RESUMEN
Background: Global incidence of ovarian malignancies is 300,000 as per GLOBOCAN 2018. The treatment protocol for advanced ovarian malignancies (stage IIIc and stage IV) includes neo-adjuvant chemotherapy and surgery followed by adjuvant chemotherapy. Aims of the study was to determine the effect of duration of chemo interruption on disease free survival of ovarian malignancies treated by interval cytoreduction followed by surgery.Methods: A total 48 patients were studied for events such as recurrence, death, patient’s status on last follow up, peri-operative period between 3rd cycle of chemo therapy and 4th cycle of chemo therapy. Based on the median duration of peri operative period patients was classified as early or delayed receivers of adjuvant chemo therapy. Difference in duration of over-all survival and disease-free survival was analysed through Kaplan Meier survival analysis using log-rank test. Hazard ratio adjusted for background characteristics such as staging, performance status, grade of tumour were analysed using cox proportional hazard model.Results: The two peri operative period categories based on mean value (85 days) didn’t show any significant association to disease free interval (minimum-21days, maximum-146 days, Hr = 1.3, p-value = 0.52). Other established factors like stage, extent of resection, response to chemotherapy, also didn’t show any significant association. Serum marker level showed a significant negative correlation with disease free survival (minimum-9 days, maximum-30659, p-value =.04, Hr = 3.19).Conclusions: The study could not establish any correlation between peri operative period and median disease-free survival. The small sample size is a limiting factor, well controlled randomized trials may needed for further clarification.
RESUMEN
Background: Osteoporosis is a chronic debilitating condition which exhibits iceberg phenomenon. Identification at an early stage of disease will enable preventive measures to reduce the incidence of disease and complications. Owing to the cost of diagnostic test, this study, various screening tools such as WHO fracture risk assessment tool, osteoporosis self-assessment tool for Asians, simple calculated osteoporosis risk estimation and osteoporosis risk assessment instrument have been used for assessment, in order to screen postmenopausal women in the preliminary stages.Methods: A facility-based cross-sectional study was conducted among 107 postmenopausal women carried over a period of five months.Results: Prevalence of osteoporosis and osteopenia was 24.3% and 69.2%. The area under the curve for osteoporosis self-assessment tool for Asians (OSTA), simple calculated osteoporotic risk estimation (SCORE) and osteoporotic risk assessment instrument (ORAI) was 0.731, 0.407 and 0.172 respectively. OSTA proved to be effective in differentiating normal BMD from low BMD score (i.e., osteopenia and osteoporosis) with a cut off of 1.1, SCORE to be more effective in screening osteoporosis than the other tools because it had a higher positive probability with a cut off 22. FRAX tool predicted probability of five and three percent probability of major fracture and hip fracture risk in ten yearsConclusions: Various tools assessed in the studies can be utilized at community level for identifying high risk women in post-menopausal stage but with different cut offs. This will reduce the cost of screening and also facilitate non pharmacological measures to reduce the progression of disease.