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Pap smear

PAP Smear
A. Understanding Pap Smear
Papanikolaou test or Pap smear is a screening method gynecology, triggered by Georgios Papanikolaou, to discover the processes of premalignant and malignant in the ectocervix, and infection in the endocervix and endometrium. Pap smear is used to detect cervical cancer are caused by human papillomavirus, or HPV. According to estimates, the UK Pap smear prevent about 700 deaths per year. Women who are sexually active are advised to undergo a Pap smear once setahun.Pap smear is an examination of women's health by taking a bit of the mucus of the cervix through a specific process and examination under a microscope to be examined changes in the surface cells of the neck rahim.Pada There are currently two types of Pap Smear is commonly held, that the old method of Pap Smear Pap Smear and Liquid Base Preparation methods that provide high accuracy results because that is picked up can be examined in full. In this way the method is simple, safe, fast, painless, requires no medication, the results are accurate and affordable. Pap tests should be done for women who have had sexual contact (regardless of age) until the age of 65 years in order to detect possible outbreaks of Cervical Cancer. The right time to do a Pap smear test is at all times outside of regular menstrual period. By doing a Pap smear test we can detect some abnormalities include the following: - Infection of bacteria, fungi, parasites and viruses - Various levels of pre-cancerous cell changes - Cervical Cancer Cells
2. Purpose of Pap Smear a. Find abnormal cells or cells that can develop into cancer, including HPV infection. b. To detect pre-cancerous, it is very important is found before a person has cancer. c. Detect abnormalities - abnormalities that occur in cells of the cervix. d. Detect any abnormalities of the cervix uteri or malignancy praganas
3. What to Do Pap Smear American Cancer Society recommends first Pap smear about 3 years after first intercourse or at age 21. After the age of 21 years, the prompts as follows: Age (years) Frequency 21-29 regular Pap smear once a year or every 2 years using liquid-based Pap smear 30-69 every 2-3 years if you have three normal test results in a sequence More than 70 you can stop if you have a Pap smear test results 3 consecutive normal Pap smears to normal and for 10 years Without looking at your age, if you have risk factors you have to do a test every year. Risk factors are: • a history of sexual activity during adolescence, especially if you have more than one sex partner • currently have many sex partners (multiple) • couples who initiate sexual activity early and who have many sexual partners before • a history of sexually transmitted diseases • family history of cervical cancer • diagnosis of cervical cancer or Pap smear showed precancerous cells • infection of human papilloma virus (HPV) • smokers • exposure to diethylstilbestrol (DES) before birth • HIV infection • a weak immune system due to several factors such as organ transplant, chemotherapy or chronic corticosteroid use If you do a total hysterectomy (surgical removal of the uterus including the cervix) ask your doctor if you need melanjutkanPap smear. If a hysterectomy done for noncancerous conditions, such as fibroids, you can stop the routine Pap smear. But if the hysterectomies performed for precancerous or cancerous condition, your vaginal canal should be examined for abnormal changes. 4. Pap Smear Preparation To make sure your Pap smear effectively, follow these tips before performing the test: a. avoid sex or using vaginal medicines or foam / cream / gel for 2 days before spermisid Pap smear because it can hide abnormal cells. b. try not to schedule a Pap smear during your menstrual period, although the test can be done better to avoid certain times of your cycle.
5. Terms of Pap Smear Taking Some important things to note in the Pap smear is as follows: a. Time taking at least 2 weeks after menstruation begins and before the next menstrual period. b. Provide information to health workers to be honest about your medical history and disease ever suffered c. Intercourse should not be done within 24 hours before the examination materials. d. Flushing the vagina with a variety of chemicals can not be done within 24 hours in advance. e. Avoid the use of drugs inserted into the vagina 48 hours before the examination. f. If you're taking certain medications, inform health care workers, because there are some medications that can affect the results of the analysis cell.
6. Making preparation techniques  The tools needed for taking Pap test are: 1) Form cytology consultations. 2) a modified Ayre spatula and cytobrush. 3) Glass objects on one side have been given a sign / label. 4) speculum Cocor duck (gravels) dry. 5) tube containing a solution of 95% alcohol fixation. How to capture the preparation: 1) Before starting the procedure, make sure that the label specimen container is filled, ensure that preparations are labeled the write date and the name and identification number of women. 2) Wear gloves. 3) Insertion of the speculum with the right size, visualization of the cervix, fixation speculum to gain exposure obtained. Be sure to carefully dispose of any material that prevents visualization of the cervix / interrupt cytology studies. 4) One of the following four methods of specimen collection for Pap smears can be used: Place the long end of a wooden spatula are slightly tapered edges / plastic scraper on and into the mouth of the cervix and the external press. Take specimens of the cervical canal with a spatula turn a full circle cotton tipped applicator tip cotton swab moistened with normal saline, insertion of the applicator into the cervical channel 2 cm and swivel 3600.  Insertion brush tool along line 1-2 cm into the cervix and rotate 90-1800.  Use a combination of methods to enter the spatula method.
5) Spread the cells on the preparations that have been labeled. When the cells were collected on a wooden spatula, place one hand near the label above the upper half of the above preparations and swab a time until the end of the preparations. Then turn the spatula and place the flat side of another near the label on the bottom half and rub one-time preparations to end preparations. 6) Immediately spray preparations with fixation material / insert material in the tube containing the solution of fixation. 7) If the facility away from the practice of coloring is simple, can be included in the envelope / packaging that can guarantee not to break the glass preparation. By making good preparation, fixation and staining microscopic preparations as well as careful observation, is a sufficient step in establishing the diagnosis.
7. Classification of Pap Smear 1) Class I: Just found normal cells. 2) Class II: Found some atypical cells, but no evidence of malignancy. 3) Class III: Overview of cytology impressive, but not conclusive of malignancy. 4) Class IV: Overview cytology suspicious of malignancy. 5) Class V: cytology picture that showed malignancy.
8. Interpretation of test results according to the Papanicolaou smear: 1) Class I: Identical to the normal smear re-examination of one more year. 2) Class II: Represents a non-specific mild infections, sometimes accompanied by: a. Specific germ or virus. b. Kariotik cells with light. 1-year re-examination again, the appropriate treatment with no erosion or kausalnya.Bila purulent inflammation, re-examination 1 month after treatment. 3) Class III: The presence of inflammatory cells with diaknostik being heavy. Review the first month after treatment 4) Class IV: The presence of suspicious cells in such cases the malignant daapat taken three roads, namely:  Do a biopsy. Do pap test again soon, with deeper taken skreping 3 preparations  Refer to biopsy confirmation. 5) Class V: The discovery of malignant cells. In this case such as the path taken 3 classes IV to confirm the results.
9. Factors Affecting Pap Smear Results Factors - factors that influence the results of the Pap Smear is a change cells - abnormal cells on the cervix that may eventually happen cervical cancer include: A. Counseling pre pap smear right: a. Time taking at least 2 weeks after menstruation begins and before the next menstrual period. b. Provide information to health workers to be honest about your medical history and disease ever suffered c. Intercourse should not be done within 24 hours before the examination materials. d. Flushing the vagina with a variety of chemicals can not be done within 24 hours in advance. e. Avoid the use of drugs inserted into the vagina 48 hours before the examination. f. If you're taking certain medications, inform health care workers, because there are some medications that can mempengaruhihasil cell analysis.
2. Way of making a willingness Not adequately capture the willingness (62%), there could be a failure of screening (15%), interpretation (23%), and false positive rates (3-15%). To consider the components of diagnostic accuracy and ektoserviks dosenviks taken with a combined cytobrush and spatula. 3. Health workers (doctors / midwives) Could be caused by: a. Failure to provide services pap test. b. Failure present in patients with abnormal test results. c. Failure to refer patients with abnormal tests.
4. Laboratory a. Failure to detect abnormal cells. b. Failure to report the preparation of the unsatisfactory quality c. Failure filed repetition. d. Hapussan too thin. e. The preparation is too dry smears before fixation. f. Fixation fluid did not use alcohol 95%.
5. Laboratory workers a. How it works not according to the procedure. b. Reagents used are expaidet. c. Reading of cytologic examination results less valid. d. Specialist skills and accuracy of anatomic pathology.
6. Characteristic factor a. Age Changes in abnormal cells on the cervix is ​​most often found at the age of 35-55 years and have a 2-3 fold risk of developing cervical cancer (cervical). The older age of a person will experience the process of deterioration, the actual process of deterioration that did not happen in just a tool but in the whole organ. All parts of the body backwards, so that in the elderly for longer likely to fall ill, for example, exposed to sick / vulnerable to infection. b. Parity Parity is a woman who had never delivered a baby that can live or viable. Parity with the number of children more than 2 people or too close birth spacing had a greater risk of changes in the incidence of abnormal cells on the cervix. If the number of children born to a lot of vaginal can cause abnormal cell changes of the epithelium on the cervix that can progress to malignancy. c. Socio-economic Lower socioeconomic groups often occurs in malignant cells - the cells of the cervix, this is due to the inability perform routine Pap tests. d. Female age at marriage Marriageable age <21 years had a greater risk of changes in cervical cells. This is because at a young age the cells of the uterus is still immature. Then the cells - the cells are not susceptible to the substance - chemical substances carried by the sperm and all sorts of changes. If it is not yet mature, it could be when there is stimulation of cells that grow out of balance with the dead cells, so that the excess cells could change the nature of a cancer cell.
7. Behavioral factors a. Multiple partners Sexual partner change - change also increases the likelihood of the risk of cervical cancer. Could have been one sexual partner carrying the HPV virus that turns the cells in the mucosal surface to split into more that would lead to cervical malignancy. b. Hygiene tools genetalia Too often menngunakan antiseptic to wash the vagina are also suspected to trigger cervical cancer. Therefore, avoid too frequent washing the vagina with antiseptic for cleaning the vagina can cause irritation of the cervix. This irritation will stimulate the cell changes that eventually turn into cancer.





REFERENCES
http://www.lusa.web.id/pap-smear/ http://ayurai.wordpress.com/2009/04/15/pap-smear/ file :/ / / H :/ pap-smear-test.html file :/ / / H :/ artikel.php.htm



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1 komentar:

gama mengatakan...

kok bahasa inggris kie..
but nice info

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