Search

Background: Sex determination is essential in forensic science, anthropology, and medical diagnostics. Traditional methods, such as DNA analysis, are resource intensive and time-consuming. This pilot study explores the utility of oral rinse-based cytology for detecting Barr bodies in exfoliated oral mucosal cells from saliva as a more accessible and efficient alternative. Aim: This study aimed to assess the viability of rinse-based cytology in identifying sex through the detection of Barr bodies. Materials and Methods: In the study, 60 participants aged 20-30, free of lesions, and nonsmokers/nondrinkers, were evenly divided into male and female groups. Unstimulated saliva was collected from each participant between 9 and 10 am Participants were instructed to tilt their heads slightly forward to accumulate saliva and then spit into disposable sterile containers. After centrifugation, two smears were prepared and stained with Papanicolaou (PAP) and hematoxylin and eosin (H and E) stains. The smears were labeled (single-blinded) and examined for the presence of Barr body by two oral pathologists. Results: H and E stain had a mean Barr body count of 2.38 and a standard deviation of approximately 2.731, whereas PAP stain had a higher mean count of 3.57 with a standard deviation of 3.933. Levene's test showed significant differences (P = 0.000) in variances between the staining methods (F = 21.001, df = 118, P < 0.001), but the average Barr body count difference of about 1.183 with P = 0.058 was not statistically significant (P > 0.05). Conclusion: Oral rinse-based cytology offers a noninvasive, cost-effective, and time-efficient approach to sex determination. While this pilot study demonstrates its potential, further research involving larger and more diverse populations is required to validate its reliability fully. This innovative approach has the potential to impact various scientific and forensic disciplines, offering a practical alternative to traditional methods. [ABSTRACT FROM AUTHOR]

Aim and Objectives: The present study was done to compare the visual inspection methods with Pap smear as a screening test for premalignant lesions of the cervix. Materials and Methods: The present observational prospective study was done at the Department of Obstetrics and Gynecology at Teerthanker Mahaveer Medical College and Research Center for 18 months. All study subjects were subjected to Papanicolaou smear, VIA, and VILI examination. If any of these tests were found positive, then a colposcopy and cervical biopsy were done. Results: The sensitivity of Pap, VIA, VILI, and colposcopy was 52.63%, 84.21%, 73.68%, and 84.21%, respectively. The specificity of Pap, VIA, VILI, and colposcopy was 60.0%, 80.0%, 60.0%, and 80.0%, respectively. The accuracy of Pap, VIA, VILI, and colposcopy was 54.17%, 83.33%, 70.83%, and 83.33%, respectively. Conclusion: It is well known that VIA and VILI are very easy to carry out and apply. Even technically they do not cost much, consume less tax and can be applied to all the patients. Even the results are calculated in a faster manner which helps in chalking out the plan in an easy way. [ABSTRACT FROM AUTHOR]

Objectives: Endometrial carcinoma (EC) is a common gynecologic malignancy in the female genital tract, especially in postmenopausal women. The current study aimed to analyze Papanicolaou (Pap) smear in patients with EC to assess the relationship between EC and abnormal cells in Pap smear, ABO blood group, and hemoglobin anemia.Materials and Methods: A retrospective study was conducted on 175 patients with EC in Imam Hossein Hospital, Tehran, Iran, during the period from 2013 to 2019. The histology information of cases was extracted from the hospital database, and Pap smear slides were taken from pathological archives. The acquired information and slides were then reviewed by an expert pathologist in the hospital. The data were analyzed in SPSS (version 18) by the Chi-square test, Fisher's exact test, and independent-samples t-test. P < 0.05 was assigned as significant.Results: The mean age of patients was 54.47 ± 11.34, ranging from 32 to 85 years, and 31.4% of the patients were premenopausal women. Grade III, invasion ≥ 50% of myometrial, and advanced stage (III and IV) were diagnosed in 30%, 7.4%, and 22.86% of the patients, respectively. The most common histological types of EC were endometrioid (66.9%), papillary (10.3%), and malignant mixed Mullerian tumor (5.7%). The abnormal Pap smear was achieved only in 37 EC patients (21.1%). Endometrial cells, atypical squamous cells of undetermined significance, and atypical glandular cells were observed in 56.8%, 29.7%, and 13.5% of the patients > 40 years of age with abnormal Pap smears, respectively. In patients with normal Pap smears, the most common results were inflammation in 75.1% and atrophy in 14.6% of the patients. Abnormal uterine bleeding was the most important problem observed in patients with EC.Conclusion: The efficacy of Pap smear in detecting EC is limited. Therefore, women with EC, >40 years of age, with heavy bleeding, anemia, O blood group, inflammation, and atrophy in Pap smear in the past 3 years need to be precisely checked up for EC. These items can be added as new criteria for EC screening procedures. [ABSTRACT FROM AUTHOR]

Introduction: Cervical cancer is the most common cause of death among women in developing countries. Among the Indian women, cervical cancer is the most common genital tract cancer. Papanicolaou (Pap) smear test plays a vital role in the detection of cervical cancer even in its premalignant condition. The aim of this study to evaluate the role of Pap smear in detecting premalignant and malignant lesions as well as nonneoplastic lesions of the cervix and to determine the prevalence of various lesions. Materials and Methods: We screened 1100 women in the age group of 21–65 years who attended our medical camp organized by the hospital in outdoor patient department. All women was willing to give consent for screening by Pap smear test were included. Results: Of 1100 cases, majority of the cases were benign comprising negative for intraepithelial neoplasia (NILM) of about 581 (52.8%) cases, 203 (18.4%) inflammatory, atypical squamous cells of undetermined significance 45 (4%), low-grade squamous intraepithelial lesion (LSIL) in 75 (6.8%), and high-grade squamous intraepithelial lesion (HSIL) in 74 (6%) women. Overall sensitivity and specificity for the detection of LSIL were 75.8% and 94.6% and those for the detection of HSIL were 68.9% and 98.6%. Conclusions: Pap smear test is a very easy, noninvasive, useful, simple, safe, and very economical tool to detect preinvasive cervical epithelial lesions. It is evident and proven that every woman above the age of 30–35 years must be subjected to cervical screening and this must be continued even in the postmenopausal period. [ABSTRACT FROM AUTHOR]

Background: Cancer of the cervix is the second most common cancer among women in the world. It accounts for 12% of all cancers in females. This study aims to evaluate the pattern of cervical cytology and its correlation with clinical and histopathological findings. Materials and Methods: This is 10 years retrospective and prospective study, in which all the Papanicolaou (Pap) smears were reported as per the 2001 Bethesda system. Clinical and histopathological correlation was done in cases where cervical biopsy or total hysterectomy specimens were available. Results: A total of 3791 Pap smears were studied with respect to age group, clinical signs and symptoms, and cytology findings. Cervical biopsy correlation was done in 200 cases. Most of the patients were in age group of 31-40 (35.61%) years. The Pap smear findings revealed 88.02% as negative for intraepithelial lesion or malignancy (NILM), 5.99% epithelial cell abnormality (ECA), and 5.99% were unsatisfactory. ECA comprised atypical squamous cells of undetermined significance (ASCUS) with 2.98%, low-grade squamous intraepithelial lesion with 1.19%, and high-grade squamous intraepithelial lesion with 0.66%. There were 36 cases (0.95%) of malignancy. Sensitivity, specificity, and positive predictive value of Pap smear in diagnosing ECA and malignancy were 89.47%, 88.70%, and 82.92%, respectively. Conclusion: Pap smear test is ideal screening method for cervical carcinoma. Nonspecific inflammation and ASCUS were most common finding among NILM and ECA group, respectively. Biopsy is considered to be the gold standard for carcinoma cervix provided that it is taken from representative areas. [ABSTRACT FROM AUTHOR]

Background and Aim: Given the importance of papanicolaou (Pap) test in the early detection and timely treatment of cervical cancer, present study was designed to determine predictors of a sample of Iranian women's intention to first Pap test practice based on the protection motivation theory (PMT) variables.Materials and Methods: In this cross-sectional study, a total of 240 women referral to the 30 primary health care clinics were selected. They completed a developed scale based on PMT variables including intention, perceived vulnerability and severity, fear, response costs, response efficacy and self-efficacy. Path analysis was used to determine the association between predictive factors and intention.Results: The results showed that PMT had goodness of fit with a χ2/df = 2.37, df = 28, P= 0.001 and RMSEA = 0.076. PMT explained 42% of the variance in women's intention to get first Pap smear test. Self-efficacy (b = 0.55, P< 0.001) and response efficacy (b = 0.19, P< 0.001) were found to be the predictors of intention.Conclusion: These findings may be used to develop tailored, theory-based educational interventions associated with Pap testing among women. [ABSTRACT FROM AUTHOR]

Granulomas are a rare finding on Papanicolaou (Pap) smear which if encountered are usually attributed to tuberculosis, especially in an endemic country like India. Here, we report an interesting case of a 40-year-old female presenting with blood-stained discharge and chronic pelvic pain for 8 years. She was advised Pap smear which showed granulomatous inflammation suggestive of tuberculosis. The patient was worked up for tuberculosis which was noncontributory. Dilatation and curettage was done which revealed multiple small bones and bony chips in the endometrial cavity. Following the removal of bones, the patient showed considerable symptomatic improvement. Repeat Pap smear did not reveal any evidence of granuloma. Even after extensive search of literature, we did not come across any such case report in which intrauterine retention of fetal bones evoked a granulomatous response in cervical smears though the presence of uterine granulomas in response to foreign body has been well documented. [ABSTRACT FROM AUTHOR]

Objectives: (1) To detect cervical intraepithelial neoplasia (CIN) using Papanicolaou test (PAP test), visual tests (visual inspection after the application of acetic acid [VIA], visual inspection after the application of Lugol's iodine [VILI]), colposcopy, and biopsy. (2) To study the biomarker p16(INK4A) expression by immunostaining.Materials and Methods: Experimental study was conducted from November 2009 to April 2011. 1500 women were screened for cancer cervix using conventional PAP test, VIA, and VILI. Sensitivity, specificity, positive, and negative predictive values of these tests were calculated individually, sequentially, and in parallel. Women having positive results underwent colposcopy and biopsy if required. p16(INK4A) expression in biopsy samples was studied using immunohistochemistry.Results: All test positive cases (n = 235) underwent colposcopy. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PAP with atypical squamous cells of undetermined significance (ASCUS) as cut-off was 40%, 99.25%, 35.25%, and 99.39%; VIA was 60%, 93.06%, 8.03%, and 99.56% and VILI was 80%, 86.06%, 5.4%, and 99.76%, respectively. When PAP, VIA, and VILI were used in parallel sensitivity, specificity, PPV, and NPV improved to 100%, 85.18%, 6.38%, and 100%, respectively. Colposcopic abnormalities were detected in 83 and biopsy proven CIN in 15. p(16INK4A) expression was seen in eight of 15 CIN cases.Conclusions: (1) PAP test and visual techniques are complementary. (2) p(16INK4A) expression was seen in majority of CIN 2 lesions suggesting a higher grade lesion. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer is a preventable disease in the vast majority of women. Papanicolaou (Pap) smear is still the most effective screening tool available for preventing cervical cancer. Therefore, it is important to investigate the significance of screening in older women. Objective: To study the distribution of cervical cancer among postmenopausal women and to determine the significance of cervical cancer screening in symptomatic and asymptomatic postmenopausal women. Materials and Methods: A total of 590 Pap smears were obtained from postmenopausal women between September 2012 and March 2013. Prefixed conventional cervical smears were stained with Pap stain. The cytology results were reported using the Bethesda system terminology. Results: Among the 590 postmenopausal women studied, 38.9% of asymptomatic postmenopausal women had clinically significant lesion whereas only 33.1% of symptomatic women had clinically significant lesion. There was low-grade squamous intraepithelial lesion at percentage of 17.5. Asymptomatic and symptomatic were 11.5% and 6.5%, respectively. High-grade squamous intraepithelial lesion was 4.5%. Asymptomatic and symptomatic were 7.5% and 2.85%, respectively. Atypical squamous cells of undetermined significance were seen in 8.85%. Asymptomatic and symptomatic were 4.25% and 4.6% respectively. Atypical glandular cells of undetermined significance were 1.7%. Only 3.2% of significant lesion was squamous cell carcinoma, and all were symptomatic. Conclusion: Postmenopausal women especially from the rural area and low socioeconomic strata suffered disproportionately from precancerous and cancerous lesions of the cervix. To reduce this burden, it's mandatory to motivate and screen asymptomatic older women. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cervical cancer being a major cause of morbidity and mortality in women in developing countries, its awareness is essential. AIM: The aim of this study is to assess the knowledge, attitude and practices of women regarding the basic screening test for detection of cancer cervix. SETTINGS AND DESIGN: Population based cross-sectional study. MATERIALS AND METHODS: Cross-sectional prospective study was conducted. Information from consenting participants (450) was collected using structured questionnaire. Answers were described in terms of knowledge, attitude and practice and their respective adequacy with respect to Papanicolaou (Pap) test, the most common test used for early detection of cervical cancer. Adequacy was compared between the categories of socio demographic and clinical variables. STATISTICAL ANALYSIS: The data collected was analyzed using statistical package (SPSS version 18.0). Adequacy was compared between the categories of the control variables by x2 test with a 5% significance level. RESULTS: Knowledge, attitude and practices regarding Pap test were adequate in 32.7%, 18.2% and 7.3% of women respectively. Major impediment to adequate practice was lack of request by physician. Knowledge, attitudes and practices were found to increase significantly with increasing age and education. CONCLUSION: Effective information, education and communication strategies are required to improve the level of awareness of public. Health-care professional should be proactive in imparting knowledge at every opportunity. [ABSTRACT FROM AUTHOR]

BACKGROUND: A serious proportion of the patients with invasive cervical cancer can be women who have had abnormal smear findings known for at least 6 months. AIMS: The aims of the study were to evaluate the cervical cytohistopathologic correlation in the population studied, and to discuss the acceptability of immediate histological verification for minor Papanicolaou smear abnormalities. MATERIALS AND METHODS: A total of 443 patients who were admitted with abnormal smear results and had undergone immediate colposcopy, cervical biopsy and endocervical curretage in the gynecologic oncology clinic between the years of 2003-2009 were enrolled into the present retrospective study. One-way analysis of variance and independent t-tests were used to study the results. RESULTS: The distribution of abnormal smear results were documented as 46.27%, 29.57%, 13.76%, 7.67%, 1.58%, 0.67%, and 0.45% for atypical squamous cells of undetermined significance (ASC-US), low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (ASC-H), squamous cell carcinoma (SCC), atypical glandular cell (AGC), and adenocarcinoma, respectively. The percentages of cervical intraepithelial neoplasia grade 2-3 (CIN 2-3) and greater lesions were 70.49%, 35.29%, 15.26%, and 9.75% for HSIL, ASC-H, LSIL, and ASC-US, respectively. Moreover, 38.36% of all the CIN 2-3 or cancer (n = 104) cases originated from those with low grade referral diagnosis (ASC-US and LSIL). CONCLUSIONS: The majority of cases in the study were predominantly ASC-US and LSIL and approximately 40% of all the high grade lesions came from those with low grade referral diagnosis. This shows poor cytohistopathological correlation and calls the triage of minor cytological abnormalities into question. [ABSTRACT FROM AUTHOR]

Introduction: Cervical intraepithelial neoplasia and cervical cancer remain important health problems. Cervical cytology by Papanicolaou (Pap) smears is an effective means of screening for cervical premalignant and malignant conditions. Aim: The aim of this study was to assess the prevalence of cervical dysplasia in pre- and postmenopausal women in western Uttar Pradesh and to find out risk factors as far as possible. Materials and Methods: A total of 4,703 cases were enrolled, cervical scrape smears were collected and stained using Papanicolaou's method and hematoxylin and eosin stain. The emphasis was put on epithelial abnormalities and smears were classified according to The Bethesda System 2001. Results: 81.06% (3812) smears were satisfactory according to The Bethesda System. Maximum numbers of cases (40.37%) were in age group 30-39 years. The epithelial abnormalities constituted 3.23% of all cases. Low-grade squamous intraepithelial lesion (LSIL) formed the largest number (1.36%), while high-grade squamous intraepithelial lesion (HSIL) formed 0.91%. Eleven cases of squamous cell carcinoma (SCC) were detected. The study has shown a relatively high prevalence of epithelial abnormalities in cervical smears with increasing age, parity, early age at first coitus (<20 year), and lower socioeconomic status in symptomatic women with clinical lesions on per speculum examination. Conclusion: Epithelial abnormalities of cervix are not uncommon in our setup and are associated with early age at marriage and parity. [ABSTRACT FROM AUTHOR]

Background: Premalignant and malignant lesions are not uncommon in Pakistani women, especially in the older age-groups Aim: This study was conducted to determine the clinicopathological importance of conventional Papanicolaou (Pap) smears for the diagnosis of premalignant and malignant lesions of the cervix. Materials and Methods: Pap smears of 1000 women were examined from January 2007 to June 2009. Only cases with neoplastic cytology were included. Results: The overall frequency of normal, inadequate, neoplastic, and infective smears was 50%, 1.8%, 10.2%, and 38.3%, respectively. Most of the patients (67%) were in the postmenopausal age-group, with the mean age being 44.7 ± 15.63 years. The commonest clinical signs/symptoms seen among the 102 patients with neoplastic gynecological lesions were vaginal discharge and abnormal bleeding (93/102;(91.2% and 62/102;60.7%). Of the 102 cases with neoplastic lesions 46 patients (45%) had low-grade squamous cell intraepithelial lesions (LSILs), 22 (21.5%) had high-grade squamous cell intraepithelial lesions (HSILs), 14 (13.7%) had squamous cell carcinoma, and 6 (5.8%) showed features of adenocarcinoma. Ten (9.8%) cases showed cytology of atypical squamous cells of undetermined significance (ASCUS) and four (3.9%) cases had atypical glandular cells of undetermined significance (AGUS). Conclusion: We conclude that cervical smear examination is well suited for diagnosing neoplastic disease. It is clear that cervical neoplastic lesions are becoming a problem in Pakistan. [ABSTRACT FROM AUTHOR]

Background: Cervical cytology by Papanicolaou (Pap) smears is an effective means of screening for cervical premalignant and malignant conditions. Cervical intraepithelial neoplasia (CIN) and cervical cancer remain important health problems for women worldwide. Aim: To study the role of Pap smear in detecting premalignant and malignant lesions of cervix; and to determine the prevalence of various lesions. Materials and Methods: This study is based on 300 patients who attended the outpatient Department of Obstetrics and Gynaecology. Pap smears were prepared from patients presenting with complaints like vaginal discharge, postcoital bleeding, inter-menstrual bleeding, dyspareunia, and pain lower abdomen. After fixation and staining, each smear was carefully examined. Results: Epithelial cell abnormalities were found in 5% smears, atypical squamous cells of undetermined significance (ASCUS) in 0.3%, squamous intraepithelial lesion (SIL) in 3.4% which includes low grade squamous intraepithelial lesion (LSIL) (2.7%) and high grade squamous intraepithelial lesion (HSIL) 0.7%. Invasive carcinoma was seen in 1.3% cases. Mean age of the patients with diagnosis of LSIL was 32.3 years and for HSIL, it was 40.5 years. The mean age of the patients with invasive carcinoma was 57 years. Conclusion: Premalignant and malignant lesions of cervix are not uncommon in our set up and can be diagnosed early by Pap smears. [ABSTRACT FROM AUTHOR]

Background: Micronucleus (MN) is a biomarker for cytotoxicity, which is formed during cell division. Increased MN scoring has been successfully used to recognize population groups at risk for cancers of oral cavity, cervix, urinary bladder and esophagus. Incorporating MN score along with cytological smear testing gives a better and cost-effective screening for high-risk patients. Objective: This study evaluated the effectiveness of using MN score assessed from Papanicolaou (PAP) smears, as a biomarker for chromosomal damage in human immunodeficiency virus (HIV) patients. Materials and Methods: Oral smears of 25 female HIV/AIDS patients, without habits such as chewing or smoking tobacco, and taking antiretroviral therapy (ART) at ART center, were recruited for the study. After careful oral examination and oral rinsing with normal saline, smears were prepared on slides by scraping the buccal mucosa with a wooden spatula. All the slides were fixed in 95% ethyl alcohol and stained with PAP stain, and 1000 cells were counted per patient. Based on Tolbert et al.'s criteria, MNs were identified, and quantitative scoring of MN was done on the basis of morphological assay. Results: Mean ± standard deviation values of frequency of MNs in HIV-infected females were 73.40 ± 19.70 and in normal females were 38.08 ± 8.56. Conclusion: MN scoring on the epithelial cells of buccal mucosa can be used as a biomarker in screening procedures for HIV patients. [ABSTRACT FROM AUTHOR]

There are several case reports documenting opportunistic fungal infection in the female genital tract, with Aspergillus spp being a rarely reported causative organism. We hereby report a case of Aspergillus infection in a 48 year-old, postmenopausal female with carcinoma of the cervix. She presented with features of pelvic inflammatory disease, and an initial routine cervico-vaginal smear revealed severe inflammation along with fungal bodies. The features were consistent with the presence of Aspergillus spp, while the background epithelial cells were negative for intraepithelial malignancy. She was offered therapy for pelvic inflammatory disease. A repeat Papanicolaou smear after two weeks was negative for intraepithelial organisms, but showed the evidence of a high-grade squamous intraepithelial lesion, with biopsy confirming squamous cell carcinoma. [ABSTRACT FROM AUTHOR]