OVARIAN MASSES AMONG YOUNG WOMEN PREDICT HIGH FREQUENCY OF MALIGNANCY WITH POSITIVE FAMILY HISTORY.

Background; Ovarian masses are very common in pre- and postmenopausal women and are usually an incidental finding. The treatment of an ovarian cyst relies on its nature, and accurate preoperative discrimination of benign and malignant cysts is therefore of crucial importance. This study was done to ascertain malignancy in adolescent women having ovarian masses. Objective; To determine the frequency of malignancy in adolescents and young women presenting with ovarian masses. Material and Methods; Patients (n = 98) fulfilling inclusion criteria from outpatient department of Nishtar Hospital, Multan, Pakistan were included in the study. Informed consent was taken from each patient ensuring confidentiality and the fact that there was no risk to the patient while taking part in this study other than the disease itself. Detailed history and physical examination of our study cases were arranged by the researcher itself. Data were entered and analyzed by SPSS. Results; Mean age of our study cases was 24.27 ± 5.19 years (with minimum age of our study cases was 15 years while maximum age was 34 years). Our study results have indicated that majority of our study cases i.e. 59 (60.2 %) were aged equal/less than 25 years. Of these 98 study cases, 43 (43.9 %) belonged to rural areas and 55 (56.1%) belonged to urban areas. Monthly family income up to Rs. 35000 was noted in 58 (59.2%) and more than Rs. 35000 was noted in 40 (40.8%) of our study cases. Of these 98 study cases, 66 (67.3%) were illiterate and 32 (32.7%) were literate. Family history of family cancer was noted in 19 (19.4%) of our study cases. Mean disease duration was 14.78 ± 5.13 months. Mean body mass index of our study cases was 26.02 ± 2.13 kg/m2 and obesity was present in 23 (23.5 %) of our study cases. Of these 98 study cases, 27 (27.6 %) were having history of use of oral contraceptives. Malignancy was diagnosed in 23 (23.5 %) of our study cases.  Conclusion; There was high frequency of malignancy noted among women having ovarian masses in our study cases. Ovarian masses were significantly associated with residential status and family history. Gynecologists treating such patients should monitor such suspected cases for early diagnosis which will improve treatment rate and quality of life of our patients. Keywords; Ovarian Masses, Malignancy, Frequency, adolescents

PROLONGED DURATION OF NEPHROTIC SYNRDROM AND TREATMENT FAILURE AMONG CHILDREN WITH NEPHROTIC SYNDROME IS ASSOCIATED WITH INCREASED HYPERTENSION.

Background; Nephrotic syndrome (NS) is one of the most common renal diseases found in the paediatric population and is associated with significant complications, including infection and thrombosis. A high proportion of children enter sustained remission before adulthood, and therapy must therefore mitigate the childhood complications, while minimising the long-term risk to health. Objective; To determine the frequency of hypertension in children with nephrotic syndrome presenting at a tertiary care hospital. Material and Methods; All the patients (n = 146) who meet inclusion of this study were registered from OPD of Department of Pediatrics, Nishtar Hospital, Multan, Pakistan. Informed consent was taken from the parents of these children describing them objectives of this study, ensuring them confidentiality of the information provided and fact that there was no risk involved to the patient while taking part in this study. Children with steroid sensitive nephrotic syndrome were taken in this study. Systolic and diastolic blood pressure was measured by researcher. Results; Of these 146 study cases, 92 (63%) were male patients while 54 (37 %) were female patients. Mean age of our study cases was 7.61 ± 2.55 years. Our study results have indicated that majority of our study cases i.e. 91 (62.3 %) were aged more than 7 years. Of these 146 study cases, 76 (52.1 %) belonged to rural areas and 70 (47.9 %) belonged to urban areas. Positive family history was noted in 11 (7.5%) and 129 (88.4%) mothers of these patients were illiterate. Compliance with the treatment was noted only in 31 (21.2%) of our study cases. Mean disease duration was 18.51 ± 10.26 months and 86 (58.9%) had duration of illness more than 12 months. Mean duration of treatment was 6.58± 2.28 months and 113 (77.4%) were taking their treatment for equal/less than 1 year. Mean systolic blood pressure was 135.85 ± 5.12 mmHg while diastolic blood pressure was 90.87 ± 3.25 mmHg. Hypertension was noted in 54 (37%) of our study cases. Conclusion; Frequency of hypertension was high among children having nephrotic syndrome in our study. Hypertension was significantly associated with family history, treatment compliance and prolonged disease duration. All clinicians treating such patients should monitor such children for hypertension for timely diagnosis and early management which will improve clinical outcomes and decrease disease morbidity. This will help to improve quality of life of our patients and also save them from future hardships. Keywords; Hypertension, Nephrotic Syndrome, Frequency