Smear Test Results Research Articles

Results of Pap Smear in Females Who are Actively Reproducing in Outlying Medical Centers at Parachinar

Objective: To ascertain the prevalence of different cervical abnormalities in connection t pap smear results with age distribution of patient.  Method The demographic makeup of the study population was deduced by calculating the percentages of patients in each age group. Numerous diseases were also identified using the results of the Pap smear test, and percentages associated with each diagnosis were computed. This methodology made it possible to thoroughly analyze the participants' diagnoses and age distribution, which revealed trends in cervical health. One hundred participants in all had Pap smears performed as part of the study. Four age groups were established based on the age distribution data gathered: 18–25, 25–35, 35–45, and 45–55 years old.  Result The majority of participants (37%) were found to be between the ages of 25 and 35, while there was a wide variation of participant ages overall. Pap smear tests are crucial for identifying potentially malignant or precancerous diseases, as evidenced by the majority of patients (71%) receiving a diagnosis of cancer or intraepithelial lesions. There was also representation from the following age groups: 18–25 (9%), 35–45 (28%), and 45–55 (4%). Four percent of the cases had atypical squamous cell lesions, two percent had low-grade squamous intraepithelial lesions, and one percent had high-grade lesions.  Conclusion These findings advance customized screening programs and therapies aimed at specific age groups and diagnostic categories as well as our knowledge of cervical health patterns. People who are fertile should definitely get screened for cervical cancer because the age group of 25 to 35 accounts for a substantial portion of diagnoses. The importance of Pap smear testing for early identification and preventive medicine is underscored by the prevalence of intraepithelial lesions or cancer.

Bi-institutional analysis of microbiological spectrum and therapeutic management of parotid abscesses

BackgroundA parotid abscess (PA) is a complication of an acute bacterial parotitis with a potentially life-threatening course. To date, data on the diagnosis and therapy of PA is sparse and mostly consists of case reports or case series. Therefore, this study aimed at comprehensively analyzing the microbiological spectrum and the therapeutic management in a bi-institutional setting.MethodsA retrospective clinical chart review was performed to identify all patients surgically treated for PA at two tertiary care centers in Germany. Data on demographics, clinical management and microbiological data including species identification, pathogenicity, type of antibiotic therapy, adjustment of antibiotics, antibiotic sensitivity testing, and smear test results were extracted. Intervention-related variables and etiology were analyzed for their statistical association with outcome variables.ResultsOverall, 85 patients were included. Most patients (92.9%) underwent surgical incision. Around half of the patients (45.9%) were treated under local anesthesia. No facial nerve palsy was observed. The most frequently detected pathogens were Streptococci (n = 23), followed by Staphylococcus aureus (n = 6) including one case of methicillin-resistant Staphylococcus aureus. Most patients (68.2%) received an aminopenicillin ± beta-lactamase inhibitor as empiric antibiotic therapy. In 6 cases the antibiotic therapy was modified after receiving the antibiogram. Four patients (5.2%) presented with recurrent PA. Etiology was idiopathic (42.4%), followed by tumorous (12.9%), obstructive, and immunosuppressive (each 11.8%). Patients with a dental focus (p = 0.007) had a longer duration of hospitalization.ConclusionThe results show that the surgical therapy of PA under local anesthesia is safe. A dental examination should routinely be performed to rule out a dental focus. Obtaining a microbiological specimen in order to modify antibiotic therapy if necessary and a histopathological specimen to rule out a tumorous etiology is obligate.

Assessing the impact of lubricant on liquid-based Pap smear test outcomes: a randomized clinical trial.

Since today cervical cancers are growing, there is an increasing need to use screening and examination methods. Meanwhile, liquid-based Pap smear test is a common screening method for women, which is widely applied today. Studies have found that use of lubricant gel in this test can affect the pathology and cytology results. Accordingly, the authors intended to evaluate the effect of use of lubricant gel on the Pap smear test results. This study was of single-blind clinical trial, the study population consisted of candidate patients for screening in terms of cervical pathology, for whom liquid-based Pap smear was done. In this study, 506 patients participated, divided into two groups of 253. One group used lubricant gel during the Pap smear, while the other group underwent this test without lubricant. The data were analyzed by SPSS 21. The study results indicated that once the two groups were compared in terms of age, interval of menstruation time and intercourse time from the sampling, no significant relationship was found between the two groups (P>0.05). It was also found that use of lubricant did not affect the cytology and pathology results of patients (P>0.05). The use of lubricant gel in patients can reduce pain in patients during examination and testing, but does not affect the cytological and pathological results of patients.

Prevalence of Trichomonas Infection in Relation to Human Papillomavirus (HPV) in Pap Smear Samples of Female Patients Referred to Shahid Sadoughi Hospital, Yazd (Iran).

Objectives Human papillomavirus (HPV) and Trichomonas vaginalis (TV) infections have been proposed as risk factors for cervical cancer. This study has been conducted with the aim of investigating the prevalence of TV and its relationship with HPV in women who underwent Pap smear testing as part of cancer screenings. Materials and methods The sampling of liquid-based cervical tissue was conducted among 500 women referred to the women's clinic of Shahid Sadoughi Hospital in Yazd, Iran. The studied samples were examined for Pap smear tests and microscopic identification of TV, as well as HPV-DNA detection and the determination of high-risk and low-risk HPV types by the polymerase chain reaction (PCR) method. The results were analyzed using the IBM SPSS Statistics for Windows, Version 24 (Released 2016; IBM Corp., Armonk, New York) software. Results The individuals included in the study were 16-72 years old. The prevalence rate of TV infection in this population was found to be 29.2%, and the frequency rate of HPV was reported to be approximately 19.4%, with high-risk HPV, including HPV-56, having the highest frequency. The Pap smear test results were reported as abnormal in 20.2%, anda significant correlation was observed between HPV infection and an abnormal Pap smear test (P < 0.05). In addition, a notable correlation was detected between TV infection and high-risk and low-risk HPV (P < 0.05). Conclusion According to the significant relationship found between the two pathogens, TV and HPV, in the abnormal Pap smear test results, TV infection can be considered a risk factor for HPV infection, as well as uterine lesions and cancer.

High rate of non-vaccine targeted high-risk HPV genotypes circulate among women in Eastern Ethiopia

The World Health Organization [WHO] recommends a genotype-specific human papillomavirus [HPV] vaccination as a primary prevention strategy to control the burden of cervical cancer globally. In Ethiopia, where the non-vaccine-targeted HPV genotypes have not been adequately studied, a vaccination initiative was launched in 2018 targeting HPV-6,-11, -16, and -18 for girls aged 14–18 years. The co-existence of both vaccine-targeted and non-targeted genotypes is a serious concern, as it can accelerate cancer progression. Therefore, this study was conducted to determine the prevalence of non-vaccine-targeted HPV genotypes and assess the level of multiple infections with other genotypes in eastern Ethiopia. A health facility-based cross-sectional study including 110 women with positive HPV DNA results was conducted from April to August 2021. A structured questionnaire to collect demographic and clinical data was used. Cervical swabs were collected using L-shaped FLOQSwabs. Women's cytological profile was determined based on Pap smear test results. An automated nucleic acid extraction system using STARMag 96 ProPrep Universal Extraction Kit was utilized following the manufacturer's protocol. An amplification assay in real-time was employed to amplify and identify the HPV Late 1 [L1] gene, which is utilized for genotyping purposes. Following this, the collected data was entered into Epi data version 3.1 software, and the analysis was performed using STATA version 14. A total of 110 women [age range 30–60 years, mean age = 36.5 years and SD ± 6.9] had positive HPV DNA results and were included in the study. Among these, 108 women had valid co-testing [Pap test and HPV DNA test] results for further analysis, and the results of the remaining 2 women were rejected. Overall, the prevalence of non-vaccine-targeted HPV was 56 (51.8%, 95%CI [0.42, 0.61]), of which 28 women (25.4%, 95%CI [0.18, 0.34]) had a single non-vaccine HPV genotype infection. The remaining 29 women (26.4%, 95% CI: 0.190–0.355) experienced multiple infections. The non-vaccine-targeted genotypes of HPV-35 accounted for 11 cases (10%, 95%CI [0.06, 0.17]), HPV-68 was detected in 9 women (8.2%, 95%CI [0.04, 0.15]), HPV-56 and HPV-66 were both found in 8 cases each (7.3%, 95%CI [0.04, 0.14]) of the total. In addition, out of these 108 women, 93 (86.1%, 95%CI [0.78, 0.91]) had low-grade squamous intraepithelial lesions, 13 (12%, 95%CI [0.07, 0.20]) no intraepithelial lesion or malignancy, and two (1.9%, 95%CI [0.01, 0.07]) high-grade squamous intraepithelial lesions. Furthermore, there was no statistical difference [p = 0.755] between vaccine-targeted and non-vaccine-targeted genotypes as the primary cause of cervical lesions. In conclusion, the findings of the present study highlight the existence of a notable prevalence of multiple infections caused by non-vaccine-targeted HPV genotypes. Therefore, it is recommended that both the Federal and regional health bureaus to evaluate the range of hr HPV genotypes protected by the current HPV vaccine and explore the option of transitioning from the quadrivalent HPV vaccine to a novavalent vaccine that includes seven high-risk HPV genotypes.

The use of urine lipoarabinomannan for establishing pulmonary TB in HIV patient: case report and systematic review

Introduction: Indonesia is still the country that provides the second-largest estimated number of TB cases worldwide. Several patients had TB with HIV-positive. HIV-positive patients with symptoms suggestive of pulmonary tuberculosis often difficult to produce sputum of sufficient quality. Lateral flow lipoarabinomannan examination with urine specimens is expected to be easy, inexpensive, fast, and accurate point-of-care testing. The aim of this research was to assess the sensitivity and specificity of the lateral flow method in detecting lipoarabinomannan (LAM) from urine specimens in HIV-positive patients with suspected pulmonary tuberculosis. Sputum cultures were utilised as a reference standard. Case Description: A 21-year-old male patient came to the clinic complaining of a cough that had not subsided since the previous month. Cough felt throughout the day with a little white phlegm. The patient admitted to having high-risk sexual behavior and had been tested positive for HIV but had not started antiretroviral therapy. The laboratory examination results showed that the leukocyte count was 3600/mm3 and the radiological examination revealed a chest X-ray within normal limits. The patient had been tested for sputum smears with negative results but was still advised to start TB treatment. The patient has not started treatment because he feels that his sputum smear test results are negative. Currently, the patient is not willing to have his sputum checked again. The polyclinic doctor knows the lipoarabinomannan (LAM) examination that uses urine specimens to diagnose TB but does not yet know its effectiveness for this patient. Conclusion: In this case report, the patient was unwilling to do a diagnostic test related to the TB. The systematic review was that the Alere Determine™ TB LAM Ag may not be clinically applicable for diagnosing tuberculosis infection in patients living with HIV at this time. However, Fujifilm SILVAMP TB LAM® could be regarded as a supplementary tool to the established diagnostic protocol for tuberculosis in HIV-positive patients.

The Effect of Multimodal Interventions Regarding Early Cervical Cancer Diagnosis on the Women's Knowledge, Attitude and Participation in Cervical Screening Program.

The objective of the present study was to assess the effect of multimodal interventions on women's knowledge, attitude, and behavior towards the participation in the cervical screening test. A quasi-experimental design is executed with a multi-stage sampling of 300 women residing in rural India. Various multimodal interventions, including a documentary film, face-to-face meetings, written booklets, reminder letters, SMS, and telephone calls, are used to motivate the women for cervical cancer screening. Following the interventions, 99% of the participants became aware of cervical cancer and increased their participation in screening from 3.0 % (Pretest) to 79.9% (Posttest). Three reminders have been sent to the participants, throughout the intervention period which has led to a considerable rise in the participants' willingness to participate in screening, hiking from 58% to 79.9%. The Pap smear test results have shown that: among 288 women, 21 have Typical Malignant cells on their cervix, and two women have been diagnosed with cervical cancer (Stage 1a and Stage 1b). The findings of the study indicate that utilizing diverse interventions in health education alters women's behavior, enhances the compliance of cervical cancer screening, and ultimately helps to prevent life-threatening risks.

A COMPARATIVE STUDY OF PAP SMEAR CYTOLOGY AND HISTOPATHOLOGY OF CERVIX BIOPSY

ntroduction: Carcinoma cervix is one of the leading causes of death of the female population in developing countries. By virtue of its accessibility, cancer of the cervix can be readily diagnosed even in its preinvasive stage. If treated in the earlier stages the patient can often be cured of the disease. Carcinoma of the cervix is the fourth most frequent cancer in women worldwide and the leading cause of death from cancer in several developing countries including India. The use of cervical smear (Papanicolaou/Pap) as a screening tool has signicantly reduced the incidence of cervical cancer. Materials and Methods: Out of 100,000 Pap smears, a total number of 75 eligible women with atypical glandular cells (AGCs) referred to gynaecology clinics in Isfahan, Iran, and seventy women were selected to undergo Pap smear test, colposcopic examination and ECC. EMC was performed in women older than 35. Pap smear test results were classied as normal, inammation, AGCs and necrosis. Colposcopy, ECC and EMC ndings were classied as normal, benign and malignant pathologic lesions. Results: Majority of the women were between 31-40 years (59.6%).On PAP smear, ASC-US was found in 5.8% of women, ASC-H in 1.4% of women, LSIL in 6.7% of women and HSIL in 6.2% of women. On colposcopy, LSIL was seen in 26.4% of women and HSIL in 17.8% of women. On histopathological examination, CIN I was seen in 16.8% of women followed by CIN II(8.2%)and CIN III(5.8%).Sensitivity and specicity of PAP smear was 29.7% and 94.4%.Sensitivity and specicity of colposcopy was 85.9% and 74.3%. Conclusion: Pap smear had a poor sensitivity compared to colposcopy but a better specicity than colposcopy .Hence, it may be better to utilise both tests in screening of premalignant lesions of cervix as they complement each other.

What is the effect of vitamin D deficiency on Pap smear test results in the postmenopausal period?

This study aimed to determine the impact of vitamin D deficiency on Pap smear test results in women in the postmenopausal period. This cross-sectional study included 394 women who applied to İstanbul Medeniyet University, Göztepe Training and Research Hospital gynecology and obstetric clinic for routine Pap smear tests. This study was conducted between May 2019 and December 2020. Cases were divided into severe deficiency (&lt;12 ng/ml), moderate deficiency (12-20 ng/ml), deficiency (21-30 ng/ml), and sufficiency (&gt;30 ng/ml) according to the vitamin D levels measured in the postmenopausal period within the scope of check-up examinations. Pap smear test results compared with vitamin D levels. The mean age of the study group was 48.70±3.46 years. There was a statistically significant association between vitamin D values and Pap smear test results (p&lt;0.05). Vitamin D greater than 20 ng/ml had a significant relationship with the normal cytology results. There was a statistically significant association between vitamin D lower than 20 ng/ml and cervicitis cytology results. The results showed that the serum vitamin D and the Pap smear test results had a significant association. It is recommended that physicians prescribe the use of vitamin D supplements in women in the high-risk group of cervical cancer.

Efficacy of Acetic Acid and Lugol's Iodine Assisted Colposcopic Imaging in Cases with Anormal Pap Smear Test Results

Efficacy of Acetic Acid and Lugol's Iodine Assisted Colposcopic Imaging in Cases with Anormal Pap Smear Test Results

Microbiological study on foreign body and vitreous samples of patients with intraocular foreign body

To evaluate the relationship between the microbiological results of the vitreous humor and those of foreign body specimens in patients with intraocular foreign body (IOFB). Seventy-one patients with an IOFB were included in this descriptive prospective case series. All patients underwent immediate IOFB removal. Vitreous sampling was performed during vitrectomy. Foreign bodies were placed directly into culture media for microbiological study. Thirteen (18.3%) patients developed endophthalmitis. The results of microbiological analysis of IOFB and vitreous humor specimens were negative in nine patients and positive in four. Fifty-eight (81.6%) patients with an IOFB had no evidence of endophthalmitis. Among them, seven patients showed positive microbiological results of foreign bodies with no manifestations of endophthalmitis. In five patients, a Staphylococcus epidermidis strain was observed in the culture of the IOFB specimen. Two patients had only positive smear test results of their vitreous humor specimen. A correlation appears to be present between the microbiological results of the vitreous humor and IOFB specimens in patients with clinical findings of endophthalmitis but not in patients with a pure IOFB without clinical features of endophthalmitis. This may justify early use of intravitreal and intravenous antibiotics before the development of endophthalmitis.

Awareness and Screening for Cervical Cancer using Papanicolaou Smear Test Among Women in A Rural Area

ackground: Cervical cancer is one of the most common cancers among women Worldwide and the leading cause of cancer mortality in women in India. Objective: The objective of this study is to assess the knowledge of cancer cervix and the practice of Pap smear test among women in a rural area. Methods: The awareness and screening for cancer cervix using Papanicolaou smear test among women were studied in 526 women at 9 different health centers in a rural area near Rajahmundry from March 5th, 2021 to March 10th, 2021 with a questionnaire survey of history, assessment of knowledge about cancer cervix, attitude and practice of Pap smear testing &amp; HPV vaccination followed by clinical examination and screening using pap smear test. Results: During the study period, a total of 526 women were surveyed, out of which screening was done in only 394 women. Most of the women belong to 30-39 years (37.2%). Distribution of the women based on socio-economic class, occupation, parity, symptoms, clinical examination, knowledge about cervical cancer, and the results of pap smear tests were also studied out of which vaginal discharge seems to be the most common symptom (15.2%), the cervical examination was normal in 91.6%, 77.3% had awareness about cancer cervix and 41.4% of participants had adequate knowledge about Pap smear test. Conclusion: Awareness about cancer cervix was adequate but the awareness &amp; the rates of pap smear testing and HPV vaccination in this area are far lower than in urban areas due to less exposure to health care information.

Vaginal Smear Test Results of Patients Between 2011 and 2020 in the Middle Anatolia Region of Turkey, A Single Centre Experience

Vaginal Smear Test Results of Patients Between 2011 and 2020 in the Middle Anatolia Region of Turkey, A Single Centre Experience

Multiple ulcerated lesions in a patient from Amazon, Brazil

Multiple ulcerated lesions in a patient from Amazon, Brazil

Epidemiological and cytological aspects of the cervix in women from the Diourbel region (Senegal) cervical smear screening

To record the results of uterine cervical smear tests of women in the Diourbel region to compare epidemiological data with the results of uterine cervical smear tests. This is a retrospective study of 201 satisfactory cervical smears performed in the period from 01 December 2018 to 01 December 2019 at the laboratory of the regional hospital Henrich Lubcke of Diourbel. All women with a satisfactory smear were included in our study, so we classified patients according to age and parity. The mean age of the patients was 38.41 years with a standard deviation of 11.51 years. The extremes were 15 and 64 years. The age group [30-40 years] was in the majority at 32.34%. Multiparous patients were in the majority, accounting for 43.28%. The cervix was macroscopically healthy in 61.19% of patients and inflammatory in 12.94%. There was 18.41% LSIL, HSIL accounted for 1% of smears. A statistically significant relationship existed between parity and smear result with P ˂ 0.01. Cervical cancer is one of the most fatal cancers in women and the smear remains the safest and most effective means of prevention.

Association of risk factors of carcinoma cervix with abnormal pap results among women attending a tertiary care hospital of jharkhand: A cross sectional study

Background: Cervical cancer has become a vital cause of cancer mortality among women worldwide. It is the fifth most common cancer overall and second most common cancer among women worldwide.&#x0D; Aims and Objectives: To assess the frequency of established risk factors of cervical cancer among study subjects and to find out the association between socio demographic variables and risk factors with results of pap smear test.&#x0D; Materials and Methods: Hospital based cross sectional study was conducted in Pathology department of Rajendra Institute of medical sciences, Ranchi for 3 months (September – November 2017) on total of 106 women who gave consent.&#x0D; Results: All the women (n=106) were married, 68 out of 106 (64.2%) were Hindus, 57 out of 106 (53.8%)were non Tribals 60.4% were from urban area and most of them 62 out of 106 (58.49%) were housewives. Amongst risk factors, 69 out of 106(65.09%) had their first sexual intercourse before 18 years of age, only 11 out of 106 (10.4%) were addicted to smoking and 42 out of 106 (39.62%) had past history of STIs. Educational status and Socio economic status was found to be significantly associated with abnormal pap smear results with p value &lt;0.05.&#x0D; Conclusion: Most of the women were from non tribal ethnicity and urban background and illiterate with the mean age of 37.9± 10.56 years. Educational status and Socio economic status were significantly associated with abnormal Pap results.

Clinico-morphological Profile of Cutaneous Fungal Infections: An Experience from a Tertiary Care Government Hospital in North India

Background: Cutaneous fungal infections are predominantly seen in hot tropical countries like India. In the past decade, there has been an escalation in recurrent and chronic fungal infections. Skin biopsy may play a critical role in rapid identification of these infections.&#x0D; Methods: Fifteen cases of cutaneous fungal infections over a period of 6 years were included. Formalin-fixed tissue was subjected to hematoxylin and eosin and histochemical staining including Gomori Methanamine Silver and Periodic Acid Schiff . Results of KOH smear test and fungal culture were included wherever available. The clinico-morphological patterns in various cutaneous fungal infections was evaluated.&#x0D; Results: Most patients were between 25 to 40 years of age and commonly presented as skin ulceration, followed by nodular swelling and multiple discharging sinuses. Candidiasis and Mycetoma infections were the commonest infections. Others included: Cryptococcosis, Dermatophytosis, Chromoblastomycosis and Mucormycosis. The predominant histopathologic patterns were perivascular and interstitial inflammation. Eleven cases were confirmed by KOH examination and culture.&#x0D; Conclusion: The morphologic spectrum of cutaneous fungal infections is varied. Initial presentations of these fungal infections may be indicative of the onset of a life-threatening systemic mycoses. Thus, the histopathologic evaluation of skin tissue specimens is critical for their rapid and accurate diagnosis.

Literatur Review : Rapid Immunochromatography Sebagai Metode Skrining Kanker Serviks Berbasis Deteksi Onkoprotein HPV pada Urin

Cervical cancer is still become main health problem especially in development country. This cancer is the second most common cancer in Indonesian women. It commonly caused by infection of Human Papillomavirus (HPV) type 16 and 18. Actually if cervical cancer was detected earlier, it shows better respond therapy than other cancers, but this opportunity is not supported by appropiate screening methods. Nowadays, pap smear and IVA are commonly used for detect cervical cancer but they only recommend for women who have had sexual intercourse. Both of them also require medical expertise and pap smear is highly cost. Based on these problem, this paper describes novel method for cervical cancer screening by using rapid immunochromatography kit which is more applicative, noninvasive, and affordable. This paper was a literature review (library research). Data obtained through the search engine using keywords: "Cervical Cancer", "HPV", "Urine", "Screening", “Lateral flow test”, and "Rapid immunochromatography". The references were taken from reliable journal in the range of 2009 to 2019. Data was also taken from textbooks and the health institution official sites which support the analysis. This method detect the presence of oncoprotein E6 &amp; E7 of HPV-16 and HPV-18 in urinusing antigen-antibody binding principle. Sensitivity and specificity test done by comparing the results of the kit with the results of pap smear tests as a standard screening method and PCR HPV test on urinsamples. We conclude that with further protocol development and standardization to achieve clinical sensitivity, this kit is a solution for noninvasive detection of high risk cervical cancer so that treatment can be do immediately and the mortality rate due to cervical cancer can be reduced as much as possible.

Gendered Silence and Misdiagnosis in the Clinical Encounter: Celia de Fréine's Blood Debts and the Hepatitis C Scandal in Ireland

Gendered Silence and Misdiagnosis in the Clinical Encounter:Celia de Fréine's Blood Debts and the Hepatitis C Scandal in Ireland* Luz Mar González-Arias (bio) … a blood disorder is a whole body issue.Unanchored, migrant—blood is its own diaspora. sinÉad gleeson, constellations (37) The history of women's health care is characterized by silenced or heavily edited episodes that have contributed to the neglect of women's bodies and minds and accordingly prevented them from receiving the best possible treatments. As Hannah Devlin has contended, this prevailing attitude toward women's health has triggered "a string of health-care scandals over several decades" in which the voices of the patients have been consistently ignored. Ireland is no exception in this respect, and its history, both past and present, is punctuated by the silencing of women's voices and bodies in the clinical encounter. The death of Savita Halappanavar in October 2012 at Galway University Hospital—where, in spite of her physical distress and severe complications in the midst of a miscarriage, she was refused a termination of her pregnancy because there was still a fetal heartbeat—stands out among the recent failures of the Irish medical, religious, and political systems with respect to women, and it has left an indelible impact on the campaigns for reproductive justice in the [End Page 264] country (Holland). The CervicalCheck cancer controversy, which first emerged in 2018 and involved scores of women who received incorrect smear-test results; the brutal procedure of symphysiotomy, performed as an alternative to caesarean sections; and the hepatitis C scandal that will be the focus of this essay have also become paradigmatic examples of obstetric violence and gender imbalances in the medical history of Ireland. Celia de Fréine's collection Blood Debts, originally published in Irish as Fiacha Fola in 2004,1 and rendered into English by the author herself in 2014, is to date the only poetic articulation of the so-called hepatitis C scandal (also known as the Anti-D scandal) in Ireland. In the late 1970s about 1,600 Irish citizens, most of them women, were infected with a contaminated blood product: Anti-D immunoglobulin, also known as the Anti-D agent. The product was given to women with rhesus-negative blood who had given birth to rhesuspositive babies in order to prevent damage to the fetus in any subsequent pregnancies. This blood product was revolutionary in the prevention of rhesus disease, but it proved disastrous for the patients who received a batch manufactured in 1976 by the Irish Blood Transfusion Service Board (BTSB) from a donor who had infective hepatitis. A number of women were diagnosed with lupus, jaundice, fatigue, and a rash, but no connection between their illnesses and the toxic agent was initially established. The scandal, which has been referred to as "Ireland's greatest medical disaster" (Keane), was made public only in 1994 when evidence was provided that the BTSB had been alerted to the possibility of contamination yet had ignored the warning.2 De Fréine is "an inhabitant of liminal spaces" (Palacios-González and González-Arias 103), and her "creative force is to be found in the rich terrain between languages, genres, geographies, and literary [End Page 265] traditions" (González-Arias, "Afterword" 102). Although mainly known as a poet, she has also published numerous essays, worked successfully in opera and filmmaking, and published and produced numerous plays. Originally from Northern Ireland, she now divides her time between Dublin and Connemara; she has been inspired and influenced by English, Irish, French, and Eastern European literary traditions; she translates her own work from Irish into English, and most of her collections have appeared in dual-language format. De Fréine is a poet who upsets traditional boundaries, a characteristic that not only flavors the formal aspects of her work but also leaves its mark on the varied themes she has worked on, the volatile relationship between health and gender featuring prominently among them. In several of her collections, for instance, de Fréine has explored posttraumatic stress disorder and the demonstrations of extreme violence against women on the part of soldiers that...

A rare case of actinomycotic osteomyelitis of calcaneum: Presented with subtalar arthritis

We are reporting an unusual case of actinomycosis infection which presented with subtalar arthritis. Actinomycosis is a chronic granulomatous disease caused by Gram-positive anaerobic bacteria. Actinomycosis is very rare and of the cases reported Cervicofacial infection is the most frequent clinical presentation. Hematogenous osteomyelitis at distant sites can occur in the rare instance in immunocompromised or pediatric patients, only a few cases have been reported in healthy patients. Case Report: A 39years, female patient presented with pain, swelling around the right ankle for 4 years with healed sinuses over the lateral aspect. She was treated for the discharging sinuses of right ankle and foot 5 years back with antibiotics and surgery elsewhere. She had a history of taking treatment (ATT for 6months) for pulmonary TB, 10years back. X-rays and Magnetic resonance imaging showed a distorted subtalar joint with multifocal intraosseous lesions in the calcaneum. Curettage and subtalar arthrodesis with Cannulated cancellous screws was done and supported with short-term immobilization. The tissue culture, fungus culture, acid-fast bacillus (AFB) culture, AFB smear, and tuberculosis polymerase chain reaction test results of intraop samples were negative. A pathologic examination confirmed the presence of actinomycosis. The patient was treated with intravenous penicillin for 2 weeks followed by Oral Doxycycline for 6 weeks, given no evidence of active infection intraoperatively. After 1year follow-up, the patient had no signs of recurring infection or complications and she is ambulant pain-free.Conclusion: Actinomycosis of the foot, though rare, can mimic tuberculosis in areas with a high prevalence of tuberculosis. In patients with recurrent discharging sinuses, a high index of suspicion is warranted to early diagnose it.