In our study the resectability rate was 25%. Management of the case depends upon the stage of the tumour at time of presentation. Surgical management is the best suitable with chance of curative resection of the tumour. Various modifications in pancreaticoduodenectomy have been done since the Whipple`s procedure was introduced. Pylorus preserving pancreaticoduodenectomy is one such modification. Pancreatic stump is associated most of the time with complications of leakage. Although the techniques of pancreaticoduodenectomy have been improved with better pre operative evaluation, anaesthetic facilities and post operative care of the patient, the long term five year survival is still not much increased. Moreover, post operative hospital stay and complication rate is still high. Alternatively, bypass procedure especially where the disease i s advanced and the tumour is not resectable, are applied. These palliative procedures are associated with short hospital stay, less post operative complications, early relief of symptoms and better quality of life. Short term survival is rather better in these patients as compared to those undergoing resection. Six months survival in our study was 66.6% as compared to 60% in resected cases. Supportive therapies including chemotherapy, radiotherapy and hormone therapy at present are not of much help.

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Primary fallopian tube carcinoma is an aggressive but rare tumor. This is an unusual presentation of papilliferous tubal carcinoma presenting with vaginal discharge through a large sinus approximately 2-3 cm in size, located posterior to the neck of cervix. Surgery was undertaken with the initial diagnosis of primary ovarian carcinoma and the fistula was left to heal spontaneously. Surgical resection was followed by adjuvant chemotherapy. The patient is doing well after the therapy.

Radon (222Rn) is a ubiquitous radioactive gas and could threaten human life due to its potential for cancer and non-cancer risks. This study examined 222Rn concentration in the Hunza-Nagar valley along the Main Karakoram Thrust (MKT) fault. For this purpose, hot springs water of Hunza and Nagar districts and that background sites were analyzed using the RAD7 detector (Durridge Company, USA). Results showed that 222Rn concentration of hot spring water was found multifold higher than the background sites. 222Rn concentrations for hot springs water in Hunza-Nagar valley had surpassed the maximum contamination level (MCL) set by the USA environmental protection agency (USEPA). The concentration of 222Rn showed a strong positive correlation (> 0.68) with hot springs' water temperature and pH. The annual mean exposure dose rates of humans for various age groups were calculated for the estimated lifetime cancer risk (ELCR) and non-cancer risks. Among the age groups of humans, infants showed higher risk compared to others. Results showed that hot spring water consumption surpassed the world health organization (WHO) threshold limit of 100 µSv/y for chronic or non-cancer and USEPA 0.1x10− 3 for ELCR risks.

BACKGROUND: Inguinal hernia repair is the most common procedure in general surgery, rangingfrom 10 to 15% of all surgical procedures. Chronic groin pain following Mesh operation may lead topotential complication and its incidence can be as high as 62.9%. A quarter of these patients suffer fromsevere impairment in carrying out their daily routine. Chronic groin pain affect physical and socialfunctioning, thereby limiting the individual’s ability to participate in any paid employment.OBJECTIVE: This study was conducted to compare the outcome of mesh repair and darning in term ofchronic groin pain in the understudy group.METHODS: All men, who consented for the study, with primary inguinal hernia between age of 18 to80 years were included in the study. Patients having bilateral, irreducible strangulated or recurrent herniawere excluded from the study. Patients were non randomly divided in to two groups, to have the repairwith either polypropylene mesh (Lichtenstien Technique) or polypropylene dam (Anatomical repair).RESULTS: A total of 200 patients were included in the study. 3 patients were excluded because ofhaving another type of hernia or bilateral repair needed. 98 patients had anatomic repair while in 99patients mesh repair (LR) was done. The mean age of the anatomical group was 61.2 years (SD= 12.7)while the mean age of mesh group was 58.3 years (SD=12.1). Statistical analysis did not reveal asignificant disparity between mesh repair versus anatomic repair with regards to the incidence ofsuperficial SSIs (0 vs 2%, P=0.497), testicular swelling (4 vs 1%, P=0.369), hematoma (3vs 2%, P =0.99), recurrence (0 vs 2%, P = 0.497), or pain (12 vs 7%, P = 0.335).CONCLUSION: It was concluded that anatomical repair can still be offered to the patient who has aninguinal hernia with knowledge that postoperative complications are not greater than that with meshrepair.KEYWORDS: Inguinodynia Mesh Plasty