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The occurrence of intussusception and appendicitis in the same patient has seldom been described in the pediatric population. Authors report a case of two- level ileo- ileal intussusception associated with acute appendicitis. A 2-year-old boy presented with colicky abdominal pain, vomiting and non-passage of stools and flatus since 4 hours. On physical examination, he was irritable and restless. Abdomen was distended, borborygmi was heard on auscultation, ultrasound of abdomen suggested ileocolic intussusception. Emergency laparotomy was performed and an ileoileal intussusception was visualized and was reduced manually. After reduction, appendix was visualized, and it was found to be inflamed and elongated. Appendectomy was performed. Authors present this case because of its rarity in occurrence in a toddler in a rural setup as ours.

Background The most prevalent clinical entity of extra pulmonary tuberculosis is tuberculous lymphadenitis. However, it resembles other granulomatous conditions pathologically and obtaining tissue for microbiological diagnosis is also difficult. Thus it is a challenging task for diagnosis and early initiation of management. Fine needle aspiration cytology and biopsy are the diagnostic methods generally used to obtain the lymph node samples for histopathological and microbiological diagnosis. Mycobacterium culture on Lowenstein-Jensen medium remains the gold standard for definitive diagnosis, but its major limitations is a prolonged turn-around time of 2–4 weeks. The GeneXpert Mtuberculosis/RIF assay is a novel molecular diagnostic method for rapid diagnosis of tuberculosis and rifampicin resistance in clinical specimens. Methods This was a cross sectional analytical study conducted on 67 cases of suspected tubercular lymphadenitis at R.L Jalappa Hospital and Research Centre, Tamaka, Kolar. The study was carried out between December 2017 to June 2019. The samples were collected using excision biopsy and subjected to GeneXpert Mtuberculosis/RIF assay and histopathology. Further, sensitivity, specificity, positive predictive value and negative predictive value was measured and compared with histopathology. Results The average age of the patients was 37.04 ± 19.27 and majority was males. The lymph nodes were predominantly present in cervical region. Histopathology analysis reveals 46 positive cases of tuberculosis Lymphadenitis and GeneXpert Mtuberculosis/RIF assay detects 42 cases of tuberculosis Lymphadenitis. In the present study, GeneXpert Mtuberculosis/RIF assay had a sensitivity of 82.60% and specificity of 85% when compared to histopathology. Further the PPV and NPV was found to be 92.68% and 68% respectively. GeneXpert Mtuberculosis/RIF showed 2 cases of rifampicin resistance out of 67 cases. In this study, the GeneXpert Mtuberculosis/RIF showed the results in 0.79 days. Conclusion The present study showed that GeneXpert Mtuberculosis/RIF is a simple and reliable technique for diagnosing tuberculosis Lymphadenitis with high specificity and sensitivity as compared histopathology. Further, the methods elicit rapid diagnosis and also detected rifampicin resistance. It is thus a reliable and useful diagnostic modality in rapid detection of the causative agent and initiation of appropriate category anti-tubercular therapy when necessary.

Background: Inguinoscrotal swellings are the most common presenting complaints in the surgical out patient department and surgeries for the same are the most commonly done elective procedures.However meticulous the surgeon is, there is always some amount of scrotal oedema. Our study is intended to use a simple and novel technique by applying a scrotal hitch after the surgery to prevent the scrotal oedema. The aim of the study was to evaluate the effectiveness of a scrotal hitch in reducing the scrotal oedema and pain postoperatively.Methods: In this study all subjects undergoing inguinal hernia surgeries at undergoing at R.L. Jalappa Hospital, Kolar from June 2019 to August 2019 were included. Of the 60 subjects, 30 in group A were given scrotal hitch and subjects in group B were given scrotal support alone. The incidence of scrotal oedema and postoperative pain and development of any complications will be compared in both the groups.Results: A total of 60 subjects were included in this study. Mean age of patients in group A is 45.63±21.745 and group B is 41.43±24.579. 2 patients with scrotal hitch developed scrotal edema whereas 6 patients developed scrotal edema in group B. The post-operative pain score was lower in patients with scrotal hitch.Conclusions: Scrotal hitch is a simple and effective technique in preventing post-operative oedema and pain. The results of this study would encourage surgeons to take up this simple procedure to prevent the commonest complication of inguino-scrotal surgeries.