Evaluation of adnexal masses: correlation of clinical examination, sonographic assessment and histopathological findings

Background: Prevalence of symptomatic adnexal masses is 1:1000 in premenopausal women and 3:1000 in post –menopausal women. Benign diseases of ovaries and fallopian tube are commonest etiology. However, as risk of neoplastic lesions increases with age and further after menopause The primary goal of diagnostic evaluation of adnexal masses is to exclude malignancy. Methods: This one-year prospective observational study was carried out on 100 female patients attending gynaecology OPD with the clinical diagnosis of adnexal mass. Female patients presenting with symptoms like lower abdominal pain, menstrual irregularity and palpable mass or asymptomatic patients with incidental finding of adnexal mass were included in the study. The aim of the study was to compare the sensitivity, specificity and predictive value of clinical examination, ultrasonography and to compare it with the histopathology. Results: Ultrasound of pelvis was done for all patients. Laparotomy was done for all cases and the specimen was sent for histopathological examination. 70% tumours were benign and 30% tumours were malignant. As per our study, ultrasonography has the highest diagnostic accuracy (93%) followed by pelvic examination (86%) and RMI score (86%). Clinical examination has highest sensitivity of 93.33% followed by CA-125 (86.66%) and ultrasonography (83.33%). Conclusions: Thus, ultrasound is the primary modality used for detection and delineation of pelvic masses. The study also showed that RMI has better performance than CA 125 in the prediction of malignancy. Thus, with such simple methods we can diagnose precisely without advanced radiological imaging

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field