ABSTRACT
Introduction: Sepsis in elderly patients is a critical clinicalissue due to high rates of morbidity and mortality. The modernage cell counters precisely measure volume, size and internalstructure of the cell thereby assessing increase in volumeand cytoplasmic granularity of leukocytes as seen in casesof sepsis. The present study was done to evaluate the useof Volume Conductivity Scatter (VCS) parameters as earlyindicators of sepsis in elderly patients and to overcome theshortcomings of blood culture by using a more precise VCStechnology to assess morphologic changes in cell populationsin sepsis.Material and Method: The study included 51 patients abovethe age of 50 years which were divided into 2 groups Group1, patients with localised infection (n= 39) and Group 2 withsystemic infection (n=12). Group 3 included 30 controlswithout any signs of infection and with total leucocyte countand differential counts within normal limits. Coulter LH 750cellular analysis system was used.Result: Significant increase in both mean neutrophil volume(MNV) and mean monocyte volume (MMV) was reportedamong the patients with sepsis as compared to localizedinfections or control. With a cut off of 145 and 170 for MNVand MMV respectively, a sensitivity of 96% and 91.4% wasobtained in predicting sepsis.Conclusion: Both MNV and MMV have the potential to beused as early indicators of acute bacterial infections.
ABSTRACT
Background and Objectives: Cervical cancer is very common type of cancer in women globally. The objective of this study was to compare the cytopathological findings of the cervical pap smears using the revised 2001 Bethesda system and to compare the cytopathological findings with the clinical features.Material and Methods: A total of 1016 pap smear sent to the Department of Cytopathology at Peoples Dental college general hospital (PDCH), Kathmandu over a period of three years were studied. Relevant history and clinical findings were retrieved for the study. The age, caste, location, gravida of the patient, the nature of complaint of patient to the doctor along with the per speculum findings, per vaginal examination findings of the patient and their relation to the cytopathological findings of pap smears were evaluated.Results: No significant relationship was observed between the (30-39 years) aged women and the available outcome of pap smear (p=0.404). Most of the females were Brahmin and Newars. The statistical analysis showed no significant relationship (p>0.05) between the ethnicity and pap smear result. The number of asymptomatic women in this study was found 22.9%. This study found 20.37% of intraepithelial lesion or malignancy. Trichomonas vaginalis and bacterial vaginosis combinely contributed to 0.7% of the total cases in this study. Three smear cases were detected having malignant epithelial cell which were diagnosed with adenocarcinoma, squamous cell carcinoma.Conclusion: In this study cervical pap smear was able to differentiate inflammatory, benign precursors and malignant cases. So, it is desirable to conduct routine Pap smear screening in women of all reproductive age regardless of race, ethnic background and socioeconomic status.
ABSTRACT
Background: Leucorrhoea is the clinical evidence of infection and can be treated satisfactorily whenever diagnosed. Occurrence of cervical cancer associated with discharge/leucorrhoea can be easily prevented if detected early. Majority of patients attending hospital present with varying degree of vaginal discharge and cytological monitoring of these subjects is mandatory to know any cellular changes in the cervical epithelium as well as the presence of any sexually transmitted diseases (STD’s) in the genital tract. Materials and methods: This research study was done at Malla Reddy Institute of Medical Sciences (MRIMS), Suraram, Hyderabad, Telangana State, India for a period of 2 years. A total of 500 cases were included in the study with women of age ranging from 20-50 years, complaining of Leucorrhoea. As told by the patients on questioning as a part of clinical history, the Leucorrhoea was found to be of different types white discharge, yellowish discharge, greenish discharge; blood stained and fouls smelling discharge. Smears were taken with a thorough history in particular reference to age at first child birth, parity, personal and genital hygiene, history of husband suffering from any sexually transmitted diseases, vaginal discharge, mass per vaginum, duration of labour and history of sexually transmitted diseases were elicited. Results: In our study of 500 cases, 348 (69.6 %) cases showed reactive cellular changes associated with repair (Inflammatory smear), 56 (11.2%) cases were due to various infectious agents, 32 cases P. Sujatha, V. Indira, Kandukuri Mahesh Kumar. Study of PAP smear examination in patients complaining of leucorrhoea - A 2 years prospective study in a teaching hospital. IAIM, 2016; 3(5): 106-112. Page 107 (6.4%) were of Reactive changes with Atrophic vaginitis, Low grade squamous intraepithelial lesion (LSIL) 18 cases (3.6%), High grade squamous intraepithelial lesion (HSIL) 5 cases (1%), Atypical squamous cells of undetermined significance (ASCUS) 4 cases (0.8%), Atypical glandular hyperplasia 4 cases (0.8%),Suspicious of malignancy 9 cases (1.8%),Shift in flora suggesting Bacterial vaginosis 7 cases (1.4%), Normal smear/ Normal study 13 cases (2.6%) ,Unsatisfactory for evaluation as more than 75 % of smear is obscured by blood – 4 cases (0.8%). Conclusion: A Pap test (Pap smear) is a quick and simple test that checks for changes to the cells of your cervix that may lead to cervical cancer. Pap smear reduces the mortality and morbidity with cervical cancer. This cytological screening should gain much popularity and should be accessible to all. It is recommended as part of routine medical examination in gynecological practice.