Introduction: Gandaki Medical College Teaching Hospital is providing specialized obstetrician and gynecologist services since last one decade.
Abstract: Background: Cervical cancer is the fourth most common cancer in women with high mortality. Since it is a preventable cancer, screening for cervical cancer with Papanicolaou test (Pap Test) is considered as the stepping stone in its cure by detecting at its premalignant state. The two methods of acquiring the sample for cytology are Conventional method and liquid based cytology. Methods: The Pap test results of the patients who visited the outpatient clinic of the Gynecologic Department of Gandaki Medical College and Teaching Hospital from January 2012 to December 2017 were reviewed and analyzed from the medical records. The findings of Pap test results were tabulated and categorized as per Bethesda system of classification (2001). Results: A total of 2004 Pap tests were taken. All of the patients in the study were married with mean age of 39.7±10.3 years. A total of 1291(64.42%) Pap tests were normal or negative for intraepithelial lesion whereas 578(28.84%) were inflammatory smears while 37(1.85%) were inadequate for evaluation. There was a presence of low grade intraepithelial lesion in 4(0.2%) and high grade intraepithelial lesion in 15(0.75%). Atypical squamous cell of undetermined significance (ASCUS) was noted in 11(0.55%) and frank malignancy was noted in 1(0.05%) of total Pap test samples. Conclusion: In a developing country like Nepal, Pap test is still the preferred cervical cancer screening tool. All women should undergo the screening test for cervical cancer with any feasible available test. Key words: Bethesda system; cervical cancer; HPV; Pap Test.
Introduction: Isolated Oligohydramnios complicates 3 to 5% of pregnancy at term both in terms of fetal outcome and mode of delivery. Aims: To study the perinatal outcome in isolated oligohydramnios (Amniotic Fluid Index≤8) and compare the outcome between Borderline (Amniotic Fluid Index=5.1-8 cm) and Severe (<5 cm) oligohydramnios. Methods: Retrospective observational study of pregnancy outcome with isolated oligohydramnios (Amniotic Fluid Index≤8 cm) at term was carried out in Gandaki Medical College Teaching Hospital, Pokhara for one year from January 2019 to December 2019. Patients were divided into Borderline Oligohydramnios (Amniotic Fluid Index=5.1 to 8 cm) and Severe Oligohydramnios (Amniotic Fluid Index ≤5 cm). The two groups were compared in terms of fetal outcome like: meconium passage, low birth weight, low APGAR (Appearance, Pulse, Grimace, Activity and Respiration) score at 1 and 5 min, Neonatal Intensive Care Unit (NICU) admission and neonatal death. Similarly mode of delivery was also compared. Results: There were total of 100 patients with isolated oligohydramnios. Of which 51(51%) were with Borderline Oligohydramnios and 49(49%) with Severe Oligohydramnios. The incidence of adverse perinatal outcome and caesarean delivery was high in patients with isolated oligohydramnios. When compared with the two groups there was significant difference in terms of meconium passage (11% vs 48.9%), low birth weight (5.8% vs 18%), low APGAR (Appearance, Pulse, Grimace, Activity and Respiration) score at 1 min (1.9% vs 14%), NICU (Neonatal Intensive Care Unit) admission (11% vs 67%) and Caesarean delivery (39% vs 79.5%). Conclusion: Isolated oligohydramnios at term has been associated with an increased risk for caesarean delivery for fetal distress and adverse perinatal outcomes. Severe oligohydramnios is a sensitive predictor for the adverse perinatal outcome both in terms of fetal outcome and termination of pregnancy.
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