Introduction: Lumbar plexus is one of the main nervous pathways supplying the lower limb which is bound to show variations. Clinicians esp. surgeons should be aware of the potential variations to plan the surgical therapies to avoid possible injuries to the structure. Current research aimed to study the formation of the lumbar plexus, observe its branching pattern and its relation with psoas major muscle and to document any variations in the formation and branching pattern. Material and methods: It was an observational study involving 50 dissections from 25 embalmed cadavers were done in the Institute of Anatomy, Madurai Medical College, Madurai, India over a period of 2 years from June 2015-June 2017. Results: Many significant variations were found in the anatomy of the lumbar plexus' branches namely iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous nerve and accessory obturator nerve. Conclusion: Knowledge of the variations in the branching pattern and formation of the lumbar plexus is essential to prevent nerve injury during routine surgical procedures like iliac bone graft, inguinal hernia surgery, low transverse incision of gynecological procedures, etc., The unusual pattern may create confusion in interpretation due to mismatch between symptoms of the patient and the findings in imaging modalities.

Background: Radiation-induced oropharyngeal mucositis is a major problem causing widespread clinical symptoms and may interfere with treatment plans, ultimately jeopardizing patient outcome. Zinc supplementation may be considered beneficial in preventing acute toxicity during chemoradiation. Aims and Objective: The aim of the study is to determine the effect of zinc supplementation on radiation-induced oropharyngeal mucositis in Stage III and IV-A oropharynx and hypopharynx cancers treated by hyperfractionated accelerated concomitant boost radiotherapy with weakly cisplatin. The objective behind the study is to know any changes in the onset, duration, and severity of oropharyngeal mucositis by implementation of oral zinc sulfate. Materials and Methods: The study is double-blinded randomized controlled assessment involving 120 patients (60 – control and 60 – experimental) treated with chemoradiation for oropharyngeal and hypopharyngeal cancers. The experimental group received oral zinc sulfate 150 mg once daily during and after treatment, whereas the control group patients were given placebo. The categorical data were analyzed using the Chi-square test and Pearson correlation. The Friedman test was used for comparison of oral mucositis grading between the groups. Results: A statistically significant difference was found in the zinc-supported experimental group showing delay in onset, decrease in severity, and duration of oropharyngeal mucositis. Conclusion: Zinc supplementation could be beneficial in managing oropharyngeal mucositis during chemoradiation of head-and-neck cancers with no untoward side effects.

Background: The anatomy of the biliary system has been the subject of extended research for many years. Largely because of their surgical importance in cholecystectomies and the ease with which they may be studied. Though, interest has been focused on the extrahepatic bile ducts very few studies have been carried out in the Indian subcontinent. Objectives was to study the anatomical variations in extrahepatic biliary system in sample of Indian cadaveric specimens.Methods: The study material consisted of 20 adult dissection room cadavers and 30 enbloc post-mortem specimens. Cadaver specimens were studied from dissection room. Post-mortem enbloc specimens were collected from the Department of Forensic Medicine, Madurai Medical College, Madurai. They were studied by conventional dissection method.Results: The key abnormalities found in all bladder were Hartman's pouch shape and neck in 2 (4%) subjects each. Gallstones were present in 2 (4%) subject. The length of the common Bile duct was ranging from as short as 6.5 cm in 24% of the subjects to 9cm in 4% of the subjects. High level of the cystic duct union with the common hepatic duct was noted in16% of specimens and in remaining 2% it was low union. Abnormal arrangement of structures in hepatoduodenal duct was normal in 98% but was abnormal in 2% of subjects. A total of 14% of the specimens had accessory ducts. Double and accessory cystic artery was found in 2% of the subjects each.  In 8% of the subjects, cystic artery had abnormal course and division. The right hepatic artery was had shown abnormal course and division in 4% of the subjects. Abnormal boundaries of Calot’s triangle was found in 2% of the subjects. Abnormal contents of Calot’s triangle include Accessory hepatic ducts in 10% of subjects.Conclusions: Anatomical variations of the extrahepatic biliary system are very common and a through an understanding of them is essential for surgeons to avoid damage to vital structures during surgical procedures and better surgical outcomes.

Cervical cancer continues to be one of the most common cancers among females, being the fourth most common after breast, colorectal, and lung cancer[1]. The FIGO 2018 staging system has brought in various pathological and radiological parameters for stage classification to guide treatment related decision making and for better prognostication. OBJECTIVE: The purpose of this study is to analyse the results of stage redistribution by applying 2018 International Federation of Gynecology and Obstetrics (FIGO) staging system for cervical cancer patients in a tertiary care cancer centre, who were previously staged according to FIGO 2009. METHODS: Data of all cervical cancer patients who underwent various forms of treatment at our institute including surgery, radiotherapy and chemotherapy from Jan 2013 to Dec 2016 were collected from the Medical Records Department For this study, we re-staged all patients by the FIGO 2018 staging system RESULTS: The data of patients with carcinoma cervix diagnosed in the 4 years between 2013 & 2016 was tabulated according to both 2009 FIGO staging as well as 2018 FIGO staging. Significant up-staging to Stage IIIC1 & IIIC2 was noted. (Table 1& 2) CONCLUSION: The current FIGO 2018 staging system for cervical cancer appears to be useful for predicting survival in patients considering radiological and pathological variables. As per our study, majority of the cancer cervix patients fall into a single subgroup – III C1; this, in a country were already most patients present with advanced disease, will skew the data further. Stage III C1 cervical cancer is not homogenous; sub classification within stage IIIC1 may result in better prognostication.

BACKGROUNDLaryngeal cancer is a malignancy associated with significant psychosocial consequence as impairment of Laryngeal function from disease and its treatment results in gross disturbances in breathing, speech and swallowing with profound impact on the patient's lifestyle and self-esteem.