INTRODUCTIONThe pancreas is a glandular organ in the digestive system and endocrine system of vertebrates. It is an endocrine gland producing several important hormones including insulin, glucagon, somatostatin and pancreatic polypeptide which circulate in the blood. The pancreas is also a digestive organ secreting pancreatic juice containing digestive enzymes that assist digestion and absorption of nutrients in the small intestine. These enzymes help further breakdown of carbohydrates, proteins and lipids in the chyme.Pancreatitis has been recognized since antiquity but the importance of pancreas and the severity of its inflammatory disorders were realized only in middle of 19th century.1-3 Acute pancreatitis (AP) is a common condition involving the pancreas. The estimated incidence is about 3% of cases presenting with pain in abdomen.4 Gall stones and alcoholism together account for 80% of acute pancreatitis.5 Although the overall mortality rate for acute pancreatitis is 2-10%, this is related primarily to the 10-30% of patients with severe disease characterized by pancreatic and peripancreatic necrosis. 6 Chronic pancreatitis (CP) is a chronic exocrine part inflammation which is accompanied by organ ABSTRACT Background: Pancreatitis has been recognized since antiquity but the importance of pancreas and the severity of its inflammatory disorders were realized only in middle of 19 th century. Pancreatitis by itself is a disease which is unique, protean and extrudes into the diagnostic arena. Objectives of the study was to study the demographic characteristics of pancreatitis, and to study the various etiological factors of pancreatitis, and to study the clinical presentation of pancreatitis and its management. Methods: Total 142 patients were enrolled over a period of 3 years for the study. Cases were studied with reference to clinical history and physical findings. Treatment was planned according to the severity of pancreatitis and presence or absence of complications with either conservative or surgical methods. Patients were followed up for 6 months to look for recurrence or complications developing after discharge. Results: 92.25% patients were male. Highest incidence was noted in 20-40 years age group (mean-38.94 years). More common among unskilled workers. Alcohol was the most common cause (78.17% patients). Abdominal pain and epigastric tenderness being the most common mode of presentation. Most of the patients were managed conservatively. Duration of hospital stay for most of the patients was 4 to 9 days. Fluid collection in abdomen was the most common complication of pancreatitis. Conclusions: Acute pancreatitis is a common cause of acute abdomen in patients presenting to the surgical emergency department. The management is mainly conservative with surgery limited to only a few selected cases, depending upon the severity of the disease.

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Breast cancer is the leading malignancy and the second leading cause of cancer-related deaths. Axillary lymph node status is a very important prognostic factor in breast cancer patients; nodal evaluation is therefore a critical part of breast cancer management. Axillary lymph node dissection results in significant morbidity. Sentinel lymph node biopsy (SLNB) is being used in many centers to stage the axilla in planning axillary dissection management of patients and hence plays an important part in reducing morbidity among patients with carcinoma breast. The objectives of this paper is to study the (1) efficacy of sentinel lymph node biopsy in detecting axillary metastasis, (2) location of sentinel lymph node in the axilla, (3) rate of involvement of sentinel lymph nodes, and (4) incidence of skip metastasis. Thirty-five patients with breast cancer with clinically node-negative axilla were selected for the study. Methylene blue dye was injected intralesional and perilesional 20 min prior to surgery. All patients underwent modified radical mastectomy with sentinel lymph node biopsy and axillary dissection and after pathological examination diagnostic statics, namely sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were computed. Sentinel lymph node was identified in all of these patients. Sixty percent patients had pathologically positive lymph nodes in the axilla. 90.48% patients of these had sentinel lymph nodes positive for malignant cells. Incidence of skip metastasis is 9.52%. 88.57% patients had sentinel lymph node mapped to level I lymph nodes. Sensitivity of SLNB is 90.48%, specificity is 85.71%, PPV of is 90.48%, NPV is 85.71%, and accuracy is 88.57%. Sentinel lymph node biopsy is an effective method of staging the axilla and deciding on axillary clearance in patients of carcinoma breast. Unnecessary axillary dissection and associated complications can be prevented in most of patients due to sentinel lymph node biopsy.