Rural Tertiary Health Care Centre Research Articles

Case series- study of pancreatic lesions and it’s management in a rural tertiary healthcare centre

Pancreatic cancer (PC) is a rising public health threat and is anticipated to account for over 48,000 cancer-related deaths by 2030. Significant advances in surgical technique have resulted in decreased perioperative morbidity and mortality after pancreatic resection. Management includes a multi modality program with neoadjuvant therapy and surgical resection.Inflammatory tumors, cystic and neuroendocrine neoplasms, and periampullary adenomas are other growing entities of pancreatic diseases. Patients present with symptoms of epigastric tenderness, jaundice, nausea, vomiting.Many surgical procedures have been proposed for periampullary tumors; these range from palliative bypass of the biliary and gastrointestinal tracts, local excisions, total pancreatectomy, and traditional pancreatoduodenectomy or the Whipple procedure. Each of these various procedures has been designed to answer a problem with postoperative mortality, long-term gastrointestinal function, or long-term survival.: To study clinical features and management of pancreatic lesions over a course of 1 year in a rural tertiary health care set up.

Adherence to timeline for decision to delivery interval in accordance with NICE guidelines and its impact on neonatal outcomes in a rural tertiary health care centre of Central India

Adherence to timeline for decision to delivery interval in accordance with NICE guidelines and its impact on neonatal outcomes in a rural tertiary health care centre of Central India

Assessment of peripheral lymph node tuberculosis: a prospective study of 24 cases

Abstract Introduction: Tubercular lymphadenitis which comes under Extra-pulmonary Tuberculosis (EPTB) has been affecting mankind since ancient times. Peripheral lymph node involvement is the commonest form of EPTB among which cervical lymph nodes are most frequently affected. Objectives: The aim of this study was to evaluate the demographic, clinical characteristics and treatment outcomes of peripheral lymph node Tuberculosis cases in a rural tertiary health care centre. Methods: The study was conducted prospectively at Prathima Institute of Medical Sciences, Nagunur, Karimnagar between January 2021 to August 2022. Pathologically confirmed cases of lymph node Tuberculosis were assessed and followed up. Results: 24 cases of lymph node TB were included with 83.3% females and 16.6% males (p=0.02) with a mean age of 32.6 ± 15.24 years. The mean age among males was 37 ± 15.59 years and among females was 31.75 ± 15.24 years. 58.3% were from rural areas. All of them presented with a history of swelling, 37.5% had a fever, 50% had a loss of appetite and 54.1% had a loss of weight. 8% had a past history of tuberculosis. 79.1% had cervical swelling and 20.8% had axillary swelling. 83.3% had multiple lymph nodes and 33.3% had lymph node matting. Three cases were lost to follow-up, 79% improved with standard anti-Tuberculosis treatment (ATT) and one case died during treatment. Conclusion: Lymph node TB is still prevalent in TB endemic countries and has to be considered first in the differential diagnosis of peripheral lymph node swellings.

To Study the Carriage and Antimicrobial Sensitivity Profile of MRSA among Nursing Staff of Rural Tertiary Health Care Centre of North India

The present study is carried to determine nasal carriage of MRSA among nursing staff posted in Medicine and allied wards of a rural tertiary healthcare center in North India and antibiotic sensitivity profile of the isolated MRSA strains. Many of the carriers of MRSA harbour pathogen in areas like nares, hand surfaces, axilla and are generally asymptomatic. Colonisation in healthcare workers has increased the incidence of serious nosocomial infection wherein healthcare workers act as vectors for transmission of infection in already immuno-compromised patients. The study undertaken was a cross sectional type where in nursing staff was analysed for nasal carriage of MRSA and antibiotic sensitivity profile of MRSA. A total of A total of 60 nursing staff members posted in medicine and allied wards were recruited in this study. A total of 34 (56.6%) were females and 26 (43.3%) were males. our study showed considerable MRSA carriage among the nurses and also reported a decreased sensitivity to commonly used drugs. Also, no resistance was detected against higher antibiotics like Vancomycin, Teicoplanin and Linezolid which points to their use in eradication of infection caused by MRSA. There is a need to strictly implement and follow the hospital infection control guidelines so as to reduce the spread of MRSA to susceptible persons.

Ovarian teratomas: One year experience in a rural tertiary health care center

Ovarian teratomas are said to originate from primordial germ cells and typically contains mature (or less frequently immature) tissue derivatives of three germ cell layers (ectoderm, mesoderm and endoderm). This report includes a series of six mature ovarian teratomas, which were diagnosed in a rural tertiary health care centre over a year and highlights three (out of six) unique cases with intestinal dysplasia, gliomatosis peritonei and struma ovarii respectively. Evaluation and possible mechanism of such rare teratomas are discussed with a brief review of literature.

English

BACKGROUND Dacryocystitis is one of the most frequent diseases of the efferent lacrimal system. It is the infection or inflammation of the lacrimal sac. This is usually because of nasolacrimal duct obstruction. Acute dacryocystitis can cause severe morbidity and rarely mortality in patients. This study wanted to identify the aerobic bacterial aetiology, and demonstrate the antibiogram of bacterial isolates of acute dacryocystitis. METHODS A retrospective record-based study was conducted in Rural Tertiary Healthcare Centre. Clinical Data of 89 patients was collected from medical records of 2014 to 2018 documents. Data of bacterial isolates and their antibiogram were retrieved from records in the Department of Microbiology. RESULTS The most common aerobic Gram-positive bacteria were Staphylococcus aureus (29.8 %) and Coagulase Negative staphylococcus (23.3 %). The most common Gramnegative bacteria were pseudomonas spp. (19.4 %) and klebsiella spp. (12.9 %). CONCLUSIONS The knowledge of bacterial profile in different geographic region, different age group will help to develop and implement treatment protocol. KEY WORDS Acute Dacryocystitis, Bacterial Profile, Antibiogram

Epidemiology of urinary candidiasis and antifungal susceptibility pattern of various Candida species at a rural tertiary health care centre of Puducherry, South India- An observational study

Urinary tract infection (UTI) is a common health problem across the globe. Although majority of them are bacterial in origin, there has been an increasing trend in the incidence of UTI due to the yeast like fungi, . UTI due to are in large proportion noscomially acquired and of growing concern is the development of resistance to the commonly used azole group of drugs for their treatment. Since the resistance is more commonly reported among non- albicans , routine species identification and antifungal susceptibility testing is crucial for successful clinical outcomes. This study was conducted to analyse the distribution and risk factors associated with Urinary candidiasis and also to determine the resistance patterns of different to various antifungal agents using phenotypic methods. : A hospital based observational study was conducted from September 2016 to December 2017 on patients presenting with symptomatic UTI. isolates were speciated using phenotypic methods like germ tube test and growth character on chromagar . Antifungal susceptibility to fluconazole, voriconazole, ketoconazole and amphotericin B were determined using disc diffusion method. All data were anlyzed using EpiData Analysis software version 2.2.2.186. A total of 101 were isolated. The incidence of Urinary candidiasis was more among females (66.4%) than in males (33.6%). People above 50 years (38.6%) were commonly affected followed by people in the age group of 21-30 years (22.7%). The incidence among hospitalized patients was 86.7% and urinary catheterization (43.5%) was the most commonly associated risk factor. The most common isolates were tropicalis (31.6%) followed by albicans (21.7%). The overall resistance patterns among various were 50.5%, 32.7%, 19.9% and 2% for fluconazole, ketoconazole, voriconazole and amphotericin B respectively. Hospitalization and urinary catheterization are the important risk factors for developing urinary candidiasis. The antifungal susceptibility varies among different and hence, identification of to species level along with antifungal susceptibility testing should be practiced as a routine in all clinical mycology laboratories.

Morphological types of anaemia integrated with distribution of red cell and platelet indices: Study in a rural tertiary healthcare centre

Anaemia is a critical global health problemA good morphological subtyping of anaemia can guide clinician in further patient management. With the advent of automation, red cell and platelet indices are available from the routinely used blood cell counters in the laboratory, these supplemented with peripheral smear examination help in a good categorization of anaemia. Aim of this study is to study the morphological types of anaemias in the adults with the Objectives of Categorization of the anaemias based on morphology and to study the distribution of the red cell and platelet indices in the same.: It was a prospective study conducted in the hematology wing of our central diagnostics over a period of three months and a total of 520 cases, which were morphologically classified according to the analyzer indices and peripheral smear. Distribution of the red cell and platelet indices in the different categories of anaemia were also noted. A majority of the anaemias were microcytic hypochromic in type (67.1%) followed by normocytic normochromic anaemias (26.5%). Increased RDW was seen in microcytic hypochromic anaemias (55%) and normocytic normochromic anaemias (6.9%). The Mean platelet count/ mean platelet volume was increased in microcytic anaemias compared to others. : Anaemias in the rural set up are predominantly of the microcytic in type. A good knowledge of the variation in RBC indices, RDW and platelet /mean platelet volume ratio along with a peripheral smear can help the reporting haematologist identify early stages of iron deficiency anaemia and can give a precise and accurate anaemia categorization at the basic entry level of laboratory investigation. Interpretation of variation in RBC and platelet indices though often neglected can contribute significantly to categorize the anaemia.

Pattern of admission and clinical outcome of patients admitted in pediatric intensive care unit of a rural tertiary health care centre

Background: In the treatment of critically ill children needing specialized airway, respiratory, and hemodynamic assistance, intensive care has become very necessary and is typically admitted into the pediatric intensive care unit (PICU) in order to ensure a better result than if the patients were admitted to other sections of the hospital. To audit admissions and their findings are significant, which may help to change procedures after extensive introspection if appropriate, leading to improved patient outcomes. Objective were to examine pattern of admission and clinical outcome of patients admitted in the pediatric intensive care unit of a rural tertiary health care centre.Methods: Information retrieved included age, sex, diagnosis, outcome, morbidity and mortality profile of patients admitted in PICU in the last five years.Results: A total of 2810 patients were admitted into PICU. (1444) 51.3% were infants, and (1366) 48.6% patients aged 1-18 years. Their ages ranged from one month to 18 years, with the mean age being 40.01 ± 45.79 months. There were 1948 (69.3%) male and 862 (30.3%) female patients giving an M: F ratio of 2.27:1. The overall mortality rate was 2.4%.Conclusions: In our PICU, mortality is low. We believe that the treatment of critically ill patients with desirable results is significantly facilitated by a well-equipped intensive care unit with advanced and creative intensive care in order to improve cost-effective patient care and prevent needless stretching of the PICU services, an extension of the pediatric wards is advocated.

Ceftaroline In-vitro Activity against Methicillin Resistant Staphylococcal Isolates in a Rural Tertiary Healthcare Centre

Introduction: The emergence of Methicillin Resistant (MR) staphylococcal infections had led to fewer therapeutic options. Ceftaroline fosamil is the only cephalosporin approved by United States of America (USA) Food and Drug Administration (FDA) till now which has activity against MR staphylococcal isolates. Until now, studies on in-vitro activity of ceftaroline are limited. Aim: To know the susceptibility pattern of Methicillin Resistant Staphylococcus aureus (MRSA) and Methicillin Resistant Coagulase Negative Staphylococci (MRCoNS) against ceftaroline in a rural tertiary health care centre. Materials and Methods: The present cross-sectional study was conducted in a tertiary care hospital in rural part of Karnataka between two months (July and August 2019). A total of 50 consecutive, non repetitive clinical isolates of MRSA and MRCoNS were obtained. Antibiotic susceptibility testing was done according to Clinical and Laboratory Standards Institute (CLSI) guidelines. The Minimum Inhibitory Concentration (MIC) of ceftaroline was detected using E-strips (Biomerieux). The CLSI breakpoints applied for the interpretation of ceftaroline MIC- Sensitive: ≤1 μg/mL; Susceptible Dose Dependent (SDD): 2-4 μg/ mL and resistant ≥8 μg/mL). Staphylococcus aureus American Type Culture Collection (ATCC) 29213 was used as a quality control. Statistical analysis was done using microsoft excel. Percentages were used in this study to analyse variables. Results: Out of 50 MR staphylococcal isolates, 10 (20%) were MRSA and 40 (80%) were MRCoNS. Of the MR staphylococcal isolates tested, 49 (98%) were sensitive to ceftaroline. The MIC 50 and MIC 90 for the 50 MR staphylococci was 0.25 μg/mL and 1 μg/mL, respectively. Conclusion: Ceftaroline demonstrated a potent in-vitro activity against MR staphylococci. So it can be used as an effective drug in the treatment of such infections.

CLINICAL PROFILE OF RECURRENT HEADACHES AMONG THE CHILDREN RESIDING IN RURAL HABITATS

Introduction: Recurrent headaches can progress to very frequent or even daily episodes of headaches and could have an enormous impact on the life of the children and adolescents. Objective: To study the clinical profile of recurrent headaches among the children residing in rural area. Methodology: A cross- sectional study was conducted at rural tertiary health care centre among the children in an age group 5 to 14 years in year 2019. A total of 160 children were enrolled, interviewed and examined as per structured proforma includes study parameters. The data were analyzed using statistical software and presented in tabular and graphical form. Results: The mean age of participants was 4.43 years with a male to female ratio as 1.1:1. The proportion of primary recurrent headache was 76.2% of which tension and migraine type was 52.4% and 41.8% respectively. Among the total migraine cases, migraine without aura was reported in 90.1% children. Somatization disorder, 63.1% was the most common cause of a secondary headache. As the age increases, frequency of recurrent headache also increases denoted by p - value, 0.004* with higher proportion participants, 62.5% age group 11 to 14 yrs. The average duration of headache illness was 1.8± 0.9 years with the mean duration of headache episodes was 3.57 hours respectively. Conclusion: Recurrent headache is a commonly encountered entity in the children from rural background which was attributed to various etiologies. Most of the children with recurrent headaches in rural regions approach late to health care setup which leads to a crippling effect on productivity in various fields like education and development.

A prospective study of etio-pathogenesis, management and complications of lower limb varicose veins among the patients admitted in a rural Tertiary Healthcare Centre

Background: In a developing country like India, study encompassing the clinical evaluation and management of lower limb varicose veins on the conventional lines seem a necessity to improve the quality care with the available resources. Aims and Objectives 1. To analyse the age and sex incidence of lower limb varicose veins. 2. To study the correlation between occupation and lower limb varicose veins, the clinical manifestations of lower limb varicose veins, the different treatment modalities like sapheno-femoral flush ligation, multiple subfascial perforator ligations, stripping and sclerotherapy and the respective clinical outcomes at the end of three months of follow up.Methods: A total 60 number of patients with primary lower limb varicose veins were admitted, investigated, operated and followed up from June 2019 to January 2020. Final outcome was evaluated. Results: It was noted that the varicose veins affected the younger adult and middle age population. A greater portion (48.3) of the patients had combined valvular incompetence (sapheno-femoral and sapheno-popliteal incompetence) Sapheno-femoral flush ligation withstripping appeared to be the best method of surgical management for incompetence in the long saphenous vein territory. Subfascial perforator ligation in patients with no junctional incompetence showed no recurrence Sclerotherapy was found to be an effective procedure especially for early varicosities. Conclusions: Majority 0f the patients presented with complications of varicose vein with combined valvular incompetence and Sapheno-femoral flush ligation with stripping appeared to be the best method of surgical management for incompetence in the great saphenous vein territory. When no junctional incompetence is present, performing sub facial perforator ligation alone for isolated perforator incompetence showed no recurrence in this study.

Time Lag in Reporting of CBNAAT Under RNTCP in Rural Tertiary Health Care Centre

Introduction: CBNAAT is a very useful rapid diagnostic test for the early diagnosis of DS and DR TB. Report of sample can be available in just 2 hours. But the results of these tests are not available for many days to weeks which results in delay in diagnosis and treatment initiation. Material and Method: This study was conducted for a period of 4 months from mid-April to mid-august 2018 in MMIMSR, Mullana. A total of 535 samples were sent for CBNAAT to TB Hospital, Ambala and the time taken from sending of samples to the receiving of report was analysed and time lag was calculated. Results: Out of 535 samples, 429 samples were negative, 104 were positive for MTB and 2 samples resulted as invalid/error. Out of 104 positive samples, 95 were rifampicin sensitive and 9 were rifampicin resistant MTB. The average time lag in reporting of CBNAAT samples was 11.1 days with shortest time being 2 days and longest being 33 days. Conclusion: CBNAAT is a very useful modality in TB diagnosis and should be made available to all eligible patients especially so in high DR-TB prevalence areas. But delay in reporting undermines the purpose of the test i.e. rapid diagnosis and treatment. There is an urgent need to establish more centres with CBNAAT facility throughout India so that there is no delay in reporting and early treatment can be started.

A study of intravenous infusion of Paracetamol versus intramuscular Tramadol for labour analgesia with respect to VAPS score at a rural tertiary health care centre

A study of intravenous infusion of Paracetamol versus intramuscular Tramadol for labour analgesia with respect to VAPS score at a rural tertiary health care centre

Psychological aspects of quality of life of breast cancer survivors

Background: Cancer is one of the most important health concerns and evaluating quality of life in cancer patients is an increasingly important issue. Objectives: To assess psychological facets of quality of life of patient suffering from breast cancer and to establish the relationship with socio- demographic determinants. Material and methods: A hospital based cross sectional study was conducted at rural tertiary health care centre among a total of 78 breast cancer patients in the year 2017. Data were collected by utilizing questionnaire focused on the psychological aspects of quality of life of breast cancer patients. Descriptive and inferential statistics were applied to find out significant association between demographic variables and quality of life. Results: Among the total of 78 breast cancer patients max, 65.3 % were in age group 45-60 years, 83.3% and 41.6% participants were unemployed and followed economic class II however; illiteracy was reported in 34.6% cases. The low age at diagnosis of disease was 30 years with max, 43.5% and 61.5% patients experienced very difficult to cope up with disease and treatment. Anxiety and depression each was experienced by maximum, 71.6% participants respectively however; almost similar psychological attitude was experienced by breast cancer patients. Determinants like occupation, economic status and marital behavior (p<0.05) were significantly associated with psychological aspects of quality of life of breast cancer patients. Conclusion: Family support, counseling, quality health care services and breast cancer supporting group could induces confidence and positive attitude towards breast cancer as well as further quality of life.

Clinical profile and outcome of respiratory distress in newborns admitted in rural tertiary health care centre of Maharashtra, India

Background: Respiratory distress is most common symptom complexes seen in newborn infants lead to high mortality. The objectives were to study various etiological factors, maternal and neonatal risk factors for development of respiratory distress along with need for CPAP, mechanical ventilation and surfactant to assess the immediate clinical outcome in newborns.Methods: The study was conducted at Krishna Hospital and Medical Research Centre, Karad in period of January to August 2018. A total of 100 neonates who were admitted in NICU within 72 hours of life were studied by clinical examination and relevant investigations. The severity of distress was assessed by Silverman-Anderson scoring, Downe’s scoring and APGAR scoring respectively for neonates.Results: It was observed that max, 90% of the distress cases were of respiratory in origin and high severity of distress was observed among 27% newborns. The proportion of respiratory distress was higher, 51% in males and low APGAR score was reported in 14% cases. Among respiratory etiology of respiratory distress, high proportion was of TTNB 35.55%. The maternal and new born factors like maternal age >30 years (32%), gestational age 28-30 weeks (87.5%), gravid 2 and 3 mothers (35%), female gender (32.6%), low birth weight (70%) developed severe distress respectively. The recovery rate of respiratory distress due to respiratory etiology was of 88.8%.Conclusions: Transient tachypnoea of new-born is the most common cause among new-borns with respiratory distress. New-borns with low gestational age, low birth weight baby, low APGAR score is more prone to develop severe respiratory distress.

Effect of acute phase of dengue fever on leucocyte count: A study in rural tertiary health care centre

Effect of acute phase of dengue fever on leucocyte count: A study in rural tertiary health care centre

Risk factors deciding the prevention and healing of diabetic foot ulcer: a prospective study in Chennai Medical College Hospital and Research Center Irungalur, Trichy, Tamil Nadu, India; a rural based tertiary medical care centre

Background: Diabetic foot ulcer is the one among and the most common complication of diabetes mellitus patients. Various studies from over the world for the past 2 decades discuss the important risk factors that decide the prevention and outcome of diabetic foot ulcer. In our prospective study we have discussed the risk factors focused on prevention and treatment of diabetic foot ulcer in a rural tertiary medical care centre.Methods: Totally 940 patients with the clinical diagnosis of diabetic foot ulcer admitted in our hospital surgical department were studied prospectively with their clinical symptoms and signs of diabetic foot ulcer and various evaluations done for the comorbid conditions with the help of other specialty departments. All these risk factors studied in our rural based tertiary medical centre were collected in a designed format were studied and discussed in comparison to the chosen data available in various studies done at various countries.Results: All the 940 patients admitted for diabetic foot ulcer who underwent a methodical evaluation for risk factor showed an elevated HbA1c more than 8 in 720 (77.5%) patients, bony involvement like osteomyelitis in 274 patients (29%) , peripheral vascular disease in 421 (44.9%), neuropathy in 533 patients (56.7%), nephropathy 163 (17.34%), retinopathy in 102 (10.85%) and heart disease in 375 (39.89%).Conclusions: Proper protocols to the prevention and management of foot ulcer in diabetic patients have not reached many health care centres and it is imperative to stress on the related comorbid risk factors which influence the prevention and healing of diabetic foot ulcer. Present study done at a rural tertiary health care centre is mainly focused on the incidence of risk factors which modulates and modify the diabetic foot ulcer prevention and management. This study aims to support the health professionals to identify the risk factors apart from the clinical picture of diabetic foot ulcer that may enhance the efficient management and avoid the unnecessary morbidity and mortality.

Clinicopathological study of cervical lymphadenopathy at rural tertiary health care centre

Background: The term lymphadenopathy refers to nodes that are abnormal in size, consistency or number. Cervical lymphadenothy is one of the common and important presentations of the underlying pathology of the head and neck region which has large number of differential diagnosis like neoplasms, infections (specific and non-specific) and in immune deficiency disorders and also, the rare disorders like Inflammatory pseudotumour (Plasma cell granuloma) and Kikuchi-Fujimoto diseases. Etiological profile of cervical Lymphadenopathy varies from region to region, in developing countries like India, acute respiratory infection, suppurative skin infection and tuberculosis are the main causes for cervical lymphadenopathy while in developed countries secondary carcinoma are the most frequent causes for cervical lymphadenopathy.Methods: This hospital based cross sectional study was carried out in the Department of Otorhinolaryngology in Rural Tertiary Health Care Centre. The period of the study was from January 2014 to June 2016.Results: In our study of 176 patients the youngest patient was 13year of age and oldest patient was 68 years old. The majority of patients affected were in the age group of 21 to 30 years (30.68%) followed by 13 to 20 years (23.86%). The least affected age group was 60 to 70 years (5.8%). There were 80 men and 96 women. The male to female ratio in present study was 1:1.2 The frequently affected age group was 21 to 30 years in men (26.25%) as well as women (34.38%). In our study Neck swelling was present in all cases (100%). fever was the second most common symptom in 54 cases (30.68%) followed by cough in 45 cases (25.56%). In our study most frequently involved lymph node group was posterior cervical in 68 cases (38.39%), followed by upper deep cervical in 66 cases (37.50%).Conclusions: In the present study it was found that tuberculosis was the most frequent cause of cervical Lymphadenopathy in 48.29% of patients, followed by reactive Lymphadenopathy in 17.34%, metastatic lymphadenopathy in 15.34% chronic nonspecific Lymphadenopathy in 14.77% and primary lymphoreticular malignancy in 4.35%. In our study out of 176 cases of cervical lymphadenopathy 141 cases (80.11%) were non neoplastic and 35 cases (19.88 %) were neoplastic.

Correlation of Histopathological Study of Breast Lesions with cytology and mammography as a measure of internal quality and diagnostic accuracy

Background: Breast cancer is the one of the leading causes death in women. Triple test approach has been widely accepted in asymptomatic women for the preoperative diagnosis of the breast lesions. Triple test includes clinical examination, mammography and Fine Needle Aspiration Cytology (FNAC) to differentiate between neoplastic and non-neoplastic lesions, histopathological confirmation being the gold standard for neoplasticlesions and best management plan for the patient. The aim was to study the histopathological spectrum of breast lesions and correlate the cytological and radiological findings with histopathological examination and to determine sensitivity, specificity and diagnostic accuracy of FNACand mammography in the diagnosis of the breast lesions. Methods: The study comprised of 552 casesofhistopathologically diagnosed breast lesions over the period of twelve years in a rural tertiary health care centre catering rural population. Results: Of the 552 cases examinedhistopathologically, 375 cases (67.9%) were benign lesions, 177 cases (32.1%) were malignant. Fibroadenoma was the commonest benign lesion, whereas infiltrating ductal carcinoma was the commonest malignant tumour. Incidence of phyllodes tumour was significantly higher compared to other studies. Overall sensitivity, specificity and diagnostic accuracy of FNAC and mammography were 95.9%, 98%, 96.6% and 84.7%, 78.5%,81.1% respectively. Conclusion: Histopathology plays an important role in diagnostic and therapeutic management of neoplastic breast lesionswith preoperative Triple test being an important supportive investigation in rapid diagnosis withfairly good sensitivity,specificity and diagnostic accuracyin neoplastic lesions. Significantly higher incidence of phyllodes tumor needs further investigation for causative mechanism. DOI: 10.21276/APALM.1427