Diagnostic value of biochemical predictive index in ovarian malignancy.

The aim of the study was to determine if diagnostic performance of CA-125 in ovarian malignancy can be improved by considering age of the patient. The study was a retrospective analysis of the medical records of 306 patients who underwent a CA-125 measurement in our Institute. Of the 306 patients, 31% had malignant ovarian diseases, 45% had benign ovarian diseases, 6% had non-ovarian gynaecological diseases and 18% had non-gynaecological diseases. A positive association was found between age and CA-125 levels in patients with ovarian diseases. Patients were divided into three age groups of 18–37 yrs, 38–56 yrs and 57–74 yrs and were given age scores as 1, 2 and 3 respectively. Biochemical predictive index (BPI) was calculated by multiplying age score and CA-125 value. Among the age groups ranging 38–56 yrs and 57–74 yrs, the CA-125 and BPI values were significantly higher in malignant ovarian diseases compared to benign ovarian diseases. ROC curve analysis revealed a cut-off of 86 for the BPI with the sensitivity, specificity, positive predictive value and negative predictive value as 58%, 78%, 56% and 80% respectively. BPI had better specificity and negative predictive value compared to CA-125, can be used in the screening of ovarian pathology.

Fulminant hepatic failure in an infant with severe dengue infection.

Fulminant hepatic failure due to dengue infection is rare, although mild liver dysfunction is common. Here we report a fatal case of fulminant hepatitis in an infant infected with dengue 3 serotype. Attention must be given to the use of hepatotoxic drugs in some cases of dengue especially in infants.

Growth hormone in intra-uterine growth retarded newborns.

OBJECTIVE: To study growth hormone levels in IUGR and healthy controls and its association with birth weight and ponderal index. METHODS: We studied 50 Intra uterine growth retarded (IUGR) and 50 healthy newborns born at term by vaginal delivery in JIPMER, Pondicherry, India. Cord blood was collected at the time of delivery for measurement of growth hormone. RESULTS: When compared with healthy newborns, IUGR newborns had higher growth hormone levels (mean +/- SD, 23.5 +/- 15.6 vs 16.2 +/- 7.61 ngm/ml, P = 0.019). A negative correlation was identified between growth hormone levels and birth weight (r2 = - 0.22, P = 0.03) and ponderal index (r2 = - 0.36, P = 0.008). Correlation of growth hormone levels was much more confident with ponderal index than with birth weight. CONCLUSION: At birth IUGR infants display increased growth hormone levels which correlate with ponderal index much more confidently than with birth weight.