Background: Ovarian tumors usually presents as adnexal masses which may be benign or malignant. Accurate and timely diagnosis of an adnexal mass is a challenge for the gynecologists. Currently clinical examination, ultrasonographic assessment and ovarian tumour markers (CA 125, beta hCG, AFP, LDH) are routinely done at our centre to evaluate patients with ovarian tumours. The study was designed to evaluate the ability of RMI 4 to discriminate benign ovarian tumor from malignant ovarian tumor in patients attending Department of Obstetrics and Gynaecology, S.M.S. Medical College, Jaipur.Methods: 200 patients diagnosed to have ovarian tumours were included in the study after obtaining written consent. Ultrasonographic characteristic, menopausal status and serum CA 125 levels were documented preoperatively. Risk of malignancy index 4 was calculated and correlated with histopathological diagnosis.Results: At a cut-off point of 450, RMI 4 had a sensitivity of 67.5% (95% CI: 50.87-81.43%), specificity of 98.75% (95.56-99.85%), positive likelyhood ratio of 54, negative likelyhood ratio of 0.33, a positive predictive value of 93.1%, negative predictive value of 92.4% and diagnostic accuracy of 92.5%.Conclusions: RMI 4 is a simple, cost effective, reliable scoring system that is easily applicable method in primary evaluation of patients with ovarian tumours with a sensitivity of 67.5% and specificity of 98.75%.

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Women with PCOS remain at a high risk of developing cardiovascular risk factors, insulin resistance, and metabolic syndrome, risk being more in obese women. Monitoring of these may be done using the central fat indices, which are inexpensive and simple. The objective of the study was to evaluate the various central fat accumulation indices amongst the different polycystic ovary syndrome phenotypes. Method: 100 women aged 18-40 year fulfilling Rotterdam criteria for diagnosis of PCOS were selected. Height, weight, waist circumference and lipid profile were measured and BMI, Lipid accumulation product and Visceral adiposity index were calculated. Body Fat Percentage was measured by the Body Fat Analyser using the bioelectrical impedance method. Data was analysed and conclusions drawn. Results: Women with hyperandrogenic PCOS [phenotypes A (HA+OD+PCO), B(HA+OD), C(HA+PCO)] (33. 3% of total) presented with raised central fat accumulation indices including BMI (mean:25. 04), BFA (mean: 29. 85), VAI (mean:182. 06) and LAP (mean:1802. 63), compared with women with non-hyperandrogenic PCOS [phenotype D (OD+PCO)] (67% of total); BMI (mean:20. 85), BFA (mean:22. 94), VAI (mean:128. 4) and LAP (mean:624. 19). Amongst women with hyperandrogenic PCOS, the central fat accumulation indices were maximally raised in phenotype A. Conclusion: Though all women with PCOS should be targeted for prevention, screening, and management of cardiometabolic features, women with hyperandrogenic PCOS should be monitored more closely since they tend to have raised central fat accumulation indices compared with non-hyperandrogenic PCOS.