Branchial cyst is a rare developmental disorder which is diagnosed rarely. Remnants of Branchial are present at birth but may become clinically significant later in life. We report a case of 14-year-old male patient with an asymptomatic branchial cyst over lateral side of neck. These cyst originate from remnants of branchial arches or branchial pouches. The definitive treatment of is complete surgical excision of the cyst. Complete surgical excision prevents recurrence or other complications.

Endometriosis is defined as the presence of functional endometrial tissue outside the uterus. Being a rare condition often it is not included in the differential diagnosis of abdominal wall swelling. The typical history is a swelling in the scar or near the scar of previous Gynaecological or Obstetric surgery. Most of the time the diagnosis is done only after excision of the swelling. A case of endometriosis in the scar of a caesarean section. We have also discussed clinical feature pathogenesis, diagnosis and treatment of scar endometriosis. DiscussionScar endometriosis is a rare condition. It is seen females after abdominal or pelvic operation. The patients of

Bull horn injuries are common injuries in the rural population 1. These types are injuries are seen in farmers who take care of the cattles. Generally the injuries are seen in the perineal area and lower abdomen 2. I am reporting a rare case where there was penetrating injury in the right thigh extending into the peritoneal cavity with evisceration of small intestine though the thigh.

Background: Acute appendicitis is the acute inflammation of the appendix. It is surgical emergency, which is associated with morbidity and mortality occasionally. There are many scoring systems for the diagnosis of acute appendicitis, of these Alvarado score is simple scoring system that can be instituted easily in outpatient setting. It is purely based on history, clinical examination and few laboratory tests. The objectives of the study were to evaluate efficacy of Alvarado scoring system in preoperative diagnosis of acute appendicitis and correlating it with postoperative findings. Material and Methods: A prospective study was conducted on 45 patients presenting with symptoms and signs of acute appendicitis at Dr. Vasantrao Pawar Medical College, Nashik from August 2014 to December 2016. The patient who met the inclusion criteria were evaluated using Alvarado scoring system. Result: In present study 45 cases with a clinical diagnosis of acute appendicitis were studied. Majority (44.44%) were in the age group of 21-30 years. In this study, 24 patients (53.33%) were male and 21 patients (46.67%) were female with male to female ratio (1.1:1). Pain was the most common presenting symptom (100%). Out of 45 patient 34 patients (75.56%) have score >7 and 11 patient (24.44%) have score <7 and among these 38 patients (84.44%) got operated. Appendix was inflamed in 63.16% cases. Conclusions: Alvarado scoring system is an easy, simple, cheap, reliable and safe tool in pre operative diagnosis of acute appendicitis and can work effectively in routine practice.

Pilomatrixoma is a benign skin tumor derived from hair follicle matrix cells. They typically present as a superficial, firm, solitary, slow-growing, painless mass in the dermis. Pilomatricomas are frequently misdiagnosed and are not usually considered in differential diagnoses, either in clinical set-up or during cytological reporting. These lesions are typically found in the head and neck region. Involvement of the lower extremities is relatively uncommon and can be mistaken for malignancy. We present the case of a 55-year-old male with a pilomatrixoma of thigh which is a rare site of occurrence of the lesion and we review the literature regarding pilomatrixomas.