Role of chromohysteroscopy in detection of endometrial pathology in abnormal uterine bleeding

Background: Abnormal uterine bleeding is one of the most common clinical problems encountered in gynaecological practice. Chromohysteroscopy is thought to improve the diagnostic accuracy of hysteroscopy and reach the final diagnosis in AUB and is the subject matter of this study.Methods: A prospective cross-sectional study was performed on 35 women with AUB, who presented to the Dept. of Obstetrics and Gynecology, JNMCH, Aligarh, over a period of 2 years (2014-2016). After transvaginal sonography, all cases underwent hysteroscopy followed by chromohysteroscopy using 5% methylene blue dye. Differentially stained pattern of the uterine cavity was observed and hysteroscopic guided biopsy was taken from stained and unstained areas, followed by endometrial aspiration biopsy. All three samples were sent for histopathological examination. Results were analyzed and compared.Results: Out of 35 cases studied, 13 cases showed diffuse light staining, while 22 cases had focal dark staining. Histopathology results from diffuse light stained group showed 9 (69.2%) had normal endometrium. Out of 22 cases with focal dark staining, 20 (90.0%) cases had abnormal histopathology. It was found that focal dark staining to detect endometrial pathology had a sensitivity of 83.3%, specificity of 81.8%, positive predictive value of 90.9 %, negative predictive value of 69.2% and accuracy 82.8%. The difference in the diagnostic ability of stained tissue biopsy was highly significant (p< 0.001) when compared to blind endometrial aspiration biopsy.Conclusions: Chromohysteroscopy is an efficacious simple tool for detecting endometrial pathology in cases of AUB.

Serum tumor necrosis factor-alpha in pre eclampsia.

Cytokines are major contributors in pathogenesis of pre eclampsia. Serum TNF-alpha was determined in 10 normal and 30 pre-eclamptic pregnant females with special reference to maternal age, parity and levels of mean arterial blood pressure. TNF-alpha was determined using sandwich ELISA technique. Serum TNF-alpha level in normal pregnant females was 9.3 +/- 0.56 pg/ml, while in pre-eclamptic pregnant females it was 67.66 +/- 61.83 pg/ml. This increase TNF-alpha was highly significant (P < 0.001). There was no significant changes in serum TNF-alpha with respect to maternal age, parity and mean arterial pressure in both normal and pre-eclamptic pregnancies.