To study Pap smear screening with follow up of all abnormal reports with colposcopy and biopsy. Setting and design: This is a retrospective study conducted on 1980 patients to evaluate all previously conducted cervical smears of patients who attended the Obstetrics and Gynaecology outpatient department at the teaching tertiary care hospital during the period August 2014 to September 2017 for a period of 3 years. Pap smear is done in all OPD patients as a part of routine screening. Materials and methodology: Pap smear is done in all OPD patients as a part of routine screening. We analysed all pap smears from August 2014 to September 2017 for a period of 3 years. The cytological interpretation of the smears was made according to Bethesda system. We also analysed subgroups of abnormal reports. Abnormal pap smears were subjected to colposcopy guided cervical biopsies for histopathological examination. Results: Pap smear was taken in 1980 patients over a period of 3 years. Of the 1545 (78.9%) abnormal cases, only 136 cases were reported to have epithelial cell abnormality. The age range of patients with epithelial cell abnormality was 20 to 70 years and the mean age was 44.1 years. The diagnosis of the 136 abnormal cases revealed 13 cases with ASC-US, 106(5.3%) cases of LSIL, 14 (0.7%) of HSIL, 3(0.1%) cases of malignancy. 336(16.9%) smears were reported normal cases and 99 (5 %) smears were unsatisfactory or inadequate samples. A total of 64 had colposcopy abnormalities and required biopsy. Of which 3 were diagnosed of chronic cervicitis, 21 were CIN 1, 23 Were CIN II, 5 were CIN III, 12 cases were of frank malignancy, most common being squamous cell carcinoma 11 cases and adenocarcinoma in 1 case. Conclusion: Pap smear is a noninvasive, simple procedure deserves to be implemented as a routine screening test in OPD. This has aided in early diagnosis of pre-malignancy and malignancy. Histopathological examination is correlating well with Pap smear and clinical presentation.

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Introduction: Abnormal uterine bleeding (AUB) in perimenopausal women requires careful evaluation due to the risk of endometrial malignancy. Symptomatic women with thick endometrium by transvaginal ultrasound (TVS) warrant endometrial sampling. D&C has been the mainstay over decades whereas pipelle has gained popularity due to good tissue yield and easy technique with no admission or anesthesia. This study aims to determine the use of office endometrial biopsy in perimenopausal women with AUB and the endometrial pathology detected by TVS. Materials and methods:In this observational study over five years, 159 women with AUB who underwent endometrial sampling were included. The patients were randomly assigned D&C or pipelle depending on symptoms and endometrial thickness after clinical examination and laboratory investigations. 79.2% of women underwent office endometrial sampling, and 20.8% underwent D&C. samples were sent for histopathology. Statistical analysis was done with respect to the type of sampling and endometrial thickness by TVS.Results: Mean age of the study group was 44 years. About 60.3% of these women had ET of 10-20 mm. It was noted that women with thinner endometrium had more benign lesions and no atypia or malignancy. Sampling was 100% adequate in D&C cases compared to 97.8% of office biopsy group, though statistically not significant. Office endometrial biopsy and D&C yielded adequate sample and a reliable histopathological report and were comparable with respect to sampling, reports and endometrial thickness. Endometrial malignancy was diagnosed in 1.3% of the study group. 56.6% of women had simple hyperplasia without atypia, and 27% had a normal endometrium. Conclusion:Office endometrial biopsy is a sensitive method to detect abnormal endometrium in women with AUB. Diagnostic Office endometrial sampling is comparable to D&C with lesser complications. TVS prior to endometrial sampling improves the sensitivity to diagnose endometrial pathology.