Background: Fine needle aspiration cytology (FNAC) is a sensitive and specific and yet an economically effective technique for diagnosis of salivary gland lesions. FNAC of salivary glands has achieved a pivotal role in the diagnosis and management of salivary gland lesions since its induction by Stewart et al in 1933. However, it has always been under scrutiny when compared to histopathology. Histopathology of salivary gland lesions is still the final method to establish diagnosis and predicting prognosis in these lesions.1Methods: A prospective observational study of 50 patients with salivary gland lesions was done at Gauhati Medical College and hospital from June 2011 to May 2012. 39 patients underwent histopathological confirmation. Cases with histopathological correlation were included in calculating diagnostic accuracy. The cytological findings were correlated with that of the histopathological diagnosis to obtain the accuracy of the cytological diagnosis. The parameters of diagnostic validity of the cytological technique in terms of sensitivity, specificity and predictive value were evaluated.Results: Study population included patients of age group ranging from 13-70 years with median age group being 31-40 years (30%). 54% of the affected patients were male with the parotid being the most commonly involved gland (62%). Neoplastic lesions constituted the major bulk of the lesions (39 cases, 78%) with benign tumours constituting 54%. The most commonly involved benign neoplastic lesion was pleomorphic adenoma (22cases, 44%). Among the non-neoplastic lesions (22%), the acute sialadenitis was frequently noted. Histopathological correlations were available in 39 cases with 11 cases being the malignant lesions. The acute sialadenitis lesions did not undergo histological examination. 28 cases of non-malignant lesions underwent the histological confirmation. In the present study, the specificity and the sensitivity were found to be 96.42% and 90.91% respectively. The predictive value of salivary gland cytology was 90.91% and diagnostic accuracy was 94.87%.Conclusions: Fine Needle Aspiration Cytology is thus a safe, reliable, quick, convenient and accurate method of diagnosis and should be considered as one of the first line of investigations in the evaluation of salivary gland lesions.

Lymphangiomas are uncommon benign malformations that can occur anywhere in the body. These are hamartomatous malformations with lymphatic differentiation, which uncommonly involve the abdomen and rarely the pancreas. The size of the cysts in pancreatic lymphangioma directly correlates with the clinical manifestations; however, most of them are non-specific. Preoperative diagnosis is challenging because conventional imaging examinations like an abdominal ultrasonogram (USG), computed tomography, or magnetic resonance imaging cannot distinguish pseudocyst, mucinous cyst neoplasms, simple cyst, intraductal papillary mucinous neoplasms, and serous cystadenoma. We are presenting a rare case of pancreatic lymphangioma where the definitive diagnosis was made postoperatively in histopathological examination. A female patient aged 27 years presented to the Surgery outpatient department with a slow-growing abdominal lump of 9 months duration. Clinical examination revealed large, non-tender, soft cystic swelling occupying the entire upper abdomen. Radiological imaging showed a large multiseptated cystic lesion occupying almost the entire abdomen and adhered to the pancreas with mass effect. USG-guided fine-needle aspiration revealed straw-colored aspirate with mature lymphocytes. On exploration, there was a large multiloculated cyst occupying the whole abdomen. Cysts were decompressed, and the entire lesion was excised. Final histopathological examination showed unremarkable pancreatic tissue with attached lesion consisting of dilated lymphatic spaces with lymphatic follicles.

Background: Despite negative recommendations, routine preoperative testing practice is nearly universal. Our aim is to bring the healthcare providers on one platform by using information-technology based preanaesthetic assessment and evaluate the routine preoperative testing’s impact on patient outcome and cost. Methods: A prospective, non-randomised study was conducted in a teaching hospital during January 2019-August 2020. A locally developed software and cloud-computing were used as a tool to modify preanaesthesia evaluation. The number of investigations ordered, time taken, cost incurred, were compared with the routine practice. Further data were matched as per surgical invasiveness and the patient's physical status. Appropriate tests compared intergroup differences and p-value <0.05 was considered significant. Results: Data from 114 patients (58 in routine and 56 in patient and surgery specific) were analysed. Patient and surgery specific investigation led to a reduction in the investigations by 80-90%, hospital visit by 50%, and the total cost by 80%, without increasing the day of surgery cancellation or complications. Conclusion: Information technology-based joint preoperative assessment and risk stratification are feasible through locally developed software with minimal cost. It helps in applying patient and surgery specific investigation, reducing the number of tests, hospital visit, and cost, without adversely affecting the perioperative outcome. The application of the modified method will help in cost-effective, yet quality and safe perioperative healthcare delivery. It will also benefit the public from both service and economic perspective.

Objective To evaluate the factors associated with mortality of a multicentric cohort of hospitalized COVID-19 patients, 0–18 y old, from 42 centers across India. Methods The National Clinical Registry for COVID-19 (NCRC) is an on-going prospective data collection platform enrolling COVID-19 patients diagnosed by real-time PCR or rapid antigen test. The data are collected in prestructured e-capture forms. The sociodemographic, clinical, laboratory, and hospital outcome data from 1 st September 2020 to 20 th February 2022 were analyzed. Results Of the 1244 enrolled hospitalized COVID-19 patients aged 0–18 y, 98 and 124 were infants and neonates, respectively. Only 68.6% children were symptomatic at admission, with fever being the most common symptom. Diarrhea, rash, and neurological symptoms were also noted. At least 1 comorbidity was present in 260 (21%) children. The in-hospital mortality rate was 6.2% ( n = 67), the highest in infants (12.5%). Altered sensorium (aOR: 6.8, CI: 1.9, 24.6), WHO ordinal scale ≥ 4 at admission (aOR: 19.6, CI: 8.0, 47.8), and malignancy (aOR: 8.9, 95% CI: 2.4, 32.3) were associated with higher odds of death. Malnutrition did not affect the outcome. Mortality rates were similar across the three waves of the pandemic, though a significant shift towards the under-five group was observed in the third wave. Conclusion This multicentric cohort of admitted Indian children showed that the COVID-19 was milder in children than adults, and the pattern was consistent across all waves of the pandemic. Supplementary Information The online version contains supplementary material available at 10.1007/s12098-022-04449-w.

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