Modified Papanicolaou staining protocol with minimum alcohol use: a cost-cutting measure for resource-limited settings.
ABSTRACT To devise a simple, cost-effective protocol for Papanicolaou (Pap) staining of cervicovaginal smears.
Five hundred coded paired cervical smears were collected from women as part of routine cervical cancer screening. One set of smears was stained by conventional Pap staining protocol (CP) and the other by a modified protocol (MP) in which alcohol was replaced by 1% acetic acid in all the steps except during fixation and prior to mounting; in addition, one alcohol-based counterstain, OG, was omitted. The smears were examined blindly by the pathologists and then decoded. Each pair of smears was compared and the two protocols were analysed for staining quality and diagnoses by McNemar and chi-square tests.
The staining quality in the MP was satisfactory. The nuclear and cytoplasmic features were comparable to the CP. Cytoplasmic transparency was maintained in the MP and the differential staining of blue/green and pink was acceptable to the pathologists and technicians. The diagnoses agreed in all cases and there was no compromise in interpreting the smears. With MP it took only 3-4 minutes to stain a batch of 50 slides. in contrast to the 20 minutes taken by CP. The MP used almost one-seventh of the amount of alcohol compared with CP, which translated into a significant cost reduction per smear.
The improvised Pap staining protocol with minimum alcohol use is a simple, cost-effective and technician-friendly procedure that can be easily adopted in high-volume, resource-limited laboratories for mass cervical cancer screening.
- [Show abstract] [Hide abstract]
ABSTRACT: BACKGROUND:: Anal cytology has increasingly been used to screen for anal intraepithelial neoplasia (AIN) among men who have sex with men (MSM) at increased risk for anal cancer. Use of liquid-based cytology has been reported to reduce fecal and bacterial contamination and air-drying artifact compared to conventional cytology. Costs associated with liquid-based cytology, however, may limit its use in resource-limited settings. METHODS:: Anal swab samples were collected from MSM participants and used to prepare conventional and liquid-based cytology slides. Abnormal conventional cytology results triggered referral for high-resolution anoscopy (HRA) and biopsy. Agreement between the two cytology techniques and the positive predictive value (PPV) ratios of histology confirmed AIN were calculated. RESULTS:: Among 173 MSM, abnormal anal cytology was identified in 46.2% of conventional and 32.4% of liquid-based slides. The results agreed in 62.4% of cases with a kappa (κ) value of 0.49 (P<0.001). HIV-infected MSM had a 3.6-fold increased odds of having discordant anal cytology results (95% CI 1.6-7.8, p=0.001) compared with HIV-uninfected MSM. Histological AIN 2 and 3 were identified in 20 MSM. The PPV ratios and 95% CI indicated no difference between the two techniques. CONCLUSIONS:: Conventional anal cytology may be a preferred option for resource-limited settings given comparable performances to liquid-based cytology for the detection of AIN, although the agreement between the two techniques was lower among HIV-infected MSM. Due to high prevalence of abnormal anal cytology and AIN, health systems should prepare adequate infrastructure for HRA services and AIN treatment.JAIDS Journal of Acquired Immune Deficiency Syndromes 03/2013; · 4.39 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: This study investigated the relationship between interleukin (IL)-18 levels and male infertility. Semen samples from 57 infertile and normal males were subjected to semen analysis. The pH of the semen samples from normal and abnormal groups showed no significant difference (p>0.05). However, semen volume, density, forward movement percentage, activity, survival rate, and normal morphology rate of the sperms in the normal group were significantly higher than those of the abnormal group (p<0.01). The IL-18 levels of semen in the abnormal group (810.91 pg/mL) were higher than that of the normal group (402.74 pg/mL; p<0.01). Analyses indicate that seminal fluid IL-18 positively correlates with IL-6, IL-8, and tumor necrosis factor-α. Seminal IL-18 level does not affect bacterial colony count. Results indicate that IL-18 may be important in male reproduction.International journal of biological macromolecules 12/2013; 64. · 2.37 Impact Factor