ABSTRACT
Objective: To determine the diagnostic accuracy of ROMA in postmenopausal women with history of ovarian mass
Study Design: Observational study
Place and Duration of Study: Dr. Ziauddin University Hospital, Karachi, from May 2014 to June 2015
Methodology: Two hundred and sixty postmenopausal women of 40-65 years of age with ovarian masses, planned for surgery, were included in the study. Their samples were obtained preoperatively and analysed on Abbot Architect i1000 SR immunoassay analyser for quantitative estimation of tumor markers, i.e. HE4 and CA125. By combination of these two tumor markers, ROMA scores were calculated and studied after histopathological verification of masses
Results: Total number of patients were 260, out of which 122 [46.9%] were diagnosed as having ovarian cancer, while 138 [53.0%] were diagnosed as benign condition. Median ROMA score levels in patients with malignant masses were 95.58 [IQR=44.4] as compared to 20.6 [IQR=14] in benign masses. ROMA had sensitivity 92.6% [CI=86.47-96.04], specificity 78.3% [CI=70.09-83.82], positive predictive value 79% [CI=70.87-84.29], negative predictive value 92.3% [CI=86.02-95.9] and positive likelihood ratio 4.26, while negative likelihood ratio 0.1. Diagnostic accuracy of ROMA was 85%, based on ROC curve analysis. ROMA had the highest sensitivity in detecting ovarian carcinoma
Conclusion: ROMA is a very useful diagnostic tool for the preoperative stratification of patients with ovarian masses showing 85% diagnostic accuracy. However, there is need of more studies with homogenous laboratory procedures for HE4 and CA125 assays as well as patients, selection criteria, so we can draw firm conclusion about utility of ROMA in clinical setups
ABSTRACT
In Pakistan, tobacco consumption is at an all-time high with the tobacco industry witnessing a boom. According to the Pakistan Tobacco Company, production and sale has taken a sharp leap from Rs.1,000 million rupees to Rs.1, 750 million in 2008. The youth remain particularly vulnerable as massive antismoking ad campaigns have failed to drill in the health hazards. The aim of this study is to assess the attitude, perception and practices of youth regarding cigarette smoking. Comparative cross-sectional study was conducted in Ziauddin University and Bahria University. Sample was taken from all years of teaching. Data was collected through self-administered structured questionnaire that was developed in English. It comprised of questions pertaining to their year of study, smoking history, and perception and practices regarding smoking. A total of 450 students were surveyed, medicine [n=260] and engineering [n=190]. One-fourth of the survey sample admitted to have tried to smoke at least once in their lifetime [p=0.001], and at least 20% medical students [n=53] and 35% of engineering students [n=66] surveyed had smoked a cigarette [p=0.001]. While students studying medicine were better aware of the risks associated with smoking and tobacco consumption, however compared to engineering students their overall knowledge of the health risks was unsatisfactory. A significant number of medical students were unable to list and hence effectively counsel about long and short term health benefits. Peer pressure and media played a large role in students picking up the habit