iosr-JDMS   Volume-14 ~ Issue-8 ~ August-2015

Abstract: Primary Non hodgkin's lymphoma (NHL) usually arises within the Lymphnode , but 20- 30% accounts for extranodal sites. Buccal mucosa as a primary extranodal sites for non Hodgkins Lymphoma is relatively rare and represent 2.5% of all malignant lymphoma. HIV associated NHL are Extranodal and have a predilection for sites in the Head and Neck region in about 50-60% of cases .Of all the extranodal NHLs, oral constitutes only 25%. It is now considered that oral NHL serves as the first indicator of HIV infection. In this study, we present a case of Non Hodgkins Lymphoma of Right Buccal mucosa associated with AIDS and Review of literatures associated with it.

[1] F Lozada, S Sanz, S Silverman, C Miranda, JA Regezi. Intra oral non-Hodgkin's lymphoma in seven patients with acquired immunodeficiency syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod.1996;82:173–8. [PubMed]

[2] EB Wolvius, EA Schulten, Wall van der. Non-Hodgkin's lymphoma of the oral cavity as the first manifestation of AIDS. Br Dent J. 1997;182:107–8. [PubMed]

[3] L Eisenbud , J Sciubba, R Mir,S-A Sach. Oral presentations in non-Hodgkin's lymphoma: a review of thirty-one cases. Part I Data analysis. Oral Surg Oral Med oral Path 1983; 56: 151-156.

[4] Z Haider. A review of non-Hodgkin's lymphoma of the oral cavity 1950-1980. J Oral Med 1986; 41: 197-200.

[5] Y Fukuda, T Ishida, M Fujimoto, T Ueda ,K Aozasa . Malignant lymphoma of the oral cavity: Clinicopathologic analysis of 20 cases. J Oral Pathol 1987; 16: 8-12

[6] N Takahashi, N Tsuda, F Tezuka, H Okabe. Primary non-Hodgkin's lymphoma of the oral region. J Oral Path Med 1989; 18: 84-91.

Keywords: Birth weight is an important determinant of child survival and development. It is also a subject of clinical and epidemiological investigations and a target for public health intervention. Low birth weight is an important determinant of childhood morbidity and mortality. Child's birth weight is a significant factor which determines vulnerability for risk of childhood illness and childhood survival. Children who are born with weight < 2.5 kg are vulnerable for dying during their early childhood .

[1]. Nelson Textbook of Paediatrics- 19th Edition.
[2]. Low Birth weight- UNICEF Statistics. UNICEF Data Monitoring the situation of Children and Women. LBW – Country, Regional and Global Estimates ( WHO, UNICEF ).
[3]. Cloherty Manual of Neonatal Care – 6th Edition.
[4]. Social and Preventive Medicine, Park, 19th edition.
[5]. Kader et al, N Am j Med Sci.2014 Jul;6(7):302-308. Socio-Economic and Nutritional Determinants of Low Birth Weight in India.
[6]. Kattula et al, The first 1000 days of life: prenatal and postnatal risk factors for morbidity and growth in a birth cohort in Southern India. BMJ Open 2014:4:e005404doi:10.1136/bmjopen-2014-005404.

Keywords: High tension electrical burns are a rare but devastating form of injury. The objective of this case report is to bring to the fore the severity of this rare form of injury and highlight the benefits of active surgical management of such a condition.A 36-yr-old male had sustained 21% high-voltage electrical injury in agricultural field due to contact with high tension wire 32 hrs before his presentation, with Burns involving left face ,neck ,thighs, hands and trunk. He received primary medical care at local Hospital before being brought to our Hospital.He was treated with I V fluids, antibiotics and had blood investigations showing rasied Bilirubin.MR Angiogram was done which showed flow in Superficial temporal artery and Facial arteries upto Mandibular level only suggestive of Vascular compromise.

[1]. Abbas.A.D.,Dabkana.T.M.,Tahir.C.,Naaya.H.U. High-tension Electrical Burns: Report of Two Cases Ann Burns Fire Disasters. 2009 Sep 30; 22(3): 160–162. [2]. Hu YC, Xu XS, Ou CS, Chen K, Zhou YS, Li BT, Zhou HY Repair of high-voltage electric burn in jaw and neck region with insular pectoralis major myocutaneous flap Zhonghua Shao Shang Za Zhi 2009; 25 (1): 22 – 24.

Keywords: Hemoglobinopathies are the world wide prevalent monogenic genetic disorder affecting the structure, function, or production of hemoglobin with variable geographic distribution. In the southeast asia and Indian subcontinent, this has been considered as common disorder of blood posing a major genetic and public health problem.

[1]. Angastiniotis M, Modell B. Global epidemiology of hemoglobin disorders. Annals of the New York Academy of Sciences 1998;850:251-269.
[2]. Steinberg MH et al. Disorders of Hemoglobin. Cambridge University Press 2001;4:205-11
[3]. Fucharoen S, Winichagoon P. Hemoglobinopathies in southeast asia. Molecular biology and clinical medicine 1997;21:299-319
[4]. Rees DC et al. The Hemoglobin E syndromes. Annals of the new York Academy of Sciences 1998;850:334-343.
[5]. Chernoff Al, Minnich V, Nanakorn S. Studies on Hemoglobin E. the clinical, hematologic, and genetic characteristics of the hemoglobin E syndromes. J Lab Clin Med 1956;47:455-489
[6]. Marsh WL Jr, Rogers ZR, Nelson DP, Vedvick TS. Hematologic findings in southeast Asian immigrants with particular reference to haemoglobin E. Ann Clin Lab Science 1983;13(4):299-306

Keywords: Parapharyngeal lymphangioma means cystic hygroma involving parapharyngeal region which can obstructs the airway laterally, this is very rare condition. We present here a case report of a 9-year-old female patient who came with a chief complaint of pain and swelling on left side of face since 8 days and was later diagnosed as having cystic hygroma in parapharyngeal region on the basis of her clinical features and further imaging studies. This report also highlights the surgical and other treatment options.

Keywords: cystic hygroma, lymphangioma, parapharyngeal Lymphangioma, swellings in neck, sclerotherapy.

[1]. Mehta M, cystic hygroma- 2 cases, Indian journal otolaryngology and head and neck surgery, 2000, 52:3:319-22
[2]. Mirza B, Ijaz L, Muhammad S, Muhammad S, Sheikh A, Cystic Hygroma: An Overview, Journal of Cutaneous and Aesthetic Surgery, 2010, 3: 3:139-44.
[3]. Kaur N, Gupta A, Amratash, Singh N. Giant cystic hygroma of the neck with spontaneous rupture. J Indian Assoc Pediatr Surg 2007;12:154-5.
[4]. Kocher HM, Vijaykumar T, Koti RS, Bapat RD. Lymphangioma of the chest wall. J Postgrad Med 1995;41:89-90.
[5]. Anton G. Fetal cystic hygroma colli, South Eastern Europe Health Sciences Journal, 2013; 3(1):97-100.
[6]. Dhrif AS, El Euch D, Daghfous M, Cherif F, Mokni M, Dhahri AB. Macrocystic lymphatic lymphangioma (cystic lymphangioma) of upper extremity: A case report. Arch Pediatr 2008;15:1416-9.

Keywords: A retrospective study of 108 cases of tracheobronchial foreign bodies was analyzed. History, clinical findings, radiological features, type of material & location of foreign bodies were studied. In our study of the 108 children who underwent rigid bronchoscopy, 102 had tracheobronchial foreign bodies (94.4%). Foreign body aspiration happened mostly in children below 3yrs of age (84.3%), choking preceded the symptoms in 82 cases (80.3%). Very few, 9 patients reported within 24hrs of the event (8.8%). There was a delay of more than 2 weeks in 13 (12.7%) cases.

[1]. National Safety Council, Research and Statistics Department. Injury Facts 2008 Edition. Itasca, III: National Safety Council; 2008. 8, 14-15.
[2]. Rizk N, Gwely NE, Biron VL, Hamza U. Metallic hairpin inhalation: a healthcare problem facing young Muslim females. J Otolaryngol Head Neck Surg. 2014 Aug 2;43:21.
[3]. Chai J1, Wu XY, Han N, Wang LY, Chen WM. A retrospective study of anesthesia during rigid bronchoscopy for airway foreign body removal in children: propofol and sevoflurane with spontaneous ventilation. Paediatr Anaesth. 2014 Oct;24(10):1031-6. doi: 10.1111/pan.12509. Epub 2014 Aug 22.
[4]. Mallick MS1.et al Tracheobronchial foreign body aspiration in children: A continuing diagnostic challenge. Afr J Paediatr Surg. 2014 Jul-Sep;11(3):225-8.
[5]. Boufersaoui A1, Smati L, et al Foreign body aspiration in children: experience from 2624 patients. Int J Pediatr Otorhinolaryngol. 2013 Oct;77(10):1683-8.

Keywords: Calcium Sodium Phosphosilicate (NovaMin®) have been used in bone and tissue regeneration for over 15 years. It is effective as an adjunct to conventional surgery in treatment of intrabony defects. It has also been incorporated in dentifrices as a remineralising ingredient for treating dentinal hypersensitivity. Recent studies with NovaMin containing dentifrices and the particulates mixed with water alone have been shown to possess a strong anti-microbial action against periodontal pathogens that could be of significant benefit to the patient in periodontal maintenance therapy.

[1]. Hench LL, Andersson Ö. Bioactive glasses. In: Hench LL, Wilson J, editors, An Introduction to Bioceramics. Singapore: Reed Healthcare Communications 1993; pp. 41-62.
[2]. Stoor P, Söderling E, Salonen JL. Antimicrobial effects of a bioactive glass paste on oral microorganisms. Acta Odontol Scand 1998;56:161-5.
[3]. Allan I, Newman H, Wilson M. Antibacterial activity of particulate bioglass against supra and subgingival bacteria. Biomaterials 2001;22:1683-7.
[4]. Allan I, Wilson M, Newman H. Particulate Bioglass® reduces the viability of bacterial biofilms formed on its surface in an in vitro model. Clin Oral Implants Res. 2002;13(1):53-8.
[5]. Greenspan D, Clark A, LaTorre G. In-vitro antimicrobial properties of a bioactive glass (NovaMin) containing dentifrice. J Dent Res 2004;83:1586.

Keywords: Inguinal Hernia is a common finding in infants & Childrens required surgical repair. Incidence 1 – 4.4% pathology is failure of obliteration of Patent Processus Vaginalis and canal of nuck in female.It occurs, in Boys is six times more than the Girls. Congenital inguinal Hernia can be life threatening, There are various methods for surgical treatment of hernia and hydrocele in children with variable cost effectiveness, recovery and cosmetic out come. This study analyses our experience with minimal invasive herniotomy in children with small incision, with good result.

[1]. Farquharson‟s, "Text book of operative surgery" 9th Ed., editor – Hodder Arnold, 2005, Pg. 466 -268.
[2]. Gross E. Robert and Willian, E. Ladd, New Eng. J. Madicine, 239:645:1948.
[3]. Harper, R.G. Garcia, A. Sin , "Inguinal hernia : A common problem of premature infants weighing 1000 gm or less at birth", Paediatrics, 56:112:1975.
[4]. Jin zhe Zhang and Xiu – Zhen Li, " Inguinal hernia in infants and children" Medicine, Paediatric surgery international, 8:6:sept. 1993, Pg. 458-461.
[5]. Jeffrey H., Haynes M.D., "Inguinal and Scrotal disorders". Surg.Clin. N.A., 86:2006 Pg. 371-81
[6]. Manoharan, Sawarakkody U. and et al, "Evidence based change of practice in the management of unilateral inguinal hernia", J. paed. Surg. 40:7:July 2005 Pg. 1163 -66.

Keywords: Ulcerativecolitis (UC) is anidiopathic (autoimmune) inflammatory bowel disease, limited to the colon. UC affects the colon and rectum, while Crohn's (CD) affect the whole gastrointestinal tract (GIT).Highest incidence of UC was in Northeast England, Norway,Minnesota,Scotland,Faroses,Iceland and Denmark.The western diet lifestyle increases the incidence of UC.Risk factors in UC include,age,smoking,diet, breastfeeding, oral contraceptives, accutane use, sulfate producing bacteria, genetic factors, autoimmune disease, and psychological factors. Bacterial and parasitic infections can produce clinical findings as idiopathic UC.Macrophages and other accessory cells are an important component of the immune response in inflammatory bowel disease (IBD).Frequent clinical symptoms of UC is diarrhea which is usually associated with mucus and blood in stool.

[1]. DaneseS,FiocciC.Ulcerativecolitis.NEngl J Med.2011;365:1713-25.
[2]. KombluthA,SacharDB.Ulcerative colitis practice guidelines in adults. Am JGastroentrol.1997;92:204-11.
[3]. HanauerSB.Inflammatory bowel disease.NEngl J Med.1996;334(13):841-8.
[4]. Jess T,GamborgM,MunkholmP,etal.Overall and cause specific mortality in ulcerative colitis:meta-analysis of population-based inception cohort studies. Am JGastroenterol.2007;102(3):609-17.
[5]. ShivanadaS,Lennard-Jones J,LoganR,etal.Incidence of inflammatory bowel disease across Europe: is there a difference between north and south?. Results of the European Collaborative Study of Inflammatory bowel Disease. Gut. 1996; 39(5): 690-7.
[6]. SonnerbergA,McCartyDJ,JocbsenSJ.Geographic variation of inflammatory bowel disease within the United States.Gastroenterol.1991;100(1):143-9.

Keywords: Parasitological axiom is that "10% of the population harbours 70% parasites". An estimated 300 million cases of scabies occur annually. The etiological agent of scabies, Sarcoptesscabieivarhominis belongs to class Arachnida and subclass Acarina. Crusted scabies, a severe variant of scabies usually seen in immunocompromised is characterized by hyperkeratotic crusts that contain large numbers of scabies mites and eggs which are highly contagious. Prompt diagnosis, quick and aggressive treatment is needed to prevent outbreaks of scabies .We are reporting two cases of crusted scabies seen in immunocompromised patients.

Key words: Crusted scabies, Immunocompromised, Mite, HIV/AIDS, Lepromatous leprosy

[1]. Alssad S Ross L HeukelbachJ et al the neglected navigating web of the incomprehensibly emerging and reemerging Sarcoptes mite Infection genetics and evolution2013; 17:253-259.
[2]. Hengge UR, Currie BJ, Jager G, Lupi O, Schwartz RA. Scabies: a ubiquitous neglected skindisease.Lancet Infect Dis. 2006;6:769–779.
[3]. Danielsen DG BoeckW treatment of leprosy or Greek Elephentiasis. Paris, JB Ballierre 1848
[4]. Gach JE, Heagerty A. Crusted scabies looking like psoriasis. Lancet. 2000;356:650.
[5]. Prens E, Hegmans J, Lien RC, Debets R, Troost R, van Joost T, Benner R. Increased expression of interleukin-4 receptors on psoriatic epidermal cells. Am J Pathol. 1996;148:1493–1502

Keywords: Background:Emergence of drug resistant tuberculosis, particularly multi drug resistant TB (MDR-TB) and extensively drug resistant TB (XDR-TB) has become an obstacle to effective TB control in India. Objectives: To study the sociodemographic and clinical profile of MDR/XDR-TB patients in Kolkata. Methodology: A retrospective study was performed on MDR patients admitted in Jadavpur and Boral TB hospitals, the two designated drug resistant tuberculosis centers (DR-TB center) of Kolkata, in 2013.

[1]. World Health Organization. Global tuberculosis report 2014. [Internet] [cited 2015 May 27 ]. Available from: http://apps.who.int/iris/bitstream/10665/137094/1/9789241564809_eng.pdf
[2]. Ramachandran R, Nalini S, Chandrasekar V, Dave PV, Sanghvi AS, Wares F, et al. Surveillance of drug-resistant tuberculosis in the state of Gujarat, India. Int J Tuberc Lung Dis 2009; 13(9):1154-60.
[3]. Sharma SK, Mohan A, Kadhiravan T. HIV-TB co-infection:epidemiology, diagnosis & management. Indian J Med Res 2005; 121(4): 550-67.
[4]. World Health Organization. TB/HIV: a clinical manual. [Internet] [cited 2015 May 28]. Available from: http://whqlibdoc.who.int/publications/2004/9241546344.pdf
[5]. Central TB Division, Directorate General of Health Services, Ministry of Health and Family Welfare. Guidelines on programmatic management of drug resistant tuberculosis (PMDT) in India. NirmanBhavan, New Delhi: Revised National Tuberculosis Control Programme; 2012. p. 18-29.

Keywords: Popliteal cyst, or Baker's cyst, are considered rare in children and may exhibit particular features, as compared with adults. Baker's cyst are fluid filled cysts that result from extrusion of synovial fluid from the knee joint into the popliteal bursa, usually following minor trauma or pathologic processes of the knee joint. Baker's cysts most frequently are located in the bursa beneath the medial head of the gastrocnemius muscle or beneath the semimebranous muscle, these two bursae often coalesce, forming a gastrocnemius-semimembranous bursa. Primary baker's cyst usually occurs in children. They usually are asymptomatic and thus are typically found incidentally in children.

[1]. Baker W.M. Vol. 21. II. St. Bartholomew's Hospital Reports; London: 1885. (The formation of abnormal synovial cysts in connection with the joints).177–190.
[2]. Pfister J.A. The popliteal fossa: an unrecognized junction. Rev Med Suisse Romande. 2004 Sep;124(9):561–564.
[3]. D. L. Janzen, C. G. Peterfy, J. R. Forbes, P. F. J. Tirman, and H. K. Genant, "Cystic lesions around the knee joint: MR imaging findings," American Journal of Roentgenology, vol. 163, no. 1, pp. 155–161, 1994.
[4]. R. Seil, S. Rupp, P. Jochum, O. Schofer, B. Mischo, and D. Kohn, "Prevalence of popliteal cysts in children. A sonographic study and review of the literature," Archives of Orthopaedic and Trauma Surgery, vol. 119, no. 1-2, pp. 73–75, 1999.
[5]. M. De Maeseneer, C. Debaere, B. Desprechins, and M. Osteaux, "Popliteal cysts in children: prevalence, appearance and associated findings at MR imaging," Pediatric Radiology, vol. 29, no. 8, pp. 605–609, 1999.

Keywords: Surgical site infections are the third most commonly reported nosocomial infections. They have been responsible for the increasing cost, morbidity and mortality related to surgical operations. Surgical site infection rate has varied from a low of 2.5% to a high of 41.9%. Staphylococcus aureus is frequently isolated from post surgical wound infections, which may serve as nidus for the development of systemic infections. Objectives: The objective of this study was to isolate and identify various gram positive cocci from surgical site infected cases and determine their antimicrobial susceptibility pattern.

[1]. Howard.J.R. Surgical infections. In: Schwartz's Principles of surgery vol.I. 9th edition. Mc Grawhill. 2010.p:143-75
[2]. Jain A, Bhatawadekar S, Modak M. Bacteriological profile of surgical site infection from a tertiary care hospital, from western India. Ind J App Res 2014;4:397–400.
[3]. Lilani SP, Jangale N, Chowdhary a, Daver GB. Surgical site infection in clean and clean-contaminated cases. Indian J Med Microbiol. 2005 Oct;23(4):249–52.
[4]. Forbes BA, Sahm DF, Weissfeld AS, editors. Skin, soft tissue, and wound infections. In: Bailey and Scott's diagnostic microbiology. 11th ed. St louis: Mosby; 2002. p. 978-79.
[5]. Collee JG, Duguid JP, Fraser AG, Marmion BP, Simmons A, Laboratory strategy in the diagnosis of infective syndromes. In: Collee JG, Duguid JP, Fraser AG, Marmion BP, Simmons A Eds. Mackie and McCartney Practical Medical Microbiology. 14th Ed. Churchill Livingstone Inc: London 1996; p.53-94.

Keywords: Globally chest trauma accounts for 10% of trauma admission and 25% of trauma deaths. Outcome of chest trauma depends on causes and mechanism of the injury, pattern of lesions and presence of associated injuries. Objective:To study the aetiology, injury pattern, management and outcome of chest trauma in Hospital Universiti Sains Malaysia (HUSM), Kelantan,Malaysia. Methods: Records of 504 patents admitted from January2003 to December 2012 who fulfilled the inclusion criteria were retrospectively reviewed. Demographic data, details of aetiology, mechanism and pattern of injury,associated injury,management including ICU admission ,ventilation requirement and outcome including length of stay(LOS) and mortality was analysed .

[1]. J.M.Ryan,Accident and Emergency,in RCG Russel,Williams NS, Bulstrode LJK(Eds).Bailey and Love's Short Practice of Surgery23rdEdn(London:Arnold Publishers,2000)270-280
[2]. National Trauma Databank 2014 annual report American College of Surgeons ,Chicago –www.facs.org/ntdbannualreport,accessed on 29 July 2015
[3]. OJ Murray,AD Lopez,Mortality by cause for eight regions of the world: Global Burden of Disease Study,The Lancet,349(9061),1997,1269-1276.
[4]. Sabariah FJ et al,July 2011.National Trauma Database,Malaysia,http://www.acrm.org.my/ntrd accessed on 15July2015.
[5]. Pang , Fatal injuries in Malaysian motorcyclists,International Medical Research Journal, 3,1999, 115-119

Keywords: Neurofibromatosis(NF) type 2, also called as MISME syndrome, is a rare autosomal dominant inherited disorder, characterized by occurrence of multiple benign neoplasms in central and peripheral nervous system associated with eye lesions1. MISME stands for multiple inherited schwannomas, meningiomas and ependymomas. To our knowledge, till now in literature simultaneous occurrence of all the above three tumors in a single patient with histological confirmation had been reported in only one case2. Here with we are reporting a very rare case of MISME syndrome with triple tumors in a 24 year old patient presenting with bilateral vestibular schwannomas, cervico medullary junction(CVJ) meningioma and an intra medullary ependymoma at D11&D12 region.

[1]. Spilberg G, Marchiori E, Gasparetto EL, Cabral RF, Takayassu TC, Batista RR,Vieira IG. Magnetic resonance findings of neurofibromatosis type 2: a case report. Cases J. 2009 Jul 2;2:6720.
[2]. Jin X, He J, Wang D, Zhang X, Wu Y, Liu H, Wu Z, Liu J, Luo JJ. MISME syndrome with triple tumors affecting cervical spinal cord. Neurology cases. 2014 Apr Vol1: 2374-3522.
[3]. Evans DG, Howard E, et al. Birth incidence and prevalence of tumor-prone syndromes: estimates from a UK family genetic register service. Am. J. Med. Genet. A.2010 Feb:152A(2):327-3.
[4]. Baser ME, Evans DG: Lack of sex-ratio distortion in neurofibromatosis 2.Am J Med Genet 2000, 95:292.
[5]. Evans DG. Neurofibromatosis type 2 (NF2): A clinical and molecular review..Orphanet Journal of Rare Diseases.2009;4(16).

Keywords: Purpose: The causative agents of suppurative keratitis vary from region to region. We undertook this study to formulate empirical management and comprehensive strategy for lab diagnosis in remote areas. Material & methods: Corneal scrapings were collected under strict aseptic conditions by the ophthalmologist. Whenever possible multiple scrapings were collected and processed in a sequential manner. Selection of media and tests were modified according to individual need. Report of microscopy was provided immediately.

[1]. Sharma Savitri, Reddy M, Rao GN. In: Modern Ophthalmology. LC Dutta. 2nd Edition.(Jaypee Publishers). 2005. 161-196.
[2]. Basak Samar K, BasakSukumar, MohantaAyan, Bhowmik Arup. Epidemiological and microbiological diagnosis of suppurative keratitis in Gangetic West Bengal, Eastern India. Ind J Ophthalmol. 2005; 53(1):17-22.
[3]. Bashir Gulnaz, Shah Azra, ThokarManzoor A, Rashid Sabia, ShakeelSaman. Bacterial and fungal profile of corneal ulcers- a prospective study. Ind JPatholMicrobiol. 2005; 48(2): 273-277.
[4]. Srinivasan M. Infective keratitis:A challenge to Indian ophthalmologists. Ind J Ophthalmol. 2007; 55(1):5-6.
[5]. Chander J, Sharma A. Prevalence of fungal corneal ulcers in northern India. Infection
1994; 22(3):207-9.
[6]. Bourcier T, Thomas F, Borderie V, Chaumeil C, Laroche L. Bacterial keratitis: predisposing factors, clinical and microbiological review of 300 cases. Br J Ophthalmol.2003; 87:834-838.

Keywords: To evaluate the safety and efficacy of a single 3 g dose of Fosfomycin trometamol in the treatment of lower uncomplicated UTI compared with those of a 5 day course of Norfloxacin (400 mg, bid). Methods: Patients attending gynecological OPD at PESIMSR Kuppam with a clinical diagnosis of lower urinary tract infection were studied. Urine samples were taken for microscopy and culture sensitivity . Patients in group 1 received single dose of 3 gm fosfomycin trometamol , patients in group 2 received 5 day course of 400 mg bid norfoxacin . Patients were evaluated at the end of 10 days for symptomatic relief, side effects, bacteriological clearance. If patient persists to have clinical or microbiological evidence of infection after course of therapy then antibiotics was changed according to culture and sensitivity report . Primary outcome was clinical cure.Secondary outcome was bacteriological cure.

[1]. Armstrong D, Cohen J. Cystitis and urethral syndromes, ST chambers. In : Infectious diseases, Mosby 2000.
[2]. Eva hummens, Pradier and Michael M. Kochan .urinary tract infections in adult general practice patients. 2012 pg 32 – 35.
[3]. Betsy Foxman . American journal of medicine. Epidemiology of urinary tract infections : incidence, morbidity and economic costs. Volume 113, Issue 1, Supplement 1, Pages 5–13, July 8, 2002.
[4]. Colgan R, Nicolle LE, McGlone A, Hooton TM. Asymptomatic bacteriuria in adults. Am Fam Physician. 2006 Sep 15;74(6):985-90.
[5]. Daniele Minardi Gianluca d'Anzeo Daniele Cantoro Alessandro Conti Giovanni Muzzonigro. Urinary tract infections in women, etiology and treatment options. 19 april 2011.
[6]. Christine A. Lasala. Urinary tract infections: managing acute, chronic and difficult cases. Urogynecology in Primary Care2007, pp 124-136.

Keywords: A retrospective observational study of histopathology of Skin adnexial tumors was done during the period of three years (n=28), from june 2013- May 2015 in a tertiary care hospital .Majority of the tumors are benign and the origin is hair follicle. Incidence is higher in females when compared to the males and head & neck region is the commonest site. Keywords: Skin adnexal tumors (SAT), Hematoxylin & Eosin staining (H&E Staining)

[1]. Radhika K, Phaneendra BV, Rukmangadha N, Reddy MK. A study of biopsy confirmed skin adnexal tumours: experience at a tertiary care teaching hospital. J ClinSci Res 2013;2:132-8
[2]. Storm CA, Seykora JT. Cutaneous Adnexal Neoplasm. Am J ClinPathol 2002; 118:S33-S49.[pubmed]
[3]. M. K. Reddy, A. J. Veliath, S. Nagarajan, and A. L. Aurora, "A clinicopathological study of adnexal tumours of skin," Indian JournalofMedicalResearch,vol.75,no.6,pp.882–889,1982
[4]. M. O. A. Samaila, "Adnexal skin tumors in Zaria, Nigeria," AnnalsofAfricanMedicine,vol.7,no.1,pp.6–10,2008.
[5]. P. S. Nair, "A clinico-histopathological study of skin appendagealtumors,"Indian Journal of Dermatology, Venereology and Leprology,vol.74,article550,2008

Keywords: Giant Mesenteric Cysts in large intestine are rare here present two children ages being 5 and 4 presented with huge big abdominal masses noticed incidentally.Ultrasonography[USG] and Computarized Tomogrphy [CT] done .one was found in the pelvic mesocolon which was enucleated and the other was in the transverse mesocolon which needed intestinal resection and anastamosis with successful outcome and review of relevant literature.

Keywords: Children , Cyst ,Mesentery, Surgery.

[1]. Richard R. Ricketts. Mesenteric and omental cysts. In: Grosfeld Jay L, O'Neill JA, Fonkalsrud EW, Coran AG, Caldamone AA (eds), Pediatric Surgery. Chapter 89. Mosby Inc. 2006;Vol II:1399–1406.
[2]. MA Chung, ML Brandt, D St-Vil, S Yazbeck. Mesenteric cysts in children. J Pediatr Surg. 1991;26:1306–08. [PubMed]
[3]. JJ Tan, KK Tan, SP Chew. Mesenteric cysts: an institution experience over 14 years and review of literature. World J Surg. 2009;33:1961–65. [PubMed]
[4]. A Prakash, A Agrawal, RK Gupta, B Sanghvi, S Parelkar. Early management of mesenteric cyst prevents catastrophes: a single centre analysis of 17 cases. Afr J Paediatr Surg. 2010;7:140–43. [PubMed]
[5]. ME Senocak, H Gündodu, N Büyükpamukçu, A Hiçsönmez. Mesenteric and omental cysts in children. Analysis of nineteen cases. Turk J Pediatr. 1994;36:295–302. [PubMed]