Vascular malformations (VMs) are developmental abnormalities of the vascular system. Malformations may involve any segment of the vascular tree: arteries, capillaries, veins or lymphatics. High-flow arteriovenous malformations (AVMs) are associated with shunting of large amounts of arterial blood into the venous system; these lesions can have dynamic and dramatic hemodynamic manifestations, such as massive arteriolisation with gross venous engorgement, organomegaly of concerned anatomical region and high-output cardiac failure. Patients with Parkes Weber syndrome have clinically significant micro- or macrofistulous arteriovenous shunts, affecting usually one extremity. The patient has dilated, frequently visible pulsatile varicose veins and other visible signs of AV shunting. The abnormality is sporadic; it is likely a somatic mutation. There is frequent intraosseous involvement. The presence of high AV shunts differentiates Parkes Weber syndrome from Klippel-Trenaunay syndrome which is a clinical triad of capillary malformation, soft tissue and bone hypertrophy and venous and lymphatic malformations. The mutations in RASA 1 gene leads to Parkes Weber syndrome characterised by the presence of multiple, small (1-2 cm in diameter) capillary malformations mostly localized on the face and limbs. We report a case of congenital AVM of the lower limb causing cardiac decompensation. The patient was safely and successfully treated by performing a knee disarticulation.

Background: Breast cancer is most frequently diagnosed cancer among women and also most common cause of cancer death among women. Early stage detection is still low and is the major reason for poor treatment outcomes in our country. Most of the breast lumps are benign. However, it is important to rule out malignancy. This prospective clinical study is done to evaluate role of triple assessment (clinical examination, mammography and histopathology) in diagnosing breast lump.Methods: All women admitted with the symptoms and signs of breast lump at our hospital were studied in the period of 2 years from July 2014 to June 2016. The findings of physical examination and mammographic examination with histopathological diagnosis were noted n compared.Results: Physical examination of breast lumps is overall less accurate as compared to mammography. There is a tendency to over diagnose malignancy on physical examination. Mammography is more sensitive and specific in the diagnosis of palpable breast lumps as compared to physical examination. Histopathology confirms the diagnosis.Conclusions: It is better to do all three that is clinical examination, mammography and histopathology for all breast lumps diagnosis.

No abstract