Pneumatosis intestinalis is a rare condition occurs in a wide variety of patients, some of whom require urgent surgery, while others can be observed with resolution of symptoms and radiographic fi ndings. Most often the need for surgery is intestinal obstruction. We report a case of pneumatosis intestinalis with an abdominal mass causing obstruction. The histological surprise and the rarity of the obstruction is highlighted in this case report.

Hypertension is a chronic disease quite common in the day to day scenario and is ranked as the rst most important risk factor driving the most death and disability combined in Kerala (2016) (3). Hypertension and insomnia are found to coexist (1) (2). The prevalence of insomnia among hypertensive patients of South Kerala has not been properly studied, this study aims to investigate the same. This study in addition to this tries to nd out the association between insomnia and antihypertensive drugs, as previous researches have suggested insomnia as a possible side effect of antihypertensive medication (5). So proper diagnostic measures should be adapted, with special surveillance of insomnia prone members of society (based on epidemiological evidences) so as to prevent and treat insomnia at early stage itself and also prevent its progression to hypertension.

A 10-year-old female child presented with resistant hypertension and hypokalaemia. There was no muscle weakness or periodic paralysis. The ratio of plasma aldosterone concentration to plasma renin activity was increased. MRI of the abdomen showed the right adrenal mass. The child underwent open right adrenalectomy. she had natriuresis in the postoperative period. She was normotensive without antihypertensive drugs at discharge and 2 months after surgery.

Cl i nic a l releva nceScientific rationale for the study Avoid higher adrenaline concentrations along with 2% lignocaine in dental practice for geriatric and medically compromised patients.