Background: Fine needle aspiration cytology (FNAC) is a widely acclaimed preoperative primary investigation in the management of salivary gland lesions. But, lack of standardized unambiguous reporting often poses challenge to the clinicians. The six-tiered category-based Milan system of reporting salivary gland cytology (MSRSGC) proposes standardization in the reporting with risk of malignancy (ROM). Aim: To find out the applicability of Milan system to diagnose the salivary gland cytology by correlating with histological follow-up and to estimate ROM for each of its category. Methods and materials: Cross-sectional study was conducted in a Tertiary Hospital over a period of 2 years. Fine needle aspiration cytology (FNAC) diagnosis was classified as per MSRSGC categories into (I) nondiagnostic (ND), (II) non-neoplastic (NN), (III) atypia of undetermined significance (AUS), (IVa) benign neoplasm, (IVb) salivary gland neoplasm of uncertain malignant potential (SUMP), (V) suspicious for malignancy, and (VI) malignant. Cytology diagnosis was correlated with histopathology, and ROM was calculated. Results: Fine needle aspiration cytology (FNAC) diagnosis was made for 50 samples as per MSRSGC. Histopathology follow-up was done for 46 cases (92%). The cytohistopathological correlation was done, and the discrepancy was noted in five cases. Our ROM for non-neoplastic, AUS, benign neoplasm, SUMP, suspicious for malignancy, and malignant categories was 0, 0, 0, 100, 100, and 100%, respectively. The sensitivity, specificity, and accuracy of FNAC were found to be 75, 100, and 98%, respectively. Conclusion: Implementing Milan system in salivary gland FNAC yields quality, standardized reporting, and also estimation of ROM helps in effective clinical management.

The mucormycetes fungus causes mucormycosis (also known as zygomycosis), a dangerous but uncommon fungal infection. Molds can be found in a variety of places. Mucormycosis is a fungus that primarily affects those who have health problems or who use medications that lower the body's ability to fight infections and sickness. It is a dangerous invasive fungal infection that can impact people who have uncontrolled diabetes, kidney failure, organ transplants, long-term steroid and immunosuppressive medicines, cirrhosis, burns, AIDS, and tumors such as lymphomas and leukemias. The researchers conducted a systematic review of a number of studies that demonstrated the presence of mucormycosis in post-COVID patients. The researchers began to observe how mucormycosis affected those who had been infected with a virus. We found nine articles on Google Scholar and the Internet using the keywords “COVID” and “mucormycosis,” describing 13 post-COVID patients infected with mucormycosis. Mucormycosis can appear in at least six different clinical syndromes, including rhino-orbito-cerebral, lung, cutaneous, gastrointestinal, disseminated, and other: pulmonary disease (three study papers with four trials each and one research report with four patients); gastrointestinal disease (one research paper with one case); and disseminated disease (one research paper with one case). Seven of the 13 patients died, according to previous study reports. According to Worldometer, coronavirus disease-2019 (COVID-19) has been reported in almost 88 million cases, with nearly 1.9 million deaths globally. Despite the fact that there are no signs of mucormycosis in COVID patients, the death rate is over 50%. The situation is really alarming. Because delayed diagnosis and inadequate treatment can lead to poor outcomes, more research is needed.

Tuberculosis (TB) is a major communicable disease that affects one-third of the world's population. The management, as well as prognosis, depends on the early identification and diagnosis. Delay in diagnosis leads to worsening of the patient's clinical condition and the emergence of resistant bacilli. The purpose of the review article is to describe the factors affecting delay in diagnosis in newly diagnosed pulmonary tuberculosis patients. For eight months, researchers searched PubMed, the WHO website, and Google Scholar for all materials pertaining to the topic. In total, 30 articles reflecting on the various causes of diagnosis delay were chosen and analyzed. The educational status, income status, distance to the healthcare facility, cost, initial consultation with the type of healthcare personnel in the healthcare system, and frequency of consultations were associated with the delays. A multimodal strategy is needed to alleviate the delay in diagnosing pulmonary tuberculosis.

Millions and millions of people are working daily in an atmosphere filled with respirable dust particles. Crystalline silica is an important dust particle which is generated in many occupations like stone carving, quarrying, sand blasting, shipping, ceramic industry, etc. The workers who are constantly exposed to the silica particle on a regular basis are more likely to develop occupational lung diseases like pneumoconiosis, chronic obstructive pulmonary disease (COPD), bronchitis, etc. These cause a decline in the lung functions. The purpose of this review article is to narrate the effects of occupational exposure of silica on lung functions. The spirometry results revealed a decline in forced expiratory volume 1 second, forced vital capacity, and ratio of forced expiratory volume 1 second to forced vital capacity. This reveals the need for proper education of the employees to take adequate preventive measures during working like wearing protective personal equipment, periodic screening, etc.

A 60-year-old male presented with complaints of hemoptysis, cough, chest pain, nasal crusting, and hematuria. He had history of diabetes for the last 20 years on orally administered antihyperglycemic agents (OHAs). He was a smoker for the past 30 years. On examination, patient had strawberry gingival hyperplasia. Auscultation revealed bilateral wheeze on all areas of chest. High-resolution computed tomography (HRCT) revealed ill-defined multifocal patchy areas of airspace consolidation in both lungs involving the upper and lower lobes. Rheumatoid arthritis (RA) factor, antinuclear antibody (ANA) enzyme-linked immunoassay (ELISA), anti-cyclic citrullinated peptide (CCP) antibodies ELISA, deoxyribonucleic acid (DNA) (double strand) antibody were negative, angiotensin-converting enzyme (ACE) was within normal limits while cytoplasmic anti-neutrophil cytoplasmic antibody (C-ANCA) was positive and perinuclear anti-neutrophil cytoplasmic antibody (P-ANCA) was negative. A diagnosis of granulomatosis with polyangiitis was made in accordance with the American College of Rheumatology Criteria for Wegener's granulomatosis. Strawberry gingival hyperplasia is a rare but pathognomonic manifestation of granulomatosis with polyangiitis (GPA); hence I present this case report.

Securing an airway in pediatric patients with TMJ ankylosis with nil mouth opening is an anesthetic challenge. Among the methods available including submandibular intubation, retrograde intubation and tracheostomy, fiberoptic nasotracheal intubation technique remains gold standard. Self-awareness and calmness are important attributes of an anaesthetist during such cases. Prior planning of the anesthetic technique and good rapport with surgeon are of key importance for successful outcomes of such difficult airway cases. We present a case of Right Temporomandibular Joint Ankylosis for surgery in a pediatric age-group with nil mouth opening managed successfully with fiberoptic bronchoscope.

The commonest elective procedure performed on a critically ill patient is tracheostomy. The major complications may be divided based on the duration of the procedure: early, medium-early, and late postoperative. The commonest late complication of tracheostomy is a tracheoesophageal fistula (TEF). Tracheostomy tube may cause injury to the posterior wall of the trachea and also due to endotracheal tube (ET) cuff overinflation. Here reporting a case of acquired tracheoesophageal fistula post-tracheostomy of a 25-year-old male posted for tracheal reconstruction surgery.

SARS-CoV-2 infection can express itself in a variety of ways, including gastrointestinal symptoms such as nausea, diarrhea, vomiting, and minor abdominal pain. Rare manifestations of SARS-CoV-2 infection have become more well-known over time. These uncommon and infrequent manifestations may make it harder to make a quick diagnosis, as well as lead to unnecessary investigations, longer hospital admissions, negative outcomes, and a greater burden on health care resources. We submitted a case to our hospital with a picture that resembled an acute abdomen, demanding surgical diagnosis and assessment. The case was found to be SARS-CoV-2 positive and did not require surgery. The importance of abdominal symptoms in the context of coronavirus disease-2019 (COVID-19) has been discussed for better evaluation of COVID-related conditions.

Lung cancer is one of the most common cancers that causes death. Autofluorescence bronchoscopy is a recent technology which uses blue light to detect precancerous lesions that cannot be detected by conventional white light bronchoscopy. This is based on the principle that there is difference in emission of this light between premalignant and malignant tissue, that can be distinguished by a change in color emitted. Advantage of autofluorescence bronchoscopy is that it has excellent sensitivity in picking up abnormal tissues; therefore, early detection of cancers can be made, and appropriate treatment can be given, thereby increasing the survival. The major drawback of this procedure is that it lacks specificity.