CERVICAL CYTOLOGICAL SCREENING AND MANAGEMENT IN PREGNANT AND POSTPARTUM WOMEN

Objeotive To examine and follow up cervical cytology of pregnant and postpartum women and study their cytopathologie characteristics, so as to determine screening and managing programs for abnormal cervical cytology. Mothods Totally 5296 patients in pregnancy and postpartum, in which 3729 by computer-assisted cytology test and 1567 by liquid-based monolayers cytology test, were examined and diagnosed by the Bethesda System made in 2001. Those proven epithelial abnormalities patients were followed up until the lesions regressed to normal. The remaining patients, who exhibited persistent abnormalities or progression, were given further examinations. Results The positive rate of cervical cytological test was 8.72% （462/5296）, including squamous carcinoma （SCA） 1 case （ 0.02% ）, high grade squamous intraepithelial lesion （HSIL） 34 cases （ 0.64% ）, low grade squamous intraepithelial lesion （LSIL） 145 cases （ 2.74% ）, atypical glandular cells （AGC） 5 cases （ 0.09% ）, atypical squamous cells cannot exclude HSIL （ASC-H） 14 cases （0.26%）, atypical squamous cells of undetermined significance （ASC-US） 263 cases （4.97%）. The 419 proven cytological abnormality cases were followed up successfully. The total transnegative rate in three months was 73.74% （309/419）, in which 303 cases （72.32%） persisted normal status for more than six months after regression. And the transnegative rate of ASC-US, ASC-H, AGC, LSIL, and HSIL were 79.56%, 64.29%, 100%, 72.14% and 44.12%, respectively. Forty-six cases received biopsy directed by colposcopy. The distribution of coincidence of cytopathologic and histopathologic diagnosis was： SCA 1 case （100%）, HSIL 10 cases （76.92%）, LSIL 13 cases （65%）, ASC-H 2 cases （50%）, ASC-US 3 cases （37.50%）, total 29 cases （63.04%）. Conclusions We should cast more attention to screening cervix lesions in pregnant and postpartum women. Their cytopathologic characteristics are liable to make the clinician give a false positive diagnosis. So we propose to follow up them closely and to lower the indication of biopsy.

Effect of Using Mouthwash Solution on Commensal Flora of the Oral Cavity among Female Students in Qassim University

Oral health is the pathway to one’s general health and wellness. Mouthwash is a product used as an adjunct to oral hygiene practices as an antiseptic and antiplaque and antimicrobial agent. The awareness of using mouthwash solution is so limited worldwide. And maybe there’s effect of mouthwash on commensal flora. The aim of this study is to measure the effect of using Mouthwash solution on commensal flora of the oral cavity. In this study, we determined three groups, the first group is considered as a basic group where Female students are not using any mouthwash, the second group used mouthwash twice daily for two weeks, group number three used mouthwash twice weekly. We take cytological sample scraping from oral cavity. All the cytological sections of all groups stained with Papanicolaou stain and examined the slides under the microscope. The study came out with the following results: The basic group that did not use any mouthwash remained unchanged, while the second group, who used mouthwash twice daily, showed a clear epithelial tissue for any bacteria and a clear background. Group number three, who used mouthwash twice a week, showed countable bacteria in epithelial tissue with a clear background. Finally, the study concluded: Cosmetic mouthwash solution has a bad effect on commensal flora if you over used it and leads to killing all your normal flora in oral cavity as much as therapeutic mouthwash will do.

Cervical Cancer： Cost Management

The present paper aims to outline the panorama of cervical cancer in Brazil, correlating the particularities of these data and their costs in the scenario of the Brazilian Army, by conducting a retrospective cross-sectional study of the military population attended in the Praia Vermelha Military Polyclinic in Rio de Janeiro, in the period of December 2011 to July 2014. The authors use an auxiliary tool for obtaining the database, the finite population sampling by quotas of age with 95% confidence interval and sampling error of 5%. Such a study is relevant when the authors consider the statistical data that cervical cancer is the second most frequent tumor in female population and the fourth cause of death from cancer in Brazil, added to the fact that, if diagnosed early, the chance of cure can reach almost 100%.

Concordance in the Interpretation of Cervical Cytology for the Early Diagnosis of Cervical Cancer

Objective: To identify the diagnostic concordance in the interpretation of cervical smears. Material and Methods: Cross-sectional study from October 2011 to January 2013. 50 samples were read by every 4 cyto-technologists who are the total staffs that read and interpret cytological specimens from a public health institution of the city of San Luis Potosí, México. The cytological diagnosis was confirmed by a certified pathologist. Checklist was developed to determine the quality of the interpretation composed of three sections: adequate sample, inadequate sample and cytological diagnosis. The diagnostic report was made by Bethesda System 2001 classification. Diagnostic concordance was measured through the Kappa coefficient. To establish the differences in cytological diagnosis between each cyto-technologist, chi square test was applied. Results: The concordance is acceptable in the classification of samples as inadequate (k = 0.66). The negative diagnosis was a significant concordance between each cytotechnologist and pathologist;however, no case had very good concordance. In the epithelial abnormalities, only the cytotechnologist 2 had significant concordance with the pathologist, however, its concordance is low. In the case of glandular abnormalities, only cytotechnologist 1 had no significant concordance with the pathologist. The percentage of true negatives was 30%, true positives 20%, false negatives 50% and false positives 0 %. There are significant differences between the readings of cyto-technologist 1 and 2 (p < 0.008), between 1 to 4 (p < 0.001), between 2 and 3 (p < 0.05), and finally between 3 and 4 (p < 0.003). Conclusions: The concordance between cyto-technologists and pathologists is below the required minimum level set by national and international standards.