Background: With increased awareness about breast cancer, many women with breast lumps are attending clinics. Though benign breast lumps are most common, they may be associated with morbidity and have become cause for concern to patients. Triple assessment by clinical, radiological and pathological examination is a standard approach in the evaluation of breast lumps. Even in cases of benign breast diseases, multimodality tests are being preferred to give reassurance to patients. This study was aimed to study distribution of various benign breast lumps in relation to age at presentation, to identify sensitivity and specificity of clinical breast examination, Ultrasonography (USG) and Fine needle aspiration cytology (FNAC) methods in the evaluation of benign breast lumps and to compare with final histopathological diagnosis.Methods: A retrospective study was conducted in department of general surgery at Malla Reddy institute of medical sciences, Hyderabad from August 2013 to July 2017. 202 females with benign breast lumps were evaluated by clinical breast examination, ultrasonography (USG) and Fine needle aspiration cytology (FNAC) methods. All patients underwent excision biopsy of lump. Final histopathological report was taken as reference standard.Results: Fibroadenoma was most common in 2nd decade. Clinical breast examination and USG showed good sensitivity but less specificity than FNAC. FNAC showed both good sensitivity and specificity. There was very good degree of agreement between FNAC and histopathological diagnosis (Kappa=0.911).Conclusions: Good clinical examination can give accurate preoperative diagnosis of benign breast lumps. Triple assessment by clinical breast examination, USG and FNAC can be useful in the evaluation of benign breast lumps.

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Background: Anal fissure is a linear tear in the lining of the anal canal below the dentate line. Among the conservative modalities glyceryl trinitrate (GTN) is emerging as first line of treatment since it breaks the vicious cycle and relaxes the sphincter. Surgery was considered as the first line of treatment if conservative measures such as bulk laxatives, stool softeners and local anaesthetics fail. Aim of this study was to study the aetiology and predisposing factors, age and sex distribution, clinical presentation, position of fissure, complications associated with medical and surgical management and comparison of efficacy of topical GTN (0.2%) and lateral anal sphincterotomy.Methods: The study was based on analysis of 60 patients who were treated for chronic fissure in ano at Malla Reddy Institute of Medical Sciences, Hyderabad from January 2018 to February 2020. Patients were divided into 2 groups. One group was managed by topical application of the ointment and other group was managed by surgery (lateral anal sphincterotomy). Statistical tool (software) used to analyse the data was SPSS 13.0 software.Results: Around 33.33% patients who were managed medically by 0.2% glyceryl trinitrate did not have relief of symptoms. Patients under surgical management had more relief of symptoms (86.6%). Almost all patients treated with glyceryl trinitrate had some form of headache. During the immediate post-operative period 13.3% patients treated with surgery had pain.Conclusions: It can be concluded that open lateral anal sphincterotomy is superior to topical 0.2% GTN with high rate of healing and very low rate of complications.

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