Large upper central chest wall defects are a reconstructive challenge. The commonly described flaps for this area do not provide very large skin paddle, and free tissue transfer remains the only option for large skin defects. Supraclavicular flap as a local flap is widely used for head and neck reconstruction and has been described for upper chest wall defects earlier. We have used nonislanded supraclavicular flap for reconstruction of two cases of large chest wall defects, which would otherwise need free tissue transfer, single flap in one case and bilateral flaps in the other. It is easy to do and has minimal morbidity. Supraclavicular flap offers a simple solution for large skin defects of the upper central chest wall and is especially useful in patients with high-operative risk and guarded prognosis.

Abstract. Carcinoid tumors are the most common neoplasm of the appendix. The clinical presentation of these lesions is often similar to that of acute appendicitis, or the tumors are asymptomatic. The carcinoids are commonly found incidentally during histopathological examination of the resected appendix following appendectomy or other abdominal procedures. Appendiceal carcinoids usually behave as benign tumors and appendicectomy alone is a sufficient treatment in the majority of cases, while for larger lesions, right colectomy should be performed. The prognosis of patients with local appendiceal carcinoids is excellent. The present study reports the case of a 22-year-old female patient that presented with recurrent right lower abdominal pain of a three-year duration. The patient underwent successful appendectomy and recovered four days later. Subsequently, an appendiceal carcinoid tumor located at the tip of the appendix was diagnosed by histopathological examination. Follow-up examination one year after surgery revealed that the patient was well with no discomfort.

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<p><strong>Background: </strong>Intertrochanteric fracture is commonly seen in elderly and osteoporotic bone due to trivial trauma and requires hospitalization. Nonoperative treatment leads to complications like bedsore, pneumonia and deep vein thrombosis. The introduction of cephalomedullary nailing has broadened its use in complex intertrochanteric fracture with least complications.</p><p><strong>Methods: </strong>A prospective observational study was conducted in Birgunj, Nepal from 4^th October 2020 to 3^rd October 2021 among 50 patients of age more than 30 years with closed intertrochanteric fractures. Ethical approval was obtained from the institutional review committee and proper informed consent was taken. Modified Harris hip scoring system was used. Type of implant used was PFN long and short.</p><p><strong>Results: </strong>The mean age of 50 patients was 66.42 years, female to male ratio was 1.5:1 (30:20) and right side (72%) with fall injury (78%) was commonly observed. According to Kyles classification, 40% patients had Kyles’s type II fracture followed by type III (38%).  Most of the cases start mobilization on 2^nd post operative day. Mean Harris hip score at 14 days, 6 weeks, 3 months and 6 months were 52.02, 64.50, 72.91 and 84.40 respectively. Early mobilization within 2 days of post-surgery had significant improvement in functional outcome throughout follow up as compared to more than 2 days (p=0.001, 0.001, 0.001 and 0.001 at 14 days, 6 weeks, 3 months and 6 months respectively). Radiological union was achieved in all cases within 6 months.</p><p><strong>Conclusions: </strong>The study results concluded cephalomedullary nailing is effective treatment for intertrochanteric fracture.</p>