INTRODUCTIONThe link between genital HPV infection and cervical cancer was first demonstrated in the early 1980s by Harold Zur Hausen. HPV has been implicated in 99.7% of cervical cancers.1 30 subtypes of HPV have been identified. Of these types 16 accounts for half the cases, while type 18, 31, and 45 account for 30% of cases. 2Transmission of HPV occurs by sexual activity. The age is an important determinant of risk of HPV infection. 3Most cervical cancers occur at squamo-columnar junction of the cervix. The greatest risk of HPV infection coincides with the greatest metaplastic activity occurring at the squamo-columnar junction. Greatest metaplastic activity occurs at puberty and first pregnancy and declines after menopause. The infection is very common in sexually active young women with a sharp decrease after 30 years of age.However cervical cancer is more common in women after 35 years suggesting infection at a young age and slow progression to cancer. Persistence of infection is more common with high-risk HPV types and is an important determinant in development of cervical cancer. The HPV infection leads to a gradual progression to more severe disease. CINI indicates a self-limiting sexually ABSTRACT Background: Human Papilloma Virus has been found to be associated with cervical squamous cell carcinoma. Studies and reviews indicate that HPV testing is more sensitive than Pap smear for identifying cervical cancer and its precursors in population screening. Hybrid capture 2 assays detect high oncogenic risk viruses and can be used as primary screening tool for women older than 30 years. Methods: A detailed history followed by a thorough clinical and gynecological examination was carried out for women attending the gynecological O.P.D. HPV-DNA (HCT) samples were collected using a cytobrush. Suspicious lesions of the cervix were further subjected to colposcopy directed loop electrosurgical excision procedure (LEEP) and sent for histopathological examination in formalin. The results of HPV-DNA (HCT) and histopatholgical report were then correlated. Results: In this study, one hundred and sixty women were screened for HPV-DNA. Thirty-two women were found to be positive for HPV-DNA. They were further subjected to colposcopy directed large loop electrosurgical procedure. The positive patients were found to have either low-grade or high-grade cervical intraepithelial neoplasia. Conclusions: The use of HPV-DNA test may make it a viable alternative to cytological screening especially as a less frequent screening.

Scar endometriosis remains under diagnosed entity. A high index of suspicion is required for correct diagnosis. Complaints of pain, increase in size or bleeding from a mass post operatively that is cyclically associated with menstrual cycle is almost pathognomonic. Surgical excision remains the treatment of choice. We report three cases treated in our institute.