Occasionally, some mydriasis is noticed apparently after the use of topical lignocaine. We wanted to definitely establish whether, under controlled conditions, topical lignocaine on its own realty dilates the pupil or not. Forty healthy eyes of 20 subjects were evaluated in a randomized controlled study. Pupil diameters were carefully measured using a rule pupillometer, before and after instilling a drop of 4% lignocaine or its vehicle as a control. In 20 eyes of 10 of these subjects, a second drop of lignocaine or vehicle was also used. The measurements taken at 10 minutes intervals upto 1 hour revealed no effect at all on the pupil size with either drops. Any ‘mydriasis’ noted clinically with lignocaine must be either because of contamination with a cycloplegic/mydriatic, or the potentiation effect of even a trace of the latter by lignocaine.

Background: Cervical cancer is second commonest cancer among Indian women. Being a major cause of morbidity and mortality, its awareness is required to assess the knowledge, attitude and practice of women regarding the basic screening test for cervical cancer. Aim: The main aim of this study was to evaluate the knowledge, attitude and awareness about cervical cancer among female patient during cervical cancer awareness months (1 January to 28 February 2015) conducted by Gynecological oncology unit of Regional Cancer Institute IGIMS Patna. Material and Methods: Present study was conducted in the Gynecological oncology unit of Regional Cancer Centre, Indira Gandhi Institute of Medical Sciences (IGIMS),Patna (India), during the cervical cancer awareness months (1 January to 28 February 2015). Three eighty eight (388) patient had been registered in between this awareness month. Patient visiting in our OPD and those who have given informed consent were selected for the study. Statistical Analysis: Chi square test was used. EPI INFO-16 software was used for analysis purpose. Result: It was found that women who belonged to higher age group (>30yr), good socioeconomic status (> 10000 R.S.), urban residents and who were literate had adequate knowledge, attitude and practice about the cervical cancer (p=.04). On assessment regarding the knowledge of Pap smear, 23% of women had heard about the test and only 13% has adequate knowledge about it. On evaluating the adequate attitude among all 388 women, only 18.4% showed adequate attitude and accepted the explanation of the significance of periodical testing. With respect to their practices, the majority (94.7%) women responded that they had never been tested. However, only 5.3% reported to have been tested at least once

Choledochal cysts are uncommon congenital anomalies of the biliary tract. The size ofcholedochal cysts rarely exceeds 10cm in transverse dimension. Out of 90 choledochal cyst operation performed between 2005-2015 in the Department of GI Surgery and Paediatric surgery, IGIMS, Patna, 15 were found to have cyst size more than 10cm. The purpose of this study is to discuss the diagnostic problems and management with these “giant choledochal cysts”.

INTRODUCTION: Computed tomography (CT) scan is the technique of choice for the investigation of patients with seizure and epilepsy (specially in resource poor state). CT scan of brain is particularly helpful for seizure patients with a predisposing history, focal onset seizure, an abnormal neurologic examination, h/o AIDS, or who are younger than 6 months old. AIM: To identify the underlying factors & to find out the prevalence of the radio evident disease in seizure patients. MATERIALS & METHODS: Patients (164 number) of all age-groups, living in both rural and urban areas and of both sexes were included in this study. Data was collected by interviewing the patients or his close attendant and analysing CT brain according to the predesigned pro forma. RESULTS: Epilepsy was more prevalent in 2nd and 3rd decade of life. Mean age was 21.97 yrs.& more common in male (64.02%), commonest type of seizure is generalized tonic-clonic seizure. CT scan brain established specific etiology in 35.36% of cases and inflammatory granuloma (58.62%) was the commonest cause of epilepsy in all age- groups.

Osteonecrosis of the femoral head is a challenge for all the orthopedic surgeons. There are many treatment modalities for the problem but there is lack of clear superior method of treatment. (Free Vascularized Fibular Graft) FVFG can arrest the progression in majority of patients if the procedure is performed before subchondral fracture. The procedure is also of benefit in young patients by long term reduction of symptoms and delay in prosthetic replacement. We are reporting a case which was done in a young patient with a satisfactory outcome.

Immature ovarianteratoma is an uncommon (<1% of ovarian teratomas) pathology and affects a younger age group of women (usually during the first 2 decades of life). It is quite a rare entity in older women. Only a few cases of immature teratoma of the genital tract in perimenopausal age group have been reported. We report here acase of unilateral immature teratoma of the ovary in posthysterectomised premenopausal woman.

Congenital Rubella Syndrome (CRS) is still not eradicated in developing countries inspite of widespread vaccination for rubella. CRS is one of the important etiology for congenital cataract and association of congenital heart disease(CHD) in these patients are high. Thus any patient who presents for congenital cataract needs to be fully investigated for CHD before planning for surgery even if patient is asymptomatic.

Asymptomatic sinus bradycardia is most often encountered during preanaesthetic evaluation of geriatric group of patients as a result of degenerative changes of heart conducting tissuesby process of ageing. Here we are presenting the perioperative management of sinus bradycardia in two elderly patients one undergoes general anaesthesia for exploratory laparotomy and other spinal anaesthesia for transurethral resection of prostate (TURP).

Vesicouterine fistula is uncommon, occurring only in 1-4 % cases. Ninety percentage of cases are Youssef syndrome which include cyclic haematuria, menouria without urinary incontinence. We report a 25 year old female had youssef syndrome after third lower segment caesarean section.

32 years old male was a case of bilateral ureteropelvic junction obstruction was admitted for pyeloplasty on left side. He had underdone right sided pyeloplasty one month back under general anaesthesia. Again he underwent left sided pyeloplasty under general anaesthesia. Shortly after extubation the patient became breathless and oxygen saturation decreased to 80%. He was managed with intravenous hydrocortisone, furosemide; and salbutamol nebulisation along with positive pressure ventilation via mask and transfer to intensive care unit. Immediate postoperative chest x-ray showed whitening of right Lung Field. The chest x-ray finding postoperative day one was suggestive of cardiomegaly with straightening of left boarder of heart. On cardiac evaluation done in postoperative period he was found to have severe mitral stenosis with severe pulmonary hypertension which was managed conservatively.

Congenital malformations of the lung are uncommon and diverse in their clinical presentation and severity. The clinical onset varies from antenatal period to adulthood and symptom varies from asymptomatic to acute life threatening. We are reporting two cases consisting of congenital lobar emphysema and congenital cystic adenoid malformation of lung affecting right middle lobe cured surgically by lobectomy.

Meig’s syndrome is a triad of ascites, right hydrothorax and ovarian fibroma. The term PseudoMeig’s is used in ovarian tumors other than fibroma or those of uterus or fallopian tubes. Here we report an interesting case of Pseudo Meig’s syndrome, who was referred to our centre as a suspected case of malignant ovarian tumor! A 40-year old multiparous lady was referred in a dyspnoeic state with a large abdominal lump, massive ascites and pleural effusion. CT scan of abdomen showed a big serosal fibroid uterus and hence we made a pre-operatve diagnosis of PseudoMeig’s syndrome. Thoracocentes is and abdominal paracentes is were both negative for malignant cells. Histopathological examination confirmed uterine leiomyoma and vanishing of pleural effusion and ascites postoperatively reconfirmed the diagnosis of PseudoMeig’s syndrome.

The giant cell reparative granulomas are non- neoplastic reactive lesions, usually triggered by trauma. They commonly present as slow growing lesions of the jaw, but the rapidly progressing aggressive lesions have rarely been reported. The aggressive giant cell reparative granulomas have atypical clinical and radiological features mimicking malignant lesions, which makes accurate diagnosis difficult. A case of aggressive giant cell reparative granuloma of maxilla in a 12 years old boy is being reported with discussion of clinical, radiological and histological features. Differentiation of such tumour from other giant cell lesions and extensive surgical excision to prevent recurrence is emphasized.

Eosinophilic granuloma is a variety of histiocytosis-X with unknown etiology. Eosinophilic granuloma is very rare benign bone tumor which presents in more than 90 % in children under the age often years. There is predominance for males. It is usually found at flat and long bones as single or multiple lesions of bone destruction. The skull and vertebral spine is often affected. We report a case of 16 years young adolescent male, presented with painless swelling in left frontal skull. CT cranium revealed 3.5cm × 2.5cm lytic lesion in skull with associated soft tissue in left coronal suture region. He underwent craniotomy and excision of mass. Histopathological features were consistent witheosinophilic granuloma. One month post-operative evaluation was normal and he kept on 6 monthly follow-up. This is a rare case of eosinophilic granuloma diagnosed in 16 years adolescent male, presented as painless frontal swelling.

Mineral Trioxide Aggregate (MTA) due to its superior biocompatibilty and ability to seal the root canal system can be used as an alternative to traditional materials for the repair of root perforations, pulp-capping and as a retrograde root filling. Though use of calcium hydroxide has a significant result in apexification of immature permanent teeth but due to advantage of MTA of single visit apexication, it becomes the material of choice. The paper discusses the overview of application of MTA through following case reports.

Gall bladder is affected primarily by the following malignancies: (1) Adenocarcinoma (2) Adenosquamous carcinoma (3) Squamous cell carcinoma. Adenocarcinoma is the most common malignancy found in Gall bladder. Pure squamous cell carcinoma of the gallbladder is a rare malignancy. Here, we present a case of pure squamous cell carcinoma in a 70 year old male patient diagnosed by fine needle aspiration cytology. The patient presented to the general surgery OPD with complaints of pain in the right hypochondrium and dyspepsia. The patient underwent ultrasound of whole abdomen during which a mass was found in the gall bladder lumen. Subsequently fine-needle aspiration cytology was done from gall bladder mass under ultrasound guidance. The patient was diagnosed as a case of pure squamous cell carcinoma arising from the gallbladder on the basis of cytology alone. Histogenesis and biological behavior of squamous cell carcinoma of gallbladder remains a matter of debate but the role of aspiration cytology in diagnosing these lesions cannot be undermined.