Histological patterns of endometrial lesions in endometrial curettage specimens of abnormal uterine bleeding patients

Background: Endometrial curettage is one of the commonest invasive gynecological procedure in reproductive as well as post reproductive age in abnormal uterine bleeding

Objective: To determine the histological types of endometrial lesions in curettage specimens, of women having abnormal uterine bleeding

Methodology: This descriptive study was conducted in Bannu Medical College from 1[st] March 2011 to 31[st] May 2014. A total of 170 endometrial curettings were included in the study. The inclusion criteria was sufficient endometrial specimen from women of any age with abnormal uterine bleeding, where as the exclusion criteria was insufficient curetting specimen. A minimum of one sections and a maximum of three sections were taken from the endometrial specimen. Sections 5 micron thick were prepared and stained with H and E and reported by histopathologist. The data was entered and analyzed in SPSS version 17

Results: A total of 170 endometrial specimens were included in this study with age range from 21 to 73 years. The most common age group encountered was 31-40 years, in which 67[39%] cases of endometrial specimen were noted. The common histological lesion were secretory phase endometrium 54 [31.7%] followed by proliferative phase 47 [27.6%], retained product of conception 16 [9.41%], endometritis 13 [7.64%] and endometrial polyp 12 [7.05%]

Conclusion: This study showed that that endometrial curettage is a significant diagnostic tool in identification of the lesion leading to abnormal uterine bleeding in any age patients

Correlation of increasing maternal gravidity with severity of polyhydramnios

To find correlation of increasing maternal gravidity with severity of polyhydramnios. This descriptive study was done in Gynecology and Obstetrics department, Khyber Teaching Hospital, Peshawar, from July 2010 to December 2011. Patients were included in the study by consecutive non-probability sampling after fulfilling the inclusion criterion and given informed written consent. Detailed history about the status of maternal gravidity was taken and thorough per abdominal and vaginal examinations were performed. Polyhydramnios was confirmed ultrasonographically and categorized as mild, moderate or severe on the basis of amniotic fluid index. SPSS 16 was used for analyzing the descriptive data. Spearman rank correlation analysis [gamma] was used to measure the strength of association between pairs of variables. The total number of patients were 532. Mean age was 30.30 +/- 6.28years and mean age of gestational amenorrhea was 35.6 +/- 3.35weeks [28-41]. The maximum number of patients [57.4%] were in the age range group of 23-30 years. The number of patients with primary gravida were 33.6%[n=180],38.8%[n=206] were with multigravida and 27.6%[n=146] with grand multigravida. Severe polyhydramnioswas in 10.4%[n=55] cases while moderate and mild in 25.5%[n=135] and 64.1%[n=341] respectively. Majority of the patients having mild polyhydramnios were primary gravida or multigravida while the grandmultigravida patients were mostly either having moderate or severe polyhydramnios. The spearman rank correlation coefficient between the pairs of variables was [gamma] + 0.02, [p=0.04]. Increasing maternal gravidity has weak positive correlation with severity of polyhydramnios

Accuracy of estimated fetal weight by clinical assessment and ultrasonography

To compare accuracy of estimating fetal weight of term fetus by clinical assessment and Ultrasonography. Comparative Clinical Trial Study. This study was conducted in obstetrics and gynecology unit of Hayt abad Medical complex. This study was carried out on 300 subjects, with full term; normal pregnancy. Patients had fetal weight estimation by two approaches. 1] Clinical assessment done by Leopold's maneuvers and symphysio fundal height in centi-meters and 2] Sonographic measurement by using Toshiba capacee with curvilinear transducer of 3.5 MHz. Birth weight at delivery was used on gold standard. The accuracy of these two methods of estimating fetal weight was compared using student t test, and [2] P>.05 was considered significant. Out of 300 cases, 292 cases were compared both. Ultrasonically and by clinical assessment while 8 babies could not be picked up of ultrasonically because of fetal weight more than 4.0 KG, out of 292 cases [218] 72.7% were assessed. Correctly by clinical assessment while [224] 74.7% were assessed correctly by ultrasonography. Clinical assessment is equally accurate as ultrasonography in normal term birth weight estimation

Frequency of ABO and Rhesus blood groups in district Swat, Pakistan

Up till now about 400 red cells antigen have been identified. The majority are inherited by Mendelian Fashion. The ABO blood group system was first to be identified and RH blood group system was the 4th one, both are most important for blood transfusion purposes. This study is conducted to determine the frequency of ABO and Rhesus [Rh] blood groups in District Swat, NWFP, Pakistan. It is a cross sectional prospective study and was conducted at Saidu Teaching Hospital district Swat, over a period of one year. [1[st] Jan, 2007 to 31[st] Dec, 2007]. A total of 22897 subjects were included in this study. Patients were collected from different wards of Saidu Teaching Hospital while the donors from common population. From each subject blood was collected, ABO and Rh blood grouping were carried out by tile method using commercially prepared anti sera. The frequency of each type was calculated. Out of 22897 subjects 17141 [74.86%] were male subjects and 5756 [25.14%] were female. Out of 17141 male subjects 15597 [90.99%] and out of 5756 female subjects 5040 [87.56%] were found to be Rh-positive. The frequency of Rh-negative group in male subjects were [9.01%] where as in female subjects were [12.22%]. The frequency of A, B, O and AB groups in Rh-positive male subjects were 25.63%, 29.54%, 26.04% and 9.78%, amongst female subjects, it was 24.53%, 28.06%, 25.54% and 9.43% respectively. In Rh-negative male subjects the frequency of A, B, O and AB is 2.25%, 2.88%, 3.01% and 0.88%, while amongst females it is 3.54%, 4.24%, 3.74% and 0.92% respectively. It is concluded from this study that frequency of Rh-positive blood group is B, O, A, and AB in both gender. Where as the most common Rh-negative in male and female subjects are O, B, A, AB, and B, O, A, and AB respectively

Detection of abnormal cervical cytology by Pap smears

Cervical intra-epithelial neoplasia and cervical cancer remain important health problems for women worldwide. Cervical cytology by Papanicolaou stained smears is an effective means of screening for cervical pre-malignant and malignant conditions. This study was designed to determine the prevalence of cervical intra epithelial neoplasia in this region and the role of pap smears for its detection. It was hospital based study on patients who attended the Out Patient Department of Lady Reading Hospital, Peshawar, Pakistan, from January to September 1997. Patients presenting with vaginal discharge, dyspareunia, post-coital bleeding, backache or pain hypogastrium were included. Patients having vaginal bleeding other than post-coital, were excluded from the study. Relevant information was obtained from the patients and recorded. Samples were collected and transferred to glass slides, fixed and stained by Papanicolaou stain. Each slide was carefully examined. Three hundred patients were included in this study. One hundred and twenty three [41%] patients had complaints of vaginal discharge, 39 [13%] post-coital bleeding, 108 [36%] dyspareunia and 30 [10%] backache and /or pain hypogastrium. Regarding contraception, 37 [12.33%] patients were pill users, 31 [10.33%] were on injectable contraceptives, 32 [10.67%] were using barrier method of contraception, 34 [11.33%] patients were having an intrauterine contraceptive device and 160 [55.33%] patients were not using any method of contraception. Pap smears revealed that 8 [2.67%] patients were having cervical intra-epithelial neoplasia. Among these patients, 1 [12%] had intra-uterine contraceptive device, 3 [38%] were on oral contraceptive pill, while 4 [50%] were not using any contraceptive method. One hundred and seventy eight [59.33%] patients were having past history of genital infection where as 128 [42.67%] patients had no such history. Age at first coitus was below 20 years in 268 [89.33%] patients whereas it was above 20 years in only 32 [10.67%] patients. All these patients belonged to poor socio-economic class. Cervical intra epithelial neoplasia is not uncommon in our set up. It can be diagnosed early by Pap smears