A unilateral double testicle is a rare anomaly characterized by migration of one testicle towards the opposite inguinal canal. The commonest erratic development is the more or less incomplete descent of the testicle along the normal route of descent, which is known as cryptorchidism. In ectopia of the testicles, as opposed to cryptorchidism, the displaced testicle does not descend along the usual route but as it migrates downwards it moves into an entirely abnormal position. Usually the migrating testicle remains on its own side of the body but may end up in an unusual position e.g. in the superficial tissue of the inguinal region above the external ring, in the area of the base of the penis, in the upper part of the thigh, in the region of perineum or in the pelvic cavity. In this case, the right and left testicles were found to descend together on the right side, whereas the left side of the scrotum was entirely empty. The case was treated with 'Bilateral Transeptal Subdartos Orchidopexy'. The case reported here is evidently one of extreme rarity as there are about 148 reported cases since the first described by Von Lenhossek in1886. Case report:A one year old boy presented with a painful swelling in the right groin and vomiting for 6 hours with a history of empty scrotum on the left side since birth. Physical examination showed a right sided obstructed inguinal hernia together with a palpable retractile right testicle and a non palpable left testicle and spermatic cord. Suspecting a right sided obstructed inguinal hernia and left sided cryptorchidism, he was submitted to emergency operative treatment under general anesthesia after adequate resuscitation.Operative findings as related to this unusual condition are described now. On inguinotomy, a redundant tunicavaginalis was discovered which extended for some distance proximally along the cord. During separation of the tunica vaginalis, it was found that the boy had two testicles on the same side of equal appearance, separated epididymis and vasa deferentia. The mesorchia was fused with the peritoneum. Both testicles were delivered into the inguinal wound (Fig.1). Both spermatic cords were followed to the right deep inguinal ring where they entered the abdomen. Isolation of the hernial sac was carefully done in a regular way without any injury to the spermatic cords and spermatic vessels.
Introduction: Respiratory diseases are the commonest cause of death in children under 5 year. Pneumonia is the leading killer of children worldwide. In developing countries childhood pneumonias are diagnosed using clinical parameters, usually based on presence of cough and increased respiratory rate. Although this is cheap, sensitive and maximizes the number of children identified and treated empirically, it is also nonspecific and highly dependent on the context in which it is being applied. So the simple chest radiograph has been an important investigative tool in the diagnoses of diseases, since the discovery of X-rays in late nineteenth century. Chest radiograph is frequently used in the management of acute lower respiratory infection in children and still considered to be the gold standard for diagnosing respiratory infection and pneumonia. Objectives: To study the role of chest radiographs in diagnosing the etiology of tachypnea in children less than five years of age and to correlate findings of chest radiographs with etiology of tachypnea. Materials and Methods: A case control study was conducted in the Department of Pediatric Medicine, CNMC, Kolkata on tachypneic children aged between 2 months to 59 months during October 2017 to September 2018, presenting to Pediatric OPD, CNMC (Calcutta National Medical College) with clinical features of tachypnea. Chest Radiographs were done and evaluated. Analysis was done by SPSS 20 software. Results: In this present study, Among 300 patients Brochiolitis was diagnosed in 30% cases, Pneumonia in 26% cases, Asthma in 15% cases, Bronchopneumonia in 8% cases; Pleural effusion and Pneumothorax in 4% cases each; Bronchiectasis, Foreign body impaction, Milliary Tuberculosis(TB), Space occupying lesion were diagnosed in 2% cases each. The comparisons between Chest x-ray findings with Final diagnosis and Patient outcomes were significant (p value <0.001). Conclusions: In this study I have seen that chest X-ray can give useful information about the presence of pneumonia more commonly in patients who complain of cough and tachypnea for 3 days and more. So physicians should have to select patients who need x-rays to avoid unnecessary exposure to radiation and wastage of time and money for all patients with pneumonia
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