Ventral hernia is a fascial defect located on the abdominal wall. Primary ventral hernias are named as umbilical, epigastric, spigelian and lumbar hernias. A lumbar hernia is a parietal wall defect that may occur anywhere in the lumbar region between the 12th rib and the iliac crest. A 47-year-old female, came with complaints of mass in left lower abdomen since 2 months. On clinical examination a defect of 8 × 8 cm was felt in the left lumbar region with positive cough impulse. CECT abdomen and pelvis was done to confirm lumbar hernia. Patient underwent mesh repair for the same. Lumbar and flank hernias are uncommon and are a challenge to treat for any general surgeon. Surgery is considered gold standard either an open mesh repair or laparoscopically.

Introduction: Inflammation is a protective response which involves immune cells, blood vessels, and molecular mediators. Neutrophils and lymphocytes help in healing and regeneration of damaged tissues and also fight infections. Neutrophil to lymphocyte ratio (NLR) is used as a pointer or marker for inflammation both clinical and subclinical. The presence of lymphovascular invasion (LVI) is understood as or points to increased risk of axillary lymph node and distant metastases. Aims and Objectives: To compare neutrophil to lymphocyte ratio [NLR] with lymphovascular invasion in carcinoma breast. Methodology: A descriptive study was conducted at JSS Hospital Mysuru over a period of two years comprising of 100 patients diagnosed as carcinoma breast and results were drawn. All demographic data was tabulated and measured as proportion, mean, standard deviation and the inferential statistics were obtained using Chi-square and Cramer's V tests. Results: 65% of carcinoma breast cases in our study had lymphovascular invasion. The percentage of lymphovascular invasion increased with increase in NLR progressively with 22.2 percent in category A to 91.8 percent in category D. Conclusion:Increase in neutrophil to lymphocyte ratio is associated with increased incidence of lymphovascular invasion in carcinoma breast.

Introduction: Neutrophil and lymphocytes are the main inflammatory cells of our body which act as line of defense against various infections. Breast cancer being one of the most common type of cancer in Indian women, is more prevalent in elderly. Its progression and prognosis are influenced by the inflammatory response of the patient in the surrounding tumor microenvironment. Neutrophil-to-lymphocyte ratio (NLR) provides a surrogate marker for prognosis of carcinoma breast. Aims and objectives: To compare various stages of carcinoma breast with different ranges of NLR and draw a correlation. Methodology: A descriptive study was done at JSS Hospital over a period of two years for 100 patients presenting with clinically palpable breast nodules which were malignant and results were drawn. All demographic data was summarized as proportion, median, standard deviation and the inferential statistics were obtained using Chi-square and Cramer's V tests. Results: If NLR is less than median (2.03) majority of the cases of carcinoma breast were found to be Stage I i.e.14.8 percent being less than NLR-1.5 and 22.2 percent between NLR -1.51 to 2.0 respectively) or Stage I i.e. 55.5 being less than NLR-1.5 and 44.4 percent between NLR 1.51 to 2.0 respectively), however if NLR was more than median the propensity of Stage III carcinoma breast increases progressively. Conclusion:Increase in neutrophils points towards advanced malignancy as corroborated by higher NLR, thereby making neutrophils and lymphocytes as significant indicators of malignancy in a clinically palpable breast nodule.