Papanicolaou smear: A diagnostic aid in sexually transmitted infections

A Comparative Analysis of Visual Inspection With Acetic Acid, Cervical Cytology, and Histopathology in the Screening and Early Detection of Premalignant and Malignant Lesions of the Cervix

Introduction: The incidence of cervical cancer and related mortality is growing worldwide. The natural history of disease progression ranges from 10 to 20 years. Hence, effective screening can help in the early detection and prevention of fatal complications. This study aims to (1) compare the sociodemographic characteristics of the women with malignant and premalignant lesions of the cervix, (2) collate the accuracy of visual inspection of the cervix with acetic acid (VIA) with Pap smear cervical cytology in the early detection of premalignant and malignant lesions of the cervix, and (3) standardize it with histopathology, a gold standard screening tool.

Methods: This study was carried out in the Department of Obstetrics and Gynaecology, Gajra Raja Medical College, Gwalior, India, from October 2020 to March 2021 including all the sexually active women of the reproductive age group and postmenopausal women attending the gynecology outpatient department and the indoor admitted patients. A total of 500 patients were included in the study. The women were subjected to a Pap smear followed by VIA. Punch biopsy was taken from the acetowhite regions and sent for histopathological examination. The women with abnormal cervical cytology results also underwent a biopsy and histopathological examination.

Results: On comparative analysis, the sensitivity and specificity of Pap smear cytology were found to be 89.5% and 65.2%, respectively. The sensitivity and specificity of VIA were found to be 94.7% and 88%, respectively. The overall accuracy of VIA testing (93.2%) is more significant than that of Pap smear (68%).

Conclusion: According to our study, it is found that visual inspection with acetic acid is more diagnostically accurate than Pap smear cytology. Hence, VIA testing could be implemented as a primary screening tool with credence. Also, as learned from our study, the premalignant and malignant lesions are more common among elderly women living under a low socioeconomic status. Hence, these groups of women must be outreached and covered through effectively targeted screening programs.

Diagnosis of Chlamydia trachomatis genital infections in the era of genomic medicine

PURPOSE

Chlamydial genital infections constitute significant sexually transmitted infections worldwide. The often asymptomatic status of C. trachomatis (CT) infections leads to an increased burden on human reproductive health, especially in middle- and low-income settings. Early detection and management of these infections could play a decisive role in controlling this public health burden. The objective of this review is to provide an insight into the evolution of diagnostic methods for CT infections through the development of new molecular technologies, emphasizing on -omics' technologies and their significance as diagnostic tools both for effective patient management and control of disease transmission.

METHODS

Narrative review of the diagnostic methodologies of CT infections and the impact of the introduction of -omics' technologies on their diagnosis by review of the literature.

RESULTS

Various methodologies are discussed with respect to working principles, required specifications, advantages, and disadvantages. Implementing the most accurate methods in diagnosis is highlighted as the cornerstone in managing CT infections.

CONCLUSION

Diagnostics based on -omics' technologies are considered to be the most pertinent modalities in CT testing when compared to other available methods. There is a need to modify these effective and accurate diagnostic tools in order to render them more available and feasible in all settings, especially aiming on turning them to rapid point-of-care tests for effective patient management and disease control.

Comparison of Learning Transfer Using Simulation Problem-Based Learning and Demonstration: An Application of Papanicolaou Smear Nursing Education

The purpose of this study was to compare the effects of simulation problem-based learning (S-PBL), a type of learning that reflects various clinical situations, and demonstration-based learning, a conventional type of learning that shows clinical skill performance, of Papanicolaou smear education on the self-confidence, learner satisfaction, and critical thinking of nursing students. A quasi-experimental control group pretest-posttest design was used. Nursing students who were classified as advanced beginners were randomly allocated to the control group (n = 53) or the experimental group (n = 52). Students in the control group participated in a conventional demonstration of a Papanicolaou smear, while students in the experimental group participated in S-PBL. The students' self-confidence, learner satisfaction, and critical thinking were measured via a self-reported questionnaire. Compared with the control group, self-confidence, learner satisfaction, and critical thinking increase significantly more (p < 0.001) in the experimental group. S-PBL was found to be an effective strategy for improving learning transfer, applying learned nursing knowledge to simulated nursing situations. Thus, S-PBL is recommended to improve training in nursing education.