RESUMO
Background: Adnexal masses present a diagnostic and therapeutic dilemma across age-groups. This study aimed to evaluate the performance of cancer antigen-125 (CA-125) in distinguishing between benign and malignant adnexal masses.Methods: This was a prospective, observational, single tertiary-care center study, done in North India from January, 2011 till December, 2012. Serum CA-125 levels was obtained preoperatively in consecutive patients presenting with ultrasonography confirmed adnexal masses. The cut-off value between benign and malignant was taken as 35 IU/ml. Histopathological diagnosis was obtained in all patients.Results: A total of 126 patients presented with adnexal masses, of which 100 were enrolled (mean age: 37.5±14.4 years, range: 18-80 years). Most of the masses were benign 81% (malignant=19%). Dermoid cyst (25.9%) and endometriomas (21%) were the most common benign masses. Serous (21%) and mucinous cystadeno-carcinoma (15.8%) were the most common malignant masses, more often seen in elderly, married, parous and post-menopausal patients. Mean CA-125 levels were significantly higher in malignant masses (257.30 [105.68-408.92] versus 19.26 [16.53-22.00], p<0.001). Overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CA-125 for diagnosing malignant adnexal mass was 94.7%, 87.65%, 64.28%, 98.6%, and 88.91% respectively. The same was 100%, 85.1%, 54.5%, 100%, 87.3% in premenopausal and 85.7%, 100%, 100%, 93.3%, 95.2% in postmenopausal women respectively.Conclusion: Benign masses form the bulk of the adnexal masses in all age groups. CA-125 levels has high sensitivity and negative predictive value in premenopausal patients while as high specificity and positive predictive value in postmenopausal patients.
RESUMO
This study was conducted to uncover the differences in the serum Cu, Fe, Zn and proteins in children of different degrees of malnutrition. For this purpose 85 malnourished and 15 normal children of school age [4-12 years] were chosen. Results revealed that serum Fe and Cu were significantly or relatively higher in malnourished than apparently healthy children irrespective of age, sex, socio-economic status or area of living. The levels of serum Zn, however, showed statistically non-significant differences between malnourished and apparently healthy children. Serum levels of total proteins and globulins were significantly or relatively lower in malnourished compared to the children of control group irrespective of age, sex, socio-economic status and area of living. The results of albumin were variable in these groups. While serum total proteins and globulins in male malnourished children were significantly lower compared to the male children of the control group, it was non-significantly different among females. The means of serum Cu, Zn and Fe in severely malnourished males and females were 48.61, 80.40; 50.00, 48.20; 227.15, 229.40 micro g/dL, respectively. These parameters in children of low and middle socio-economic status were 58.30, 90.00; 47.80, 58.67; 240.15, 148.00 micro g/dL, respectively while in severely malnourished children of three age groups [4-6, 7-9 and 10-12 years] were 38.25, 81.00, 71.55; 50.50, 46.66, 49.77; 224.88, 155.00, 279.78 micro g/dL, respectively. It can be concluded from the present study that serum Cu and Fe levels are increased, while serum total proteins and globulins are decreased in children of 4-12 years of age suffering from disease malnutrition