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Foley's catheter and Cook cervical ripening balloon are comparable regarding efficacy and safety profile when used to ripen the cervix in pregnant women with stillbirth, unfavorable cervix and scarred uterus. However, Foley's catheter has a shorter induction to delivery interval and is relatively cheaper device.

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Objective: To determine the effectiveness of RMI in identifying cases of potential ovarian malignancy, and to compare the performance of RMI-4 and RMI-3 in predicting ovarian malignancy. Design: Retrospective descriptive study. Materials and methods: Women who underwent surgery for adenxal mass between January 2010 and December 2012 were included in this retrospective study. Age, menopausal status, ultrasound findings and CA-125 serum levels and final histopathology report of the excised tumor were extracted from the records. RMI-3 and RMI-4 were calculated and their performances in prediction of borderline and malignant ovarian cancer were compared. Results: 172 patients were included; 131 (76.2%) benign, 15 (8.7%) borderline, and 26 (15.1%) malignant tumors. In patients with malignant ovarian masses, RMI-3 gave sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and diagnostic accuracy of 80.7%, 93.1%, 70%, 96% and 91% respectively. For RMI-4 these figures were 76.9%, 93.8%, 71.4%, 95.3%, and 91% respectively. In patients with borderline ovarian masses, RMI-3 gave sensitivity, specificity, PPV, NPV and diagnostic accuracy of 60%, 93.1%, 50%, 95.3% and 83.7% respectively. For RMI-4 these figures were 52.9%, 93.1%, 50%, 93.8%, and 88.5% respectively. Both RMI-3 and RMI-4 are more accurate in predicting malignant rather than borderline adenxal masses. Main outcome measures: Accuracy indices of RMI-3 and RMI-4. Conclusion: RMI is a simple, reliable and applicable method in the primary evaluation of patients with ovarian masses. The performance of RMI-3 and RMI-4 is comparable.

ObjectiveTo evaluate the concordance of Pap smear, Colposcopy and histopathology in patients with cervical intraepithelial neoplasia (CIN) in a local tertiary care hospital.DesignRetrospective descriptive study.Materials and methodsAll patient with CIN undergoing LLETZ during the period from January 2007 to July 2013 were included in the study. Case records were reviewed regarding demographics and clinical data, Pap smear reports, colposcopy findings and histopathology (HPR) reports following colposcopically directed cervical biopsy (CDB) and that following Large Loop excision of Transformation zone (LLETZ).Resultspatients with CIN undergoing LLETZ were included. Agreement between Pap smear and HPR was 96.2% with sensitivity of 80.6% and specificity of 60%. Agreement between CDB and HPR was 86.4% for high grade and only 33.3% for low grade lesions. Level of concordance of Pap smear with CDB was 96.2% for high grade and only 50% for low grade lesions.Main Outcome MeasuresAgreement between Pap smear, colposcopy, CBD and HPR.ConclusionPap smear and CDB are complimentary to each other, and each cannot be used independently. LLETZ improves the yield of high grade lesions and detecs minimally invasive cancer which could be missed by CDB.