RESUMO
Background: Cervical cancer is still one of the most common cancers affecting females in India, leading to a lot of mortality and morbidity. The objective of this study was to assess the awareness of the human papillomavirus (HPV) infections and vaccination among the medical students of a tertiary care teaching hospital.Methods: A total 300 final year I and II medical students were requested to complete a questionnaire regarding cervical cancer, primary and secondary preventive measures and attitude of students towards HPV vaccination and the answers were then analysed.Results: Among 300 medical students, 46.6% were males and 53.4% were females. Most of them were aware of the common risk factors like early marriage (92.7%), multiple partners (99%), multiparity (83.3%) and HPV exposure (85.7%). Most were aware of the cervical cancer symptoms like offensive vaginal discharge (70%), irregular vaginal bleeding (92.7%) and postcoital bleeding (80.3%). 90% were aware that cervical cancer is preventable and 74% were aware that vaccine is available in India. 70% were aware about the best age to vaccinate is 9-13 years. About 10% were already vaccinated and all were females. Out of 270 students who have not administered HPV vaccine, 53.4% didn’t take the vaccine because of lack of awareness. High cost (18.8%), fear of side effects (13.8%) and doubt on efficacy (14%) were the other reasons reported for non-administration of vaccines.Conclusions: The study showed that there were gaps in knowledge regarding HPV infection and vaccination existed amongst the medical students. So, awareness among the students should be created and a more integrated teaching regarding various aspects of HPV infection, cervical cancers and its prevention needs to be introduced in the medical education system.
RESUMO
Background: Pre-operative knowledge regarding the nature of ovarian mass is necessary in order to plan surgery. Risk malignancy index (RMI) is a simple scoring system based on three factors serum CA 125, USG score and menopausal status. The RMI was interpreted as 1) score >250=high risk, 2) 25-250=intermediate risk, 3) score <25=low risk. The objective of the study was to evaluate risk malignancy index (RMI) in pre-operatively clinically diagnosed ovarian mass and to compare the validity of individual parameter in RMI i.e. menopausal status, serum CA 125 and USG score to differentiate the nature of clinically diagnosed ovarian masses as benign or malignant.Methods: This was an observational study conducted in the Department of obstetrics and gynaecology, Trichy SRM Medical College and Research Centre, Trichy from January 2017 to January 2018 with a sample size of 77 cases with clinical diagnosis of ovarian mass admitted for surgery. The validity of RMI and validity of individual parameters were calculated and compared.Results: A total of 77 patients with ovarian tumors were enrolled in this study. According to the histological examination of the surgical specimens of the 77 women, 27.3% (n=21) had malignant tumors and 67.7% (n=56) had benign disease. Most common benign tumour was serous cystadenoma and the most common malignant tumour was mucinous cystadenocarcinoma. Among 77 patients, 42.85% (n=33) were postmenopausal, 44.15% (n=34) had USG score of 4, 27.27% (n=21) had serum CA125 level >cut-off values and 27.27% (n=21) had RMI >250. In cases where RMI>250, 18 out of 21 were malignant. In cases where USG score was 4, 19 out of 34 were malignant. Of the cases where serum CA125 level was > cut-off values 16 out of 21 were found to be malignant. RMI showed better sensitivity of 85.71%, specificity of 94.64%, PPV of 85.71%, NPV of 94.64% and diagnostic accuracy of 92.20%.Conclusions: RMI is highly valuable and reliable in differentiating benign and malignant ovarian lesions and facilitates selection of cases for conservative management and oncology referral.