BACKGROUNDBreast lumps are showing a rising trend nowadays. Heightened anxiety associated with breast lump and its classification into benign and malignant is necessary. Seeing the burden of disease and rising trend of malignancy, our study aimed to document the spectrum of breast lump at Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna.Aims and Objectives-Breast lumps are quite common, but the principal issue is differentiating malignant from the benign subgroups. The determinants of histologic diagnosis are multifactorial, ranging from environmental, genetic to sex and age-related factors. This study aimed to document the spectrum of breast lumps in our environment. MATERIALS AND METHODSThis is a descriptive prospective analysis of consecutive breast lumps biopsied at Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna between December 2015 and November 2016. The data were analysed using statistical package for social sciences (SPSS) version 22.0. RESULTSA total of 200 patients with 220 breast lumps were seen, 198 females and 2 males giving male: female ratio of 1: 99. The ages of the patients ranged between 16 -82 years with a mean of 37.0 +/-SD 13.0. Majority (59.6%) of the patients had benign lumps. Fibroadenoma was the commonest (35%), followed closely by invasive ductal carcinoma (14.4%) and then fibrocystic change (5%). The occurrence of breast cancer was strongly age-related, being 1 in 5 biopsies at 20 -29 years and 3 in 5 biopsies at 40 -49 years' age groups. Over two-third patients with breast cancers were premenopausal. CONCLUSIONMost patients with breast complaints present with lumps and majority are benign, fibroadenoma being the commonest histology. Occurrence of breast cancer is strongly age-related with majority of cancer patients presenting late.

BACKGROUNDEnteric perforation is one of the most frequently encountered acute surgical emergency in Northern India and always warrants operative intervention. But the kind of intervention, whether primary repair or ileostomy is a contentious issue. MATERIALS AND METHODS120 cases of ileal perforation were studied in retrospective manner from August 2015 to July 2016 to gather information on demographic profile, clinical presentation and laboratory data. Details were obtained for operative findings and kind of operative intervention done and postoperative course of the patients. Based on the kind of operative intervention received, patients were divided into four groups. RESULTSIleal perforation occurred in young males (age 29.2 ± 7.9 years). Male [M] Female [F] ratio has been found to be M: F, 2.33: 1. In our study 60% of patients had Widal positive supporting typhoid aetiology; 50% of patients underwent primary closure, while 30% underwent ileostomy. Nature of clinical presentation, laboratory data and operative findings in both groups has been analysed. CONCLUSIONWe have carried out this study to label some of the preoperative and intraoperative factors, which can serve as a guideline for decision making in operative intervention in a specific patient. KEYWORDSIleal Perforation, Ileostomy, Primary Closure, Typhoid. HOW TO CITE THIS ARTICLE:Yashaswi YK, Bhushan V, Prakash P, et al. A descriptive study of surgical management of ileal perforation.

BACKGROUNDDiabetes is the most common non-communicable disease globally. Awareness of mucocutaneous manifestations may lead to recognition of yet undiagnosed DM. MATERIALS AND METHODSIt is a descriptive and observational study conducted on 75 diabetic patients. Investigations performed included urine for sugar, protein, fasting and post prandial blood sugar, blood urea, serum creatinine, lipid profile, liver function test and ECG. Special investigations like culture and sensitivity of pus, skin scrapings for fungal infections and biopsy of skin lesion was done in selected cases. Analysis was carried out using SPSS 10. RESULTSOf 75 patients examined, 60 patients (80%) suffered from cutaneous lesions. Some patients suffered from more than one lesion; 50% of total cases suffered from infections. Diabetic dermopathy in our study was observed in 20% of the patients. Some of the cutaneous markers of diabetes mellitus like necrobiosis lipoidica diabeticorum, diabetic bullae, acquired perforating dermatosis and stiff skin syndrome is not seen in our study. CONCLUSIONThis study was done to highlight the importance of association of cutaneous lesions and diabetes mellitus. KEYWORDS BACKGROUNDDiabetes is the most common non-communicable disease globally. It is estimated that nearly 380 million adults worldwide will have diabetes by 2025. Diabetes among adults has reached approximately 20% in urban populations and 10% in rural population. It may be due to genetic defect, autoimmunity, defect in the formation of insulin or decreased insulin sensitivity. It may occur at any age, but greatest number of individuals with Diabetes was aged 45 -64 yrs. 1 DM increases with ageing. Prevalence is slightly greater in men than female. Risk factors are changes in lifestyle like diet, lack of dietary fibres, sedentary lifestyle, alcohol and stress. 2 The cutaneous signs are the manifestations of multiple factors. Abnormal carbohydrate metabolism, other altered metabolic pathways, atherosclerosis, microangiopathy, neuronal degeneration and impaired host mechanism all play an important role. 3 Cutaneous involvement has been found in 43% -66% of diabetic patients approximately. 3 This study was done to highlight the importance of association of cutaneous lesions and diabetes mellitus.

BACKGROUNDInfection is an important cause of morbidity and mortality in post-operative patients. Frequently emerging multidrug resistance and difficulty in curing patients with medications necessitates such study. Surgical Site Infections (SSI) are defined as infections that occur at the incision site within thirty days after surgery.The objectives of the study were to determine the pattern of pathogens involved and their antibiotic sensitivity isolated from superficial surgical site infections. MATERIALS AND METHODSThis is an observational study that was conducted for 6 months. Pus culture and sensitivity reports were collected prospectively from hospitalised patients who developed postoperative wound infections. The patients who developed faecal/biliary/urinary fistula or operated for malignancies and with negative cultures were excluded from the study. Analysis was carried out using SPSS 10. RESULTSDuring the study period 60 patients were analysed, E. coli 36 (60%) is the most common isolate in our study followed by 12 (20%) Klebsiella. Staphylococcus epidermidis is the least commonly found isolate, 1 (1.7%). All isolates were sensitive to penicillin derivatives and carbapenem. Quinolones, Aminoglycosides and Monobactams were also showing some promise in our study. However, Cephalosporins were ineffective against most of the important isolates in our study. CONCLUSIONThere was compelling evidence that Cephalosporins were ineffective against the common pathogens causing SSI and it is time for surgeons to court 'new' antibiotics effective against today's pathogens for both prophylaxis and empirical therapy.