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A case of migration of intrauterine contraceptive device (IUCD) into the peritoneal cavity diagnosed following pregnancy is presented here. It had to be retrieved by laparoscopic approach. The complications of lost IUCD are discussed, and... more
A case of migration of intrauterine contraceptive device (IUCD) into the peritoneal cavity diagnosed following pregnancy is presented here. It had to be retrieved by laparoscopic approach. The complications of lost IUCD are discussed, and the need for regular follow-up post-insertion for an early diagnosis of perforation and its complication is emphasized.
With 528000 new cases every year, cervical cancer is the fourth most common cancer affecting women worldwide, after breast, colorectal, and lung cancers; it is most notable in the lower-resource countries of sub-Saharan Africa. It is also... more
With 528000 new cases every year, cervical cancer is the fourth most common cancer affecting women worldwide, after breast, colorectal, and lung cancers; it is most notable in the lower-resource countries of sub-Saharan Africa. It is also the fourth most common c Liquidbased cytology has recently become an alternative to conventional pap smears in the detection of intraepithelial lesions as well as in invasive carcinoma of the uterine cervix. Several reports have discussed its benefits to cytologic diagnosis. In most of these reports, a significant rise in sensitivity was achieved with liquid-based procedures, without major losses in specificity. a use of cancer death (266000 deaths in 2012) in women worldwide. LBC reduces the proportion of inadequate smears, caused by obscuring factors like blood and inflammation. It leads to an increase in the number of cellular abnormalities detected because it forms a mono-layered suspension of cells with minimal over-lapping. LBC reduces the sc...
BACKGROUND: An association has been reported with presence of endometrial cells on cervical smears and clinically significant uterine lesions. Hence for early detection of endometrial pathology, the 2001 Bethesda system has suggested the... more
BACKGROUND: An association has been reported with presence of endometrial cells on cervical smears and clinically significant uterine lesions. Hence for early detection of endometrial pathology, the 2001 Bethesda system has suggested the mandatory reporting of presence of any atypical endometrial cells regardless of age and menstrual status and out of phase normal looking endometrial cells in women aged 40 years or more. OBJECTIVES: To assess the association between atypical glandular cells of endometrial origin in cervical cytology and histopathological findings in abnormal uterine bleeding cases. SETTINGS AND DESIGN: The study was conducted at JSS hospital, Mysore in the department of pathology. This was a descriptive type of study. The sample was collected from patients attending the gynecology OPD with the complaints of abnormal uterine bleeding in JSS hospital. MATERIALS AND METHODS: Smears for cervical cytology are collected using either pap smear or manual liquid based smear ...
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Cytology is a new field of rapid cost effective screening method of cervical cancer. It has become a major help in diagnosis of cervical conditions in women from poor resource countries. This concept of screening will help to control... more
Cytology is a new field of rapid cost effective screening method of cervical cancer. It has become a major help in diagnosis of cervical conditions in women from poor resource countries. This concept of screening will help to control cervical cancer at an early stage and save women of morbidity and mortality. Latest concepts in diagnosis of HPV, the causative organism in cervical cancers by using liquid based cytology, cell block, PCR and IHC has been highlighted in the book.
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Cervical cancer (CC) is the fourth most common cancer in women, and the seventh overall, with an estimated 528,000 new cases in 2012 Although the annual number of cases has increased, cancer of the cervix has declined in relative... more
Cervical cancer (CC) is the fourth most common cancer in women, and the seventh overall, with an estimated 528,000 new cases in 2012 Although the annual number of cases has increased, cancer of the cervix has declined in relative importance: it was the second most common cancer of women in 1975. In addition, the incidence and mortality of CC is variable within lowand middle-income countries (LMIC). In India, there are 20.2 per 100000 new cases of CC diagnosed and 11.1 per 100000 deaths annually, accounting for more than one fifth of the global CC deaths. In sub-Saharan Africa, 34.8 per 100000 women are diagnosed with CC annually and 22.5 per 100000 women die from this disease. Therefore, various cost effective methods are required besides conventional pap smear screening to detect cervical cancer in low resource settings. Various other methods are being introduced in low and middle income countries (LMIC) to improve detection at low cost. The tests discussed are manual liquid based ...
Abnormal uterine bleeding (AUB) is a commonly encountered complaint in gynecology department. Endometrial cancer is the fourth most common malignancy in women and the most frequent gynecological cancer in developed countries. With 5,28,... more
Abnormal uterine bleeding (AUB) is a commonly encountered complaint in gynecology department. Endometrial cancer is the fourth most common malignancy in women and the most frequent gynecological cancer in developed countries. With 5,28, 000 new cases every year, cervical cancer is the fourth most common cancer affecting women worldwide, after breast, colorectal, and lung cancers. Though the cytological examination has been the mainstay for early detection of cervical cancer, and found to be useful in detection of endometrial cancer, its widespread use has not been possible in the developing countries due to paucity of resources, man power and other facilities Its sensitivity reduces to less than 50% when there is presence of obscuring blood, inflammation or thick areas of overlapping epithelial cells. Manual Liquid Based Cytology (MLBC) is a cost effective technique that enables cells to be suspended in a monolayer and thus improve detection of precursor lesions and specimen adequacy. The residual sample can be used for other tests like Cell block and immunocytochemistry. Objectives: 1. Toimprove the diagnosis of gynecological cancers by a method called as Manual Liquid Based Cytology (MLBC). 2. To study a cost effective method of studying both endometrial and cervical cancer with help of ancillary techniques like cellblock, immunocytochemistry 3To compare the findings between conventional pap smear (CPS) and MLBC in detection of gynecological conditions of endometrium and cervix. Methodology: Samples were collected using Ayres spatula by split sample technique from transformation zone of cervix which included outpatients of gynecology dept. The women were aged between 20-60 years, 82 cases with bleeding history were taken to study endometrial pathology, while 100 cases of white discharge per vagina were selected to study the cervix. 60 cases were later subjected to ancillary studies like cellblock with Immunocytochemistry. Histopathological correlation was done for cases wherever possible. Results: The study on endometruim showed MLBC is more sensitive and specific than CPS in diagnosis of malignant lesions. The contingency coefficient for LBC/Histopathology V/s CPS/Histopathology was 0.572 V/s 0.556. It was observed for cervical lesion that increased detection rate was 150% for low grade intraepithelial lesion. The Positive predictive value for diagnosing neoplastic lesions on cell blocks was 75%, while Concordance Rate of CB/Histopathology Vs CPS/Histopathology was 74% vs. 54%. Conclusion: MLBC is a cost effective method for detections of cancerous lesions of endometruim andcervix. It has been found to be useful in both Endometrial and cervical cytology in increasing the detection of infection and neoplastic conditions of female genital tract.
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In this paper, we propose a novel method to classify Breast Lesions based on minute changes in the cell and nuclear features of the cell. It is important to note these changes as they play a significant role in diagnosis and the line of... more
In this paper, we propose a novel method to classify Breast Lesions based on minute changes in the cell and nuclear features of the cell. It is important to note these changes as they play a significant role in diagnosis and the line of treatment by an oncologist. To overcome the problem of inter-observer variability the method of scoring is used to grade the lesions considered for the study. We have used the Modified Masood Score and designed an algorithm which classifies a given breast lesion into 6 classes namely Benign, Intermediate class-1,Intermediate class-2, Malignant class-1,Malignant class-2 and Malignant class-3. We have developed a sensitive model using the feed-forward neural network and Pattern Network to achieve the above objective. The Rank of the features is observed using ReliefF Algorithm.
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All patients who were admitted in our hospital with history of seizures in the postpartum period (within 6 weeks after delivery) were included in the study to ascertain the cause of seizures and their outcome, and women with prior h... more
All patients who were admitted in our hospital with history of seizures in the postpartum period (within 6 weeks after delivery) were included in the study to ascertain the cause of seizures and their outcome, and women with prior h recruited, primipara women (67 patients) had high risk of seizures. Women between the age group of 21-25 years constituted a large number of patients in this study (44.26%). Seizure occurr more on the first day following delivery (69.47%). Imaging of the patients showed posterior reversible encephalopathy syndrome (PRES) as the most common cause of seizure (35.57%), second most common cause was cerebral venous thrombosis (CVT) (31.5 list (29.47%). 3 patients had intracerebral haemorrhage (3.15%). Eclampsia patients had normal imaging with high blood pressure, high (+++) urine albumin and deranged haematological values. Women with PRES and eclamps mortality of 10% in our study. Conclusion: women (35.57%), followed by outcome and patients of
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Introduction: Vaginal bleeding in the first trimester is a common obstetric situation ranging from an insignificant episode to life threatening emergency. The major causes are abortion, ectopic, and molar pregnancy. Ultrasonography is... more
Introduction: Vaginal bleeding in the first trimester is a common obstetric situation ranging from an insignificant episode to life threatening emergency. The major causes are abortion, ectopic, and molar pregnancy. Ultrasonography is playing an increasing role in the diagnostic process. This study was taken up to evaluate its utility vis-à-vis clinical examination findings. Methods: This was a prospective study done at JSS Hospital Mysore, a tertiary care teaching hospital. All obstetric cases with a history of bleeding per vagina in the first trimester of pregnancy between November 2007 and September 2009 were included. A complete general physical and pelvic examination was done to arrive at a clinical diagnosis. Patients were then subjected to ultrasound examination. Clinical diagnosis and ultrasound diagnosis were correlated. Results: 165 of all obstetric cases (4247) had the first trimester bleeding (incidence of 4%). Commonest causes were abortion (83%), ectopic (13%), and mol...
A Prospective cohort study was carried out on all inpatients admitted to J.S.S Hospital, Mysore with complaints of bleeding per vaginum in the first trimester of pregnancy during the study period from Nov 2010 to Sep 2012. A detailed... more
A Prospective cohort study was carried out on all inpatients admitted to J.S.S Hospital, Mysore with complaints of bleeding per vaginum in the first trimester of pregnancy during the study period from Nov 2010 to Sep 2012. A detailed clinical examination was done to arrive at a provisional clinical diagnosis. Patients were then subjected to ultrasound examination. Clinical diagnosis and ultrasound diagnosis were correlated.One hundred and twenty cases of first trimester bleeding were evaluated by ultrasonography. Commonest cause of bleeding was abortion (81.6%) followed by ectopic pregnancy (11.7%) and molar pregnancy (6.7%). Out of 120 cases 76 cases were confirmed on ultrasonography while 44 cases were proved by ultrasonography which had been misdiagnosed on clinical examination with a disparity of 63%.Ultrasonographic diagnosis proved to be very accurate on statistical evaluation. To conclude , Ultrasound is a sensitive, cost effective and a non invasive diagnostic tool in first ...
Research Interests: Obstetrics and Medicine
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Background: 2-5% of the pregnancies are complicated by antepartum haemorrhage. About one third of them are due to placenta previa thus contributing to a significant amount of maternal and perinatal morbidity and mortality. In the present... more
Background: 2-5% of the pregnancies are complicated by antepartum haemorrhage. About one third of them are due to placenta previa thus contributing to a significant amount of maternal and perinatal morbidity and mortality. In the present times with liberally increasing caesarean section rates, there is a changing trend in the incidence and complications of placenta previa. The objective of this study was to evaluate the obstetrical characteristics and maternal and perinatal outcome of cases of placenta previa.Methods: This was a prospective observational study conducted in the Department of Obstetrics and Gynaecology of JSS Medical College and Hospital, Mysore during the period January 2017 to June 2018.Results: Out of total 13,150 deliveries during this period, placenta previa was observed in 131 cases with an incidence of 1%. Majority belonged to the age group 25-29 years (48.8%). 66% of the cases presented with painless vaginal bleeding as their chief complaint. The major risk fa...
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Research Interests: Obstetrics and Medicine
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Abstract Conventional Pap Smear (CPS) examination has been the mainstay for early detection of cervical cancer. However, its widespread use has not been possible due to the limitations attached to it, like, presence of obscuring blood,... more
Abstract Conventional Pap Smear (CPS) examination has been the mainstay for early detection of cervical cancer. However, its widespread use has not been possible due to the limitations attached to it, like, presence of obscuring blood, inflammation, etc reducing its sensitivity considerably. Automated method in use in developed countries may not be affordable in the developing countries due to paucity of resources. On the other hand, Manual Liquid Based Cytology (MLBC) is a technique that is cost effective and improves detection of precursor lesions and specimen adequacy. Therefore aim of the study was to compare the usefulness MLBC with CPS in cervical cancer screening. A prospective study of 100 cases through MLBC and CPS was conducted from October 2009 to July 2010, in a Medical College in India, by two Independent Pathologists and correlated with Histopathology (22 cases). Morphological feature as seen through MLBC and CPS were compared. Subsequently, all the cases were grouped ...