Background: Of the many scoring systems currently available, the modified Alvarado scoring system (MASS) is the most widely employed, because of its ability to reduce negative appendectomy rate (NAR). Unfortunately, this system is more accurate in western population. In spite of the advances in the diagnostic and imaging techniques NAR have not decreased much. This clearly indicates the need of development of new diagnostic scoring system so we have developed new diagnostic scoring system (Yash Score). The objective of this study was to develop and study diagnostic accuracy of new diagnostic scoring system (Yash scoring system) for acute appendicitis.Methods: A prospective comparison YSS and MASS was done on 418 patients. Depending on clinical judgement appendicectomy was done. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy for YSS and MASS were calculated using SPSS 17.0 statistical software for statistical analysis and compared using Chi-square test.Results: The sensitivity and specificity of YSS was found to be 99.48 per cent and 92.86 percent respectively. The sensitivity and specify of MASS was 52.05 per cent and 100 per cent respectively. The positive predictive value and negative predictive value of YSS was 99.48 per cent and 92.86 per cent respectively. Negative and positive predictive values of MASS were 13.02% and 100% respectively.Conclusions: Comparison in between YSS and MASS in the present study shows significant statistical difference.

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Splenic Hydatid Cyst is a very rare presentation with less than 5% of total incidences of Cystic Echinococcosis. It is usually due to spread of cysts from other regions leading to secondaries. Primary isolated splenic hydatid cyst without involvement of any other organs is even rarer. We report an unusual case of a female who presented as Abnormal Uterine Bleeding (AUB) with an incidental finding of Isolated Splenic Hydatid Cyst with absence of involvement of any other organ. Patient underwent laparotomy and total splenectomy was done. This case report targets to report a rare case of incidental finding of isolated unilocular hydatid cyst of spleen and describes its management.

BACKGROUND At present, the ideal treatment of patients diagnosed to have carcinoma breast includes multimodal treatment therapy. However, the sequence of various modalities in the treatment of breast cancer varies according to the stage of the tumour at the time of presentation. Early breast cancer cases first undergo surgical treatment modality before systemic therapies, while advanced cases should undergo systemic therapies first followed by surgical interventions if possible. However, treatment of stage IIIA and IIIB patients (locally advanced disease) but having an operable lump poses a dilemma of whether to go for surgery first or systemic therapy first. We wanted to compare the outcome in terms of metastasis/recurrence between adjuvant and neo-adjuvant chemotherapy in selected cases of stage IIIA and stage IIIB carcinoma breast for a follow-up period of 1 year at a tertiary care hospital in central India. METHODS This is a comparative observational study conducted at Acharya Vinoba Bhave Rural Hospital (AVBRH) of Jawaharlal Nehru Medical College from October 2017 to Sept 2019, which included patients of TNM stage IIIA and IIIB breast carcinoma, half of whom were treated with adjuvant chemotherapy and other half treated with neoadjuvant chemotherapy along with standard surgical procedure like MRM/toilet mastectomy. RESULTS Distribution of patients according to presence of lymphovascular Invasion was done which was statistically non-significant. However, when disease recurrence or disease metastasis/mortality was compared with lymphovascular invasion in neoadjuvant group, it was found to be statistically significant (p value=0.022) In the adjuvant group 90 % of patients belonged to stage IIIA while in neo-adjuvant group only 50 % patients belonged to stage IIIA. Rest patients in both group belonged to stage IIIB. This difference in adjuvant and neo-adjuvant group was statistically significant. (p=0.022) In comparison of outcome in both adjuvant and neo-adjuvant chemotherapy, 5% patients of adjuvant group developed metastasis and died succumbing to it while another 5 % developed recurrence during follow up. In the neo-adjuvant group 35% patients developed distant metastasis or died due to disease while another 5 % patient developed local recurrence in axilla for the disease. This difference in the outcome of two groups was statistically significant with p value of 0.013. CONCLUSIONS In our study we found that for a locally advanced breast cancer patient (stage IIIA &B) with an operable breast lump, adjuvant chemotherapy is superior than neoadjuvant chemotherapy with a significant p value of 0.013. Superior in terms of lesser distant metastasis/recurrence when we followed up the patient for 1 year after the completion of treatment.

Introduction: Chronic wound and its care has always been a health burden for patient, health care professionals and the entire health care system. There have been certain topical preparations available in market today for application in chronic wound management. In our study, we are comparing effects of cadexomer and povidone iodine ointment in context of reduction in bacterial overload, slough reduction, facilitations of granulation tissue formation, reduction in size of the wound and ultimately in percentage of wound healing and its cost of management. Aim: Comparison of outcome of Povidone Iodine Ointment and Cadexomer iodine Ointment in management of the wound. Methodology: This cross section observational study has been conducted among 40 patients diagnosed as chronic wound with 20 patients in each group. Student’s paired t-test and Pearson’s Correlation Coefficient is being used as statistical analysis. Results: The percentage of patient treated with cadexomer iodine ointment shows significantly (p<0.05) higher rate of wound healing along with significant reduction in bacterial overload and promotion of granulation tissue formation. Conclusion: Cadexomer as a vector with iodine ointment shows higher rate of reduction of biofilm, slough and debris with better rate of promotion of granulation tissue formation, thus leading to increased and effective rate of healing of wound as well as cost effective management of chronic wounds.