At the above mentioned levels of physiological compromise, patient survival after conventional trauma surgery can be predicted to be very unlikely. Damage-control measures would be worth attempting.

Surface epithelial tumors account for more than 90% of ovarian tumors, of which serous tumors comprise 46%. Sex-cord stromal tumors constitute 8% of ovarian tumors, fibroma being the commonest, comprising 70% in this category. Combination of different types of tumors can occur in ovary with most common being Mucinous cystadenoma and Brenner tumour. We report a case of a very rare combination of ovarian tumour-Fibroma with Serous cystadenoma of the ovary. This combination is not mentioned in any standard textbooks or reference books of gynaecologic pathology. Extensive search of the English Literature showed only one reported case with this combination of ovarian tumors. To the best of our knowledge, this is the second case to be reported in English Literature.

In conclusion, we showed that the SF-36 score is a good measure of QOL in this patient group. Those patients on the elective waiting list for repair of IH have a significantly impaired QOL compared with age-, sex- and comorbidity-matched controls.

Background: Severe truncal multi trauma patients often develop coagulopathy, acidosis and hypothermia that makes major reparative trauma surgery dangerous. It was aimed to try to develop physiological indicators that would predict a poor outcome when conventional reparative surgery was applied. These indicators may help in the decision to switch from conventional reparative surgery to surgery limited to the control of major haemorrhage or organ disruption: so-called 'damage-control' surgery. Method: A retrospective review was conducted of 40 patients with severe multivisceral trauma (Injury Seventy Score (ISS) > 35) who were admitted to the intensive care unit at Waikato Hospital and who underwent conventional reparative surgery. Results: Survival was strongly associated with base deficit (BD), core temperature and ISS. Using multiple logistic regression on these indices, outcome could be predicted with 92.5% accuracy (sensitivity = 93%, specificity = 92%, positive predictive value for death = 96%). Either severe hypothermia (< 33°C) or severe acidosis (BD > 12 mEq/L), or a combination of moderate core temperature < 35.5"C, and a BD of > 5 mEqL were strong predictors of death if conventional reparative surgery was practised. Conclusions: At the abovementioned levels of physiological compromise, patient survival after conventional trauma surgery can be predicted to be very unlikely. Damage-control measures would be worth attempting.

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