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Background: Research examining the role of vitamin D deficiency and the development of menstrual disorders in women is of widespread interest. Studies have been published showing that supplementation with high-dose vitamin D can lead to the restoration of the menstrual cycle. We lack adequate information regarding the effect of vitamin D levels on the physiology of menstruation and further on fertility in women of reproductive age due to the contradictory results reported by studies. Objective: To study the association of 25-hydroxy vitamin D with menstrual cycle characteristics including long and short cycle length and cycle irregularity. Materials and Methods: In this cross-sectional study, serum vitamin D levels of 166 women attending an outpatient department with menstrual irregularities after excluding all obvious causes of menstrual disorders (n = 83) between April-June 2019 were measured and were compared with women of similar profiles with complaints other than menstrual irregularities (n = 83). Results: A decreased level of vitamin D was associated with a 13.3 times odds of an irregular cycle (OR (95% CI): 13.30 (5.79-30.60), p < 0.001). 25-hydroxy vitamin D was not associated with age or body mass index. We found a significant difference (p < 0.001) in mean vitamin D levels among the females with irregular cycles vs. regular cycles. Conclusion: Vitamin D plays a role in the physiology of reproduction specific to the menstrual cycle and ovulation. Long-term prospective studies assessing the exact cutoff value and the exact dose of supplementation required are needed. Key words: Menstrual disturbances, Ovulation, Reproductive period, Vitamin D deficiency, Dietary supplements, Polycystic ovarian syndrome.

Introduction: Ovarian tumors pose a diagnostic predicament as it is difficult to differentiate benign from malignant without a histopathology report. Appropriate tumor markers may serve as diagnostic aid to better decision making in the management of these cases. We attempted to determine the relationship between age, serum markers, and histopathological sub types of ovarian tumors to help distinguish benign from malignant tumors.Methods: A retrospective cross sectional study of all cases with ovarian tumors that had available histopathology reports and tumor marker levels was done at a single centre. Variables examined were age, histopathology report and serum tumor markers CA-125, CEA, CA19-9, LDH, and βHCG. Results: Histopathological analysis revealed 26% teratomas, 28% cystadenomas, 14% corpus luteal cysts, 26% carcinomas and 6% endometriomas. CA-125 was the only marker that was significantly raised in malignant versus benign tumors (p=0.008) and increased with increasing age. All women with raised CEA reports had teratomas, and none with cancers had a raised CEA. CA19-9, LDH and βHCG were not significantly different in benign versus malignant tumors.Conclusions: CA-125 may be used as an adjuvant diagnostic tool for ovarian cancer in older women. The role of CEA as a marker for teratomas needs further evaluation.

Background: Early diagnosis of ovarian tumors is a challenge due to variable presentation. Early diagnosis of ovarian cancers aids in timely management and better clinical outcomes. Aim of study was to determine the different clinical presentations of ovarian tumors and compare those in benign tumors versus malignancies.Methods: Clinical data of all women operated for ovarian masses was extracted from case files at a tertiary care centre and evaluated and clinical features compared in women with benign versus malignant tumors.  Results: We found 50 cases of ovarian tumors with 26% malignancies. The mean age was 38.48+14.9 years. Malignancies were significantly common in menopausal than menstruating (χ2=13.57, p=0.001, fishers exact). Pain was the commonest symptom and combined lumbar and iliac pain was reported in 67% cases. The location of pain was not significantly different in women with malignancy compared to those with benign tumors (likelihood ratio χ2=7.93, p=0.24). The odds of reporting a mass in abdomen were significantly greater in women with cancers than benign tumors (OR= 4.9, 95%CI 1.07-24.06, p=0.01). More women with cancer had history of distension of abdomen compared to women with benign tumors (χ2=9.43, p=0.002).Conclusions: Lumbar pain is most frequent complaint in women with ovarian pathology. Symptoms of distension in abdomen or presence of lump in abdomen are a significant guide to alert the physician regarding possibility of malignancy must be evaluated without delay.