ABSTRACT:The incidence of cervical fibroids is 0.5-1%. It is usually single; they are usually confined to supravaginal portion of the cervix. Rarely it becomes submucous and polypoidal. So it is usually subserous or interstitial. It can be anterior, posterior or central in position. We had different types of cervical fibroids of which we will describe a few. Usually cervical fibroids cause infertility, difficulty in labor, infections, metrorrhagia, menorrhagia, constipation, retention of urine and dyspareunia. The cervical fibroid distorts the shape of cervix and grows bigger. It pushes the uterus upward giving the appearance of lantern of Saint Paul's dome in a case of a central cervical fibroid. Most of the patients in the reproductive age get admitted for menorrhagia due to fibroid. Its growth is dependent on estrogen. It does not grow after menopause. KEYWORDS: Cervical fibroid, fibroid polyp, hysterectomy. CASE 1:A 52 year old housewife, completed the family, who had previous two LSCS section and sterilization done 20 years ago, got admitted with retention of urine for the past 12 hours. She gave history of burning micturition and frequent retention of urine for which catheterization was done a number of times outside.She had lower abdominal pain and post coital bleeding. She had irregular menstrual history. Foley's catheter was introduced. Bimanual examination showed cervix was replaced by huge mass 8×11 cm occupying the whole cervix and vagina. This was a central cervical fibroid wherein the uterus was found sitting on top of it.The uterus was palpable per abdomen as a soft globular mass2×3 cm suggestive of a fundal fibroid. Patient was anemic and 2 units of blood transfusion were given. Routine investigations were normal. Ultrasound(USG) report showed a small fundal fibroid 2×2 cm and a huge central cervical fibroid of size 8.3×11.3 cm (figure1). Patient was explained and consent for laparotomy was obtained.Laparotomy showed plenty of adhesions due to previous surgeries which were released .The bladder was found plastered with the mass. So a transverse incision was made at the level of the UV fold to push the bladder up. Uterine vessels supplying the fibroid were engorged and tortuous were carefully cut and ligated (figure 2).The uterus along with the central cervical fibroid shelled out without injuring the bladder, ureter and rectum. Pre-operative ureteric stenting could have helped in the surgery of shelling the cervical fibroid. Vault and abdomen closed after perfect hemostasis. The cut section of the specimen showed the uterus sitting on top of the cervical fibroid and had a small fundal fibroid of size 3×3cm.The specimen was sent for histopathology, because of the increased cellularity and mitosis, leiomyosarcoma was thought of initially by the pathologist. Later on, they confirmed it as a feature of highly cellular leiomyoma with hyaline and cystic degeneration (figure 2) Post-operative period was uneventful. Patient passed urine freely. She came for follow up. She had no complaints.

Ovarian tumors are rare in children and constitute 1% of all childhood malignancies and 8% of abdominal tumors. Large cysts and those complicated by torsion make their presence clear by their symptomatology. However, ovarian pathology is still mostly discovered at laparotomy for presumptive appendicitis. Accurate diagnosis of these tumors at such a young age is a great challenge to surgeons and pathologists. This article reviews the clinical presentation, radiological imaging, gross and histopathological findings at the Pathology Department of a Paediatric Referral centre in Hyderabad KEY WORDS: Ovarian tumors, pediatric age group, neoplastic, non-neoplastic lesions, germ cell tumors, surface-epithelial tumors, sex cord tumors. INTRODUCTION: Ovarian tumors are rare in children and constitute 1% of all childhood malignancies and 8% of abdominal tumors. Moreover, 10 to 30% of ovarian neoplasm operated during childhood or adolescent girls are malignant. It is well-known that germ-cell tumors are the commonest ovarian neoplasm in the first two decades of life constituting approximately two-thirds of all ovarian tumors. Malignant germ cell tumors constitute one-third of germ cell origin tumors and two-thirds of all ovarian malignancy in this age-group (1) Norris and Jensen found that <1% of epithelial carcinoma occurs below 20 years of age (2). Sex cord stromal tumors are rare tumors accounting for 5%-8% of all ovarian malignancies (3). Granulosa cell tumors are found in pre pubertal girls in

Background: Fine needle aspiration cytology (FNAC) is an accurate, cost effective & safe technique for diagnosing salivary gland lesions. We conducted this study to observe the cytological spectrum of different salivary gland lesions in two tertiary care hospitals. Methods: This is a prospective study carried from June 2010 to April 2014 at SBMCH Chromepet and SRM MCH & RC, Potheri. Fine needle aspiration was performed on patients presenting with complaints of salivary gland lesions. Data was statistically analyzed. Result: FNAC is performed on total of 135 salivary gland lesions. 11 were non diagnostic aspirate (8.2%), 58 were non neoplastic lesions (42.9%) and 66 were neoplastic lesions (48.9%). The most common benign tumor of salivary gland is pleomorphic adenoma and mucoepidemoid carcinoma was the most common malignant tumor. The most common major salivary gland involved is parotid gland. Conclusion: In the present study, neoplastic lesions were more common than non-neoplastic lesions. We conclude that inspite of few diagnostic pitfalls FNAC still plays a vital role in differentiating neoplastic from non-neoplastic salivary gland lesions to provide guideline for appropriate patient management.

The most common peripheral vestibular disorder generally is agreed to be BPPV. The hallmark of the disease is brief spells (lasting seconds) of often severe vertigo that are experienced after specific movements of the head. The head movements that most commonly cause symptoms are rolling over in bed and extreme posterior extension of the head as if looking under a sink.  Current understanding of this disease has evolved such that specific therapies based on accepted theories have been developed and proved successful in controlling symptoms. HISTORY: This disorder was first described by Barany in 1921. He documented the various components of this disorder as 1. Nystagmus, 2. Fatiguability of the nystagmus and 3. Vertigo. He failed to correlate the onset of nystagmus with specific positions of the head.  Dix & Hallpike 1952 described the Dix Hallpike maneuver for eliciting the nystagmus. They also described the unique features of nystagmus accompanying this disorder. These features were 1. Very short latency, 2. Directional features, 3. Brief duration and 4. Reversibility on returning the patient to a seated position.  Schuknecht postulated that BPPV was caused by loose otoconia from the utricle which in certain positions displaced the cupula of the posterior canal. (Schuknecht theory). He later modified his theory and proposed that it was due to the deposition of otoconia on the cupula of the posterior semi-circular canal. He termed this theory as cupulolithiasis. The cupulolithiasis theory proposes that calcium deposits become embedded on the cupula making the posterior semi-circular canal sensitive to gravity.  Hall & Ruby suggested that BPPV could result from deflection of the posterior canal cupula caused by debris within the posterior canal. This theory became known as the canal lithiasis theory. In this theory the calcium debris doesnot become adherent to the cupula but float freely within the canal. Head movements like looking up, down, or rolling over to the affected ear may result in the displacement of the sludge causing the classic symptoms.  Hall & Ruby described 2 types of BPPV: 1. BPPV with a fatiguable nystagmus, where the deposits are freely mobile within the cupula of the posterior canal,  BPPV with a non-fatiguing nystagmus where the calcium deposits are fixed on the cupula of the posterior canal.Anatomy and physiology: The vestibular system monitors the motion and position of the head in space by detecting angular and linear acceleration. The 3 semicircular canals in the inner ear detect angular acceleration and are positioned at near right angles to each other (Fig. 1). Each canal is filled with endolymph and has a swelling at the base termed the "ampulla" (Fig. 2). The ampulla contains the "cupula," a gelatinous mass with the same density as endolymph, which in turn is attached to polarized hair cells. Movement of the cupula by endolymph can cause either a stimulatory or an inhibitory response, depending on the direction of motion and the particular semicircular canal. It should be not...

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