Background: Study aimed at assessing the impact of elevated fluoride from drinking water on thyroid gland structure and function in fluorosis prone areas. Iodine is incorporated in the thyroid synthesis by thyroid gland but in the presence of low Iodine levels fluoride is likely to interfere with the concentrating capacity of thyroid of iodine in thyroid production, consequently reflecting changes in thyroid parameters and also cytomorphological features manifesting hypothyroidism in association with different pathological entities.Methods: Prakasam district in Andhra Pradesh is fluorosis prone zone and subjects are picked up from highly vulnerable zone in this district and their specimens are collected to study cytomorphological changes of the thyroid gland and biochemical parameters of blood samples for thyroid function test were considered. Cytological study by way of Fine Needle Aspiration Cytology (FNAC) of thyroid gland, biochemical parameters pertaining to function of thyroid gland namely Free triiodothyronine (FT3), Free Thyroxine (FT4) and Thyroid stimulating hormone (TSH) were assessed in the subjects from fluorosis prone zone.Results: The results were statistically significant with concurrent association of different cytological alterations of thyroid gland in these subjects like Hashimoto’s thyroiditis of hypothyroidism, adenomatous goitre, colloid goitre and few of follicular adenoma/neoplasm. FNAC makes cytological changes evident showing different morphological features that comprise different pathological entities largely with an evidence of hypothyroidism in most of the cases in the given study.Conclusions: The results of the study strongly suggest assessing the magnitude of the problem of fluorosis and also magnitude of its influence on thyroid structure and function that warrants assessment of the thyroid function by biochemical and cytological studies.

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Acute appendicitis is sudden inflammation of the appendix, usually initiated by obstruction of the lumen. This results in invasion of the appendix wall by gut flora, and it becomes inflamed and infected.: To investigate retrospectivelythe prevalence and implications of unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis.This is retrospective assessment of hospital records of 150 patients who were diagnosed as acute appendicitis and underwent appendicectomy during March 2018 to February 2020 at Government Medical College, Bhagya Nagar, Ongole, Andhra Pradesh .Data of the patients were assessed based on age, sex, histopathological diagnosis, coexisting pathologies and uncommon findings on histology. According to histopathology report, negative for acute appendicitis were noted in 82 cases (55%), whereas positive for acute appendicitis in 68 cases (45.3%) . Rare findings were foundin 38 (55.8%) cases out of 68 cases. Parasites were found in 7 (18.4%) (Enterobius Vermicularis, Balantidum Coli, Schistosoma Haematobium), Mucocele in 12 (32%), carcinoid tumour in 8(21%), B cell malignant lymphoma in 2 (5%), leiomyoma in 2 (5%), Primary appendiceal adenocarcinoma in 3 (8%), Acute appendicitis with dysplastic changes in 2 (5%) and inflammatory bowel polyp was reported in remaining two cases(5%).: Even though unusualpathologies can be seen rarely during appendectomy, this should be kept in mind for further evaluation of each cases.

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