Objectives: FNAC plays a pivotal role in any lesion for the ease of diagnosing and treatment of an ailment. The role of FNAC in bone lesions has not been studied in great vastness but it can definitely ease the time taken for diagnosing on histopathology. The aim of the study was to study the sensitivity, specificity, positive predictive value, and negative predictive value of FNAC in bone lesions, comparison of cytological findings to histopathological findings and to identify the accuracy of FNAC in bone lesions. Methods: The study was retrospective and observational study. All the FNAC samples were studied and correlated with the histopathology findings where available. Results: A total of 92 cases were studied. The accuracy of the study stands at 81.3% along with the sensitivity of 87.5% and specificity of 75% with a positive predictive value of 77.8%. Non-neoplastic lesions were 18, followed by primary benign bone tumors 29, Primary malignant bone tumors 28, secondary tumors of bone 6, and unsatisfactory smears 11 cases were identified. Conclusion: FNAC plays a very crucial role in diagnosing and early intervention and treating any ailment. Bone FNAC also is beneficial for identifying the treatment modality. It should be used on regular basis for bone lesions.

Introduction: Direct laryngoscopy and endotracheal intubation are a noxious stimulus and induces sympathomimetic responses. Although properly tolerated in normal and healthy subjects, it can impose serious arrhythmias, left ventricular failure, myocardial ischemia, or rupture of cerebral aneurysm in vulnerable patients. Various techniques are currently working to attenuate this response, but, so far, none of them have been proven to be superior. Esmolol and Lignocaine; attenuate those responses however are related to some untoward outcomes such as bradycardia and hypotension. In low doses, the chances of those expected untoward outcomes are relatively low. Aim and Objectives: We designed this prospective clinical education to assess and compare the efficacy of intravenous Esmolol and Lignocaine in attenuating sympathomimetic responses to laryngoscopy and endotracheal intubation. Methods: After the Institutional Ethics Committee approval, 52 consenting patients of ASA physical repute I or II of age between 20 and 60 years, scheduled for surgeries requiring general anesthesia, remained randomly owed to two groups; Group E and Group L, given 2 mg/kg of inj. Esmolol intravenously and inj. Lignocaine 2 mg/kg, respectively, 2 min before intubation. Final outcome variables such as heart rate (HR), systolic blood pressure (BP), diastolic BP, and mean arterial pressure (MAP) had been recorded and compared between the two groups immediately after intubation (AI) and then at 1, 3, and 5 min AI. Results: There was no statistically huge distinction regarding the demographic profiles of both the study groups. There has been a substantial rise in mean HR in the lignocaine group all through laryngoscopy and intubation, which did not settle to baseline level even after 5 min (p<0.0001). In the esmolol group, a significant attenuation of HR was observed immediately AI and 1, 3, and 5 min following intubation. MAP was well controlled in the esmolol group. Throughout the study period, readings of mean arterial pressure were much higher in esmolol group. In the lignocaine group, the values of study parameters were higher than the baseline at every point of time. Diastolic BP was elevated in both groups. Conclusion: Esmolol was found to be more effective for attenuation of hemodynamic tension response to laryngoscopy and intubation when compared with Lignocaine. However, Lignocaine is also safe and effective to some extent.

Objectives: Local anesthetics administered by spinal anesthesia acts through sodium channels. Mutations of sodium channels may be responsible for resistance to local anesthetic agents. The scorpion venom contains neurotoxins that block the sodium channels. In view of the high prevalence of scorpion stings in our region and observation of failure of spinal anesthesia in patients with a history of scorpion stings in routine practice, the present study is planned. Methods: Forty patients of the American Society of Anesthesiologists Grade I or II who were undergoing infraumbilical surgery were divided into two groups as S (patients with h/o scorpion bite) and C (patients with no such history). The subarachnoid block was given with 3.2 ml of injection Levobupivacaine 0.5% heavy using 26 gauzes Quincke spinal needle. A blind observer recorded a sensory block using a needle prick and a motor block using the Bromage scale. Onset of sensory and motorized block, time to peak of sensory, and motor block and its relation to number of scorpion bites were observed in both the groups. Results: The onset of sensory (2.61±1.68 mins) and motor blockade (2.91±1.80 mins) was significantly delayed in Group S (p=0.010 and 0.004, respectively). Time to peak of sensory and motor blockade was also prolonged in Group S (6.45±2.83 mins and 7.8±3.95 mins) compared to Group C (3.60±0.84 mins and 4.56±1.30 mins) which was statistically significant (p<0.05). Patients who had previous scorpion bites (Group S) had a significant failure rate of spinal anesthesia compared to the control group. Conclusion: In this study, it was observed that the patients with scorpion bites had a significant failure rate of spinal anesthesia, suggesting probable resistance to the local anesthetic agents.

Objectives: The liver is a common site for primary as well as secondary malignancies. Ultrasonography (USG)-guided fine needle aspiration cytology (FNAC) is a rapid, accurate, economical, and safe diagnostic procedure for various hepatic lesions. The aims of the study were to categorize and study the cytomorphological features of the hepatic lesions, study the age and sex distribution and analyzing cytological features of the hepatic lesions, and to evaluate the sensitivity, specificity, and diagnostic accuracy of USG-guided FNAC in diagnosing hepatic lesions. Methods: A prospective and observational study of 64 patients with clinically and radiologically diagnosed hepatic lesions and referred for FNAC in department of pathology of a tertiary care hospital. USG-guided FNAC was performed in each patient and cytological features were analyzed. Results: In our study, out of total 64 USG-guided FNAC of liver, metastasis was most common – 33 cases (51.56%), followed by primary hepatocellular carcinoma – 18 cases (28.12%), liver abscess – 6 cases (9.37%), and 7 cases (10.93%) were unsatisfactory smears. Conclusion: USG-guided FNAC, in expert hands being simple, safe, quick, reliable, cost-effective, efficient, and easily available OPD-based procedure and with less number of complications, it has a very important role in accurate diagnosis of primary hepatocellular carcinoma, secondary malignant tumors of liver, and inflammatory lesions of liver.