We reported a case of a 12-year-old girl child with an uncommon intracranial metallic foreign body who was hit by her younger sister with sickle that got stuck to skull. Patient presented to us with stuck sickle in her head and was fully conscious with complaint of headache. She was very much afraid of her injury and was screaming with pain and fear. There was no neurological weakness. Computed tomography scan revealed that metallic foreign body was located adjacent to the confluence of major sinuses posteriorly on her skull. The location and position of foreign body suggested that it was of low velocity, and was hit from pointed end of sickle. It was taken out after doing craniectomy all around the sickle point and dural tear was repaired with pericranium. The postoperative course was uneventful.

BACKGROUND Hernia repair is one of the common general surgical operations. Open mesh repair method (Lichtenstein's repair) is known as "Gold Standard" for inguinal hernia. Slowly another technique Total Extra-Peritoneal (TEP) repair emerged. TEP repair is considered to be an "advanced" laparoscopic procedure and still not available widely. MATERIALS AND METHODS Our study compared outcomes of laparoscopic inguinal hernia repair with open mesh hernia repair. Total of 75 patients in each group included in study. RESULTS The mean age of patients presenting with hernia was 36.96 years and 37.08 years, while mean weight was 58.4 kg and 61.56 kg for laparoscopic and open group respectively with age ranged from 21 to 55 years. Mean operative time was 90 minutes (Unilateral), 117 minutes (Bilateral) and 70 minutes for laparoscopic and open mesh hernioplasty respectively. Analgesic dose required for laparoscopic group and open group was 3.58 and 3.16 respectively. The cost of surgery in laparoscopic group was 11000-14000 Rs. (Mean-12,000 Rs.), while in open group was 6000-8500 Rs. (Mean-7000 Rs.). CONCLUSION Although laparoscopic totally extraperitoneal hernia repair has many advantages over open mesh repair, but when it comes to availability of the technical expertise, operative time, cost of surgery, open hernioplasty seems better.

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Eccrine spiradenoma is one of the rare, benign dermal neoplasm showing eccrine sweat gland differentiation. The literature search accounts for less than 100 reported cases of eccrine spiradenoma. Clinically, the lesion presents as solitary, intradermal, circumscribed, round or oval, firm, painful or tender nodule measuring from 0.3 - 5 cm in diameter. Rarely if ES, presents as multiple lesions, in combination with other types of adnexal tumors such as cylindromas & trichoepitheliomas, it can be considered as a part of the Brooke-Spiegler syndrome. Majority of these tumours appear on the head/face & upper trunk region of the body. Spiradenomas arise in early adulthood in most instances with few reports also of congenital cases and no sex predilection seen. The definitive diagnosis is made by excisional biopsy of the tumour. Complete tumor excision with clear surgical margins is considered the primary treatment for these cases. Here, we present a rare case report of a 58 years old male presenting with a soft, cystic lesion in the left lumbar region of the abdomen for past 2 years duration. Surgical excision of the tumour was done with clear margins and the specimen was sent for histopathological examination. Due to the overlapping histomorphological features, this tumour is often confused with cylindromas and trichoepitheliomas along with other vascular tumours. Eccrine Spiradenoma, although a benign tumour, but malignant transformation has been described especially in long-standing cases or multiple lesions. So, early diagnosis is very important to prevent recurrence and to identify any onset of malignant transformation.