OBJECTIVE:To determine the proportion of primary vesicoureteric reflux in children between 1 month and 12 years with urinary tract infection admitted in a tertiary care hospital. METHODOLOGY: A Hospital based descriptive cross sectional study was conducted between May 2010 and October 2011 in the Department of pediatrics, Chennai Medical College Hospital, Trichy. Convenient sampling technique was applied to select the study subjects. Renal ultrasound and voiding cystourethrography (VCUG) examinations were performed in all confirmed cases of first UTI under 5 years of age and recurrent UTI at any age. Any children with underlying anatomic abnormalities of urinary tract or neurogenic abnormalities were excluded from the study. The severity of reflux expressed as a grade, which is based on the system established by the International Reflux Study in Children. The data was analyzed by proportions and chi -square test using SPSS statistical package version 11 at 95% confidence interval. P value <0.05 was considered significant. RESULTS: First UTI commonly occurred under 2 years of age (54%). Recurrent UTI predominantly occurred beyond 2 years of age (70%).In less than 2 years age group the percentage of UTI was slightly higher in males(53%) than females(47%).After 2 years females had a higher percentage(64%) of UTI than males ( 36%).In first UTI under 2 years fever was the presenting complaint in 90% cases. In recurrent UTI fever was seen only in 28.5% cases. Common presentations of recurrent UTI under 2 years were irritability (64.3%), vomiting (42.8%), poor feeding (35%) and failure to thrive (35%).Common presentations of recurrent UTI in older children were specific urinary symptoms such as increased frequency (70%), dysuria (60%) and abdominal pain (45%).In first UTI only 22.5% cases were presented with VUR whereas in recurrent UTI 32% cases were presented with VUR. Grading of VUR in our study was Grade I 41%, Grade II 32%, Grade III 9%, Grade IV 9% and Grade V 9%. In first UTI severe Grades of VUR (> Grade 2) were not seen. The sensitivity and specificity of ultrasound in detecting VUR were 36.4% and 100% respectively. CONCLUSION: Since the Vesicoureteric Reflux appears to be more common in the recurrent UTI, Voiding cystourethrogram (VCUG) is recommended in all the cases of recurrent UTI, so that prophylaxis can be entertained to prevent renal scarring and chronic glomerular insufficiency. Even in the first UTI, if the child is not ORIGINAL ARTICLE Journal of Evolution of Medical and Dental Sciences/ Volume 2/ Issue 14/ April 8, 2013Page-2406shown improvement as expected, VCUG can be done. Since USG is safe noninvasive it is recommended in all confirmed cases of UTI. INTRODUCTION: Urinary tract infection (UTI) is a common bacterial infection in infants andchildren. The risk of having a UTI before the age of 14 years is approximately 1-3% in boys and 3-10% in girls 1 . The diagnosis of UTI is often missed in infants and young children, as urinary symptoms are minimal and often nonspecific. Rapid evaluat...

Background: Pre-operative knowledge regarding the nature of ovarian mass is necessary in order to plan surgery. Risk malignancy index (RMI) is a simple scoring system based on three factors serum CA 125, USG score and menopausal status. The RMI was interpreted as 1) score >250=high risk, 2) 25-250=intermediate risk, 3) score <25=low risk. The objective of the study was to evaluate risk malignancy index (RMI) in pre-operatively clinically diagnosed ovarian mass and to compare the validity of individual parameter in RMI i.e. menopausal status, serum CA 125 and USG score to differentiate the nature of clinically diagnosed ovarian masses as benign or malignant.Methods: This was an observational study conducted in the Department of obstetrics and gynaecology, Trichy SRM Medical College and Research Centre, Trichy from January 2017 to January 2018 with a sample size of 77 cases with clinical diagnosis of ovarian mass admitted for surgery. The validity of RMI and validity of individual parameters were calculated and compared.Results: A total of 77 patients with ovarian tumors were enrolled in this study. According to the histological examination of the surgical specimens of the 77 women, 27.3% (n=21) had malignant tumors and 67.7% (n=56) had benign disease. Most common benign tumour was serous cystadenoma and the most common malignant tumour was mucinous cystadenocarcinoma. Among 77 patients, 42.85% (n=33) were postmenopausal, 44.15% (n=34) had USG score of 4, 27.27% (n=21) had serum CA125 level >cut-off values and 27.27% (n=21) had RMI >250. In cases where RMI>250, 18 out of 21 were malignant. In cases where USG score was 4, 19 out of 34 were malignant. Of the cases where serum CA125 level was > cut-off values 16 out of 21 were found to be malignant. RMI showed better sensitivity of 85.71%, specificity of 94.64%, PPV of 85.71%, NPV of 94.64% and diagnostic accuracy of 92.20%.Conclusions: RMI is highly valuable and reliable in differentiating benign and malignant ovarian lesions and facilitates selection of cases for conservative management and oncology referral.