BACKGROUND/AIM: Liver abscess though a relatively rare condition is a significant health problem in developing countries. Since the presentation, etiology and stage of the abscess varies to a large extent and in view of various possible complications that might arise in this condition defining the treatment strategies for this condition has always been a complex issue. In this study we will try to evaluate efficacy, recurrence rate, complications, morbidity & mortality, duration of hospital stay associated with various management strategies. MATERIALS AND METHODS: The following study was done in a set of 100 patients diagnosed with liver abscess admitted in our hospital. The management strategies compared includes use of antibiotics alone, Sonographic guided percutaneous drainage with Antibiotics and operative intervention in complicated cases. The efficacy, recurrence rate, complications, morbidity & mortality, duration of hospital stay associated with each management strategy was evaluated and observed. Followup was done for a mean period of 12.54 months. RESULTS: Of the 100 cases of liver abscesses included in this study, 26 cases (26.0%) who had abscess less than 200 cc or multiple small abscess involving both lobes were managed conservatively.74/100 (74%) who had abscess > 200 cc or left lobe abscesses were subjected to Intervention. Out of 74 cases patients underwent percutaneous drainage or laparotomy or laparoscopic drainage as required. There were no deaths in the study group. CONCLUSION: Thus in majority of cases percutaneous aspiration was the main form of treatment. All patients were started on antibiotics which were continued for 10-14 days depending on improvement. Majority of patients responded excellently to percutaneous aspiration and antimicrobials. While patients who had smaller abscesses or multiple small abscesses were successfully managed with antimicrobial therapy alone but relapse rates were high. Mortality was not observed in our series. Recurrence rate was 8.0% and recurrence rate in conservatively managed group was 30.7% while that in operatively managed cases is 0%.

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Mass in the Right Iliac Fossa (RIF) is clinically difficult to differentiate, ultrasonography a quick non-invasive investigation has bridged the gap between clinical examination and direct visualization. The study was done to know the efficacy of ultrasonography in pre operative evaluation of RIF mass. MATERIALS AND METHODS: The data for this prospective study was obtained from 300 patients admitted/ attending OPD with a clinical diagnosis of RIF mass. Ultrasonography was done and a provisional diagnosis was obtained. The final diagnosis was obtained with histopathological examination[HPE] or by other standard methods. The sonological diagnosis was compared with final diagnosis. RESULTS: Out of 300 patients studied 236 were operable. Ultrasonography was able to diagnose 228 out of the 236 (Sensitivity of 96.7%) as operable cases and the remaining eight were inconclusive report. Ultrasonography was able to rule out all non operable cases with 100% specificity. The final diagnosis correlated with sonological diagnosis in 284 cases with sensitivity of 94.6% while clinical diagnosis correlated with final diagnosis in 232 cases with sensitivity of 77.3%.The most common conditions being appendicular mass followed by appendicular abscess and ileocaecal TB. DISCUSSION: Thus ultrasonography in experienced hands is an invaluable tool for preoperative evaluation of RIF mass. It has favorable sensitivity and specificity in differentiating RIF mass and 100% sensitivity and specificity in detecting cases which needs emergency intervention. In countries like India where other radiological investigation modalities are present only in higher center, ultrasonography becomes an invaluable tool in diagnosis and evaluation of RIF mass for practitioners in semi-urban and rural settings.

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Background: Breast cancer is the most common of all cancers and is the leading cause of cancer deaths in women worldwide, accounting for >1.6% of deaths and case fatality rates are highest in low-resource countries. Prognostic factors include the type of tumor, size of the tumor, tumor grade, number of involved lymph nodes, Ki67 status (cellular marker for proliferation), and the patient's age. Numerous studies have been conducted on these prognostic factors and their relationships with one another, however, the studies have not reported proper association of Ki67 proliferative index with other clinicopathological parameters. Breast cancer aggressiveness can be correlated with proliferation status of tumor cells, which can be obtained with Ki67 marker. the present study is considered to analyze the association of Ki67 with tumor size, lymph node involvement, histological grade, ER, PR, HER2 status in breast carcinoma.These predictive and prognostic factors help us to stage, plan and choose an appropriate mode of management that increases the patients longevity and improves their quality of life. Methods: In this prospective observational study, all the excised mastectomy specimens of patients with carcinoma breast were processed. Histological Grading of tumor was done based on modified Bloom and Richardson score and lymphovascular invasion, surgical margin status and metastatic lymph node deposits were noted. Paraffin blocks were selected for immunohistochemistry and four marker panel including ER, PR, HER2 and proliferative index Ki67 were done and studied along with controls.The parameters used were: age, tumor size, stage of the disease, number of lymph nodes positive, HPE grade, ER, PR, HER2, Ki67. Statistical analysis was done. Results: Total 41 cases were taken for the study. Patients age ranged between 25 to75 years, most were between 40-50 years of age. The mean age of presentation was 49.22±11.21years. 75.6% patients had Ki67 between 22-40% indicating that younger the age group more aggressive is the breast cancer. Ki67 expression decreased as the patient's age increased. Tumors were between 1.6 to 10cm in size in greatest dimension and most were between 3 to 6 cm. As tumor size increased, an increased expression level of Ki-67 was noticed. A positive relationship was observed between involved lymph nodes and the mean level of Ki67 expression. On histopathological examination tumour grade-III had high Ki67 and proliferative index was gradually increasing from grade-I to grade-III. Proliferative index Ki67 was also compared with stage of disease in non metastatic breast cancer, it was found to be higher in later stage of disease. This study demonstrated HER2/-neu positivity with higher frequency of Ki67. A significant relationship was also found between Ki67 and tumor grade and age of the patient.A positive relationship was observed between