Mediastinal masses create significant diagnostic dilemma for the clinicians, radiologists and histopathologists. While imaging studies help in narrowing the differential diagnosis, accurate categorisation is not always possible. FNAC is a useful and cost effective tool. However, sampling error and complexities in performing the technique are major hurdles in the usefulness of this diagnostic modality.

The testis is the organ upon which the survival of the human species depends. Abnormalities of testicular vessels may lead to loss of gametogenesis and hormone production. Reported here is a case of bilateral variations of the testicular vessels observed in a male cadaver during the first year MBBS dissection classes. The right testicular vein bifurcated into two veins just before its termination and both the branches terminated into the inferior vena cava. The left testicular artery arose from the abdominal aorta just above the level of origin of the inferior mesenteric artery. There was an arterio-venous anastomosis between the left testicular vein and the left testicular artery. The arterio-venous anastomosis might be functionally important as it can change the quality of the blood entering the testis. DOI: http://dx.doi.org/10.3126/kumj.v11i2.12496 Kathmandu University Medical Journal Vol.11(2) 2013: 168-170

Giant cell fibroma is a form of fibrous tumour affecting the oral mucosa. Its occurrence is relatively rare in paediatric patients. Clinically it is presented as a painless, sessile, or pedunculated growth which is usually confused with other fibrous lesions like irritation fibromas. Here we are presenting a case where a seven-year-old male patient reported with a painless nodular growth in relation to lingual surface of 41 and 42. Considering the size and location of the lesion, excisional biopsy was performed and sent for histopathological analysis which confirmed the lesion as giant cell fibroma.

IntroductionFracture of the clavicle bone is a very common injury owing to its subcutaneous location. Controversy exists about the optimal treatment of midshaft clavicle fractures in the presence of significant displacement and comminution of the fracture. Traditionally, non-surgical management was considered the first treatment option for most clavicle fractures. However, recent evidence shows that the non-surgical option causes more complications than previously reported. The purpose of this study was to compare the clinical and radiological outcomes of conservative treatment and surgical treatment for midshaft clavicle fractures. Materials and methodsA total of 45 patients meeting the inclusion criteria were included in this randomized study. The patients were allocated to two groups: conservative and operative on an alternate basis. Patients in the conservative group were managed with figure-of-eight bandage, whereas patients in the operative group were treated surgically by plate fixation. Primary outcome was recorded at six weeks, three months, six months, and 12 months follow-up using the Disabilities of the Arm, Shoulder, and Hand (DASH) and American Shoulder and Elbow Surgeons (ASES) scores. We also assessed patient's satisfaction after the treatment, fracture union, and complication rates among the study cohort. ResultsThe ASES scores were significantly better in the operative group at three months and six months follow-up; however, at 12 months follow-up, there was no significant difference in the score between the groups. Although not statistically significant, the DASH score was better in the operative group than in the conservative group at all the follow-ups. This study showed that the time to union was lesser, rate of nonunion was lower, and return to work was faster on the operative group. The mean satisfaction score in the operative and conservative groups was 4.16±0.76 and 4.05±1.24, respectively (p = 0.76). ConclusionThis study suggests that open reduction and internal fixation with plate reduced the incidence of mal-union and non-union; however, surgical treatment showed no significant difference in the functional outcome as compared to conservative treatment.

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