Background: This is a prospective study aimed at evaluating patients presenting with breast related complaints at Dr. D.Y. Patil Medical College, Pimpri, Pune. It outlines various clinical patterns in benign breast disorders; this includes age, type of presentation, side and quadrant of breast involved, size of breast lump and the eventual diagnosis.Methods: A prospective study was conducted at Dr. D.Y. Patil Medical College, Pimpri, Pune, between July 2016 and July 2017. Author evaluated 50 patients, male and female, of all ages, presenting with complaints suggestive of a benign breast disorder. Patients that were a proven case of carcinoma of breast and those diagnosed with a malignant condition of the breast during evaluation were excluded from the study.Results: The incidence of benign breast disorders is the highest in the age group of 21 to 30 years (42%). Most common presentation of benign breast disorder in the series was found to be lump in the breast (58%). The Left breast (44%) was noted to be more commonly involved than the Right breast (40%). Most commonly involved quadrant of breast was the upper inner quadrant (30%), followed by the upper outer quadrant (24%).Most of the breast lumps were of size ranging from 3 to 3.9cm (36.58%) followed by those of size ranging from 2 to 2.9cm. (21.95%). Fibroadenoma (42%) was the most common benign breast disorder in present study, followed by fibro-adenosis (18%).Conclusions: Every benign breast disorder presents in a certain age group and follows a certain clinical pattern as outlined in this study. Detailed history taking and clinical examination while keeping in mind these clinical patterns, along with ultrasound and FNAC (triple test), aids in establishing the diagnosis of a benign breast disorder within 72 hours. Hence, the anxiety caused by breast lumps and nodularity can be alleviated by excluding the diagnosis of carcinoma breast. And since majority of benign lesions are not associated with an increased risk for subsequent breast cancer, unnecessary surgical procedures can be avoided.

Background: Multinodular goitre (MNG) is a clinicopathological entity characterized by an increased volume of the thyroid gland with formation of nodules. The present study has been planned to study the various clinical presentations and diagnostic accuracy between operative findings and histopathological findings in a case of multinodular goitre.Methods: The present study was a hospital-based prospective study conducted in Dr D.Y. Patil Medical College, Hospital and Research Centre, Pune between July 2016 to September 2018. 100 patients aged between 15 to 75 yrs. clinically diagnosed as multinodular goitre were included.Results: FNAC finding of multinodular goitre in the study group showed colloid goitre was seen in 62 cases, 27 cases had multinodular goitre. 6 cases had neoplastic etiology, 3 cases had Hashimoto’s thyroiditis and 2 cases had papillary carcinoma of thyroid. HPE finding wise distribution showed that 10 cases were malignant, and 90 cases were benign. FNAC finding was significantly associated with histopathological finding in detecting malignant or benign lesion of multinodular thyroid gland and diagnostic accuracy of FNAC is 92%. Clinical finding comparison with operative finding showed that diagnostic accuracy of detecting malignant or benign lesion was only 35%. There was no significant difference among the two methods for detecting type of lesion in multinodular thyroid.Conclusions: Females are predominantly affected. About 8% cases of MNG are malignant. Considering the histopathological report as a gold standard, correlation of FNAC finding with histopathological finding was very much accurate and significant for detecting malignant and benign lesion of multinodular thyroid.

Background: Chronic idiopathic pain syndromes are amongst the most challenging and demanding conditions to treat across the whole age spectrum. Despite these patients having undergone numerous diagnostic work-ups, their pain remains a challenge to all known diagnostic and treatment methods.Methods: To evaluate role of diagnostic laparoscopy in chronic abdominal pain a prospective observational study was done. The present study was conducted on patients with undiagnosed chronic abdominal pain coming to the Department of Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune. 75 patients with chronic abdominal pain who attend the General Surgery Department (OPD) were included in the study. Patients were included in the study after taking their voluntary informed consent. The categorical variables were assessed using Pearson chi-square. The quantitative variables were assessed using T-test. The test was considered significant only if the p value comes out to be less than 0.05.Results: Based on the findings of the study after performing diagnostic laparoscopy for 75 patients with chronic abdominal pain it was found that most common finding was of appendicitis (32%) followed by abdominal Koch’s (24%) and post-operative pain relief using VAS showed p value of less than 0.05 at 3 months of follow up post diagnostic laparoscopy.Conclusions: The present study concluded that laparoscopy is an effective diagnostic role in evaluating patients with chronic abdominal pain, in whom conventional methods of investigations have failed to elicit a certain cause. The advantage of diagnostic laparoscopy over non-invasive methods is the ability to perform therapeutic procedure at the same time in cases of chronic abdominal pain. Diagnostic laparoscopy is safe, cosmetically better and having less morbidity.

Background: Acute abdominal pain is a common complaint in the emergency department. Diagnostics of one of the most common pathologies behind acute abdominal pain, acute appendicitis, has radically changed over the last decades. There are several different diagnostic scores for suspected acute appendicitis. The Alvarado score being most widely known. Appendicitis Inflammatory Response (AIR) score was designed to overcome drawbacks of previous scores. This score incorporated the C-reactive protein value in its design and was developed and validated on a prospective cohort of patients with suspicion of acute appendicitis.Methods: Patients with pain in RIF were admitted. Scores were assessed, patients whose score was significant by either of the system were subjected for appendicectomy. The specimens of appendix were sent for histo-pathological examination (HPE). Post-operative histopathology report was correlated with the scores. Sensitivity, specificity, positive predictive value and negative predictive for AIR and Alvarado score were calculated.Results: For scores >4, AIR score has higher sensitivity and specificity. The negative predictive value (NPV) of AIR score was higher and the positive predictive value (PPV) of AIR score was also high. For scores >8, Alvarado score has higher sensitivity as compared to AIR score whereas AIR score has higher specificity as compared to Alvarado score. NPV of Alvarado score was higher while PPV of AIR score was higher.Conclusions: In this study AIR score had Alvarado score displaying higher sensitivity and specificity.

Background: Clinical versus radiological assessment of patients treated for deep vein thrombosis. Aims and objectives of this study were to evaluate the patient treated for deep vein thrombosis (DVT) with reference to clinical examination and radiological imaging. To compare the predictive value of clinical methods versus radiological methods in the assessment of recovery of a patient following treatment of DVT. To study the sensitivity and specificity of the clinical and radiological methods used in assessing the effectiveness of treatment of DVT.Methods: A prospective observational study was conducted on 80 patients of 18-50 years age groups with deep venous thrombosis treated with standard treatment protocol at Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune over a period of 2 years. All patients were assessed clinically and radiologically using colour Doppler, post treatment at an interval of 3 months and 6 months. Results: At the end of 3 months of treatment, to detect complete recovery, the clinical assessment was found to have a lower sensitivity (56.25%) and specificity (81.25%) on comparison with radiological assessment. At the end of 6 months of treatment, to detect complete recovery, the clinical assessment was found to have a relatively better sensitivity (100%) but lower specificity (65.31%) on comparison with radiological assessment when compared to assessment after 3 months of treatment.Conclusions: The study has suggested that clinical assessment of patients after treatment of DVT has a varied value as far as complimenting radiological assessment of the same series of patients is concerned. When assessing patients after 3 months of treatment, clinical methods were found to be far inferior to radiological methods while after 6 months of treatment they were found to be on par with radiological methods. Hence, clinical methods can be used along with radiological methods for assessment, but radiological methods remain gold standard.