CT guided FNAC is a well established method in the cytological diagnosis of pulmonary lesion. Aim: Aim of our study is to evaluate the pathological spectrum of disease in lump through CT guided FNAC. Material & method: 69 causes were evaluated retrospectively for a period of 4 yrs. Result: out of 69 cases 52.1% were male. Mean age was 54. 34 years. 65.2% having malignant lesion & 34.7% have benign. Adeno CA was the predominant malignant tumour. Conclusion: CT guided FNAC can diagnose pulmonary lesion fairly accurately leading to less morbidity & mortality as treatment can be started early.

Various adjuvants have been used with local anesthetics in spinal anesthesia to improve the quality of block and to provide prolonged postoperative analgesia. Dexmedetomidine, the new highly selective α2-agonist drug, is now being used as a neuraxial adjuvant. AIM: The aim of this study was to evaluate the onset and duration of sensory and motor block, hemodynamic effect, postoperative analgesia, and adverse effects of dexmedetomidine or fentanyl given intrathecally with hyperbaric 0.5% bupivacaine. METHODOLOGY: Fifty patients classified in American Society of Anesthesiologists classes I and II scheduled for lower abdominal surgeries were included in this prospective cohort study at Amala Institute of Medical Sciences. Patients received either 15 mg hyperbaric bupivacaine plus 25 μg fentanyl (group 1, n = 25) or 15 mg hyperbaric bupivacaine plus 5 μg dexmedetomidine (group 2, n = 25) intrathecally. RESULTS: Patients in dexmedetomidine group (2) had a significantly longer duration of motor and sensory block than patients in fentanyl group. (1) The mean time regression of motor block to reach Bromage 0 was 176.2±5.71 min in dexmeditomidine group and 166.36±5.97 min in fentanyl group (P<0.05). Duration of analgesia was 239.52±9.05 min in Dexmeditomidine group and 189.96±5.35 min in fentanyl group (p<0.05). A significant decrease in heart rate was noted in dexmedetomidine group. CONCLUSION: Intrathecal dexmedetomidine is associated with prolonged duration of analgesia and motor block along with significant decrease in heart rate.

BACKGROUND: Brachial plexus blocks, alone or in combination with general anesthesia, has become one of the most important anesthesia techniques for surgeries in the upper limb. Prolongation of analgesia using perineural catheters are not yet popular, and we are in need for an adjuvant that can prolong the action of local anesthetics after single injection peripheral nerve blocks. Dexamethasone and clonidine are two commonly used adjuvants. This study was undertaken to compare the analgesic efficacy of dexamethasone and clonidine. MATERIALS AND METHODS: Ninety adult patients fitting under the inclusion criteria were assigned to three groups of thirty each and received ultrasound guided supraclavicular brachial plexus block. They received either dexamethasone 8 mg (Group D) or clonidine 1mcg/kg (Group C) or saline 2 ml (Group S) with 15 ml of 0.5% bupivacaine. The onset of sensory and motor blocks, duration of analgesia and the duration of motor block were assessed. RESULTS: The onset of sensory and motor block were comparable in all the three groups (17.50±2.86 minutes and 30.33±4.14 minutes; 17.17±3.13 minutes and 31.0±4.8 minutes; 18.33±3.55 minutes and 31.0±5.48 minutes for groups D, C and S respectively. The duration of analgesia and motor blockade was markedly prolonged in dexamethasone group (19.41±2.60 hours and 17.19±2.13 hours) and moderately prolonged clonidine group (11.49±1.66 hours and 10.41±1.18 hours) when compared to saline group (7.56±1.65 hours and 6.22±1.43 hours). CONCLUSION: Dexamethasone proves to be a better adjuvant compared to clonidine, as it considerably prolongs analgesia and is devoid of significant side effects. But the prolonged motor block is still a matter of concern and the search for an adjuvant that selectively prolongs analgesia without impairing motor function continues.

OBJECTIVE: Our study aims to evaluate the efficacy of ultrasound guided TAB in postoperative pain relief in a cohort of patients undergoing total abdominal hysterectomy by comparing it with patients who do not receive TAB. The primary end point studied was total 24 hour morphine consumption. The secondary objectives measured were postoperative heart rate, systolic & diastolic blood pressure, respiratory rate, postoperative pain score, nausea, vomiting and sedation score. STUDY DESIGN:Forty patients of ASA I aged 30 to 60 years scheduled for total abdominal hysterectomy surgery in Amala Institute of Medical Sciences, Kerala, India were included in this prospective cohort study. Study duration was for 15 months. First 20 consecutive patients satisfying the inclusion criteria and who received ultrasound guided transverses abdominis block with 15 ml of 0.25% bupivacaine on each side was designated as TAB group. The first 20 patients satisfying inclusion criteria and who did not receive TAB were designated as Non-TAB group. The relevant data of each patient were recorded and the results were statistically analyzed. RESULTS:Patients who received transverses abdominis block with bupivacaine had significantly reduced 24 h morphine requirements in milligrams (TAB group 6.75±2.45, Non-TAB group 12.00±2.51, p value<0.01). The mean time (in hours) to first request for morphine was significantly longer in patients who received transverses abdominis block (TAB group 5.8±2.97, Non-TAB group 1.93±1.17, p value<0.01). There was significant difference in the pain scores at the end of first postoperative hour, with patients without TAB complained of significant pain at rest, cough and movement. At all other time intervals in the first 24hrs the pain scores were higher in the non-TAB group but not significantly different. But pain requiring rescue analgesic (>3) was significantly higher in non-TAB group. CONCLUSIONS:In conclusion we found that ultrasound guided transverses abdominis block provided substantial reduction in morphine consumption when compared with control group. TAB also reduced significantly the time to first dose of rescue morphine. The technique is found to be safe and effective. The study reinforces the recommendation for TAB as a part of multimodal post-operative analgesic regimen.

Undoubtedly, most ovarian lesions, endometrial pathology and uterine lesions are best detected with ultrasound. Computed tomography (CT) imaging offers better diagnostic capabilities for large pelvic masses, tubo- ovarian abscesses, postoperative and postpartum complications. In some cases, Computed Tomography (CT) is employed to achieve optimal differential Diagnosis to determine the clinical pathway to follow. Hence based on above findings the present study was planned for Assessment of Suspicious Ovarian Masses by Comparative Study of USG and CT Techniques. The present study was planned in Department of Radio- Diagnosis, Katihar Medical College, Katihar (Al-Karim University), Bihar, India. In the present study 50 females were enrolled having Suspicious Ovarian Masses. Computed tomography (CT) and USG characteristics of different lesions were noted and recorded. The histopathological diagnosis was followed up and recorded. The results of this study were analysed and compared with other available studies in literature. The data generated from the present study concludes that Ultrasonography is usually the first imaging modality in evaluation of female patients suspected to have pelvic pathology. Computed tomography is superior diagnostic imaging modality than USG prior to treatment which improved detection and characterization of tumour due to better diagnostic accuracy and consequently reduction of invasive procedure which lead to significant reduction of mortality and morbidity from tumour. Keywords: Ovarian Masses, Comparative Study, USG, CT Techniques, etc.