There is a marked increase in the incidence of gall bladder cancer (GBC) in recent times in India. There is no hospital based data or any registry system available for this cancer from Bihar. The present study aims to make a first insight into the pattern of GBC in Bihar during the year (2005-14). A retrospective study was carried out in the Department of G.I. Surgery at the Indira Gandhi Institute of Medical Sciences(I.G.I.M.S), Patna, Bihar, to study the pattern of GBC. The data obtained were analyzed for statistical significance by calculating the average value of the parameters followed by samplet-test. Most of the patients were from rural background with poor economic status.

Introduction: Oral cancer is the one of the most prevalent disease in Bihar. The main reason of oral cancer is the use of tobacco and tobacco related products. Seventy-five percent of all head and neck cancers begin in the oral cavity. According to the National cancer institute’s surveillance, epidemiology, and ends results (SEER) program, 30 percent of oral cancers originate in the tongue, 17 percent in the lip, and 14 percent in the floor of the mouth. Aim and Objective: The study was conducted for screening of oral cancer among tobacco consuming patients reported to dental OPD at IGIMS, Patna in male and female groups. Materials and Method: Retrospective study was conducted to access the prevalence of oral cancer among 4200 outpatients who reported to dental OPD at IGIMS, Patna from October 2011 to December 2014. The clinical diagnosis of oral cancer was made after intra-oral examination of patients showing characteristic features of oral cancer. The patients were grouped under male and female categories. According to^{[2],[12],[13]} American oral cancer society following physical criteria is included for oral cancer detection. 1) Most common symptom is sore mouth with easy bleeding and ulcer doesn’t heal. 2. Most common sign of oral cancer is pain that doesn’t go away. 3. Lump or thickening in the cheek and lymph node enlargement, their consistency of lymph node are hard and painless. 4. Red or white patches on gingiva, tongue, floor of the mouth etc 5. Sore throat or feeling of something caught in the throat. 6. Difficulty in swallowing, eating, drinking water etc 7. Unexplained loss of teeth. 8. Numbness in the part of oral cavity. Results: The total numbers of oral cancer patients screened were 120. The prevalence of oral cancer in this study was 120 (2.86%). Majority of subjects were male, 85 out of 120 (70.8 %) in comparison to females, 35 out of 120 (29.16%). Conclusion: The findings of the study clearly indicate that prevalence of oral cancer and use of smokeless tobacco has direct relationship in causation of oral cancer. The male are consuming more tobacco products than female so, occurrences of oral cancer are more in male.

Background: As 1^ST Year preclinical medical students start and/or enter the MBBS course, they go through the anatomy dissection, which involves interaction with cadavers and cadaveric material. Aim & Objective: The objective of this study was to record the reactions of students during the first exposure to the human cadaver in the course of First MBBS. Material & Methods: Questionnaire was distributed to all 1st year medical students. The questionnaire was made with the objective of identifying specific patterns of reaction and problems faced by the students in their first exposure to the human cadaver. Results: The commonest symptoms experienced were loss of appetite (33%). The commonest cause of their symptoms was studied and the result shows that it was the smell of the embalmed cadaver, as reported by 55% of the 1st year students.

Osteoporosis is a silent disease increasing the fracture risk and load on public hospitals. Proper diet and preventive medication can reduce the chances of osteoporosis. Presently we have population data regarding osteoporosis from northern and southern part of India but no such data is available from eastern region. The aim of present study was to collect such data for assessment of osteoporosis in our population. 363 (246 males, 117 females) patients with age more than 20years (average age 43.01years) were selected for the study. The patients with BMD data measured using distal radius quantitative ultrasound and expressed as T score were collected. It was analyzed by logistic regression analysis. Average BMD was minus 1.2 (normal). 201 (55.37%) patients had normal BMD, 140(38.56%) were osteopenic and 22(6.06%) were osteoporotic. In less than 50 years of age most of the females were osteopenic while most of the males were having normal BMD. The prevalence of osteoporosis was 4 times higher in females of age more than 50 years. In males the prevalence of osteopenia and osteoporosis was same in all age groups. There was significant difference in incidence between males and females (p 0.002) while insignificant (0.772) in two age groups.

Atherosclerosis is the most important cause of cardiovascular disease and is associated with deposition of atherogenic lipoprotein in vessel wall. This study was intended to study the lipid profile in dyslipidemia patients taking statins. This was an observational retrospective population based study conducted on 100 patients in medicine OPD of IGIMS, Patna from January 2015 to April 2015. There was greater proportion of diabetic participants (64%). Mean cholesterol, LDL-C & TG levels among diabetic males were 194 mg/dl, 115 mg/dl & 180mg/dl respectively. Mean cholesterol, LDL-C & TG level among diabetic females were 197 mg/dl, 118 mg/dl & 182 mg/dl respectively. Mean cholesterol, LDL-C & TG levels among non-diabetic males were 197 mg/dl, 115 mg/dl & 177 mg/dl respectively. Mean cholesterol, LDL-C & TG levels among non-diabetic females were 198 mg/dl, 115 mg/dl & 175 mg/dl respectively. This study data suggest that cholesterol, LDL-C &TG levels were higher than levels traditionally considered as optimal.

Agenesis of lung, a rare congenital anomaly, defined as complete absence of bronchus, parenchyma, and vessels which may present in adult life with features of recurrent chest infections and chest X-Ray may present as opaque hemithorax with ipsilateral shifting of mediastinum. Here, a case of an adolescent presenting with frequent attacks of cough, expectoration and dyspnea since childhood, proved to be a case of right pulmonary agenesis along with dextrocardia is to be discussed.

Patients with myelomeningocele have high incidence of associated anomalies. Among the urological anomalies neurogenic bladder is common. Posterior urethral valve can be a rare comorbid possibility associated with myelomeningocele. It is important for clinicians to be aware of this disease association and if left untreated can significantly increase morbidity and mortality.

Background: Uterovaginal prolapse is a very common morbidity among Indian women. Vaginal pessaries still have role in the management of uterovaginal prolapse. Vaginal pessary gives symptomatic relief and does not cause any discomfort, women tend to forget it. Long forgotten pessaries get incarcerated in the vagina and their removal poses problems. Forgotten pessary is one of the causes of foul smelling discharge per vaginum. Safe removal of the incarcerated vaginal foreign body is essential and requires skill and experience. A 60 year old postmenopausal lady presented with foul smelling vaginal discharge. She had a history of inserting a ball bearing into her vagina for reducing her prolapsed uterus. Speculum examination and per vaginum examination revealed embedded metallic ball bearing in the vagina. Attempts at removal by gentle traction was not successful for the fear of injuring adjacent structures. Metallic ball bearing was removed under general anaesthesia with the help of ortho deptt with a wire cutter. This case report is unique as here ordinary metallic ball bearing was used as a vaginal pessary and in spite of long duration it did not cause much discomfort or serious complications.

Hypertrophic cardiomyopathy is characteristically associated with asymmetric hypertrophy of interventricular septum causing partial obstruction of the left ventricular outflow and reducing ejection fraction. Since Hypertrophic cardiomyopathy is the most common genetic cardiovascular disease, it is very commonly encountered by anesthesiologist during preoperative examination. Surgery and anesthesia often complicate the perioperative outcome if adequate monitoring and proper care are not taken. General anaesthesia is considered safer because of more cantrolled hemodynamics. Regional anesthesia is considered to be dangerous in these patients, especially in those with obstructive HCM, vasodilation associated with sympathetic blockade of the lower extremities may lead to a critical reduction of preload and afterload. Nevertheless, epidural anesthesia has been used safely for vaginal delivery in patients with HCM. Our report indicates that cesarean section also may be managed safely with epidural anesthesia in patients with HCM, by taking precaution.

The extra tooth present in the dental arch is called as supernumerary tooth (ST) tooth and when the extra tooth which is similar to the adjacent teeth is called as supplemental tooth. It results from the abnormal instruction received during odontogenesis. These teeth are extra in the arch or unerupted. When it remains unerupted, it may cause disturbance to the developing teeth. In this case the patient approached for psychological (cancer- phobic) reason for the treatment. This case is also interesting because of presence of ST between upper first and second molar, which has rare in occurrence and is termed as “paramolar tooth”. The supernumerary tooth was extracted under local anesthesia.

We describe anaesthetic management of 41-year-old female admitted for total abdominal hysterectomy having history of 35% full thickness burn with scar marks over face, neck, both upper limbs whole of anterior abdomen and inguinal region on both sides. Graft was taken from both thigh and right leg which had left scar mark. With burn contractures over neck and involvement of limbs she was difficult to intubate and difficult intravenous access as well. Keeping in view the difficult airway access she was planned for combined spinal epidural anaesthesia. Gaining intravenous access posed a challenge because of burns scars on upper limbs, graft scars on both thigh and right leg. Central venous cannulation was not attempted because of distorted anatomy of neck. Left leg was warmed by wrapping it in towels moistened with warm water to dilate veins and intravenous line secured. Because of pain experienced by patient after an hour of starting surgery general anaesthesia was given and airway secured with i- Gel, which went uneventful.

Foreign bodies in the genital tract is a commonly encountered in both men and women but more common in women. These are encountered more commonly in the younger age group compared to post menopausal age. Foreign bodies might cause symptoms such as pain or offensive vaginal discharge or might remain asymptomatic. The common location of such foreign bodies is the vagina and are less commonly found within the uterus. Here we report a case of rice grain found inside the uterine cavity of a post menopausal woman with chronic uterovaginal prolapse.

Various methods, such as lllizarov bone transport, allogenic bone grafts, bone graft substitutes,vascularized bone transfers etc are available in treating segmental bone loss. Free vascularised fibular graft is an autografting method that requires expertise only. However, this method is not popularized due to its technical demand and there are not many reports regarding its application in treating a large segmental bone loss of forearm. We are reporting a case which was done in our institute to exhibit its possibility of effectively treating the long segmental bone loss of ulna. Patient recovered with gain of a good range of movement and there was no donor site morbidity after three months of follow up.

Newborn babies undergoing emergency posterior sagittal anorectopexy (PSARP) present several challenges for the anaesthesiologists. Such neonates require constant monitoring and immediate intervention during anaesthesia and multiple congenital anomalies pose further predicaments. Anaesthetic management of a newborn depends upon the type of surgical emergency and their condition. We report here four cases of high anorectal malformation admitted about same time for primary PSARP and were successfully managed under general anaesthesia.

Lipoblastoma is not a rare entity in children. The more common sites are extremities and trunk. We report here a rare case of huge Lipoblastoma in neck region with axillary extension.

Osteoma is a benign, slow-growing osteoblastic lesion. It is the most common benign tumor of the sinonasal tract. The frontal sinus is the most frequently involved anatomic site followed by the ethmoid, the maxillary sinus, and, more rarely, the sphenoid sinus. As osteomas are usually asymptomatic, they are very often incidental radiographic findings. Giant osteomas of the paranasal sinuses are rare but readily extend into the intraorbital or intracranial cavity, causing serious complications. A rare case of large ethmoidal osteoma in a 34 year old male with extensive intraorbital involvement is being discussed.