Doxorubicin (DOX) is a widely used chemotherapeutic agent with demonstrated reproductive toxicity. This study sought to determine the DOX-induced toxicity in the ovary and uterus and the preventive effects of quercetin (QCT) and vitamin E (Vit.E). Female rats were divided into six groups as follows: control, QCT (20 mg/kg), Vit.E (200 mg/kg), DOX (accumulative 15 mg/kg), DOX/QCT, and DOX/Vit.E. After 3 weeks, the toxicity of DOX in ovarian and uterine tissues and the potential palliative effects of QCT and Vit.E were evaluated by histopathological-stereological methods. The findings indicate a dramatic decline in the number of ovarian follicles (p < 0.001), ovarian and its associated structures volume, the volume of the uterus, its layers, and related structures (p < 0.05). Coadministration of QCT and Vit.E with DOX-treated rats demonstrated an alleviative effect on most of the studied parameters. Nevertheless, few adverse effects were recognized concerning these antioxidants administration (p < 0.05). In conclusion, the findings of this study support the protective role of these dietary supplements in the prevention of DOX-induced toxicity in uterine and ovarian tissues.

Stereological and histopathological evaluation of doxorubicin-induced toxicity in female rats' ovary and uterus and palliative effects of quercetin and vitamin E.

Background Cervical cancer can be controlled to a greater extent by screening to improve morbidity and mortality. Pap smear is important screening method, which has proven to be highly effective in reducing the number of cases and the mortality from cervical carcinoma. Any abnormality detected in pap smear has to be confirmed with cervical biopsy, which remains the reference investigation. Objective To find the changes of cervical cytology by pap smear, to classify cervical lesions into malignant and benign groups on cytological and histopathological basis and to correlate the changes observed in cervical cytology with cervical biopsy. Method This is a prospective cross sectional study done in between July 2014 and July 2015 in Dhulikhel Hospital, Kathmandu University Hospital. During the period, all the samples requested for pap smear were studied. The cases who had undergone both pap smear and cervical biopsy were compared. Clinical data were obtained from requisition submitted along with the cytology and tissue specimens received in the department. Result During the study period, total 1922 pap smears were performed and out of them 75 patients were advised to do cervical biopsy. On cytology, out of total 1922 number of cases, 67.90% were normal, 27.90% were inflammatory smears, 3.80% were unsatisfactory (inadequate) and 0.40% were high grade intraepithelial lesions. Highest numbers of patients screened for pap smear ranged from 31 to 40 years. On histopathology, 78.70% had chronic cervicitis, 8% had normal findings, 1.30% had moderate and 6.70% had severe squamous intraepithelial lesions. The frank malignancy was found in 5.30%. The mean age ± SD for carcinoma was 52.75±6.29. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value of pap smear were 77.80%, 100%, 100% and 97% respectively considering cervical biopsy as the gold standard Conclusion This study revealed a good correlation of cervical cytology with cervical biopsy. Pap is a cost effective screening method for early detection of premalignant and malignant cervical lesions. However, biopsy is considered as the gold standard for the confirmation of abnormalities detected in cervical smear.

Correlation of Cervical Pap Smear with Biopsy in the Lesion of Cervix.

Background: Carcinoma cervix is among a curable cancer, if identified at an early stage. Pap smear is a simple, safe, noninvasive, outdoor and effective method for detection of lesions of the cervix but it fails to localize the lesion. Cervical biopsy, on the other hand is a gold standard but invasive technique.Materials and Methods: A prospective cross-sectional study was done in Nobel medical college from January 16, 2017 to January 15, 2018 where all pap smears received in a Department of Pathology were included in the study. However, only cases that had undergone both Pap smear and cervical biopsy were compared. Out of the 1492 pap smears, 118 cases underwent biopsy. Correlation was then done regarding cytological and histological diagnosis.Results: Majority of the cytological findings were normal. 7 patients of HSIL revealed moderate dysplasia and higher lesions in biopsy. 2 cases were that of adenocarcinoma which were diagnosed as inflammatory smear in Pap smear.Conclusion: Cervical Pap smear is reliable screening test to identify high grade squamous cell lesions and carcinoma, but it fails to localize the lesion and adenocarcinoma is hard to identify in a pap smear. Hence, cervical biopsy should be carried out to confirm the findings of Pap smear and in case of strong clinical suspicion.

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A correlation study of cervical cytology on Pap smear with cervical biopsy in a tertiary hospital of Eastern Nepal

Background: Abnormal uterine bleeding (AUB) is defined as changes occurring in the frequency of menstruation, duration of flow or amount of blood loss. This is a study carried out to evaluate the patterns of endometrial histological findings in woman with AUB. Histopathological findings are absolutely essential for the workup and management of AUB patients. Materials and Methods: This is a retrospective study carried out on the endometrial samples collected in the Department of Obstetrics and Gynaecology at Mahatma Gandhi Memorial Government Hospital attached to K.A.P Viswanatham Government Medical College, Trichy, during 1 year period from November 2017 to October 2018. Inclusion Criteria: Patients attending the gynaecology OPD and admitted at gynaecology ward in MGMGH with a complaint of AUB were included in the study. Exclusion Criteria: The following criteria were excluded from the study: (1) AUB due to gestational causes such as abortion, tubal pregnancy, and gestational trophoblastic diseases, (2) hormone replacement therapy within the past 6 months, and (3) obvious cervical pathology such as cancer cervix. Results: Normal cyclical endometrium was found to be the most common finding. Proliferative endometrium was seen in 56% of cases and secretory endometrium in 33% of cases. Maximum number of cases of AUB were seen in the age group of 41–50 years (194 cases, i.e., 48%). Incidence of endometrial carcinoma is common in the age group of 50–60 years (6 cases). Conclusion: Histopathological examination is the gold standard investigation for patients presenting with AUB. Benign pathologies can be treated with hormonal therapy or conservative surgical modalities which greatly reduce the need for hysterectomy.

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Histopathological Correlation of Abnormal Uterine Bleeding

Background: Cervical cancer is the second most common cancer in females and is a major cause of morbidity and mortality. Pap smear is simple, cost effective and sensitive tool for screening of various non-neoplastic and neoplastic lesions of cervix. The objective of this study was to determine the pattern of various cervical smear abnormalities in our center, to study the prevalence of epithelial cell abnormalities in our study population and to determine the accuracy of Pap test by correlating with histopathology. Methods: This was a retrospective study of 7127 cervical pap smears screened and reported at department of pathology, Sri Aurobindo institute of medical sciences Indore, Madhya Pradesh, India during the period of January 2013 to December 2015. Pap smear was done by the conventional method and reporting was done based on the Bethesda system .Emphasis was put on epithelial cell abnormalities and the findings of abnormal epithelial lesions were correlated with histopathology. Results: In this study, the epithelial cell abnormalities constituted 2% of all cases. Low grade squamous intraepithelial lesion was the most common epithelial cell abnormality found in our study group followed by HSIL and then squamous cell carcinoma. About two thirds of the abnormal epithelial lesions were found in the age group above 40 years. Our cytological diagnosis correlated well with histopathology. Conclusions: Pap smear is a cost effective and sensitive screening method for detection of cancerous, pre-cancerous and non-cancerous lesions of cervix.

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Cervical Pap smear study and detection of abnormal epithelial lesions and determination of its accuracy by cytohistological correlation in patients of tertiary care teaching hospital in central India

Background: Abnormal uterine bleeding (AUB) interferes with the quality of life of an otherwise healthy woman. Until the pathology underlying menorrhagia is, accurately diagnosed, proper therapy is hardly possible. The objective of the study was to analyze different histopathological patterns of endometrium in AUB and observe the incidence of various pathologies in different age groups and their relation to parity.Methods: This two-year prospective studywas done in the department of pathology in atertiary care centre, which included 250 cases of clinically diagnosed AUB patients were evaluated. Histopathological examination of endometrial biopsies and hysterectomy specimens were done, followed by clinical correlation.Results: Out of 250 cases of AUB, Premenopausal bleeding was seen in 216 cases (86.4%) and 34 cases (13.6%) had postmenopausal bleeding. The commonest finding observed in the study was proliferative phase endometrium (37.2%), followed by secretory endometrium (34%) and endometrial hyperplasia (16%). Disordered proliferative endometrium was seen in 2.4% of patients. Endometrial carcinoma was seen in 4 (1.6%) cases. Endometrial hyperplasia was seen mostly in the age group 41-50 years (27 cases). Two cases of endometrial carcinomas were presented after age 60 years.Conclusions: Our study revealed the highest incidence of AUB in the perimenopausal age group (41-50 years). Hence a thorough histopathological workup and clinical correlation are mandatory in cases of abnormal uterine bleeding.

Histopathological spectrum of endometrium in abnormal uterine bleeding

Introduction: Cervical cancer is one of the most common forms of cancer worldwide. In developing countries, cancer of uterine cervix is ranked second with a relative frequency of 15% of all cancers in women. Screening women with regular Pap smears allows diagnosis of treatable pre-invasive lesions. The objective of the study was to correlate the Pap smear diagnosis with histopathology and to know the accuracy of Pap smears, so as to assess the efficacy of Pap smears in diagnosing cervical lesions. Material and methods: This two year retrospective study was done in the department of Pathology in a tertiary care centre, which includes 250 Pap smears for which histopathological diagnosis was also done. Detailed clinical history of patients was taken from requisition forms received in cytology department along with Pap smears. The cervical biopsies or hysterectomies received from the same patients were also studied and then correlated with the diagnosis of Pap smears. Results: Out of 250 Pap smears, maximum patients (32%) belonged to the age group of 41-50 years and were multipara. Maximum cases were reported as NILM (59%),followed by ASCUS (16%), LSIL (15%), HSIL (7%), squamous cell carcinoma (1.6%) and 0.8% cases of adenocarcinoma were diagnosed. On histopathology, 41.2% cases were diagnosed as chronic cervicitis, 27.2% cases as chronic cervicitis with squamous metaplasia, CIN I (22.4%),CIN II (4.0%),CIN III (2.8%), squamous cell carcinoma (1.6%) and (0.8)% cases of adenocarcinoma. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy was 75.24%, 97.98%, 96.20%, 85.38% and 88.8%. Conclusion: As per our study, maximum number of cases diagnosed on Pap smears correlated on histopathology, thereby concluding that Pap smears have an important role in diagnosis of cervical lesions.

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Simridhi Bindroo

Papers

Histopathological spectrum of endometrium in abnormal uterine bleeding

Correlation of Cervical Pap Smear with Histopathological Diagnosis in Cervical Lesions: A 2 Years Retrospective Study