audit of clinicopathological indications of abdominal hysterectomy

To determine clinical indications of abdominal hysterectomy and compare these with histopathological diagnosis. A descriptive study. Case records of all the women that underwent major gynaecological operations in one calendar year period i.e. January to December, 2005 were reviewed. The cases that underwent total abdominal hysterectomy were selected and studied for the indications. All the patients had been admitted through the out patient department [OPD] for the complaints of irregular vaginal bleeding with or without pain and mass in lower abdomen. A total of 306 major gynaecological operations were carried out, of which 180 [58.81%] were abdominal hysterectomies. Majority of the women [65%] were between 35-45 years of age. The most frequent presenting symptom was pain and irregular vaginal bleeding [57.5%], irregular vaginal bleeding [25%] and mass in lower abdomen [7.2%]. Disparity was found between clinical and histopathological diagnosis in cases of leiomyoma [36% clinical and 38.3% histopathological] and adenoma [11.1% clinical and 27.2% histothological]. Clinical diagnosis of dysfunctional uterine bleeding was made in [26.1%] of which only 20% were confirmed histopathologicaly. There was a disparity of 6 - 16% between clinical and histopathological diagnosis especially in cases of adenomas, dysfunctional uterine bleeding and leiomyoma. Therefore, accurate clinical assessment of cases should be the main stay of diagnosis and categorization for different indications of hysterectomy

PAP smear screening in hospital based population

To reduce the mortality rate in women due to cervical cancer by early detection. To calculate magnitude pattern and proportion of PAP positive cases among high risk population and associate variables to PAP positive cases. Descriptive, cross-sectional Gynaecology and Obstetrics out patient department of Shaikh Zayed Medical Complex and Sir Ganga Ram Hospital Lahore from June 2005 to May 2006 The smears were analysed in Histopathology department of Shaikh Zayed Medical Complex. A total of 1500 smears were taken, 511 [34.1%] from Sir Ganga Ram Hospital and 989 [64.9%] from Shaikh Zayed Medical Complex. The mean age was 42 +/- 8 years with a range of 35-80 years. Prevalence of positive cases was 3.9% with majority of [2.5%] falling in the age group 35-40 yrs. Cases with positive cervical intraepithelial neoplasia [CIN] had strong association with family history of cancer [p-<0.002, OR=3.284,CI: 1.497-7.2203]. On examination cervix bled to touch in 25 cases [p-<0.0001.0R=2.721,Cl: 1.595-4.645], it was suspicious looking in 8 cases [p-<0.0001,OR=8.714,CI:3.758-20.21] and 5 cases had post menopausal bleeding [p-<0.006. OR=3.582,CI: 1.354-9.481]. However no association was found with smoking, hormonal intake or post coital bleeding. PAP smear should be used as a routine test for every woman aged 35 or above coming to the gynaecology department for symptoms of abnormal vaginal discharge, bleeding, or low backache for early detection of cervical cancer