Primary ovarian leiomyosarcoma (POLMS) is an exceedingly rare neoplasm accounting for only 0.1% of all ovarian malignancies and most commonly occurring in postmenopausal women. Prognosis is poor with only a 20% 5-year survival rate. Surgery remains to be its mainstay treatment. Discussed here is a 72-year-old nulligravid with hypogastric pain. Transrectal ultrasound showed a right ovarian new growth, probably malignant on International Ovarian Tumor Analysis (IOTA) simple rules, with a 79.2% risk of malignancy by IOTA ADNEX and an unremarkable uterus. Other workups were normal. She underwent primary cytoreductive surgery. Histopathologic diagnosis was ovarian leiomyosarcoma with positive immunohistochemical staining for desmin, S-100 protein, smooth muscle actin, and epithelial membrane antigen. She refused adjuvant chemotherapy postoperatively. The latest published literature on POLMS was also reviewed to develop the provisional criteria for its prompt diagnosis, thereby decreasing the heterogeneity of the diagnostic approach as well as supporting future researches on manifestations, clinical courses, and therapeutic plans.
Ovary ; Prognosis ; General Surgery

Introduction: Postpartum depression (PPD) is a major health concern for child-bearing women and has its effects on her children. Advocacies for mental health have paved way for more awareness of conditions such as PPD. Currently, there is no particular screening protocol employed by attending physicians of these women. There is also a lack of data that determines the practices of obstetricians when dealing with patients with PPD or those at risk of developing it. Objective: This descriptive study evaluated the knowledge, attitudes, and practices of OB-GYN consultants and residents on the screening of PPD. Materials and Methods: A validated questionnaire was utilized with some modifications made to tailor fit the targeted population. All affiliated consultants and residents of the Philippine Obstetrical and Gynecological Society-accredited training hospitals in a Region VII were included while those retired were excluded. The Google Form link of the questionnaire was disseminated to the different institutions who gave approval to conduct the study. Anonymity and confidentiality of data acquired were maintained throughout the study. Results: A total of 110 responses were received. The key findings of the study showed that the respondents have above average knowledge on PPD including its risk factors, symptoms, complications, and treatments. They generally have positive beliefs toward their role in the screening and management of PPD. Moreover, majority of them have already tried screening for PPD although not routinely. Conclusion There is a significant relationship between the knowledge, attitude, and practices of the consultants and residents on the screening of PPD. Systems should be put in place to ensure effective treatment and follow-up of patients and thus impact good clinical outcomes.
Depression ; Postpartum Period ; Depression, Postpartum ; Mass Screening

BACKGROUND: The IOTA Simple Rules provide a standardized ultrasound description in order to correctly classify ovarian tumors as benign or malignant even among non - expert readers. Its high accuracy rate was noted in foreign studies but was never validated in the local setting. The IOTA inconclusive tumors that were either assumed to be malignant or referred to experts in other studies were separately addressed in this research.

GENERAL OBJECTIVE: To determine the accuracy of the IOTA Simple Rules to predict malignant ovarian tumors

MATERIALS AND METHODS: Subjects: Patients with ovarian tumors admitted for surgery with complete ultrasound records done at Women's Health Unit and those with histopathologic report from the Department of Pathology. Setting: Department of Obstetrics and Gynecology in a tertiary hospital from August 2015 to February 2017. Design: Cross-sectional Diagnostic Accuracy Test. Data Collection: After obtaining approval from the IRB and Office of the Medical Director, the ovarian tumors were tallied and categorized according to their IOTA classification and final histopathologic diagnoses. The sensitivity, specificity, positive and negative predictive values, and accuracy were obtained using a 2x2 table. The biopsy reports of the inconclusive tumors were also reviewed and the sonographic characteristics of those which turned out to be malignant were noted.

RESULTS: A total of 110 adnexal masses were included, with the IOTA Simple Rules applicable in 84.55% of cases. It produced an accuracy rate of 100%. Among the 17 inconclusive tumors, two proved to be truly malignant with the presence of only one papillarity in a borderline tumor and the complex appearance of a germ cell tumor.

CONCLUSION: The IOTA Simple Rules is an accurate preoperative diagnostic tool in predicting ovarian malignancy. Two malignant tumors were classified as inconclusive and their sonographic characteristic of only one papillarity and the complex appearance of these tumors may warrant malignancy.

Human ; Female ; Gynecology ; Obstetrics ; Physician Executives ; Tertiary Care Centers ; Ethics Committees, Research ; Adnexal Diseases ; Ovarian Neoplasms ; Ultrasonography ; Sensitivity And Specificity ; Biopsy ; Neoplasms, Germ Cell And Embryonal

BACKGROUND: Gestational diabetes is associated with adverse maternal and neonatal outcomes with long term implications. Recent studies indicate that these risks are preventable or at least reducible by early detection and appropriate management, therefore screening is ideal. However, it is still controversial to which plasma glucose level of 50g Glucose Challenge Test for screening is best to identify pregnant women at risk for gestational diabetes mellitus. Several studies had shown variations in the cutoff values in different population. In the Philippines, there is no published study with regards to the appropriate cutoff value for screening and for further testing with 3-h 100g Oral Glucose Tolerance Test in the diagnosis of GDM.
OBJECTIVE: To determine the accuracy of the following 50g GCT threshold values: 120mg/dl, 130mg/dl, 140mg/dl, 150mg/dl, 160mg/dl for screening gestational diabetes mellitus using 3-h 100g OGTT as the gold standard.
STUDY DESIGN: Cross-sectional Study (Diagnostic Test)
STUDY SETTING: Tertiary Hospital, Privilege Mothers' Service, Basak, Lapu-lapu City, Cebu
STUDY POPULATION: One thousand four hundred sixty pregnant women under Privilege Mothers' Service were screened from January 2005- December 2009.
METHODOLOGY: A 1-h 50g GCT was performed among all pregnant subjects between 24-28 weeks gestation and followed by a 3-h 100g OGTT within a week to diagnose gestational diabetes mellitus using Carpenter and Coustan diagnostic criteria.
MAIN OUTCOME MEASURES: The sensitivity, specificity, positive, negative predictive values of the various threshold values were computed. The receiver operating characteristic curve (ROC) was used to determine the most accurate cut-off value of 50-g GCT. Results: The prevalence rate of GDM in this study population was 3.1% (44/1406). The sensitivities of the following cut-off values were 120mg/dl, 130mg/dl, 136mg/dl, 140mg/dl, 150mg/dl and 160mg/dl were 73%, 66%, 68%, 50%, 34%, and 25%, respectively. The specificities were 26%, 85%, 81%, 91%, 94%, and 97%, respectively. The positive predictive values were 3%, 12%, 10%, 15%, 17% and 22%, respectively. The negative predictive values were 97%, 99%, 99%, 98%, 97.7%, and 97.5%, respectively. The Receiver Operating Characteristic Curve (ROC) curve identified a GCT threshold value of 136 mg/dl for detecting GDM, which showed the sensitivity of 68% and false positive rate of 19%.
CONCLUSION: The threshold of 136mg/dl maybe recommended as a better cut-off value of 1-h 50g-GCT with higher accuracy for universal screening of gestational diabetes mellitus and for further testing with 3-h 100g OGTT in the diagnosis of GDM.

Human ; Female ; Glucose Tolerance Test ; Diabetes, Gestational ; Blood Glucose ; Diagnostic Tests, Routine ; Sensitivity And Specificity