Phyllodes is a tumor of breast. This fibro-epithelial lesion occurs in less than 1% of all breast tumors in female. They can be benign, borderline or malignant. It commonly occurs in age group of 45-50 years. It is also known as cystosarcoma phyllodes/ serocystic disease of Brodie. Treatment can be either wide local excision or mastectomy to achieve histologically clear margin. Palpable axillary lymphadenopathy can be identified in up-to 10-15% of patients but less than 1% has pathological positive nodes. Mammography and ultrasonography are main imaging modalities. Here, we present a case of a 14-year-old female presenting with a rapidly enlarging breast mass, which was ultimately found to be a Phyllodes tumor.

Background: In this ongoing era of 21st century, trauma is the leading cause of death in individuals between age 1 and 44. In trauma, also road traffic accidents (RTAs) are the major cause of death. Blunt abdominal trauma is a frequent emergency and is associated with significant morbidity and mortality.Methods: A prospective analysis of 50 patients of blunt abdominal trauma admitted in SMIMER hospital Surat within a span of 12 months was done. Unstable patients with initial resuscitation underwent focused assessment sonography for trauma (FAST). Failed resuscitation with free fluid in abdomen confirmed by FAST immediately shifted to operation theatre for laparotomy and proceed. Hemodynamically stable patients underwent computerized tomography of abdomen.Results: Most of the patients in our study were in the age group of 21-45 years with M:F ratio of 4:1. RTAs (62%) was the most common mechanism of injury. Spleen (38%) was the commonest organ injured and the most common surgery performed was splenectomy. In total non-operative management (NOM) was done in 58% of cases and surgical management was done in 42% of cases.Conclusions: Appropriate patient selection, early diagnosis and repeated clinical examination and use of appropriate investigations forms the key in management of blunt abdominal trauma. To conclude, initial resuscitation measures and correct diagnosis forms the most vital part of blunt abdominal trauma management.

Background: Haemorrhoids are common perianal disease. Milligan-Morgan haemorrhoidectomy operation is a classical haemorrhoid resection procedure that has been widely used as gold standard.  Classical haemorrhoidectomy is associated with considerable postoperative pain. This leads to patient discomfort; prolonged hospital stays and increased cost. The causes of post haemorrhoidectomy pain are multifactorial. Methylene blue has been widely used as biological dye. It is an inhibitor of soluble guanylate cyclase. It has also been found to reduce cyclooxygenase products. The mechanism of action of methylene blue is likely to be related to the destruction of dermal nerve endings.Methods: A prospective study of 114 indoor patients was conducted to compare the effects of 1% intradermal methylene blue injection at local site and injection paracetamol (I.V.) as per requirement after Milligan-Morgan haemorrhoidectomy admitted to Surat municipal institute of medical education and research (SMIMER) hospital at Department of General Surgery. Samples were divided into two groups each of 57 patients, in case group patients were given intradermal methylene blue at local site after haemorrhoidectomy and in both groups’ injection paracetamol was given as per requirement. Both groups are assessed by visual analogue scale (VAS).Results: Present study concluded that mean post-operative score according visual analogue scale (VAS) in case group was significantly lower as compared to control group on 1st and 3rd post-operative day.Conclusions: Methylene blue injection has an analgesic effect at local site after post conventional haemorrhoidectomy without any significant side effects of methylene blue.

The complete androgen insensitivity syndrome (AIS), previously called testicular feminization syndrome, is an X-linked recessive rare disorder. AIS is the most common male pseudohermaphrodite. Patient has 46, XY chromosome and testis. The individual is phenotypically female and genotypically male. Antimullerian hormone is produced by the testis. So, uterus and fallopian tubes do not develop in fetus. The fault lies with androgen receptors which are mutated. Male differentiation of external genitals does not occur. The individuals are reared as girls and the condition is suspected when the individual is evaluated for primary amenorrhea, infertility or when unilateral/bilateral inguinal hernia is diagnosed in girls. This disorder includes a spectrum of changes ranging from male infertility to completely normal female external genitalia in a chromosomally male individual. These cases need proper diagnosis and appropriate management. We report this case for its interesting presentation. The patient is a 23 year old female, presented with bilateral labial swellings and primary amenorrhoea. Subsequent investigations were done which revealed that the patient is a genetically male with absence of female internal genitalia but presence of testes. Proper psychological support was also given to her, which is more important.

Pancreatitis is a systemic disease owing to release of inflammatory mediators and digestive enzymes. Acute pancreatitis is sudden inflammation of the pancreas. Alcohol and gallstones are main cause of acute pancreatitis. Chronic pancreatitis is the persistent inflammation and irreversible fibrosis associated with atrophy of pancreatic parenchyma. There are various complications associated with pancreatitis such as strictures, pancreatic necrosis, pseudo-cyst of pancreas, pancreato-cutaneous fistulas, venous thrombosis, arterial aneurysm in various arteries around pancreas etc. Common bile duct (CBD) strictures are a common complication in patients with advanced chronic pancreatitis and have a variable clinical presentation ranging from an incidental finding to overt jaundice and cholangitis. CBD strictures occur as a consequence of recurrent acute inflammatory episodes which may ultimately result in a periductal fibrotic stricture. CBD can be compressed as a result of extrinsic compression by large pseudocyst or aneurysm. The diagnosis is mostly made during investigations for abdominal pain but jaundice may be the initial clinical presentation. The jaundice is typically transient but may be recurrent with a small risk of secondary biliary cirrhosis in longstanding cases. Vascular complications in chronic pancreatitis are rare. Venous thrombosis is the most common complication of pancreatitis affecting venous system. It occurs as consequences of an inflammatory mass in head of pancreas, and splenic vein thrombosis occurs in association with chronic pancreatitis in 4-8% cases. Present case is a case of acute pancreatic collection in head of pancreas with aneurysmal small bleeding causing complete CBD compression and extensive venous thrombosis involving superior mesenteric vein, portal vein, splenic.