Pub Date : 2021-07-01DOI: 10.4103/jcrsm.jcrsm_29_21
A. Purty
{"title":"Fostering collaborative research partnerships – Lessons learned","authors":"A. Purty","doi":"10.4103/jcrsm.jcrsm_29_21","DOIUrl":"https://doi.org/10.4103/jcrsm.jcrsm_29_21","url":null,"abstract":"","PeriodicalId":32638,"journal":{"name":"Journal of Current Research in Scientific Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80399266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/jcrsm.jcrsm_19_21
Manzoor Hussain, T. Shera, Omair Shah, N. Choh, Feroze A. Shaheen, T. Gojwari, G. Bhat, G. Gulzar
Aims And Objectives: We evaluated the role of Dyna CT in localizing HCC lesions and their selective vascular supply to help guide chemoembolization. We also evaluated the role of Dyna CT in assessing drug deposition within the lesion and predict the need of further drug delivery. Methods: 24 patients with documented HCC were taken up for TACE after a pre-procedural contrast CT and MRI. An intra-procedural Dyna CT was done in all patients to obtain a three dimensional overview of the vascular network. Selective cannulation of the tumor arteries was achieved using a combined digital subtraction angiography and Dyna CT image guidance. Additional lesions and vessels identified on Dyna CT were also treated. Drug deposition within the lesion marking technical success was assessed on completion Dyna CT and the need for additional drug delivery was assessed. Results: Contrast CT identified 36 lesions, DSA 33 lesions and Dyna CT 39 lesions in 24 patients. Dyna CT was the most sensitive for lesions <10 mm (p=0.006). Dyna CT identified 4 additional supplying lesion supplying arteries (2 hepatic, 2 extra hepatic) compared to DSA. In 6(25%) patients DYNA CT helped in improvement in catheter position in the form of more selective catheterization. 35 (90%) lesions showed homogenous Type 1 deposition, two lesions (5%) showed Type 2 and the other two (5%) showed type 3 deposition of lipoidol on completion Dyna CT. The latter two were further treated to achieve type 1 deposition and 100% technical success. Conclusion: Dyna CT can effectively guide TACE procedure by not only identifying the lesions and their vascular supply but also helping in guiding the catheter for selective cannulation and drug deposition. Completion Dyna CT can effectively assess drug deposition and the need for additional treatment in the same setting if needed.
{"title":"Transarterial chemoembolization of hepatocellular carcinoma: Can intraprocedural DYNA computed tomography serve as a guiding tool for the interventionist?","authors":"Manzoor Hussain, T. Shera, Omair Shah, N. Choh, Feroze A. Shaheen, T. Gojwari, G. Bhat, G. Gulzar","doi":"10.4103/jcrsm.jcrsm_19_21","DOIUrl":"https://doi.org/10.4103/jcrsm.jcrsm_19_21","url":null,"abstract":"Aims And Objectives: We evaluated the role of Dyna CT in localizing HCC lesions and their selective vascular supply to help guide chemoembolization. We also evaluated the role of Dyna CT in assessing drug deposition within the lesion and predict the need of further drug delivery. Methods: 24 patients with documented HCC were taken up for TACE after a pre-procedural contrast CT and MRI. An intra-procedural Dyna CT was done in all patients to obtain a three dimensional overview of the vascular network. Selective cannulation of the tumor arteries was achieved using a combined digital subtraction angiography and Dyna CT image guidance. Additional lesions and vessels identified on Dyna CT were also treated. Drug deposition within the lesion marking technical success was assessed on completion Dyna CT and the need for additional drug delivery was assessed. Results: Contrast CT identified 36 lesions, DSA 33 lesions and Dyna CT 39 lesions in 24 patients. Dyna CT was the most sensitive for lesions <10 mm (p=0.006). Dyna CT identified 4 additional supplying lesion supplying arteries (2 hepatic, 2 extra hepatic) compared to DSA. In 6(25%) patients DYNA CT helped in improvement in catheter position in the form of more selective catheterization. 35 (90%) lesions showed homogenous Type 1 deposition, two lesions (5%) showed Type 2 and the other two (5%) showed type 3 deposition of lipoidol on completion Dyna CT. The latter two were further treated to achieve type 1 deposition and 100% technical success. Conclusion: Dyna CT can effectively guide TACE procedure by not only identifying the lesions and their vascular supply but also helping in guiding the catheter for selective cannulation and drug deposition. Completion Dyna CT can effectively assess drug deposition and the need for additional treatment in the same setting if needed.","PeriodicalId":32638,"journal":{"name":"Journal of Current Research in Scientific Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76804880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/jcrsm.jcrsm_40_21
J. Victor, V. Jaganathan, T. Rao, P. Lingam
In certain anatomical regions achieving seal in the VAC, dressing is challenging. Inadequate seal during VAC therapy can make the therapy ineffective and also leads to wastage of resources. The use of strips of hydrocolloid dressing around the wound can achieve seal when using VAC therapy in these regions. We present our clinical experience with a case series of four patients in whom this technique was used. Hydrocolloid dressings being easily available in most clinical settings and being cost-effective also, this technique can be a simple, readily available solution for a commonly encountered problem during VAC therapy.
{"title":"Use of hydrocolloid dressing to achieve seal in vacuum-assisted closure therapy in anatomically challenging regions","authors":"J. Victor, V. Jaganathan, T. Rao, P. Lingam","doi":"10.4103/jcrsm.jcrsm_40_21","DOIUrl":"https://doi.org/10.4103/jcrsm.jcrsm_40_21","url":null,"abstract":"In certain anatomical regions achieving seal in the VAC, dressing is challenging. Inadequate seal during VAC therapy can make the therapy ineffective and also leads to wastage of resources. The use of strips of hydrocolloid dressing around the wound can achieve seal when using VAC therapy in these regions. We present our clinical experience with a case series of four patients in whom this technique was used. Hydrocolloid dressings being easily available in most clinical settings and being cost-effective also, this technique can be a simple, readily available solution for a commonly encountered problem during VAC therapy.","PeriodicalId":32638,"journal":{"name":"Journal of Current Research in Scientific Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73224837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/jcrsm.jcrsm_25_21
Shafqat Bano, Dilleswari Pradhan, P. Behera, Asaranti Kar, Akruti Mishra, Tushar Kar
Introduction: Endometriosis is a benign, chronic, multifactorial, debilitating gynecological disease defined by the presence of ectopic foci of endometrial glands and stroma. Diagnostic laparoscopy and histopathological study of hysterectomy specimens are the definitive tool for diagnosis which carries associated risks. The objective of this study is to analyze the presence of protein gene product 9.5 (PGP9.5) antibody-positive nerve fibers by immunohistochemistry (IHC) in endometrial biopsy samples and endometriotic lesions in suspicious cases of endometriosis. Materials and Methods: This was a case–control study carried out in a tertiary care center. It comprised of cases of endometriosis interna (adenomyosis), endometriosis externa (endometriosis), and age- and parity-matched women without endometriosis taken as control. Clinically/radiologically diagnosed cases of endometriosis and those undergoing laparoscopy for infertility with confirmation after histopathology were included in the study. Endometrial biopsy samples were subjected to IHC using PGP9.5 antibody and examined for The presence of nerve fibers. Statistical analysis was done using SPSS software, and analysis of nerve fibers stained by PGP9.5 was done by the Kruskal–Wallis test. Results: A total of 60 cases are included in this study broadly divided into three groups (30 women with adenomyosis, 10 with endometriosis externa, and 20 women without endometriosis). Majority (26/30 = 65%) belonged to the third to fourth decade of life with pain being the most specific symptom. Small nerve fibers were noted in endometrial foci of the endometriosis cases but not in women without endometriosis (P = 0.001). Conclusion: The presence of nerve fibers can be taken as a novel marker of clinical endometriosis, and thus, it could replace hysterectomy as a definitive modality for diagnosing endometriosis.
{"title":"Diagnosis of endometriosis by detection of nerve fibers using protein gene product 9.5 immunohistochemistry","authors":"Shafqat Bano, Dilleswari Pradhan, P. Behera, Asaranti Kar, Akruti Mishra, Tushar Kar","doi":"10.4103/jcrsm.jcrsm_25_21","DOIUrl":"https://doi.org/10.4103/jcrsm.jcrsm_25_21","url":null,"abstract":"Introduction: Endometriosis is a benign, chronic, multifactorial, debilitating gynecological disease defined by the presence of ectopic foci of endometrial glands and stroma. Diagnostic laparoscopy and histopathological study of hysterectomy specimens are the definitive tool for diagnosis which carries associated risks. The objective of this study is to analyze the presence of protein gene product 9.5 (PGP9.5) antibody-positive nerve fibers by immunohistochemistry (IHC) in endometrial biopsy samples and endometriotic lesions in suspicious cases of endometriosis. Materials and Methods: This was a case–control study carried out in a tertiary care center. It comprised of cases of endometriosis interna (adenomyosis), endometriosis externa (endometriosis), and age- and parity-matched women without endometriosis taken as control. Clinically/radiologically diagnosed cases of endometriosis and those undergoing laparoscopy for infertility with confirmation after histopathology were included in the study. Endometrial biopsy samples were subjected to IHC using PGP9.5 antibody and examined for The presence of nerve fibers. Statistical analysis was done using SPSS software, and analysis of nerve fibers stained by PGP9.5 was done by the Kruskal–Wallis test. Results: A total of 60 cases are included in this study broadly divided into three groups (30 women with adenomyosis, 10 with endometriosis externa, and 20 women without endometriosis). Majority (26/30 = 65%) belonged to the third to fourth decade of life with pain being the most specific symptom. Small nerve fibers were noted in endometrial foci of the endometriosis cases but not in women without endometriosis (P = 0.001). Conclusion: The presence of nerve fibers can be taken as a novel marker of clinical endometriosis, and thus, it could replace hysterectomy as a definitive modality for diagnosing endometriosis.","PeriodicalId":32638,"journal":{"name":"Journal of Current Research in Scientific Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78319309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/jcrsm.jcrsm_26_21
Veda Murthy Reddy Pogula, E. Galeti, I. Qazi, Ayesha Galeti
Leiomyomas are benign mesenchymal tumors commonly presenting as uterine masses. They are most frequently seen in females during the reproductive age. Extrauterine leiomyomas are rarely seen and primarily observed in the genitourinary tract. In general, patients come up with soft-tissue mass near the urethral meatus and urinary symptoms. We report a case of distal urethral leiomyoma in a 34-year-old woman who presented with periurethral mass with a history of hematuria and dysuria. She underwent complete excision of the mass. Due to their unusual location, these leiomyomas should be treated with great care during surgery. Postsurgery, the patient remained asymptomatic, and there was no evidence of recurrence in the follow-up.
{"title":"Female anterior urethral wall leiomyoma: A rare presentation","authors":"Veda Murthy Reddy Pogula, E. Galeti, I. Qazi, Ayesha Galeti","doi":"10.4103/jcrsm.jcrsm_26_21","DOIUrl":"https://doi.org/10.4103/jcrsm.jcrsm_26_21","url":null,"abstract":"Leiomyomas are benign mesenchymal tumors commonly presenting as uterine masses. They are most frequently seen in females during the reproductive age. Extrauterine leiomyomas are rarely seen and primarily observed in the genitourinary tract. In general, patients come up with soft-tissue mass near the urethral meatus and urinary symptoms. We report a case of distal urethral leiomyoma in a 34-year-old woman who presented with periurethral mass with a history of hematuria and dysuria. She underwent complete excision of the mass. Due to their unusual location, these leiomyomas should be treated with great care during surgery. Postsurgery, the patient remained asymptomatic, and there was no evidence of recurrence in the follow-up.","PeriodicalId":32638,"journal":{"name":"Journal of Current Research in Scientific Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83081785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/jcrsm.jcrsm_53_21
D. Sneha, S. Poral, C. Kiran, M. Marenika, M. Maunika, Emil Phinehas
Paratesticular tumors are rare and account for 7% of intrascrotal neoplasms which generally present as painless inguinal or scrotal swelling. Around 200 cases of paratesticular liposarcoma cases have been reported worldwide. They are usually misdiagnosed before surgery. Incomplete treatment may lead to local recurrence. We report a rare case of paratesticular liposarcoma. A 65-year-old man presented with right scrotal painless swelling for 2 years and gradually increasing in size. On examination, swelling in the right inguinal scrotal region was cystic in consistency. Testicular tumor markers were normal. The patient underwent right high orchidectomy with tumor excision. Sample sent for biopsy. Histopathological study reveals paratesticular liposarcoma. The long-term survival is approximately 50% with a favorable prognosis.
{"title":"A rare case of scrotal neoplasm-paratesticular liposarcoma","authors":"D. Sneha, S. Poral, C. Kiran, M. Marenika, M. Maunika, Emil Phinehas","doi":"10.4103/jcrsm.jcrsm_53_21","DOIUrl":"https://doi.org/10.4103/jcrsm.jcrsm_53_21","url":null,"abstract":"Paratesticular tumors are rare and account for 7% of intrascrotal neoplasms which generally present as painless inguinal or scrotal swelling. Around 200 cases of paratesticular liposarcoma cases have been reported worldwide. They are usually misdiagnosed before surgery. Incomplete treatment may lead to local recurrence. We report a rare case of paratesticular liposarcoma. A 65-year-old man presented with right scrotal painless swelling for 2 years and gradually increasing in size. On examination, swelling in the right inguinal scrotal region was cystic in consistency. Testicular tumor markers were normal. The patient underwent right high orchidectomy with tumor excision. Sample sent for biopsy. Histopathological study reveals paratesticular liposarcoma. The long-term survival is approximately 50% with a favorable prognosis.","PeriodicalId":32638,"journal":{"name":"Journal of Current Research in Scientific Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84317135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/jcrsm.jcrsm_84_21
U. Jyothish, Subhasis Das
Background: The nasal cycle is the alternating congestion and decongestion of the nostrils during normal breathing, marking the shift between the sympathetic and parasympathetic systems, the latter being prominent when breathing through the left nostril. The post-exercise period is characterized by a gradual shift from sympathetic to parasympathetic dominance. It is hypothesized that breathing only through the left nostril will aid in accelerating this shift in the postexercise period. Objectives: The objective of this study is to assess the effect of left nostril breathing on post-exercise recovery times of heart rate and blood pressure (BP). Materials and Methods: A total of 60 young healthy male volunteers were instructed to walk on a flat treadmill, following a fixed protocol. Heart rate and BP were measured at rest and postexercise they were monitored every minute until they reached the baseline. The recovery time was noted. The procedure was the same on the 3rd day, except that during the postexercise period, the participants were instructed to breathe only through their left nostrils. Results: The recovery times of heart rate and BP, when breathing through the left nostril only, was significantly lower than when breathing normally. Conclusion: The left nostril breathing technique lowered the postexercise recovery times of cardiovascular parameters, which can be attributed to improved parasympathetic tone. These findings on the post-exercise state may be extrapolated to pathological states of sympathetic dominance, and left nostril breathing can be used as an adjunct to pharmacological therapy to manage such conditions.
{"title":"Effect of left nostril breathing on postexercise recovery time","authors":"U. Jyothish, Subhasis Das","doi":"10.4103/jcrsm.jcrsm_84_21","DOIUrl":"https://doi.org/10.4103/jcrsm.jcrsm_84_21","url":null,"abstract":"Background: The nasal cycle is the alternating congestion and decongestion of the nostrils during normal breathing, marking the shift between the sympathetic and parasympathetic systems, the latter being prominent when breathing through the left nostril. The post-exercise period is characterized by a gradual shift from sympathetic to parasympathetic dominance. It is hypothesized that breathing only through the left nostril will aid in accelerating this shift in the postexercise period. Objectives: The objective of this study is to assess the effect of left nostril breathing on post-exercise recovery times of heart rate and blood pressure (BP). Materials and Methods: A total of 60 young healthy male volunteers were instructed to walk on a flat treadmill, following a fixed protocol. Heart rate and BP were measured at rest and postexercise they were monitored every minute until they reached the baseline. The recovery time was noted. The procedure was the same on the 3rd day, except that during the postexercise period, the participants were instructed to breathe only through their left nostrils. Results: The recovery times of heart rate and BP, when breathing through the left nostril only, was significantly lower than when breathing normally. Conclusion: The left nostril breathing technique lowered the postexercise recovery times of cardiovascular parameters, which can be attributed to improved parasympathetic tone. These findings on the post-exercise state may be extrapolated to pathological states of sympathetic dominance, and left nostril breathing can be used as an adjunct to pharmacological therapy to manage such conditions.","PeriodicalId":32638,"journal":{"name":"Journal of Current Research in Scientific Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81404317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/jcrsm.jcrsm_34_21
C. Jyothi, K. Sriambika
Duplex ureters are congenital malformations with varying clinical consequences. Identification of this entity is pivotal as exemplified by the failure of first-line investigations to explain the cause for some presenting symptoms in few cases. We report an interesting case of complete duplication of the right ureter in a male cadaver. A brief review regarding embryogenesis, association with other anomalies, and clinical significance is discussed.
{"title":"Unilateral complete duplex ureter – report of a rare underdiagnosed anomaly","authors":"C. Jyothi, K. Sriambika","doi":"10.4103/jcrsm.jcrsm_34_21","DOIUrl":"https://doi.org/10.4103/jcrsm.jcrsm_34_21","url":null,"abstract":"Duplex ureters are congenital malformations with varying clinical consequences. Identification of this entity is pivotal as exemplified by the failure of first-line investigations to explain the cause for some presenting symptoms in few cases. We report an interesting case of complete duplication of the right ureter in a male cadaver. A brief review regarding embryogenesis, association with other anomalies, and clinical significance is discussed.","PeriodicalId":32638,"journal":{"name":"Journal of Current Research in Scientific Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74151226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/jcrsm.jcrsm_83_20
J. Pandiaraja
Courvoisier sign is one of the important clinical signs used in the diagnosis of hepatobiliary disease. According to this sign, when the gallbladder is palpable in a jaundiced patient, it is unlikely due to stone. There are exceptions for Courvoisier signs such as double impacted stone, oriental cholangitis, and AIDS-associated cholangiopathy. In our case, there is a gallstone with palpable gallbladder due to concurrent occurrence of gallstone with gallbladder carcinoma compressing the adjacent biliary tree.
{"title":"An unusual finding of Courvoisier sign: Gallstone with locally advanced carcinoma gallbladder","authors":"J. Pandiaraja","doi":"10.4103/jcrsm.jcrsm_83_20","DOIUrl":"https://doi.org/10.4103/jcrsm.jcrsm_83_20","url":null,"abstract":"Courvoisier sign is one of the important clinical signs used in the diagnosis of hepatobiliary disease. According to this sign, when the gallbladder is palpable in a jaundiced patient, it is unlikely due to stone. There are exceptions for Courvoisier signs such as double impacted stone, oriental cholangitis, and AIDS-associated cholangiopathy. In our case, there is a gallstone with palpable gallbladder due to concurrent occurrence of gallstone with gallbladder carcinoma compressing the adjacent biliary tree.","PeriodicalId":32638,"journal":{"name":"Journal of Current Research in Scientific Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74611811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/jcrsm.jcrsm_23_21
K. Solanki, S. Kochar, Laxmi Poonia, P. Gaur, Krishna Poonia, S. Choudhary
Background: Abnormal uterine bleeding (AUB) is a common and devastating condition affecting women of all ages. Among all patients attending gynecology outpatient department clinic, more than one-third patients are related to AUB, and this proportion rises to 70% in the perimenopausal and postmenopausal age. The condition has a high reported prevalence rate of 17.9% in India. Aims and Objective: To compare endometrial sampling histopathology by Pipelle curette versus Karman cannula in patients with AUB at a tertiary care hospital in Northwest Rajasthan. Materials and Methods: It was a prospective study conducted on 100 female patients of all age groups attending the department of obstetrics and gynecology over a period of 1 year with clinical diagnosis of AUB. After detailed history, examination, and relevant investigations, each patient was subjected first to endometrial aspiration using Pipelle curette followed by endometrial aspiration using Karman cannula No. 4. Samples collected were sent for histopathological assessment and the results were compared. Results: In our study, in 84% of cases, samples obtained by both Pipelle curette and Karman cannula were adequate. In 5% of cases, samples were inadequate by both methods. In 10% of cases, Karman cannula sample was adequate, but Pipelle curette sample was inadequate. In 1% of cases, sample could not be obtained by both procedures due to stenosed nulliparous cervix with large fibroid obstructing cervical os. Considering Karman cannula as the standard, Pipelle curette endometrial sampling demonstrated 100% sensitivity, specificity, positive and negative predictive value (PPV and NPV), and accuracy with regard to diagnosis of adenocarcinoma and endometrial hyperplasia. For secretory endometrium, the corresponding values were 76.5%, 100%, 100%, 95.4%, and 99%, respectively. With regard to proliferative endometrium, sensitivity, specificity, PPV, NPV, and accuracy were 92%, 96%, 98.6%, 80%, and 93%, respectively. With regard to atrophic endometrium, specificity, NPV, and accuracy were 100%, 99%, and 99%, respectively. Pipelle curette had a concordance rate of 87.5% with hysterectomy specimen, while Karman cannula had a concordance rate of 100%. Conclusion: Both Pipelle curette and Karman cannula endometrial aspiration biopsy are easy to perform, efficient, and safe outpatient endometrial sampling procedure in recognizing the endometrial lesions including malignancy and endometrial hyperplasia; however, Karman cannula had more adequate sample than Pipelle curette.
{"title":"A comparison of endometrial sampling histopathology by Pipelle curette versus Karman cannula in patients with abnormal uterine bleeding at a tertiary care hospital in Northwest Rajasthan","authors":"K. Solanki, S. Kochar, Laxmi Poonia, P. Gaur, Krishna Poonia, S. Choudhary","doi":"10.4103/jcrsm.jcrsm_23_21","DOIUrl":"https://doi.org/10.4103/jcrsm.jcrsm_23_21","url":null,"abstract":"Background: Abnormal uterine bleeding (AUB) is a common and devastating condition affecting women of all ages. Among all patients attending gynecology outpatient department clinic, more than one-third patients are related to AUB, and this proportion rises to 70% in the perimenopausal and postmenopausal age. The condition has a high reported prevalence rate of 17.9% in India. Aims and Objective: To compare endometrial sampling histopathology by Pipelle curette versus Karman cannula in patients with AUB at a tertiary care hospital in Northwest Rajasthan. Materials and Methods: It was a prospective study conducted on 100 female patients of all age groups attending the department of obstetrics and gynecology over a period of 1 year with clinical diagnosis of AUB. After detailed history, examination, and relevant investigations, each patient was subjected first to endometrial aspiration using Pipelle curette followed by endometrial aspiration using Karman cannula No. 4. Samples collected were sent for histopathological assessment and the results were compared. Results: In our study, in 84% of cases, samples obtained by both Pipelle curette and Karman cannula were adequate. In 5% of cases, samples were inadequate by both methods. In 10% of cases, Karman cannula sample was adequate, but Pipelle curette sample was inadequate. In 1% of cases, sample could not be obtained by both procedures due to stenosed nulliparous cervix with large fibroid obstructing cervical os. Considering Karman cannula as the standard, Pipelle curette endometrial sampling demonstrated 100% sensitivity, specificity, positive and negative predictive value (PPV and NPV), and accuracy with regard to diagnosis of adenocarcinoma and endometrial hyperplasia. For secretory endometrium, the corresponding values were 76.5%, 100%, 100%, 95.4%, and 99%, respectively. With regard to proliferative endometrium, sensitivity, specificity, PPV, NPV, and accuracy were 92%, 96%, 98.6%, 80%, and 93%, respectively. With regard to atrophic endometrium, specificity, NPV, and accuracy were 100%, 99%, and 99%, respectively. Pipelle curette had a concordance rate of 87.5% with hysterectomy specimen, while Karman cannula had a concordance rate of 100%. Conclusion: Both Pipelle curette and Karman cannula endometrial aspiration biopsy are easy to perform, efficient, and safe outpatient endometrial sampling procedure in recognizing the endometrial lesions including malignancy and endometrial hyperplasia; however, Karman cannula had more adequate sample than Pipelle curette.","PeriodicalId":32638,"journal":{"name":"Journal of Current Research in Scientific Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85608823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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