Study of diagnostic importance of fine needle aspiration cytology in various body lesions in a predominantly rural mountainous region of Jammu and Kashmir, G.M.C Doda, India

Background: Fine Needle Aspiration Cytology (FNAC) is a procedure of choice as the first line of investigation in diagnosing non-neoplastic and neoplastic swellings of different areas as it has been found to be highly accurate and very useful, cost effective, offer early diagnosis after presentation and  treatment. In this present study in Department of pathology, data was collected and scrutinized. Cytology of various sites including breast, head and neck, salivary glands, thyroid, lymph nodes, etc. was done.Methods: FNAC is performed with the help of 21-22-gauge needle attached with 20 ml syringe by taking all aseptic precautions. Total of 70 cases were collected over a period of 4 months from April 2019 to July 2019.Results: Out of total 70 samples maximum number of cases were found in 21-30 years of age (16 cases); Males were 34(49%) and females were 36(51%) in number. 38 cases (54%) were non-neoplastic ,23 cases (33%) were neoplastic and in 9 cases (13%) no opinion was made. This study included 70 cytologically diagnosed cases. Out of which 38 cases (54%) were non-neoplastic, 23 cases (33%) neoplastic and in 9 cases (13%) no possible opinion could be made due to a number of factors like: Material not corresponding of representative area, small size of lesion, wrong technique, cystic areas, hemorrhage and necrosis and small foci of neoplastic lesion.Conclusions: Even though a number of limitations, FNAC has high accuracy in diagnosing benign and malignant lesions of various sites and thus reduces the period between presentation of tumours and their diagnosis which results in early management

Giant pleomorphic adenoma of submandibular salivary gland: a case report

The most common benign salivary gland tumor is the pleomorphic adenoma (PA). They can attain grotesque proportions and weigh several kilograms. They can cause facial disfigurement and, if untreated, could lead to airway compromise. Authors report a case of a large PA arising from the right submandibular salivary gland in a 48-year-old male. The lesion measured 9cmx8cmx5cm

Pilonidal sinus: excision and primary closure over suction drain and its outcome

Background: Pilonidal sinus is a chronic inflammatory disease predominantly involving Sacrococcygeal region. Despite advances in medical sciences, management of pilonidal disease is still not well defined. Treatment varies from simple techniques to more sophisticated surgeries with their own pros and cons. Methods: This prospective observational study comprised of forty-two patients who underwent the surgery for pilonidal sinus as per the procedure described. This study was carried from 1 May 2019 till 30 November 2022. Median age of the patients was 24.5 years, ranging between 19-32 years. Sinus discharge was the predominant symptom of our study population with 34 patients (80.94%) complaining of same. Results: Mean operative time was 54 minutes with a range of 45-78 minutes. Average hospital stay was 1.8 days though it ranged from 1 to 3 days. Five patients (11.90%) developed seroma while four patients (9.52%) had superficial wound site infection. We had two recurrences (4.76%) over the follow-up period of 1 year. Conclusions: Excision and primary closure of the pilonidal disease is effective with comparable complication rates and shorter time off work. The surgery can be easily performed

Enhanced Recovery after Surgery (ERAS) in Patients Undergoing Colorectal Surgeries

Abstract Enhanced Recovery after Surgery (ERAS) is a collection of strategies that combine in a structured pathway allowing the surgical and anaesthetic teams to decrease the physical insult and aid recovery enabling earlier discharge. 222 patients undergoing elective colorectal surgery -106 cases and 116 controls were included in a prospective comparative study done over a period of two years. Patients were matched for age, gender, co-morbidity, type of disease, American Society of Anesthesiologists (ASA) grade, type of surgery and stoma formation. Primary outcome measures of this study were length of hospital stay, mortality and morbidity. Secondary outcome measures were early oral feeding, return of bowel functions and number of readmissions within 30 days. Mean post-operative hospital stay was 4 days for patients in ERAS group compared to 8.7 days for the control group. There was no significant difference between the ERAS and control group for morbidity (22.6% Vs 31.1%; P = 0.16) and mortality (0% Vs 0.86%; P > 0.05). Regular feeding was tolerated much earlier in ERAS group (3days Vs 7days; P = 0.00). Bowel functions returned earlier in ERAS group (2.9 days Vs 5.3 days; P = 0.00). Readmission within 30 days of discharge was higher for ERAS group (6.6% Vs 0%; P = 0.05). Treatment of colorectal surgery patients according to an enhanced recovery after surgery programme leads to faster recovery and shorter hospital stay. Principles of ERAS programme are applicable and will be most beneficial for the patients