Saloni

Abstract

Background: Postmenopausal bleeding is a frequent finding accounting for 5-10% of women in gynaecology. About 10% of these patients have primary or secondary malignancy. Aim: The histopathological patterns of endometrium, in postmenopausal women presenting with bleeding were studied along with the frequency of endometrial cancer. Materials and Methods: It was both a prospective and retrospective, observational study carried out over a period of one and half year in tertiary care teaching hospital on 112 postmenopausal women ,above 40 year of age with history of one year of amenorrhoea without hormone replacement therapy. The samples were obtained by dilatation and curettage and endometrial pipelle procedure. Results and Discussion: Maximum patients belonged to age group of 46-50 year. The most common histopathological pattern observed was atrophic endometrium in 42(37.5%) patients followed by simple hyperplasia in 13(11.6%) and endometrial polyp in 7(6.25%) cases. Irregular shedding of endometrium was diagnosed in 8(7.14%). The maximum patients of endometrial carcinoma (5.35 %) were noted in 61- 65 age groups. Inflammatory pathology was found in 4(3.56%) and atypical hyperplasia was seen a single case (0.89%). In 8 cases, the opinion could not be offered due to inadequacy of sample. Conclusion: As the incidence of malignancy in postmenopausal period remains sufficiently high, it requires immediate investigation in the form of endometrial sampling for early diagnosis, prompt treatment and vigilant follow up. Keywords: Postmenopausal bleeding, Histopathology, Endometrial cancer.

View Article

Abstract

Introduction: The pre analytical phase is an important component of laboratory medicine. It includes the time from the order of test by the clinician until the sample is ready for analysis – it can account up to 70% of errors during the total diagnostic process. The major 5 key components for the establishment of quality and reliability in the laboratory diagnostics include (a) Quality laboratory process (QLPs), (b) Quality control(QC), (c) Quality Assurance/Assessment (QA), (d) Quality Improvement (QI) and (e) Quality policy(QP). Objectives: 1. To stratify the pre-analytical errors documented during pre analytical testing process; 2. To formulate the possible corrective measures to be taken to minimise such errors. Materials and Methods: A prospective study was done for a period of 6 months from 1st august 2019 to 31st Jan 2020 in Clinical Biochemistry laboratory of PGIMER satellite centre, Sangrur. All types of pre-analytical errors were Recorded. In our study, total blood specimens received during Aug 2019 to Jan 2020 were 2980. Out of which 284 specimens were sorted with pre analytical errors. Results: These 284 specimens were categorised as follows: Improper request form (n= 24); improper labelling (n=39); improper tube collection (n=51); insufficient sample n=48); in-vitro haemolysis (n=66), sample not received(SNR) (n=56). Conclusion: Pre-analytical errors are not inevitable and can be avoided with a diligent application of proper quality control, proper education of phlebotomist about the errors and effective collection systems to improve the total quality management of laboratory so as to ensure total quality patient care. Keywords: Pre-analytical errors, Clinical biochemistry laboratory, Quality management.

View Article

Abstract

Introduction: Liver cirrhosis is a major cause of mortality worldwide. Several studies reported that adrenal insufficiency (AI) is common in critically ill cirrhotic patients. However, there is scarcity of data on hepatoadrenal syndrome in cirrhotic patients. As this is an important complication of cirrhosis, this study is needed to know the profile of Adrenal Insufficiency in cirrhotic patients. Aims and Objectives of the Study: 1. To study adrenal insufficiency in patients of cirrhosis. 2. To determine the relationship between BMI and serum cortisol levels. Materials and Methods: 50 patients of cirrhosis admitted in medicine/gastroenterology ward of DMC&H, Ludhiana. Depending on the levels of cortisol, patients can be categorized into 3 groups. Clinically diagnosed patients of cirrhosis were included in our study whereas HIV/Immunodeficiency, Severe chronic heart disease, Chronic obstructive lung disease, Chronic hemodialysis, Severe sepsis, septic shock and patients on steroid therapy were excluded. Results: AI was present in 14 (28%) patients of Cirrhosis. The difference between cortisol levels with respect to BMI was found to be statistically significant. Conclusions: AI forms important part of spectrum of Cirrhosis and these patients should be evaluated for adrenal dysfunction. Keywords: Adrenal insufficiency, Cirrhosis, Cortisol.

View Article

Abstract

Obesity is a common disorder in our country. It leads to many health risks. Ultrasonography can accurately assess the severity of fatty infiltration in liver. The liver enzymes (AST, ALT) are also altered in triglyceride overload. This study aims to assess the severity of fatty liver on US (Ultrasonography) with increased BMI and to investigate the association of severity of fatty liver with liver enzymes. A comparative prospective study was conducted on 179 patients. Severity of fatty liver was graded on Ultrasonography as follows- Group A- Normal liver, Group B- Grade 1 fatty changes, Group C-Grade 2 fatty changes and Group D-Grade 3 fatty changes. BMI of each patient was calculated. Patients with known liver disease were excluded. Serum liver enzyme levels were recorded. There was significant correlation between value of liver enzymes and increasing BMI. Also, Patients with more BMI have higher grade of fatty infiltration. Keywords: Obesity, AST, ALT, Ultrasonography.

View Article