INTRODUCTIONMastalgia, or breast pain, is a common complaint that may affect up to 70% of women in their lifetime.1 It is not unusual for women to have 2-3 days of mild breast pain premenstrually but 8-30% of women report moderate to severe breast pain with duration of 5 or more days each month.2 Fifteen percent of women who present to a breast clinic with mastalgia will require treatment. 3Breast pain is classified as cyclical mastalgia, noncyclical mastalgia and non-specific extra-mammary pain. Cyclical mastalgia is a breast pain that has clear relationship to the menstrual cycle. Non-cyclical ABSTRACT Background:The aim of the present study is to observe the clinical profile and management of mastalgia. The objectives of the present study were to assess the clinical profile of breast diseases causing mastalgia, to study the response of mastalgia to the following three drugs: Danazol, Bromocriptine, topical non-steroidal anti-inflammatory drugs (topical diclofenac gel). Methods: It was prospective type of study. Inclusion criteria: Patients of age group 15-50 years, all patients suspected or diagnosed for breast pathology with mastalgia. Exclusion criteria: immune-compromised patients, all patients undergoing surgical removal of breast lump, pregnant females. Evaluation of pain was done using visual analog scale, prior to giving the treatment and after giving the treatment each week for the first month and thereafter monthly for the next 6 months. Results:The clinical profile of mastalgia was as follows: fibroadenosis accounting for 37 (46.25%), followed by 10 (12.5%) cases of fibroadenoma, 08 (10%) cases of mastitis, 06 (7.5%) cases of breast abscess, 03 (3.75%) cases of duct ectasia, 02 (2.50%) cases of galactocoele, 02 (2.50%) cases of breast carcinoma and 12 (15%) cases of nonspecific extra-mammary pathology. Patient's response rate to different drugs included in the study was: 64.8% to danazol, 56.9% to bromocriptine and 76.01% to topical diclofenac gel. Conclusions: Cyclical mastalgia accounted for more proportion of patients than non-cyclical mastalgia. Common causes of mastalgia being fibroadenosis, followed by fibroadenoma, mastitis, breast abscess, duct ectasia, galactocoele, breast carcinoma and non-specific extra-mammary pathology. Danazol and bromocriptine are effective in treatment of mastalgia, though they show different side effect profiles and varying patient compliance.

Background: Ventral hernias are defined as a protrusion of abdominal contents through the abdominal wall muscle. It can be categorised as spontaneous or acquired or by their location on the abdominal wall like epigastric hernia, umbilical hernia, para umbilical hernia etc. This original article reveals that laparoscopic trans abdominal pre peritoneal (TAPP) mesh placement for ventral hernia usually follows the current principle of hernia surgery and give better results from open pre peritoneal ventral hernia repair.Methods: A prospective study conducted in Dr. D. Y. Patil Medical College and Hospital, Pune for the period of 2017-2019 comparing laparoscopic TAPP vs. open preperitoneal ventral hernia repair. Total of 25 patients for laparoscopic TAPP repair and 25 patients for open preperitoneal repair were compared.Results: Total 50 cases were studies in which 25 for laparoscopic and 25 for open repair. Majority of patients were female than males. Incidence of para umbilical (56%) was found to be more. Intra operative, post-operative complications were found to be more in open repair than laparoscopic TAPP repair.Conclusions: Laparoscopic TAPP ventral hernia repair is safe with fewer complications. Therefore, offers successful treatment for ventral hernia repair with added benefits of laparoscopy such as better visualization and magnification of the hernia defects which are not clinically apparent and less chances of injury which is not possible by open technique. Laparoscopic TAPP ventral hernia repair gives equal results in terms of recurrence and less complications than open ventral hernia repair.

Background: An association between hiatus hernia and cholelithiasis has been suspected for a long time but has never been adequately documented. Cholelithiasis is an asymptomatic disease. The precise incidence of hiatus hernia is not known. In current era as the practise is getting result oriented not diagnosing Hiatus hernia and persistence of symptoms is considered as failure in case of surgery. Coexistence if diagnosed preoperatively is of great help in management of the patient. The purpose of the study is to study association of Hiatus hernia with cholelithiasis in patients with dyspepsia.Methods: This is a prospective study conducted in DR. D. Y. Patil Medical College, Pune, Maharashtra for a period of two years. 100 patients of dyspepsia were enrolled in the study. All patients of dyspepsia were subjected to USG- abdomen. Patients were divided into diagnosed cholelithiasis (A) and non-cholelithiasis (B) as per USG findings. Both groups were subjected to upper gastro intestinal scopy. Appropriate statistical method was applied to know the incidence of hiatus hernia in cholelithiasis and non -cholelithiasis patients. Comparison was done to know the association between hiatus hernia and cholelithiasis in the patients with dyspepsia.Results: Total 24% patients had both hiatus hernia and cholelithiasis. Whereas 23% patients had neither hiatus hernia nor cholelithiasis on applying chi-square, p-value is 0.58. This is statistically insignificant.Conclusions: There is no obvious association between hiatus hernia and cholelithiasis in patients with complains of dyspepsia.