Lymphangiomas are cystic lesions that arise due to malformations (congenital or acquired) in the lymphatic system and are composed of thin-walled septa lined by endothelial cells that enclose blocked lymph fluid. Lymphangiomas can occur in any part of the body, and at any age but generally, 90% occur in children < 2 years of age and 90% times in the upper part of the body like head, neck, and axillae. Abdominal lymphangiomas are rare (only 1% of all lymphangiomas) and pancreatic are even rarer. When occurring in the pancreas, they mostly present at later ages with recurrent abdominal pain +/-palpable abdominal mass and mostly in 'women', although most commonly they are an incidental finding. Here we present a case of a young 'male' with the complaint of epigastric pain that responded to acetaminophen, USG and CT raised the suspicion of cystic lymphangioma and EUS FNA showing pathognomic lab findings in the aspirated fluid. A definitive diagnosis can be made on histology. In asymptomatic patients, conservative treatment is preferred while in patients with symptoms and compression of adjoining structures due to size, En-bloc resection is curative with an excellent prognosis.

1.1. Introduction: COVID-19 pandemic affected the activities of every department, but most significantly the health department. It is essential to understand and quantify any such effects on the healthcare for better future planning. 1.2. Objective: We used de-identified retrospective data to 1) quantify the prevalence of common surgeries in the thoracic surgery department, 2) investigate the impact of COVID 19 on the patients’ characteristics, and number and proportion of the thoracic surgeries in our department, and 3) search for the possible causes for any such effects. 1.3. Materials and Methods: We used a HIPPA complaint retrospective data of the patients who had surgery in the Thoracic Surgery division of Hayatabad Medical Complex, between December 2018 to July 2021 to work out the effects of the pandemic on the amount and kinds of surgeries in the thoracic department during the pandemic. 1.4. Results: Our data consisted of a total of 242 cases. During the pandemic, the total number of thoracic surgeries increased by 53%. The top five most common thoracic surgeries during the pandemic identified by prevalence were decortication (34.2%), hydatid cystectomy (10.8%), emergency thoracotomy (7%), esophagectomy (5.7%), and feeding jejunostomy (5.7%). During the pandemic, thoracic surgeries were generally more prevalent among males, and among relatively younger patients (age ≤10 years). We saw a significant drop in the proportion of surgeries for oncologic indications. However, no significant change was seen in the baseline characteristics, complications and mortality of the cases. 1.5. Conclusion: Although the pandemic had no significant effect on the baseline characteristics and the safety and efficacy of our procedures, the unplanned diversion of patients from other hospitals resulted in a sudden increased burden on our unit. We recommend a close communication between the different healthcare facilities, under a strict monitoring body, to prevent over burdening of the departments and smooth delivery of care to patients.

This study was designed to assess the population status of Oncorhynchus mykiss (Rainbow trout), Salmo trutta (brown trout) and Schizothorax plagastimous (swati fish) in river Swat. Data were collected from four Sub- Areas (SAs) namely Madyan (SA1), Mankiyal (SA2), Kalam (SA3) and Mahoo Dhand (SA4). Fishes captured with electrofisher were identified morphologically and the wet weight and body length were determined. A total of 502 fishes were captured and identified. The highest capture (206) was recorded at SA4 whereas the lowest (64) at SA1. Similarly the highest captured specie (276) was Salmo trutta while the lowest (22) was Schizothorax plagastimous. The body length ranged from 15-36 centimeters whereas the wet weight varied from 47- 304 grams. Out of 502 fishes, 64, 104, 124 and 206 were from SA1, SA2, SA3 and SA4, respectively. The mean wet weight of Oncorhynchus mykiss, Salmo trutta and Schizothorax plagastimous 137.15g, 124.57g and 138.85g, respectively.