Background: Fine needle aspiration cytology (FNAC) is a sensitive and specific and yet an economically effective technique for diagnosis of salivary gland lesions. FNAC of salivary glands has achieved a pivotal role in the diagnosis and management of salivary gland lesions since its induction by Stewart et al in 1933. However, it has always been under scrutiny when compared to histopathology. Histopathology of salivary gland lesions is still the final method to establish diagnosis and predicting prognosis in these lesions.1Methods: A prospective observational study of 50 patients with salivary gland lesions was done at Gauhati Medical College and hospital from June 2011 to May 2012. 39 patients underwent histopathological confirmation. Cases with histopathological correlation were included in calculating diagnostic accuracy. The cytological findings were correlated with that of the histopathological diagnosis to obtain the accuracy of the cytological diagnosis. The parameters of diagnostic validity of the cytological technique in terms of sensitivity, specificity and predictive value were evaluated.Results: Study population included patients of age group ranging from 13-70 years with median age group being 31-40 years (30%). 54% of the affected patients were male with the parotid being the most commonly involved gland (62%). Neoplastic lesions constituted the major bulk of the lesions (39 cases, 78%) with benign tumours constituting 54%. The most commonly involved benign neoplastic lesion was pleomorphic adenoma (22cases, 44%). Among the non-neoplastic lesions (22%), the acute sialadenitis was frequently noted. Histopathological correlations were available in 39 cases with 11 cases being the malignant lesions. The acute sialadenitis lesions did not undergo histological examination. 28 cases of non-malignant lesions underwent the histological confirmation. In the present study, the specificity and the sensitivity were found to be 96.42% and 90.91% respectively. The predictive value of salivary gland cytology was 90.91% and diagnostic accuracy was 94.87%.Conclusions: Fine Needle Aspiration Cytology is thus a safe, reliable, quick, convenient and accurate method of diagnosis and should be considered as one of the first line of investigations in the evaluation of salivary gland lesions.

Background: Appendicitis is the most common abdominal emergency worldwide. Lifetime risk of acute appendicitis is 8.6% and 6.7% for man and women respectively. Clinical examination is helpful in diagnosis of acute appendicitis in only 70-87% of the cases. To compare Tzanaki and Alvarado scoring system in diagnosing acute appendicitis. Methods: This was a prospective, comparative, cross-sectional study, which was conducted at the Mahatma Gandhi Medical College and Research Institute Hospital. Patients with acute appendicitis were included in the study. Relevant history, examination and laboratory investigations done. Patients were scored according to both Alvarado scoring system and Tzanakis scoring, and both were documented in the proforma. Sensitivity, specificity, positive predictive value, negative predictive value were assessed and compared for both scoring systems. Results: 70 patients were included in this study. 54.3% of patients have Tzanakis score more than 8. 35.7% of patients have Alvarado score more than 7. 82.9% of patients had evidence of appendicitis in histopathological examination. Tzanakis score: sensitivity-65.52%, specificity-100%, PPV-100%, NPV-37.50%, accuracy-71.43%. Alvarado score: sensitivity-36.21%, specificity-66.67%, PPV-84%, NPV-17.78%, accuracy-41.43%. Conclusions: Tzanakis scoring system is an effective scoring system in diagnosing acute appendicitis.

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Background: Ventral hernias comprise the second most common hernia presentations in the surgical world. This study was undertaken to know the different clinical types, age incidence, predisposing factors for ventral hernia and also to study the post-operative results of different operative procedures.Methods: 250 cases of abdominal wall hernias were studied during the period of 3.5 years from January 2013 to June 2016. Out of which 150 cases were studied retrospectively from January 2013 to December 2014 with the help of the case sheets available in the MRD. The prospective study was done from January 2015 to June 2016 in which each patient was evaluated separately and thoroughly and his surgery planned so as to obtain satisfactory results. 69.6% were incisional hernias following an operation. 8% patients had presented with complications like irreducibility, obstruction and strangulation. The presence of associated diseases, large hernia, poor condition of local tissue (muscle), all make the surgical management of ventral hernia a complex problem. Either anatomical repair or Mesh repair were undertaken for all patients in this study.Results: Females were affected much more than the males. The proportion of females to males affected with ventral hernia was 5:1. Out of the three types of hernia that were studied only epigastric hernia showed more incidence in males whereas incisional and paraumbilical hernias were much more common in females. Most common age presentation was fourth and fifth decade. 92% of ventral hernias were uncomplicated at the time of presentation. In 100% of the cases swelling was the complaint followed by pain (18.8%). Previous surgery was the most common etiological factor in the development of ventral hernias (69.6%) followed by obesity (23.2%) In both groups mesh repair (63.6%) and anatomical repair (36.4%) there were no recurrences or deaths in the follow up period of 3 months.Conclusions: Ventral hernias are common surgical complaints. Prevention is the better treatment in the form of meticulous dissection and proper post-operative care to avoid incisional hernias. Presence of ventral hernia is an indication for surgery even in presence of co-morbid conditions like ascites, COPD, BPH as these patients are more prone for complications and of course these conditions need proper addressal. Mesh repair has nowadays become the standard of care but the results of the surgery depends upon the expertise of the surgeon.

Background: There is inadequate data on relationship between histologic thyroiditis, thyroid functional status and antithyroid antibody levels. Aim of the study was to correlate prevalence of antithyroid antibody levels with thyroid functional status and histological evidence of thyroiditis in thyroidectomy specimen.Methods: Thirty-two patients undergoing thyroidectomy were evaluated clinically and with thyroid function tests, preoperative TPOAb and TGOAb, ultrasound neck and FNAC. Histopathological examination to detect histological thyroiditis done. Patients with previous thyroid surgery or on thyroxine, antithyroid drugs, steroids, immune-suppressive drugs were excluded. Results: Overall twenty-five out of thirty-two patients had elevation of one or other thyroid antibody levels (TPOAb- 22/32, TGOAb- 20/32). More than half of the patients with elevated antibodies were euthyroid biochemically, less than quarter each being hypothyroid and hyperthyroid. The incidence of hypothyroid increased in those with elevation of both antibody levels. FNAC reported four as Hashimoto's thyroiditis. Histology on the other hand showed a primary diagnosis of Hashimoto's thyroiditis in three, in one each as the secondary diagnosis with papillary carcinoma being the primary diagnosis in one and follicular adenoma in another. Histologic lymphocytic thyroiditis was seen in three cases and found to be always associated with a primary diagnosis such as colloid goitre. Thus, overall five patients had an additional primary diagnosis with thyroiditis being a secondary diagnosis. When histological thyroiditis was correlated with antibodies, it was seen that only seven out of eight with histological thyroiditis had elevated antibody levels. High titters in patients with histological thyroiditis were associated with euthyroid status in two patients and hyperthyroid status in the remaining three.Conclusions: The study found no correlation between clinical and biochemical functional status with clinical examination under diagnosing both hypothyroidism and hyperthyroidism. No definite correlation was noted with mild increases in antithyroid antibody levels and histological thyroiditis, very high values and raises in both TPOAb and TGOAb may suggest histological thyroiditis.