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1.
Madhusudan Dey 《Medical Journal Armed Forces India》2013,69(1):27-30
Background
Cervical priming agents mainly prostaglandins in different doses and routes are used during first trimester vaccum aspiration to prevent cervical injury and shorten the abortion procedure. This study was carried out to assess women''s acceptability, the efficacy and side effects of oral versus vaginal administration of misoprostol in facilitating cervical dilatation prior to first trimester vaccum aspiration.Methods
A randomised control study where 120 women were divided in oral (51) and vaginal (69) group. Each group received 400 mcg of misoprostol either orally or vaginally 04 h prior to first trimester pregnancy termination. Baseline cervical dilatation, women''s acceptability and side effects and complications were noted in both the groups.Results
There was no difference between the oral and vaginal misoprostol groups with respect to mean cervical dilatation (5.53 mm vs 5.43 mm; p > 0.05). A total of 88% of women in the oral group expressed satisfaction with the route of misoprostol administration as compared to 74% in the vaginal route. The women in the vaginal group were experienced more preoperative vaginal bleeding (43% vs 25%).Conclusion
Oral administration of misoprostol is an effective alternative to vaginal administration in preinduction cervical ripening prior to first trimester pregnancy termination. 相似文献2.
Background
Hysteroscopic surgery requires pre-operative cervical ripening to facilitate adequate dilatation of the cervix for insertion of operative hysteroscope. This study was conducted to compare the efficacy of intracervical misoprostol with vaginal misoprostol in achieving cervical ripening before operative hysteroscopy.Methods
In this randomised comparative study conducted at a tertiary care teaching hospital, 56 patients needing operative hysteroscopy were divided into two groups of 28 patients, one for intracervical misoprostol and the other for vaginal misoprostol. Four hundred microgram of misoprostol was inserted on the night before and in the morning of operative hysteroscopy intracervically in group I and vaginally in group II.Results
Primary outcome measure was number of patients achieving 7 mm preoperative dilatation of cervix. Largest Hegar dilator that could be passed into the uterine cavity past the internal optic sheath without resistance was noted in each case. Mean cervical dilatation prior to operative hysteroscopy was calculated. In addition, incidence of slipping of vulsellum and cervical laceration was also noted. Time to achieve full cervical dilatation was recorded. In 23/28 cases of group I and 5/28 in group II, size 7 Hegar dilator could be passed without effort. Mean cervical dilatation was 7.5 mm in group I and 5.7 mm in group II. Slipping of the vulsellum and cervical lacerations were seen in significantly less patients in group I. Mean time to achieve cervical dilatation to 10 mm was 43.39 seconds in group I and 103.96 seconds in group II (P<0.0001).Conclusion
Intracervical administration of misoprostol is an effective method of achieving cervical ripening for easy cervical dilatation up to 10 mm prior to operative hysteroscopy. 相似文献3.
BK Goyal Premansu Roy PM Bhat NK Das KG Paul BS Duggal 《Medical Journal Armed Forces India》2012,68(2):129-131
Background
Hysteroscopic surgery requires pre-operative cervical ripening to facilitate adequate dilatation of the cervix for insertion of operative hysteroscope. This study was conducted to compare the efficacy of intracervical misoprostol with vaginal misoprostol in achieving cervical ripening before operative hysteroscopy.Methods
In this randomised comparative study conducted at a tertiary care teaching hospital, 56 patients needing operative hysteroscopy were divided into two groups of 28 patients, one for intracervical misoprostol and the other for vaginal misoprostol. Four hundred microgram of misoprostol was inserted on the night before and in the morning of operative hysteroscopy intracervically in group I and vaginally in group II.Results
Primary outcome measure was number of patients achieving 7 mm preoperative dilatation of cervix. Largest Hegar dilator that could be passed into the uterine cavity past the internal optic sheath without resistance was noted in each case. Mean cervical dilatation prior to operative hysteroscopy was calculated. In addition, incidence of slipping of vulsellum and cervical laceration was also noted. Time to achieve full cervical dilatation was recorded. In 23/28 cases of group I and 5/28 in group II, size 7 Hegar dilator could be passed without effort. Mean cervical dilatation was 7.5 mm in group I and 5.7 mm in group II. Slipping of the vulsellum and cervical lacerations were seen in significantly less patients in group I. Mean time to achieve cervical dilatation to 10 mm was 43.39 seconds in group I and 103.96 seconds in group II (P<0.0001).Conclusion
Intracervical administration of misoprostol is an effective method of achieving cervical ripening for easy cervical dilatation up to 10 mm prior to operative hysteroscopy.Key Words: cervical ripening, intracervical administration, misoprostol, operative hysteroscopy 相似文献4.
Background
Medical Termination of Pregnancy (MTP) is a commonly performed during the first trimester. Dilatation and Evacuation (D & E) mandates rapid dilatation of cervix with metal dilators, which requires anaesthesia and may be associated with trauma to the uterus, cervix and later cervical incompetence. The problem of rapid cervical dilatation is obviated with intravaginal misoprostol.Methods
Intravaginal misoprostol tablet 200 microgram was inserted, a night prior to MTP to ripen the cervix. Cervix was dilated with metal dilators only in cases where cervix did not loosen up sufficiently. Products of conception were removed by suction.Results
Out of 108 cases cervical dilatation was not required in 96 cases (88.9%).Conclusion
Intravaginal misoprostol 200 microgram proved effective as a priming agent prior to MTP in the first trimester.Key Words: Misoprostol, MTP 相似文献5.
Nandaram Seervi Nupur Hooja Lata Rajoria Asha Verma Kusum Malviya Neha Mehta 《Medical Journal Armed Forces India》2014
Background
Nearly 20% of all confirmed pregnancies end in spontaneous abortion. Misoprostol's use in early pregnancy failure is varied and dose and route are not well established. The aim of this study was to compare the efficacy and the side effects of different regimes of misoprostol in causing expulsion of products of conception in early pregnancy failure.Method
Women patients with an ultrasound diagnosis of early pregnancy failure, less than 12 weeks gestation were divided into two, Group-A: tab. Misoprostol 800 mcg 6 hourly vaginally, upto 3 doses. Group-B tablet misoprostol 600 mcg 6 hourly, sublingually for 3 doses. All observations were noted and statistical analyzed.Results
Mean gestational age was 7.93 weeks. Mean induction abortion interval 18.183 h. Women patients with less than six weeks gestational age had least mean induction-abortion interval time, 15.75 ± 2.82 h in vaginal group but was highest in sublingual group 22 ± 2 h and 18.43 h in overall (P = 0.02). Though after 8 weeks, both routes were equally effective. Mean dose required in group-A was 20044 mcg and in group-B was 1564 mcg (P < 0.001). Efficacy of protocol was 88.89% in group-A and 92.85% in group-B.Conclusion
Both regimes had comparable efficacy, acceptability (90%) and side effects. In women patients less than six weeks period of gestation, the vaginal (800 mcg) route was distinctly superior, in women patients with 6–8 weeks the sublingual (600 mcg) route was more advantageous. The correct dose must be used for the route chosen. The route of administration should be decided in accordance with the preference of the patient and the clinical situation. 相似文献6.
Manu Tiwari Jyoti Kotwal Anupam Kotwal Priyanka Mishra Brig Vibha Dutta Brig Sanjiv Chopra 《Medical Journal Armed Forces India》2013
Background
Iron deficiency anaemia (IDA) is the most common cause of anaemia in pregnancy in Indians and is associated with increased risk of low birth-weight infants. Studies from developed countries recommend iron supplementation based on serum ferritin levels. However, screening by serum ferritin is not feasible in all cases in India. This study was undertaken to document haematological profile of pregnant Indian women.Methods
We studied the correlation between second and third trimester ferritin concentration and haemoglobin (Hb) and red cell indices in 100 consecutive ANC cases to select the best haematologic characteristic to identify women who needed iron therapy. Hb and red cell indices, RBC count, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, red cell distribution width were analysed and PBS studied to subtype anaemia if present.Results
Proportion of iron deficiency anaemia in pregnancy was 34% and significant correlation was found between serum ferritin and RDW-CV% and TRBC. No correlation was found between ferritin levels and Hb, MCV, MCH and MCHC. Serum ferritin levels were <12 ng/mL in 30 out of 52 non-anaemic cases suggesting prevalence of sub-clinical iron deficiency in 58% cases. None of the red cell indices correlated with ferritin level in this group. Only TRBC showed some correlation with ferritin (r = −0.090, p > 0.05).Conclusion
All pregnant women in India should continue to get iron supplements unlike what is recommended in the developed countries where iron supplementation is based on serum ferritin levels. 相似文献7.
Yu Zhang Hao-Ping Zhu Jian-Xia Fan Hong Yu Li-Zhou Sun Lian Chen Qing Chang Nai-Qing Zhao Wen Di 《中华医学杂志(英文版)》2015,128(20):2736-2742
Background:
In China, no multicenter double-blinded prospective randomized controlled study on labor induction has been conducted till now. This study is to evaluate the efficacy and safety of intravaginal accurate 25-μg misoprostol tablets for cervical ripening and labor induction in term pregnancy in nulliparous women.Methods:
This was a double-blinded, prospective randomized controlled study including nulliparous women from 6 university hospitals across China. Subjects were randomized into misoprostol or placebo group with the sample size ratio set to 7:2. Intravaginal 25-μg misoprostol or placebo was applied at an interval of 4 h (repeated up to 3 times) for labor induction. Primary outcome measures were the incidence of cumulative Bishop score increases ≥3 within 12 h or vaginal delivery within 24 h. Safety assessments included the incidences of maternal morbidity and adverse fetal/neonatal outcomes.Results:
A total of 173 women for misoprostol group and 49 women for placebo were analyzed. The incidence of cumulative Bishop score increases ≥3 within 12 h or vaginal delivery within 24 h was higher in the misoprostol group than in the placebo (64.2% vs. 22.5%, relative risk [RR]: 2.9, 95% confidence interval [CI]: 1.4–6.0). The incidence of onset of labor within 24 h was significantly higher in the misoprostol group than in the placebo group (48.0% vs. 18.4%, RR: 2.6, 95% CI: 1.2–5.7); and the induction-onset of labor interval was significantly shorter in the misoprostol group (P = 0.0003). However, there were no significant differences in the median process time of vaginal labor (6.4 vs. 6.8 h; P = 0.695), incidence (39.3% vs. 49.0%, RR: 0.8, 95% CI: 0.4–1.5) and indications (P = 0.683) of cesarean section deliveries, and frequencies of maternal, fetal/neonatal adverse events between the groups.Conclusion:
Intravaginal misoprostol 25 μg every 4 h is efficacious and safe in labor induction and cervical ripening. 相似文献8.
Background
Use of conjunctival autograft following excision of primary pterygium has reduced the recurrence rate. This study evaluates the efficiency of fibrin glue as compared to sutures in attaching the conjunctival autograft with reference to surgical time, post operative comfort and recurrence during follow up.Methods
60 patients with primary pterygium were included and divided into two groups. In the first group autograft was secured in place with help of 10-0 polyamide monofilament suture while in second group fibrin glue was used. Both the groups were compared in terms of operative time, post op comfort and recurrence.Results
The average surgical time taken was 50.93 ± 4.96 min with suture group and 34.43 ± 4.94 min with fibrin glue group. Pain and foreign body sensation was markedly less with fibrin glue group. At the end of final follow up at 6 months, 3 cases (10%) from suture group and 1 case (3.33%) from fibrin group had recurrence.Conclusion
Fibrin glue is effective and safe for attaching conjunctival autograft during pterygium surgery. Although more number of recurrences were observed in suture group as compared to fibrin glue group the difference was not statistically significant (p 0.612). 相似文献9.
Background
The objective of this study was to confirm the effectiveness and safety of methotrexate and misoprostol or misoprostol alone for abortion up to 12 weeks of gestation.Methods
A group of volunteer patients desiring MTP with gestations up to 84 days (12 weeks) were studied. The patients were divided into 2 groups. Group 1 patients with gestation up to 56 days were further subdivided as (a) Patients who received methotrexate 50 mg IM + misoprostol 800 gms intravaginal and (b) patients who only received 800 gms of misoprostol. Group 2 included the patients who were 8-12 weeks pregnant and they received same treatment as group 1 (b). Outcome measures assessed included successful abortion (complete abortion without need for surgery), side effects, decrease in hemoglobin and mean duration of vaginal bleeding.Results
Complete abortion occurred in 36 (90%) of 40 patients in group 1 (a), 10 (67%) of 15 patients in group 1(b) and 29 (83%) of 35 patients in group 2. There were only 2 patients with clinically significant decrease in hemoglobin, but none required transfusions. Vaginal bleeding lasted 15 ± 6 days in group 1 (a), 16 ± 6 days in group 1(b) and 16 ± 5 days in group 2. All the patients stopped bleeding when endometrial thickness was < 5mm. Five percent women had stomatitis after methotrexate and 44% patients had fever with chills after misoprostol administration.Conclusion
Considering the low cost and availability of methotrexate and misoprostol, these drugs constitute a good alternative for medical abortion. They are safe and effective.Key Words: Methotrexate, Misoprostol, MTP, Induced abortion 相似文献10.
Background
Over the last decade, mesh augmented surgical repair is being increasingly used in pelvic organ prolapse. Perigee and Apogee are comprehensive, single-use needle suspension kits that provide a standardized delivery method for mesh or graft-augmented repairs. This study has been carried out to study the safety and efficacy of the Perigee and Apogee mesh repair systems.Methods
10 cases of posterior vaginal wall prolapse with or without Apical prolapse underwent Apogee mesh repair surgery and 10 cases of anterior vaginal wall prolapse underwent Perigee mesh repair surgery. Depending on the findings either Apogee or Perigee or both were used. Patients were followed up for complications of the surgery if any, and for the relief of the symptoms related to prolapse and associated symptoms of bowel/bladder dysfunction. Objective cure rate was prolapse < stage 1 as per the POPQ system. Data collected was statistically analyzed.Results
The objective and subjective cure rates were 100%. Postoperative complications were minor. No patient developed de novo urinary urge symptoms, stress urinary incontinence or UTI postoperatively. There were no operative complications like bladder injuries, hematoma and rectal injuries. The mean blood loss was 180 ml and the mean duration of surgery during the Apogee and Perigee mesh repair was 51.5 ± 2.99 min and 60.9 ± 4.65 min respectively.Conclusion
In the present study there was a significant improvement in the degree of prolapse after the mesh repair surgeries and the results were consistent even at 12 months follow up. 相似文献11.
Nandaram Seervi Nupur Hooja Lata Rajoria Asha Verma Kusum Malviya Neha Mehta 《Medical Journal Armed Forces India》2014,70(4):360-363
Background
Nearly 20% of all confirmed pregnancies end in spontaneous abortion. Misoprostol''s use in early pregnancy failure is varied and dose and route are not well established. The aim of this study was to compare the efficacy and the side effects of different regimes of misoprostol in causing expulsion of products of conception in early pregnancy failure.Method
Women patients with an ultrasound diagnosis of early pregnancy failure, less than 12 weeks gestation were divided into two, Group-A: tab. Misoprostol 800 mcg 6 hourly vaginally, upto 3 doses. Group-B tablet misoprostol 600 mcg 6 hourly, sublingually for 3 doses. All observations were noted and statistical analyzed.Results
Mean gestational age was 7.93 weeks. Mean induction abortion interval 18.183 h. Women patients with less than six weeks gestational age had least mean induction-abortion interval time, 15.75 ± 2.82 h in vaginal group but was highest in sublingual group 22 ± 2 h and 18.43 h in overall (P = 0.02). Though after 8 weeks, both routes were equally effective. Mean dose required in group-A was 20044 mcg and in group-B was 1564 mcg (P < 0.001). Efficacy of protocol was 88.89% in group-A and 92.85% in group-B.Conclusion
Both regimes had comparable efficacy, acceptability (90%) and side effects. In women patients less than six weeks period of gestation, the vaginal (800 mcg) route was distinctly superior, in women patients with 6–8 weeks the sublingual (600 mcg) route was more advantageous. The correct dose must be used for the route chosen. The route of administration should be decided in accordance with the preference of the patient and the clinical situation. 相似文献12.
Background
To present the feasibility of lingual mucosal graft urethroplasty in anterior urethral strictures and appraisal of donor site morbidity.Methods
From November 2007 to December 2010, 14 patients underwent dorsal onlay lingual mucosal graft urethroplasty for anterior urethral strictures. Lingual mucosal graft was harvested from the lateral and undersurface of the tongue. Check micturating cystourethrograms were done 2 weeks after catheter removal and uroflowmetry after 3 months. Success was defined as normal uroflowmetry rates at 3 months in the absence of any postoperative instrumentation. Tongue was assessed for any residual pain, taste disturbances or restricted movement at 3 months.Results
Four patients had submucosal fibrosis of the oral cavity and their buccal mucosa was unfit for grafting. Mean (range) stricture length was 5 (3–16) cm and the operation time 170 (140–210) min. Graft width averaged 1.6 cm. Average length of harvested graft was 6.5 cm. Mean duration of follow-up was 12.8 months. Two patients developed stricture at the proximal anastomotic site. There were no donor site complications.Conclusions
Lingual mucosal graft harvesting is simple, gives graft lengths comparable to buccal mucosa and is associated with negligible donor site morbidity. 相似文献13.
Background
Tobacco use is increasing among women and girls across the globe as well as in all parts of India. In India, 8 to 10 lakh people die due to tobacco related diseases every year. This tobacco epidemic among women needs to be prevented.Objectives
Study was conducted to find the prevalence and pattern of tobacco consumption and it's association with education among females (15–49 years) in a rural village of Pune, Maharashtra, India.Material and Methods
A cross-sectional study was carried out among 313 females (15–49 years) in a rural field practice area of a Medical College in Pune during Feb 11 to May 11. Pre-tested questionnaire was used for collecting data by interview after obtaining informed consent. Statistical analysis was performed (Epinfo software version 3.5.3.).Results
Out of 313 female studied, 14.05% (44) and 0.96% (03) were found to be current and former tobacco user respectively while 84.98% (266) never used any form of tobacco in their lifetime. Mishri consumption (45%) was commonest form of smokeless tobacco use followed by quid use (36%). Majority of the tobacco users (54.55%) were illiterate. There was significant association between tobacco consumption and education level (p = 0.0295). Tobacco consumption was more with increasing age.Conclusion
Tobacco consumption was found to be prevalent in 14.05% of women. Almost all of them used smokeless tobacco, mainly mishri. Tobacco consumption was directly associated with age and inversely with educational level. Therefore increasing women's literacy may bring down tobacco use among women. 相似文献14.
Background
Strategic blood reserves are an important component in meeting blood needs and this can be accomplished through the establishment of a frozen blood program.Methods
One hundred units of packed RBC were glycerolized using the Haemonetics ACP 215 automated cell processor and placed in a −86 °C deep freezer for freezing and storage. Product weight, hematocrit, RBC count, WBC count and hemoglobin were recorded prior to freezing. Twenty five bags were thawed and deglycerolized after every three months starting at one year from the date of first glycerolization In addition to the earlier parameters the bags were assessed for supernatant osmolality, pH, supernatant hemoglobin, ATP levels and supernatant potassium and from these red cell recovery, percentage hemolysis, supernatant glycerol and red cell viability were estimated. All tests were repeated at the end of 7 and 14 days.Results
The mean red cell recovery was found to be 86.12% on Day 0 and 84% on Day 14. All the bags showed residual glycerol and pH within the acceptable limits upto Day 14. Percentage hemolysis, Mean ATP levels and mean supernatant potassium levels were within acceptable limits upto Day 14. All the units were sterile upto Day 14.Conclusion
The data in this study showed that the red cells which were glycerolized using the automated platform ACP 215, frozen at −80 °C for more than a year and deglycerolized again using the ACP 215 had excellent viability while being stored at 4 °C during the 14 days of post-thaw storage. 相似文献15.
Background
Infertility is an important issue in women with Premature Ovarian Failure (POF). With no conclusive treatment available to enhance fertility in these women, it is the use of donor eggs with In-Vitro Fertilization (IVF) which can fulfil their desire to become a mother in a novel way. Hormone replacement therapy (HRT) in POF apart from correcting the endocrine defect also helps in improving the milieu of the uterus by improving its vascularisation and the sub endometrial blood flow. We thus aimed to carry out a study to find out whether hormone replacement therapy if administered prior to the oocyte donation cycle in patients of premature ovarian failure improves the pregnancy rate.Methods
A comparative study was carried out incorporating 46 subjects with 23 in each group. Group A received HRT prior to their oocyte donation cycle while the second group entered into the oocyte donation programme directly after an artificially induced menstruation.Results
It was observed that, although the HRT group had a slightly higher pregnancy rate, with a better mean endometrial thickness as compared to the non HRT group it was not statistically significant.Conclusions
Institution of hormone replacement therapy does improve the vascularisation of the uterus, corrects the histologic features of the uterine lining and makes the endometrium receptive but whether it enhances the pregnancy rate needs to be elucidated with further studies. 相似文献16.
目的 探究足月妊娠高血压孕妇应用cook球囊和米索前列醇的分娩情况与母儿结局。 方法 选取2017年6月—2018年5月间于瑞安市妇幼保健院计划分娩的足月妊娠高血压产妇110例,采用随机数字表法随机分为球囊组(55例)和米索前列醇组(55例),分别应用cook球囊和口服米索前列醇引产,比较2组产妇的分娩情况、经阴道分娩者引产到生产的情况、引产及分娩期间并发症、新生儿情况以及引产后不良反应发生情况。 结果 2组产妇胎膜破裂时间、第一产程时间及第二产程时间差异无统计学意义(P>0.05),球囊组经阴道分娩、促宫颈成熟有效、催产素使用及人工破膜例数明显高于米索前列醇组,而引产到临产的时间明显低于米索前列醇组(P<0.05)。球囊组经阴道分娩的总例数(74.54%)明显高于米索前列醇组(52.72%),且球囊组引产到分娩的最长时间明显少于米索前列醇组(P＜0.001)。球囊组引产及分娩期间并发症的总发生率43.64%,明显低于米索前列醇组65.45%(P=0.035)。2组产妇所产新生儿的Apgar评分、新生儿死亡率、送入新生儿监护室的例数、新生儿吸氧例数及并发症发生情况差异无统计学意义(P>0.05)。2组产妇头晕、恶心、呕吐和潜伏期长时间镇痛的发生情况差异无统计学意义(P>0.05)。 结论 对于足月的妊娠高血压产妇,与口服米索前列醇相比,cook球囊能有效缩短产程时间,提高引产的成功率,减少分娩并发症,安全性高。 相似文献
17.
Background
Studies have justified that social and cultural factors influence young people not to use condoms. Sexually active people associate condoms with lack of trust, while others believe carrying them could imply sexual inexperience. The aim of this study was to provide an intervention model based on this social perception and assess the impact of the intervention in improving condom use.Methods
2083 personnel in the intervention group were subjected to behaviour change intervention based on perception and use of condoms. Using a cluster design, we randomly assigned 40 departments to department-based intervention (20) or assessment (20) groups. Around 100 persons in the same age group of 18–45 years were again randomly assigned to each group. Chi Square test was used to assess the effectiveness of the intervention.Results
Over 6% individuals in the control group (Table 2) had non-regular partners and out of them 23.5% had used a condom. Again, in the same group (Fig. 1), 45.36% individuals thought it is acceptable for single men to use condoms with their partners and 8.15% agreed that it is alright for married women to use condoms with their husbands. The perception significantly increased in the intervention group (p < 0.001).Conclusion
This study thus highlights the importance of continued behavioural intervention in filling certain gaps in the social and structural perception to improve condom use for effective HIV prevention in the community. 相似文献18.
R. Shashikumar Richa Chaudhary V.S.S.R. Ryali P.S. Bhat Kalpana Srivastava J. Prakash D. Basannar 《Medical Journal Armed Forces India》2014
Background
Empathy is essentially a desirable quality among clinicians and can be developed during medical education. Studies from outside India have shown that higher empathy is related to better competency and choice of specialty may be related to empathy levels in them. Change in empathy levels among undergraduate medical students with progressive training has been often ascribed to reasons such as curriculum content, timing of clinical rotations. Gender differences in empathy levels also vary among different countries. Since many of such factors differ in India there is a need therefore to understand empathy and its correlates among medical students in India.Method
A cross sectional study was undertaken in a large medical college among the undergraduates of first, third, fifth, seventh and ninth semesters to measure their empathy levels. The evaluation was done using the Jefferson's Scale for Physician's Empathy- Student version.Results
The study revealed highest empathy at entry level and a significant fall by seventh semester (p = 0.002). Female students had significantly higher empathy levels than male students (p = 0.012) across all semesters. The variance in empathy scores according specialty chosen is not statistically significant (p = 0.2468).Conclusion
The progressive decline in empathy levels with years in medical college here is seen much later than in western studies. Female students are more empathetic than male students. The relation of mean empathy scores and choice of specialty is inconclusive and at variance from other studies. 相似文献19.
Awadhesh Kumar Mishra Ajith Nilakantan Kavita Sahai Rakesh Datta Ajay Malik 《Medical Journal Armed Forces India》2014
Background
Contact Endoscopy is a non invasive tool to visualise alterations in cell architecture in vivo. In this study we investigated the diagnostic accuracy of Contact Endoscopy in detecting malignancy in oral mucosal lesions.Methods
76 patients with oral mucosal lesions requiring biopsy were included. Contact Endoscopy was performed by Otolaryngologist before biopsy and findings recorded. The lesion was then biopsied and sent for histopathological examination by Pathologist who was blinded to Contact Endoscopy findings. Findings of Contact Endoscopy were compared with histopathological findings taking the latter as the gold standard. Two biopsies were reported as ‘inconclusive’ on histopathological examination and hence excluded from the final analysis. Data of the remaining 74 patients is presented here.Results
Clinically lesions were diagnosed as ulcero-proliferative lesions in 34 patients, Leukoplakia in 19, Erythroplakia in 9, Lichen planus in 5 and Submucous fibrosis in 7 patients. Histopathological examination revealed presence of malignancy in 97.06% of ulcero-proliferative mucosal lesions, 10.53% of leukoplakia and 33.33% of erythroplakia while corresponding figures on Contact Endoscopy were 94.12%, 5.26% and 11.11% respectively. No malignancy was detected in lichen planus and submucous fibrosis by either technique. When compared with histopathological examination, CE showed sensitivity of 84.21%, specificity of 94.44% and accuracy of 89.19%. No adverse effects on the patients were seen due to the procedure or stain.Conclusion
Contact Endoscopy may be useful in determining cellular structure in vivo without biopsy to detect oral malignancy early. Further studies are suggested. 相似文献20.