Using a practical scoring system for diagnosing acute appendicitis can help reduce the rate of unnecessary surgery. This prospective study was carried out to evaluate Alvarado scoring system for diagnosing of acute appendicitis in our set up. Out of total 100 patients, appendicitis was confirmed in 80 patients, thus giving negative appendectomy rate of 20% (male 6%, female 14%). Perforation rate was 4%. Positive predictive value was 89%. The sensitivity was 54% and specificity 75%. Alvarado score is not a sensitive tool for aiding diagnosis of acute appendicitis.

Patient: Male, 35Final Diagnosis: Male breast cancerSymptoms: Painless breast massMedication: —Clinical Procedure: Modefied radical mastectomySpecialty: SurgeryObjective:Unusual setting of medical careBackground:Cancer of the male breast is a rare malignancy comprising less than 1% of all male cancers. The traditional surgical management for male breast cancer is modified radical mastectomy. Other surgical methods such as breast conserving surgery with or without sentinel lymph node biopsy have been used with variable results.Case Report:A 35-year old male presented with a 2×2 cm right breast adenocarcinoma. Modified radical mastectomy for male breast cancer as the traditional surgical operation for this rare malignancy is illustrated with special emphasis on oncologic sound resection.Conclusions:Modified radical mastectomy is the corner stone surgical treatment for male breast cancer even though the breast tissue rudimentary. The recurrence of male breast cancer is less with mastectomy than breast conserving surgery.