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BACKGROUND Among all the disorders of female reproductive system, adnexal masses are one of the most common disorders. The main purpose of the study was to evaluate an adnexal mass and to differentiate the mass as benign or malignant and facilitate selection of appropriate treatment algorithm. For few benign lesions, radiological follow-up is very suitable for further management and additional follow-up may not be useful when an imaging abnormality is not found. METHODS Our study was conducted in Osmania General Hospital and its allied hospital named Government Maternity Hospital, Hyderabad, on about 150 patients. This is an institution-based, multicentric, cross-sectional, prospective, analytical study. All clinically suspected female patients with adnexal masses referred to the Department of Radiodiagnosis were evaluated. These patients were first subjected to ultrasonography, followed by magnetic resonance imaging (MRI) (plain and contrast wherever required). MRI findings were compared with ultrasonography. These findings were compared with operative findings and histopathological findings, wherever performed. RESULTS In the present study, females in the age group of 21 – 40 years showed majority of pelvic lesions - 81 (54 %). Most of the pelvic masses were arising from the ovary - 102 (68 %). Majority of the adnexal lesions on MRI were benign in nature - 132 (88 %). MRI showed a sensitivity of 100 %, specificity of 97.7 %, and a positive predictive value of 83 %, & a negative predictive value of 100 %. CONCLUSIONS In practice, ultrasonography (USG) is the primary modality for diagnosing the pelvic mass. MRI is superior to ultrasound and can be used as problem solving technique in the assessment of pelvic mass. The multiplanar imaging capability allows accurate identification of origin of mass and characterisation of mass. This is helpful to the preoperative planning of sonographically detected mass and avoids surgery in possible cases. MRI is the technique of choice for staging, treatment planning and post treatment follow-up of pelvic malignancies. KEYWORDS MRI, USG, Adnexal Masses, Ovarian Masses, Board Ligament Lesions, Fallopian Tube Lesions, Cysts

BACKGROUND Ovarian torsion occurs when the ovary twists on its fibrovascular pedicle resulting in vascular compromise. Initially, there is twisting of the ovary, fallopian tube, or both structures, causing venous, lymphatic and arterial compromise with resultant ovarian oedema and adnexal enlargement. We wanted to determine the most common ultrasonography (USG) and magnetic resonance imaging (MRI) findings in surgically proven cases of ovarian torsion. METHODS We present a series of cases obtained on retrospective review of USG and MRI findings in 10 surgically proven cases of ovarian torsion between June 2018 to June 2020 in the Department of Radiology, MVJ Medical College & Research Hospital, Hoskote. RESULTS Significant enlargement of the ovary with size ranging from 5 to 15 cms with peripherally displaced follicles and free fluid in the pelvis in noted in all the patients on USG and MRI. Other common MRI features include ‘twisted vascular pedicle’ sign seen in 7 (70 %) cases, areas of haemorrhage within the ovarian stroma in 7 (70 %) cases and abnormal ovarian enhancement in 9 (90 %) cases. CONCLUSIONS Ultrasound and MRI are the main diagnostic imaging modalities prior to treatment. Improved detection and characterisation of pelvic mass contributes to better diagnostic accuracy. The most common findings in US and MRI features of ovarian torsion include ovarian enlargement with peripherally displaced follicles and free fluid in pelvis. Other common MRI features include ovarian haemorrhage, twisted vascular pedicle, abnormal ovarian enhancement and deviation of the uterus towards the same side. KEYWORDS Ovarian torsion, USG, MRI

BACKGROUND In clinical practice, breast lump is a very common presentation of numerous breast diseases which ranges from benign cysts to malignant lesions. The difference between benign and malignant is very important for patient care and proper management. The diagnosis of breast lump includes clinical examination supplemented by imaging. Various literature has concluded that ultrasound evaluation with fine needle aspiration cytology (FNAC) correlation has comparable sensitivity and specificity to histopathology. Our aim was to study the ultrasonographic characteristics of breast lesions in patients and compare the sensitivity of ultrasonography in diagnosing benign and malignant breast lesions with FNAC. METHODS This is a diagnostic validation study, conducted at Department of Radiodiagnosis and Department of Pathology, Narayan Medical College and Hospital. All females more than 30 years coming for routine breast screening, found to have Breast Imaging Reporting and Data System (BI-RADS) 2 and above were subjected to ultrasonography and FNAC under ultrasonography (USG) guidance, and compared with histopathology. Data was collected, entered and analysed using Microsoft Excel, Epi Info, and SPSS software. Sensitivity and specificity with correlation, positive predictive value (PPV), negative predictive value (NPV) was calculated to compare the two diagnostic modalities. RESULTS USG had 83.3 % sensitivity, 97.56 % specificity, 95.24 % positive predictive value, 90.91 % negative predictive value, 33.32 % positive likelihood ratio and 17.13 % negative likelihood ratio. FNAC had 96.67 % sensitivity, 97.56 % specificity, 96.67 % positive predictive value, 97.56 % negative predictive value, 38.66 % positive likelihood ratio and 3.42 % negative likelihood ratio. CONCLUSIONS Breast ultrasound and FNAC both are important diagnostic tools for breast lesion. Sensitivity, specificity and other features are better for FNAC than ultrasound for breast lump. KEYWORDS Breast Lump, FNAC, USG, Adenocarcinoma, Squamous Cell Carcinoma

BACKGROUND Abdominal cystic lesions are not so uncommon in the paediatric age group. Ultrasonography (USG) is the initial investigation of choice for detection of lesions. Computed tomography (CT) and magnetic resonance imaging (MRI) further compliment the findings of USG and help in the final diagnosis of various abdominal lesions in this age group. Because of the overlap in imaging features, histologic analysis is usually necessary to establish a diagnosis. The major role of the radiologist is to document the cystic nature of these abdominal masses and to determine the origin. Our aim was to study the incidence of cystic abdominal lesions in the paediatric age group and role of imaging in the diagnosis of various types of cystic lesions. METHODS This is a cross sectional study of 60 children who have been referred to radiology department with abdominal symptoms, over a period of 18 months (from April 2018 to September 2019) in Niloufer hospital, Hyderabad. Children suspected to have abdominal lesions have been referred to radiology department. USG is the initial investigation done and further CT / MRI has been done according to the findings on USG. Paediatric patients of age day 1 to 12 years, both male and female suspected to have abdominal cystic lesions either clinically or sonologically have been included in the study. Retroperitoneal lesions are excluded from study. RESULTS Out of the 60 patients studied, 44 patients were females and the rest were males. The most affected age group was between 0 - 1 year which constituted to 50 percent of the total cases studied. The most common pathologies are ovarian cyst and duplication cyst which constituted about 49 % of the cases. Statistical significance has been observed between the gender and incidence of cystic lesions. CONCLUSIONS Imaging plays a key role in the evaluation of various types of cystic lesions in the paediatric age group and arrive at a particular diagnosis based on specific imaging features. The radiologist must consider patient age, clinical parameters and imaging findings to formulate the likely diagnosis of cystic lesions. USG being cost effective, widely available and with no risk of radiation has been chosen as the first modality for investigation. KEYWORDS Cystic Lesions, USG, CT / MRI, Ovarian Cyst, Enteric Duplication Cyst

BACKGROUND Ultrasonography (US) has become popular in the present day practice in the evaluation of breast lesions. The USG findings can be supplemented by fine needle aspiration cytology (FNAC) and correlation between the two diagnostic modalities can help improve the diagnosis. We wanted to study the ultrasonographic features of breast lumps and to correlate the findings with fine needle aspiration cytology. METHODS This was a prospective study done on 55 patients of breast lumps who attended the ultrasound at department of Radiology, Maheshwara Medical College, Patancheru, Hyderabad, Telangana over a period of eight months. RESULTS Majority of the cases were reported as Benign i.e., 81.8 % (45 / 55), 12.7 % (07 / 55) constituted Malignant cases. Suspicious of malignancy in 5.4 % (03 / 55) cases. Most of the benign lesions were noted in the 20 - 50 years age group while malignant lesions were observed between 41 years to more than 60 years of age. The sensitivity, specificity, PPV and NPV of ultrasonography and FNAC in diagnosing breast lesions were 87.5 %, 93.6 %, 70 %, and 97.7 % respectively. CONCLUSIONS Ultrasonography is a primary imaging technique for evaluation of breast lumps and has good sensitivity, specificity, PPV and NPV for diagnosing breast lesions. It is complementary to FNAC and when both modalities are used together they can diagnose majority of the lesions. This can reduce the radiation exposure and the more invasive and expensive breast biopsy procedure. KEYWORDS USG, Breast Lesions, FNAC, BIRADS

BACKGROUND Thyroid lesions are the most common abnormality in the endocrine system. The importance of imaging is that cancers of the thyroid must be differentiated from the much more frequent benign adenomas and multinodular goiters. METHODS Study of 97 patients was carried out. All patients diagnosed and suspicious of thyroid lesions were included in my study. Patients referred to the radiology department for USG and/or CT scan thorax investigations, and found to have thyroid lesion, were included in this study. RESULTS In our study, there was a higher incidence of all thyroid diseases in females. The overall sex ratio was M:F = 1:4.7. Most of the patients were in the 31-40 yrs. age group. The largest group was comprised of non-toxic goitre followed by thyroid neoplasms. Most of the patients had multinodular type of goiter followed by solitary nodular goiter. Simple diffuse goiter was seen only in 10.5% cases. Majority of the patients showed mixed consistency, followed closely by solid consistency. Majority of the malignant lesions was papillary type of carcinoma (46%) followed by follicular carcinoma (20%) and metastasis (13.3%). CONCLUSIONS USG had high sensitivity of 86.6% and specificity of 96.5% in differentiating benign from malignant thyroid lesions which was better than that of CT scan which had a sensitivity of 66.6% and specificity of 80%. CT scan was found to be useful in staging of thyroid malignancies.

BACKGROUND In adults, the normal portal venous pressure is 5-10 mmHg. Portal hypertension is defined as portal venous pressure of more than at least 5 mmHg greater than the pressure in the hepatic veins or inferior vena cava.1 Clinically significant portal hypertension, sufficient to cause serious complications and therefore requiring treatment, is defined as an increase of 12 mmHg. The objective of the study is to study the role of ultrasound and colour doppler sonography in 1. evaluation of portal hypertension, 2. identifying specific features of portal hypertension on these modalities, that permit its accurate diagnosis and 3. detecting the complications at an early stage. MATERIALS AND METHODS Forty adult patients referred to the radiodiagnosis department of Sri Lakshmi Narayana Institute of Medical Sciences with clinical diagnosis of portal hypertension were included in study. All patients included in the study underwent ultrasonography (USG) of abdomen using a curvilinear and a sector probe of 3.5-5.0 MHZ coupled with colour Doppler equipment. Statistical analysis was done using percentage and proportions. RESULTS The most common age group presenting with portal hypertension was between 51-65 years. The frequency of portal hypertension was more in males. Diameter of portal vein of >13 mm was seen in 53% and

BACKGROUND Obstructive jaundice due to bile duct calculus is one of the frequent clinical problems which needs proper diagnosis before initiation of treatment. USG and MRCP play a very important role to diagnose such calculus. MATERIALS AND METHODS Initial USG evaluation of patients with Obstructive Jaundice was done. Then those patients having biliary obstruction due to calculus or due to causes not detected by USG were subjected to MRCP. RESULTS Detection rate of calculus by USG In comparison to MRCP- 1) Proximal bile duct- 92.85%. 2) Distal bile duct - 77.27%. CONCLUSION USG should be done as initial examination which provides a guide to choose patients for MRCP examination in detecting bile duct calculus.

BACKGROUND Both Transverse Abdominis Plane (TAP) block and Paravertebral Block (PVB) can be used to provide postoperative analgesia in inguinal hernia surgeries. Present study was done to evaluate the postoperative analgesic effect of USG-guided TAP block with USG-guided PVB for unilateral inguinal hernia repair under general anaesthesia. MATERIALS AND METHODS Sixty, American Society of Anesthesiologist (ASA) grade 1 and 2 adult patients undergoing inguinal hernia repair under general anaesthesia were randomly allocated to TAP (Gp I) and PVB (Gp II) group of 30 each. In Gp I patients received local anaesthetic mixture of 0.5% bupivacaine (15 mL) and 2% Xylocaine with adrenaline (15 mL) in TAP plane under real time USG. In Gp II, the same anaesthetic mixture was injected 1 cm deep to superior surface of transverse process of T10,12 and L2 vertebra under ultrasound guidance. The postoperative pain using the Visual Analogue Scale (VAS), the number of analgesic doses and total drug requirement in the first 24 hours of postoperative period was noted. Statistical Analysis Used- SPSS version 14.0 (SPSS Inc., Chicago, IL), Chi-square test, Student’s t-test. P ˂0.05 was taken as statistically significant. RESULTS VAS scores were statistically significantly lower in Gp II as compared to Gp1 at 1, 2, 4 and 6 hours postoperative time interval (p value

BACKGROUND Acute appendicitis is the most common surgical emergency. So far no single criteria can accurately confirm the preoperative diagnosis of acute appendicitis in the suspected cases. Every effort should be made to establish an exact diagnosis. This has resulted in considerable research to find out the role of various clinical scores, laboratory, radiological parameters and diagnostic laparoscopy in diagnosing appendicitis. However, despite availability of various biochemical and radiological diagnostic investigations like total leucocyte count (TLC), C-reactive protein (CRP), Procalcitonin (PCT), D-dimer and ultrasonography (USG) and computed tomography (CT) scan, a negative appendectomy rate of 5% - 30% has been reported in literature. A wide variation exists in sensitivity, specificity, positive predictive value and negative predictive value of these parameters in various studies conducted earlier. The present study is aimed to evaluate, correlate and compare the diagnostic efficacy of clinical score, various biochemical investigations and USG in cases operated with pre-operative diagnosis of acute appendicitis with confirmation of final diagnosis by histopathology. MATERIALS AND METHODS This study was carried out during a period from February 2014 to July 2015 and included 100 consecutive patients of acute appendicitis. Alvarado score, total leucocyte count, C–reactive protein, Procalcitonin, D-dimer and ultrasonography were performed in all cases preoperatively and histopathological examination done postoperatively. RESULTS Age of patients ranged from 10 to 74 years with mean age of 29.24 years; 71 were males and rest were females with the maleto-female ratio being 2.44: 1. Alvarado score was ≥ 7 in 75 cases of proven appendicitis and in 4 cases of normal appendix with sensitivity, specificity, PPV, NPV and diagnostic accuracy of 78.94%, 20.00%, 94.93%, 4.76% and 76%. TLC was ≥ 10,000/mm3 in 55 cases of the patients with acute appendicitis and in 3 cases of normal appendix. The sensitivity, specificity, PPV, NPV and diagnostic values of TLC were 57.89%, 40.00%, 94.83%, 4.76% and 57.00% respectively. CRP was ≥ 5 mg/dL in 90 cases and 86 cases had acute appendicitis on histopathology. The sensitivity, specificity, PPV and NPV of CRP were 90.53%, 20.00%, 95.56% and 10.00% respectively with a diagnostic value of 87%. D-dimer ≥ 0.5 µg/dL was seen in 69 cases and 65 cases were having acute appendicitis on histopathology. The difference was not found to be significant (p= 1). Sensitivity, specificity, PPV, NPV and diagnostic accuracy were 68.42%, 80%, 98.48%, 11.76%, 66% respectively. Procalcitonin level in 33 cases was ≥ 1 ng/dL, out of which 32 cases had acute appendicitis on histopathology. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of PCT were 33.68%, 80%, 96.97%, 05.97% and 36% respectively. USG findings suggested acute appendicitis in 90 cases, out of which 86 patients had acute appendicitis. The sensitivity, specificity, PPV, NPV and diagnostic accuracy were 90.53%, 20.00%, 95.55%, 10.00%, 87% respectively. Histopathological findings of acute appendicitis were confirmed in 95 cases, while in five cases appendix was normal on histopathology. CONCLUSION Negative appendectomy rate in our study was 5%. Alvarado score, various laboratory investigations or USG are not sufficient on their own for taking the decision for surgery. USG and CRP were the most sensitive investigations with equal diagnostic value. Among the inflammatory markers, the diagnostic value of CRP was higher than PCT and D-dimer. CRP and USG along with Alvarado score can increase the diagnostic accuracy in acute appendicitis.

BACKGROUND Thyroid disorders are the most common endocrine disorder seen in clinical practice and solitary thyroid nodule is one of the common presentations of thyroid disease. A discrete swelling in an otherwise impalpable gland is termed isolated or solitary nodule of thyroid.1 The prevalence of thyroid nodule increases from near zero at 15 years to 50% by about 60 to 65 years on sonography. At most 10% of these nodules are palpable even by experienced clinicians. This study is about the clinical presentation, histopathology and management of solitary nodule thyroid in MGM GH Tiruchirappalli. AIMS AND OBJECTIVES- To determine the age and sex incidence among the cases of solitary nodule thyroid. To study the percentage of euthyroid, hypothyroid or hyperthyroid state in patients presenting with solitary nodule thyroid. To study the proportion of malignant and benign cases among the solitary nodule thyroid at M.G.M. Govt. Hospital, Tiruchirappalli. MATERIALS AND METHODS This study includes 58 cases of solitary nodule of thyroid noted during the period Jan 2016-Dec 2016. Factors were tabulated and analysed statistically. RESULTS From the present study, the mean age at presentation found to be 42.5 years with preponderance to females. Because of periods of fluctuations in the demands of the hormonal requirement in female in their life cycle (puberty, menstrual cycles, pregnancy, menopause), the chances of thyroid nodule formation are very high as compared with male counterparts. From the study, distribution of malignancy is about 10.34. The incidence of malignancy found to be 12%, sensitivity is 87.5%, specificity is 100% for FNAC and HPE. CONCLUSION Majority of the patients are between 30-49 years of age. Incidence of solitary thyroid nodule is more common in female. Female: male ratio is almost about 15:1 Commonest symptom is swelling over anterior or lateral aspect of neck Among the benign lesion dominant nodule is most common and papillary and follicular carcinoma are common in malignant lesion.

BACKGROUND An injured spleen is a well-known entity to those involved in trauma care. The majority of individual with a splenic injury now receive nonoperative intervention and therapy. This shift from operative to nonoperative treatment over the past several decades is a tremendous success story in which clinical judgment and reason triumphed over standard surgical dogma. In emergency room, restoration of airway, breathing and circulation should be focussed on. A careful history is the most important one. Nevertheless, the severity of the splenic injury plays a dominant part in determining whether nonoperative management is appropriate or-if-not-whether splenorrhaphy or splenectomy will be the more appropriate surgical option. As a general rule, younger, healthier patients with lower grade splenic injuries and fewer associated injuries and comorbidities are usually managed nonoperatively or with splenic repair, whether unstable, actively bleeding patients with more severe splenic trauma and/or multiple associated injuries require splenectomy. The aim of the study is to evaluate- 1. The impact of blunt or penetrating abdominal trauma on spleen. 2. Various modes of injury. 3. Various modes of clinical presentation of cases. 4. The value of various available investigations employed. 5. The various methods of treatment. 6. The morbidity and mortality. MATERIALS AND METHODS This study was a prospective study of 20 cases of splenic injury admitted in the triage ward of Mahatma Gandhi Memorial Government Medical College Hospital, Trichy, over a period of 2 years from December 2014 to December 2016. Once the patient is admitted, the name, age, sex and mode of injury are noted. The time interval between splenic injury and admission and time interval between admission to hospital and surgery are recorded. After resuscitating the patient, all patients were subjected to careful clinical examination. RESULTS The total number of patients who had sustained splenic injuries were 20. In this study of the 20 patients, 15 cases were males and 5 cases were females. After improving the general condition of the patient, laparotomy proceeded in 12 cases, in which splenectomy done in 8 cases and splenoraphy in 5 cases. CONCLUSION Road traffic accident is the commonest cause for splenic injury abdomen. Predominance of male over female in splenic injury abdomen with the ratio of 3:1.People in the age group of 3 rd and 4 th decade were commonly involved in splenic injury abdomen constituting about 55%. Based upon the grading of injuries and haemodynamic stability of the patient and other associated injuries, decision of laparotomy versus conservative management was taken. 12 patients were managed surgically, 8 underwent splenectomy and 4 underwent splenoraphy by topical haemostatic agents and sutural repair. Overall mortality due to splenic injury abdomen was 15%. Sepsis and associated injury were the major causes of death.

BACKGROUND The aim of the study is to study the- 1. Correlation between sonological and histopathological diagnosis of acute appendicitis. 2. Prevalence of acute appendicitis in various age groups. MATERIALS AND METHODS The study was conducted in the Department of Radiodiagnosis, MVJ Medical College and Research Hospital, Bangalore, for a period of 2 years from March 2013 to February 2015. Data collection was prospective. A computer-assisted search of all the reports of ultrasonography with the diagnosis of acute appendicitis was conducted within the departmental database. A total of 244 patients (128 male patients and 116 female patients) with acute appendicitis were identified and the study was conducted. RESULTS In the study, total of 244 patients were diagnosed with acute appendicitis. Out of these, 128 patients were males and 116 patients were females. The incidence of acute appendicitis was most prevalent in age group between 21 to 30 years (36.5%) in our study. The least incidence was noted in age group of above 60 yrs. with only 1 out of 244 patients (0.4%) was diagnosed with acute appendicitis. The histological features noted were suppuration/inflammation, gangrenous, lymphoid hyperplasia and perforation. In our study, 143 inflammation/suppuration (58.6%), 37 gangrenous (15.1%), 24 lymphoid hyperplastic (9.8%) and 1 perforation (0.4%) was noted. Hence, the incidence of inflammation/suppuration was found to be most common and perforation was found to be the least finding. The suppurative/inflammatory feature was most common histological type in all the age groups except for the age group above 60 yrs. The gangrenous features were most commonly seen in the age group between 11 to 20 yrs. followed by 20 to 30 yrs. Faecolith was most commonly found in age group of 21 to 30 yrs. (12 cases) followed by age group of 11 to 20 yrs. (10 cases). CONCLUSION It was noted that the incidence of acute appendicitis was most commonly noted in younger age group and its incidence decreases as the age advances. The most cases revealed suppuration/inflammation and perforation was noted to be of the least histological variant.

BACKGROUND Doppler velocimetry is a non-invasive method of measuring changes in blood flow. (1,2,3) Randomised Control Trials (RCTs) have shown that using Doppler indices in the management of Intrauterine Growth Restriction (IUGR) cases leads to a significant reduction in perinatal mortality rate. Deterioration of various Doppler indices precedes abnormal Biophysical Profile (BPP) by 1-2 weeks. (1,2,3,4) Umbilical artery indices only reflect the placental status. Fetal response to this increasing placental insufficiency can be deduced from studying the Cerebroplacental Ratio {CPR}, which gives us an idea of the fetal response to the placental status and is potentially more advantageous in predicting fetal outcome. OBJECTIVES To compare CPR in predicting fetal outcome with UA and MCA indices. MATERIALS AND METHODS Prospective cohort study of cases of IUGR - January 2013 to December 2013. 180 cases of clinically diagnosed IUGR were selected. Obstetric USG and Doppler was performed. The S/D ratio, RI, PR values were obtained and CPR calculated. All cases were managed as per the protocol then in place using U/A SD ratios for determining the timing & mode of termination RESULTS Of 180 cases of IUGR were selected most women were primigravidae, 20-34 years, and from low socio-economic status. (3) 25 women (13.8%) had oligohydramnios (AFI

INTRODUCTION Guided fine-needle aspiration cytology (FNAC) is an easy, rapid, minimally invasive and a cost effective diagnostic method for detecting benign and malignant lesions of liver. AIM The main aim of the present study was to establish the incidence of various hepatic lesions and to find out adequacy and utility of the procedure. MATERIAL AND METHOD A total of 174 cases were included in the study from Government Medical College, Kota and associated hospitals. All cases diagnosed to have single or multiple hepatic mass lesions on USG were included in the study. RESULTS Most common age group affected by hepatic lesion was 51-60 years (34.0%). 91.4% cases were having adequate aspirates. 95.6% of the total diagnosed cases were malignant and among malignant cases majority were metastatic. CONCLUSION USG-guided FNAC is a very useful procedure in the diagnosis of hepatic lesions as the procedure is simple and safe. Thus, FNAC is a simple and effective diagnostic tool in our hand.

AIMS & OBJECTIVES: 1. To differentiate cystic lesions from solid lesions. 2. The possibility to differentiate the intrinsic thyroid lesions from those arising from adjoining structures. 3. To evaluate the neoplasms and to differentiate benign from malignant lesions by USG characteristics and to correlate with FNAC reports. 4. Role of USG in rapidly growing thyroid lesions: To differentiate haemorrhage into the cystic lesions and rapidly growing malignant tumours. 5. Compare the results of our study with similar studies available in the present literature. MATERIALS & METHODS This study included 75 patients who attended outpatient departments of the Endocrinology, Medical and Surgical Units and also those who were inpatients. RESULTS Broadly pathological conditions of thyroid glands can be divided into nodular and diffuse thyroid diseases. Among Nodular Diseases Majority are benign, only few are malignant. Characteristics of benign lesions are: 1. Well-differentiated margins. 2. Thin complete peripheral sonolucent halo. 3. Coarse peripheral calcifications. Characteristics of malignant nodules are: 1. Ill-defined margins. 2. Thick incomplete peripheral halo. 3. Fine punctuate calcifications. Diffuse Thyroid Diseases 1. Hashimoto’s thyroiditis: Painless diffuse enlargement of thyroid gland usually in women with coarse echotexture and no normal gland tissue. There may be discrete hypoechoic nodules within it with cervical lymphadenopathy. 2. Goitres: a) Simple diffuse goitre: Symmetrical enlargement of gland without tenderness or bruit or lymphadenopathy, T3, T4 and TSH are within normal limits and no thyroid autoantibodies in the serum. a) Diffuse Toxic goitre: Diffuse enlargement of gland with increased vascularity on colour Doppler study. b) Multinodular goitre: Multiple hypoechoic nodule within normal thyroid parenchyma. c) Colloid goitre: Present as single or multiple swellings in the thyroid gland. CONCLUSION USG is the fast and cost effective modality of imaging investigations of choice in thyroid diseases. It helps to know: 1. Whether patient has focal or diffuse abnormality. 2. Whether lesions are solitary or multiple. 3. Whether they are cystic or solid. 4. Whether the lesion is benign or malignant can be differentiated by sonographic characteristics. 5. Further Hashimoto’s thyroiditis or toxic goitre can be successfully differentiated by USG and colour Doppler findings. 6. US guided FNAC is the confirmatory tool.

BACKGROUND The Parotid gland is the most common salivary gland to be affected by different pathological variants of swellings which present as a mass in the retromandibular area. The pathology of these lesions varies from inflammatory lesions, cysts, benign and malignant neoplasms. In our study we included only the cases which turned out to be Tuberculosis of the parotid gland. METHODS A small hospital based study of 100 cases of parotid swellings were carried out in the department of Otorhinolaryngology & Head Neck Surgery, MGM Medical College & LSK Hospital Kishanganj, Bihar, India from December 2012 to December 2015. All the cases of parotid swellings were analyzed by taking detailed history, clinical features, biochemical, microbiological, ultrasonographic & CT scan findings, and FNAC. The cases which were diagnosed as Tuberculosis of the parotid, were included in the study. Pathological variants other than tuberculosis were excluded from the study. RESULTS In our series there were 47 males (47%) and 53 females (53%), out of which 5 patients (5%) were diagnosed with tuberculosis of the parotid gland. Amongst the 5, male patients were 3(3%) & females 2(2%).

OBJECTIVES : 1. To assess the effectiveness of Triple assessment in evaluation of breast diseases. 2. To compare triple assessment (as a combined diagnostic modality) to each of its components. 3. To find advantages of ultrasonogram over mammography. METHODS: Patients atten ding surgical clinic with breast related complaints during the period from 1 st January 2009 to J une 31 st 2010 were assessed using the Triple test. Each patient was subjected to clinical examination, ultrasonography, mammography, FNAC, and HPE and the resul ts analyzed. RESULTS: 40 patients were included in the study, with age ranging from 15 yrs to 60 yrs. The sensitivity, specificity, positive and negative predictive values of clinical examination is 100%, 92%, 88.24%, 100%; FNAC is 8.7%, 100%, 100% 92%; Ma mmogram is 86.7%, 92%, 86%, 92%; and USG is 66.67%, 100%, 100% 83%, respectively. CONCLUSION: In patients with definite lump, clinical examination and FNAC alone may be sufficient to rule out malignancy. USG to the Triple assessment did not add up to the n egative predictive value of Triple Test. Mammogram is needed in patients with no clinically palpable lump and to rule out multi - centric and multi - focal disease