Background: There is paucity of data on the spectrum of breast diseases in India due to lack of reporting system. This study was conducted to understand the pattern of breast diseases in northwest India. It is by far the largest study to provide epidemiological data on breast disease spectrum in India. Methods: Total of 8604 breast pathological reports were obtained from four major diagnostic centers in North West India. These included benign and malignant breast lesions. Results: There were 5985 (69.56%) lesions in the benign group and 2619 (30.43%) lesions in malignant group. Women formed 92.73% (7978) of the study group. Among benign lesions, most common were discrete benign lumps 59.19% (3543) followed by fibrocystic changes 16.02% (959). The most common age group was ≤20 years for discrete benign lumps and gynecomastia whereas 31-40 years for fibrocystic changes. Among malignant lesions, the most common was infiltrating duct carcinoma (not otherwise specified) with 32.72% (857) followed by infiltrating duct carcinoma (moderately differentiated) 26.84% (703) with the most common age group of 41-50 years. Among breast lesions in men, male breast carcinoma formed 2.25% (59) of malignant breast lesions. Gynecomastia formed 0.65% (560) of all breast lesions. Conclusions: Most common breast lesions were discrete breast lumps. Benign lesions are more common in early 20’s while malignant lesions are more common in the 5th decade. The study revealed a higher proportion of male breast carcinoma.

Cancers survivors with second tumour mass. The difficult thing in these situations is definitive diagnosis. One sentence which shapes the future of a patient-a steep see saw of definitive and palliative treatment. What saves the clinician in this scenario is the immunohistochemistry (IHC). It single handedly brightens the path and leads to conclusion. This case report demonstrated the same in breast cancer survivor.

Background: Laparoscopic Cholecystectomy [LC] has become the gold standard for treatment of benign gall bladder disease. Pain after laparoscopic cholecystectomy though primarily visceral, often affecting sub diaphragmatic region and often referred to the right shoulder region, also has a parietal component which occurs at the trocar site.Aim: This study was conducted to compare postoperative pain control with use of 0.5 % bupivacainesoaked sheet of regenerated oxidized cellulose in the gallbladder bed versus port site infiltration of 0.5 % bupivacaine after laparoscopic cholecystectomy.Material and Method: Total patients were 75, which were divided in three groups -Group A (n=25) bupivacaine-soaked sheet of regenerated oxidized cellulose was placed in the gall bladder bed, Group B (n=25) bupivacaine was infiltrated at trocar site before skin suturing, Group C (n=25) was the control group. Nature of painvisceral, parietal or shoulder was assessed on VAS at 3,6 & 24hrs after surgery. Results: All patients demonstrated different intensities of visceral and parietal pain in all groups. No patient had shoulder pain. Visceral pain at 3, 6 & 24hr was significantly less in group A (2.04±1.71, 1.56±1.68 & 0.40±0.57) as compare to group B (3.08±0.70, 2.56±1.29 &1.28±0.54) & group C (4.32±0.62, 3.84±0.85 & 3.08±0.91) (p< 0.05). Parietal pain at 3,6 & 24hrs for group B (2.28±1.45, 1.36±1.22& 0.60±0.50) was less than group A (2.76±0.66, 2.28±0.54 & 1.12±0.44) & group C (4.64±0.86, 3.68±0.90 &3.16±0.80) (p<0.05). Postoperative analgesic requirement was 16% in Group A, 20% in Group B and 100% in Group C. Conclusion: Bupivacaine (0.5%) soaked sheet of regenerated oxidized cellulose (ROC) in the gall bladder bed is safe, increases postoperative comfort and decreases postoperative analgesics requirement after laparoscopic cholecystectomy as compare to trocar site infiltration.

Background: Gynecologic cancers form a huge burden of morbidity and mortality around the world. This study was undertaken to study the pattern, histopathological types and relative frequencies of gynaecological malignancy cases reported at four major hospitals and pathology centers in Jaipur region. Method: Retrospective review of records of gynecologic cancers obtained from four major pathology departments in Jaipur region in which histopathological data of all female diagnosed with the genital tract malignancies for a ve year period were included in the study. Results: Most common genital tract malignancy was cervical cancer (51.8%) followed by ovarian cancer (24.6%), uterine cancer (17.6%) and vaginal cancer (3.96%). Mean ages for ovarian, uterine, endometrium, fallopian tube, vulva and cervical cancers were 42.79±15.84, 50.93±13.14, 61.21±7.61, 63.50±19.09, 56.05±17.89 and 51.29±11.95 years respectively. Conclusion & Recommendations: Cervix carcinoma is the most common female genital tract malignancy followed by ovarian carcinoma and uterine cancer. Squamous type of cervical cancer was the commonest type. Hospital facilities for screening and regular gynecological examinations and well-dened follow-up surveillance system can change disease morbidity and mortality.

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