was positive in 6 women. Downstaging showed 74 women with abnormal cervix. VIA was postive in 44 women and VIL in 53 women. The sensitivity and specificity of VIA was 77.7% and 75%, and that of VIL was 69% and 57% respectively. Diagnostic accuracy of VIA was 76%,VIL was 63%. Pap smear showed 87% accuracy. The correlation between colposcopy and histopathological examination was 93-98%. Precursor cancer cervical lesions, were found in 27% of women. Referral women with cancer precursor lesions formed the largest group of 24% (n=24) of total women. Early carcinoma cervix was detected in 3% (n=3) of which one woman was referred. The burden of carcinoma cervix in India can be brought down by screening camps and early referral.
Subject(s)
Acetic Acid/diagnosis , Adult , Aged , Carcinoma/diagnosis , Cervix Uteri/pathology , Coloring Agents/diagnosis , Colposcopy , Early Detection of Cancer , Female , Humans , Hydrogen-Ion Concentration , India/epidemiology , Indicators and Reagents , Iodides/diagnosis , Mass Screening/methods , Middle Aged , Reproducibility of Results , Sensitivity and Specificity , Uterine Cervical Neoplasms/diagnosis , Vagina/chemistry , Vaginal Smears , Young AdultABSTRACT
A pilot project on Community Based Rehabilitation was launched by the Hind Kusht Nivaran Sangh in South Arcot District of Tamil Nadu with the help of the Hemerijckx Rural Centre, Rawttakuppam on an experimental basis to assess the cost effectiveness and suitability of its application in other districts. Twenty cured disabled leprosy patients with grades 1 and 2 deformities from 17 villages were given training in trades like cycle repairing, tailoring, pesticides spraying, doll making, cane work, cigar making, fish net knitting and incense stick making. The duration of the training varied from two to six months depending upon the trade. Local artisans and craftmen from among the community members were identified, motivated, and utilised as trainers. The travel and maintenance costs paid to the trainees was an incentive to learn the trade and the honorarium paid to the trainers motivated them to spare their time to impart the skill within the specified period. On completion of training, start-up funds needed for purchase of tools and accessories required for pursuing the vocation were arranged through banks under DRI scheme, IRDP schemes from BDO office and from other voluntary agencies. The total expenditure incurred for training 20 cured disabled leprosy patients worked out to only Rs. 25,350/-i.e., approximately Rs.1,250/- per patient. Out of the 20 patients trained, 17 have already started earning through the skills imparted to them.