Correlation of PAP smear findings with clinical findings and cervical biopsy.

OBJECTIVES: Carcinoma of the cervix is the most common cause of the death in Nepal. Cervical carcinoma does not develop suddenly from normal epithelium but is presented by a spectrum of intraepithelial neoplastic changes that are precancerous lesion and were termed as cervical intraepithelial neoplasia (CIN). Cervical cytological screening is designed to detect over 90% of cytological abnormalities. It has also been established that most cervical cancers can be diagnosed at the preinvasive stage with adequate and repetitive cytological screening. Keeping in view of the importance of carcinoma and the precancerous lesion (CIN) of cervix, study of different methods for the early detection of abnormalities in cervix, correlation with the clinical findings and comparison between the techniques was carried out. MATERIAL AND METHODS: Patients with suspicious cervix attending Gynaecology OPD of TUTH and Western regional hospital (Pokhara) who have undergone for pap smear cytology test along with biopsy were selected. Detail history with clinical examination was performed and the findings were correlated. RESULTS AND CONCLUSION: Unhealthy cervix with discharge was found to be common even in chronic cervicitis however bleeding and tenderness were associated with more advanced lesions. Pap smear test was found to be equally sensitive to histopathological examination for the early detection of different cervical lesions. However, it is advised to perform biopsy if any abnormalities are detected in pap smear for correlation and confirmation.

Effect of low intensity laser radiation on healing of open skin wounds in rats.

Two full thickness skin wounds were produced on either side of dorsal midline in rats to study the effect of low intensity laser radiation on wound healing. Wounds on left side were irradiated daily with Helium Neon laser at 4 Joules/sq cm for 5 min. Wounds on right side were not exposed and served as controls. The mean +/- SD of time required for complete closure in control group was 14.1 +/- 0.86 days (range 12-15 day) while irradiated test wounds took only 10.3 +/- 0.68 days (range 9-12 days) to heal (P < 0.001). Granulation tissue was significantly (P < 0.001) more in test than in control wounds. Early epithelisation with increased fibroblastic reaction, leukocytic infiltration and neo vascularisation was seen in the laser irradiated wounds. The collagen hydroxyproline concentration of scar tissue was also significantly higher (P < 0.001) in test group on 17th post-operative day. The study establishes the biostimulatory effects of low intensity laser radiation on healing of skin wounds.

Fibrinolysis in idiopathic menorrhagia.

Serum fibrin/fibrinogen degradation product (FDP) was studied in 64 patients of menorrhagia without any organic cause in addition to 24 healthy women by Thrombo - Wellcotest HA - 13 Kit (Wellcome, England). Serum FDP levels were found to be less than 10 micrograms/ml in healthy subjects, whereas in idiopathic menorrhagia it was more than 10 micrograms/ml in 59.34% patients. Semi-quantitative estimation of FDP in 14 patients of idiopathic menorrhagia indicated a positive correlation between duration of bleeding and FDP levels. Bleeding appears to be due to increased fibrinolytic activity in uterus secondary to plasminogen activator. Such patients are likely to be benefitted with anti-fibrinolytic agents.

Endoscopic and histologic appearance of the gastric mucosa in patients with portal hypertension.

To assess reliability of the endoscopic and histologic appearance of the gastric mucosa for diagnosing portal hypertension, 50 patients with portal hypertension and 1323 controls were studied. Endoscopic evidence of mild gastritis was seen more frequently in patients with portal hypertension than in the control group (42% vs. 13.1%, p less than 0.001). The mosaic sign was also seen more frequently in patients with portal hypertension compared with controls (14% vs. 0.9%, p less than 0.001). However, the mosaic sign was found to be nonspecific, and the sensitivity for diagnosis of portal hypertension was only 14%. Biopsy specimens from the stomach of all patients with portal hypertension and 100 controls with a normal endoscopic appearance revealed mucosal vascular congestion in 72% of patients with portal hypertension compared with 59% of controls (NS). There was no correlation between endoscopic and histologic evidence of congestive gastropathy. Similarly, there was no correlation between the severity of mucosal vascular congestion and the degree of inflammatory changes observed in the biopsy specimens; both in the control (r = 0.1) and in patients with portal hypertension (r = 0.14). It is concluded that endoscopic and histologic features of the gastric mucosa in patients with portal hypertension are of low sensitivity and nonspecific and cannot be used to diagnose portal hypertension.

Immunological studies in leprosy. III-Cutaneous response to antigens in spectrum of leprosy.

Delayed type of hypersensitivity response was assessed in 65 cases of leprosy of different types, and 18 control using lepromin (Dharmendra) and candida antigens. 0.1 ml of antigen was injected intra-dermally and results were recorded after 48 hours. The induration of 5 mm or more was taken as positive for early (Fernandez) reaction in lepromin test, and also for candida reaction. Both types of tests were positive in decreasing order from tuberculoid to borderline type while negative in borderline lepromatous and lepromatous type.

Immunological studies in leprosy--II: Study of lymphoblast transformation to PHA in different types of leprosy patients.

Ninety cases of different types of leprosy were studied for lymphoblast transformation response using PHA-M. The difference of percentage was statistically analysed and found to be highly significant when total leprosy cases were compared with control cases and with different types of leprosy cases (P = less than .005), except control and TT where it was significant only (P = less than .05). The difference between TT and other types was also calculated and has been observed to be highly significant (P = less than .005). There was gradual decrease in lymphoblast transformation percentage from tuberculoid pole to lepromatous pole.

Status of T and B lymphocytes in peripheral blood.

T and B lymphocyte percentage was studied by Erythrocyte (E) and Erythrocyte antibody complement (EAC) rosette formation respectively in 90 cases including 65 cases of different types of leprosy and 25 healthy controls. The patient with different types of leprosy were classified according to Ridley and Jopling (1962). The mean percentage of T-lymphocyte was observed in gradually decreasing manner from tuberculoid pole to lepromatous pole. The fall in T-lymphocyte percentage was highly significant when control cases were compared with total cases of leprosy and different histological types of leprosy. This indicates that there is a gradually increasing loss of cell mediated immune response from tuberculoid to lepromatous pole.

Rhinosporidiosis of conjunctiva--an unusual presentation, a case report.

PIP: Rhinosporidial infection of conjunctiva is rare. This report describes a case of rhinosporidiosis of conjunctiva in a male child, aged 8 years from Bundelkhand region of Uttar Pradesh, India.^ieng

Bacteriological Analysis of Patients Suffering From Infected Scabies.

Scabies is considered to be the commonest disease among the patient attending most Dermatology outpatientdepartments in ourcountry. Pyoderma sometimes appears as the main clinical presentation in scabies. The treatment of pyoderma can be rational only if the clinician has thorough knowledge of the nature and behaviour of the causative organisms as well as their sensitivity patterns to antibiotics. A bacteriological survey of 75 patients with scabies was done in the Department of Dermatology of the BRD Medical College Gorakhpur in association with the Department of Pathology. This study involved a detailed history and clinical examination as well as culture and sensitivity test in each case. Staphylococcus was found to be the commonest organism responsible for the secondary infection.