The accuracy of risk malignancy index in prediction of malignancy in women with adnexal mass in Basrah, Iraq.

BACKGROUND: Adnexal masses indicate a variety of gynecological and nongynecological disorders, which may be benign or malignant. Early detection of malignancy is crucial to a proper planning of treatment and improvement of survival. OBJECTIVE: To determine the accuracy of risk of malignancy index (RMI) in prediction of malignant adnexal mass. SUBJECTS AND METHODS: This was a prospective multicenter study which included 101 women with adnexal masses. RMI2 with cutoff value of 200 was used to discriminate between benign and malignant tumors. Histopathological examination was used to confirm the final diagnosis. RESULTS: Out of the studied women, 20.8% proved to have malignant tumors. The RMI showed a sensitivity of 100%, a specificity of 96.2%, a positive predictive value of 87.5%, and a negative predictive value (NPV) of 100%. The RMI identified malignant cases more accurately than any individual criterion in diagnosing ovarian cancer. The receiver operating characteristic analysis showed that the area under the curve of the RMI, CA 125, ultrasound, and menopausal status were significantly high with values of 1.0, 0.99, 0.86, and 0.85, respectively. CONCLUSION: The RMI is a simple sensitive, practical, and reliable tool in preoperative discrimination between benign and malignant adnexal masses that can facilitate selection of cases for timely referral to oncology center.

Diabetes and Ramadan: review of the literature.

During the month of Ramadan, Muslims fast every day from dawn to sunset. In the healthy subject, this fasting does not have any harmful consequences on health. However, it can induce several complications for patients with diabetes. The aim of this review twofold: first, it seeks to give some clues about methodological aspect of research during Ramadan and to show the impact of various diabetes monitoring and treatment, including biochemical and clinical parameters, diet and caloric intake, drug intake when fasting. Second, it intends to determine whether or not Ramadan fasting induces complications in patients with types 1 and 2 diabetes and ultimately to elaborate some advice as to the management of fasting patients. Several studies have shown that Ramadan fasting did not alter biochemical parameters in patients with type 2 diabetes. However, other studies have shown that there is either an increase or a decrease in biochemical parameters during Ramadan. Ramadan fasting would be acceptable for patients with well-balanced type 2 diabetes who are conscious of their disease and compliant with their diet and drug intake. If patients with type 1 diabetes wish to fast, it is necessary to advise them to undertake control of their glycaemia several times a day. Patients with type 1 diabetes who will fast during Ramadan may be better managed with fast absorption insulin.

The behavioural and reproductive consequences in offspring (first generation) of mice continuously exposed to a strong magnetic field.

The behavioural and reproductive activities of the offspring of mice that had spent their whole lives exposed to a continuous strong magnetic field (76655 gamma) were investigated. The data obtained revealed that intermale fighting was drastically inhibited in such animals. Exposure to such a condition also significantly reduced other behavioural responses (e.g. social and non-social elements) recorded in the social encounters between experimental and 'standard opponent' intruders. Preliminary results on the reproductive activity of exposed mice were evaluated by mating them with female counterparts which had also spent their whole lives under the same condition of the magnetic field intensity. None of the mated females became pregnant. The magnetic field thus influences the behavioural and reproductive responses in mice. These effects may be mediated by their influences on the neurophysiological sites that control these activities.

Effect of chronic exposure to a magnetic field on two forms of murine aggression.

The effect of continuous exposure to a relatively strong magnetic field for about 3-4 weeks were evaluated on social (inter-male) aggression in isolated males and on maternal attack by lactating female mice. This study revealed that exposure to intense fields produced a significant reduction in social and maternal aggression towards anosmic (passive) standard opponent intruders. The detailed ethologically-assessed results indicate that such exposure produces a significant decline in most behavioural categories recorded throughout this study in isolated male and lactating female mice. Defensive behaviour, however, seemed enhanced in lactating mice. These results may be explained in terms of the magnetic fields interfering with the function of the central nervous system or the physiological substrates which control such types of behaviour.

Studies on tube restraint-induced attack on a metal target by laboratory mice.

This study examines factors influencing the attack on a metal target by laboratory 'TO' strain mice confined within a narrow perspex tube and contrasts this form of behaviour with attack seen in less equivocal forms of 'aggression test'. The effects of sex, housing condition, reproductive experience, density, anosmia and castration (in the male) were systematically examined. This 'model' of 'aggression' shows few parallels with social conflict, parental defense and electroshock-induced forms of attack as none of the above manipulations influenced the level of target biting in this situation. Thus, in spite of claims that tube restraint-induced attack may show parallels with intermale aggression, the data suggest that it involves a totally different motivation.

Attempts to determine the status of electroshock-induced attack in male laboratory mice.

An attempt was made using a combination of simple experimental manipulations and videotape recorder (VTR) analysis of bite targets employed to determine whether electroshock-induced attack on anosmic opponents in laboratory mice was an offensive or a defensive behaviour. VTR analysis suggested that ventral surface biting was more evident in this form of attack than in social conflict. Individually- and group-housed males showed similar levels of fighting on exposure to electroshock, but dominant males from pairs showed greater attack than their subordinate partners. Zinc sulphate-induced anosmia, 36 h of food deprivation, castration and lithium chloride treatment reduced electroshock-induced attack. Although significant changes were not obtained, there was some evidence that acute treatment with dexamethasone or ACTH augmented this behaviour. The direction of these changes is similar to that seen with social conflict, and it is suggested that electroshock-induced attack in the mouse (unlike the rat) is largely an aggressive offensive behaviour. The high incidence of ventral surface biting may be a consequence of the upright postures assumed on subjecting the animals to electroshock.

Effects of lithium chloride injections on rank-related fighting, maternal aggression and locust-killing responses in naive and experienced 'TO' strain mice.

Three experiments investigated lithium chloride's (LiCl) effects on three forms of aggression in male 'TO' strain mice. Models of aggression investigated, included attack by preisolated males on male conspecifics (rank-related or intermale fighting), attack by lactating females on male intruders (maternal aggression) and the locust-killing response (a form of predatory aggression?) In the first study, injections of naive male mice with 0.2 and 0.4 mEq of LiCl resulted in marked declines in rank-related fighting. The effects of this treatment on locust killing could not be assessed, as this activity was already at a low incidennce in controls. In a second experiment, LiCl injection had little influence on the locust-killing response in selected, experienced male killer mice. As in Experiment 1, rank-related fighting was suppressed by this treatment. The third experiment revealed that LiCl injections did not influence either maternal aggression or locust killing in naive females and predatory aggression in experienced-killer females. These results provide further support for the contention that these three behaviors have very different physiological bases. The data suggests that one should be cautious when extrapolating between different models of aggression even within the same species.