A 24-year-old male presented to the institute in GI Oncosurgery Department as a diagnosed case of metastatic adenocarcinoma of rectum. The cross sectional imaging done in the radiology department also showed evidence of polypoidal infiltrative rectal mass with perirectal, bilateral iliac and paraaortic lymphadenopathy and bony lesions [Table/ Fig-1]. Patient underwent abdominoperineal resection with abdominal lymph node dissection after receiving neoadjuvant chemotherapy and radiotherapy. Thereafter, patient received multiple cycles of FOLFOX-4 based chemotherapy and was on regular follow up for one and a half years, when he presented with complain of painless right scrotal swelling. USG examination revealed multicystic septated lesion involving head and body of right epididymis measuring 3.0 x 1.6 x 3.6 cm. On colour Doppler imaging there was no internal vascularity b]. Mild ipsilateral hydrocele was also present. Bilateral testis were unremarkable. Imaging differentials of cystic lymphangioma, loculated hydrocele, epididymal cysts and spermatocele were considered and patient

Background: The prevalence of clinical HTN in children and adolescents is 3.5%. Measuring BP with an inappropriate cuff is the most common cause of misdiagnosing hypertension. Incorrect measurement can result in unnecessary investigations, treatment, and follow-up for the mistaken diagnosis of hypertension, or no treatment for hypertension in individuals mistakenly thought to have normal BP. Methods: A Prospective case control study of healthy children 4-12 years of age visiting Flushing Hospital Medical Center ACC, between Jan-Nov 2018. Data collected included age, gender, ethnicity, body mass index (BMI), arm circumference, and BP values obtained with different size cuffs. Subjects were divided into 4 BMI groups, differentiated as underweight (B1, BMI < 18.5), normal weight (B2,18.5-24.9), overweight (B3,25-29.9), or obese( B4, > 30). Result: The study was conducted with 137 patients with average age of 7.67 ± 2.48 (Median age 7.0). The study sample included 64 (43%) females and 73 (57%) males with 91% were Hispanic. Two patients were obese and given the limited sample size were excluded.The systolic BP was found to be 5 mmHg less with the larger cuff and 5 mmHg more with the smaller cuff. A one-way ANOVA was done to compare the effect of age on changes in systolic BP when a larger cuff was used. These was no statistical significance between changes in systolic BP for the different age groups (F(8,125)=1.318, p =0.2407). A one-way ANOVA was done to compare the effect of BMI on changes in systolic BP when a larger cuff was used. There was no statistical significance between changes in systolic BP for the BMI groups (F(2,131)=2.349, p =0.09). The same was done for the smaller cuff and systolic BP. No statistically significant change was found because of age (F(8,113)=0.7423, p=0.65 ) or BMI (F(2,119)=2.916, p =0.05). No statistical/clinical difference was found when measuring diastolic BP. Conclusions: Systolic BP in children aged 4-12 years was 5 mmHg higher when measured with a smaller cuff and 5 mmHg lower when measured with a larger cuff. Diastolic BP was not clinically significant for different cuff sizes. Age and BMI did not affect the differences in BP measurement.