Background: Anaemia is the most common problems encountered by clinicians in Hadoti Region. The affected population includes male, female as well as children. Over the last two decades, it has been found that incidence of megaloblastic anaemia is increasing. Folic Acid and Vitamin B12 deficiency are the most common cause of megaloblastic anemia. Of these two micronutrients, Vitamin B12 deficiency is more common now, due to vegetarian life style of people. At present, Anemia control or prophylaxis program give only Iron and Folic acid. This study has been chosen to focus on this issue. The cases for increasing incidences of Folate / Vit. B12 deficiency needs to be elucidated.Objectives: To focus on the incidence of megaloblastic anaemia in Hadoti Region. & Probable Causative factors will be analysed Methods: All patients presenting to our hospital over a period of 2 months with a haemoglobin <10 g/dl and peripheral smear findings consistent with megaloblastic anaemia will be included in the study. Diet, drug intake, previous blood transfusion, presenting symptoms and other relevant history will be taken into consideration. Complete blood counts, peripheral film examination, reticulocyte count and cobalamin and folate assays will be recorded. Patients with chronic disease like renal disease, cancer, tuberculosis, liver disease etc will be excluded from the study. All data will be collected and evaluated statistically. Result:In the present study, total 500 patients who were admitted in medicine, paediatric and gynaecology ward were evaluated. All these patients met the inclusion criteria. Depending on the MCV value, serum assay and peripheral smear finding, they were categorised into 3 groups-Macrocytic, normocytic and microcytic anaemia. The normal MCV value but with megaloblastic blood film or low serum markers were considered into macrocytic anaemia. Total 100 patients were diagnosed as macrocytic anaemia. The sex distribution were-70(male), 30(female). Fifty five per cent of patients with cobalamin deficiency and 08% of patients with folate deficiency were found. All the patients were vegetarian and from middle class and low socio economic group. Conclusion:Cobalamin deficiency was responsible for megaloblastic anaemia in the majority of our patients. The supplementation program for Anemia control and prophylaxis should vary according to the regional requirements. Vitamin B12 should be included in the nutritional programme along with iron and folic acid. Awareness camp and Education program about megaloblastic anemia can be implemented for the prevention.

Introduction: Pregnancy associated breast cancer is defined as "The diagnosis of breast cancer is made during pregnancy or within one year afterward." The incidences of breast carcinoma are 1 in 3000 pregnancy in west. Risk is increasing because of increased number of late pregnancies. Young age, lactating breast (dense) and paucity of incidences not only delay but confuse the pathologist for accurate diagnosis.Case Report: A 28 year lactating female with 2 months old baby, presented with breast lump. Lump was mobile, non-tender and of size 2x1 cm since 3 months and gradually increasing in size. On USG, it was benign. On FNAC, aspirate was milky mixed with blood, showing monotonous cells with abundant cytoplasm, bland nuclei in a secretary background. Final diagnosis was lactational changes in breast. After six months, lady came back with previous lump which was increased in size up to 6X5 cm. On FNAC, smear was having bizarre cells, reported as malignant and confirmed on histopathology. Patient was responded to chemotherapy and lump reduced in size. Conclusion:Pregnancy associated breast cancer is on rise. High grade of suspicion and complete evaluation including trucut biopsy will lead to correct diagnosis.

Head and neck cancer constitute one of the most common cancer in India. Unlike western, it is associated with trismus and submucosal fibrosis in indian patients which makes the treatment more difficult. Irrational and inappropriate treatment leads to higher recurrence and mortality rate in India.