Background: Lymphadenopathy is a very common clinical manifestation of many diseases. It is defined as an abnormality in the size of character of lymph nodes, caused by the invasion or propagation of either inflammatory cells or neoplastic cells into the node. The study intends to find out systematically the various pathological conditions presenting with enlarged lymph nodes in the neck, also the various nodes of clinical presentations and behaviors of these conditional.Methods: The clinical material consists of all inpatients and outpatients presenting to department of General Surgery. The study was conducted during the period from January 2017 to June 2018. This study consisted of 50 consecutive cases and diagnosis was made on the basis of clinical and histopathological findings. Patients, in whom FNAC and/or biopsy of enlarged node could not be carried out, were excluded.Results: Out of 50 cases in the study, 76% were non-neoplastic. 44% of the cases were due to tuberculosis. Majority of the cases were in 3rd and 4th decade of age. After swelling in the neck, pain and fever were the most common presentation.Conclusions: In the present study, non-neoplastic accounted for 76% of cases, 44% turned out to be tuberculosis and 30% reactive lymphadenitis. Among the neoplastic lesions, malignant secondaries accounted for 16% while non-Hodgkin’s lymphoma and Hodgkin’s lymphoma accounted for 6% and 2% respectively. In this present study, fine needle aspiration cytology was found to be reliable and cheapest method of diagnosis without any significant morbidity and with good patient compliance.

Introduction: Varicose veins are abnormally dilated veins of lower limbs with defective valves. Incidence involves one out of five in the world and the problem is ever growing due to increasing population, increased life span and change in life style. Hence, there is a need to delineate the epidemiology of the varicose veins in the local population which visited the hospital. Aim: To study the various clinical presentations, management and complications of varicose veins. Materials and Methods: It was a prospective observational study; conducted by the Department of General surgery at Sri Siddhartha Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India from September 2018-February 2020. All 75 patients enrolled were evaluated by detailed history, clinical examination and investigations- venous doppler study of the lower limbs, to locate the site of incompetence. All the cases that underwent surgical procedure were followed postoperatively for any complications every one month for development of surgical site infections, after three months for healing of ulcer and at six months for any signs of recurrence. The collected data was entered in Microsoft Excel spread sheet and analysed using descriptive statistics. Results: The study included 75 cases with primary varicose veins. The age of these patients ranged from 21-69 years. Male to female ratio was 1.5:1. Most of them were farmers (48%) by occupation requiring prolonged hours of standing. All cases presented with dilated veins. The common associated symptoms were pain (50.7%) followed by itching (28%) with slight increased incidence in the left lower limb (50.7%). Majority of the patients have involvement of long sephenous system (81.3%). Majority of them (48%) had combined valvular incompetence. Sapheno-femoral flush ligation with stripping appeared to be the best method of surgical management for incompetence in the long saphenous vein territory. Ten (13.3%) cases had postoperative complications. Conclusion: Varicose veins are a common disease, middle age group, males and occupation with prolonged hours of standing are affected the most. Surgical procedures have beneficial effects in minimising morbidity due to varicose vein.

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Context: Nipple areola complex (NAC) is an essential part of breast reconstruction. It functions as an imperative aesthetic unit for the breast. Numerous surgical techniques to the gamut of NAC reconstruction such as skate flap, star flap, Swiss Roll flap, C-V flap, silicone rods, spiral flap made of residual scar tissue and tissue engineering and many others have been added. Despite the availability of surfeit of techniques, a simple reliable method to maintain nipple projection remains obscure. The purpose of this study was to demonstrate the advantages of Skate flap and tattooing in NAC reconstruction. Methods and Material:The NAC reconstruction Skate flap technique involved marking of the flap design on the patient's breast in afore tattooed scar tissue. Dermal flaps were raised with subcutaneous pedicle and closed with inverted dermal absorbable sutures followed by simple interrupted non-absorbable sutures. After this, full thickness skin graft was used to cover the adjacent donor defect to recreate the areola. The newly constructed nipple was guarded using a syringe barrel. This was done to avert compression on the anew nipple. This was left in place for up to 6 weeks. Surgical outcome was evaluated by recording post-operative complications, nipple projection at intervals and surgical revisions, if needed. Callipers were used to record projection of the nipple at the time of surgery and at 1, 3 and 6 months post-operatively. Results: A total of 26 NAC reconstructions in 19 post burn breast patients were performed over duration of 18 months employing Skate flap and tattooing. Mean nipple projection at time of surgery was 6.77 mm and 4.66 mm at end of 6 months follow up. There was a mean net projection loss of 31% at the end of 6 months post-operatively. Overall patient satisfaction on the outcome of reconstruction was generally favourable. No post-operative complications were noted. Conclusion: The study shows that the use of a Skate flap is a safe, easily performed, reliable and reproducible technique for maintaining projection in reconstructed nipples for a long period. Using the burnt scarred tissue helps in achieving excellent projection since contracture is somewhat lessened and also a more aesthetically pleasing nipple reconstruction is achieved matching the surrounding topography.