BackgroundVisceral Leishmaniasis (VL), a severe parasitic disease, could be fatal if diagnosis and treatment is delayed. Post kala-azar dermal leishmaniasis (PKDL), a skin related outcome, is a potential reservoir for the spread of VL. Diagnostic tests available for VL such as tissue aspiration are invasive and painful although they are capable of evaluating the treatment response. Serological tests although less invasive than tissue aspiration are incompetent to assess cure. Parasitological examination of slit-skin smear along with the clinical symptoms is routinely used for diagnosis of PKDL. Therefore, a noninvasive test with acceptable sensitivity and competency, additionally, to decide cure would be an asset in disease management and control.Methodology/principal findingsWe describe here, the development of antibody-capture ELISA and field adaptable dipstick test as noninvasive diagnostic tools for VL and PKDL and as a test of cure in VL treatment. Sensitivity and specificity of urine-ELISA were 97.94% (95/97) and 100% (75/75) respectively, for VL. Importantly, dipstick test demonstrated 100% sensitivity (97/97) and specificity (75/75) in VL diagnosis. Degree of agreement of the two methods with tissue aspiration was 98.83% (κ = 0.97) and 100% (κ = 1), for ELISA and dipstick test, respectively. Both the tests had 100% positivity for PKDL (14/14) cases. ELISA and dipstick test illustrated treatment efficacy in about 90% (16/18) VL cases when eventually turned negative after six months of treatment.Conclusions/significanceELISA and dipstick test found immensely effective for diagnosis of VL and PKDL through urine samples thus, may substitute the existing invasive diagnostics. Utility of these tests as indirect methods of monitoring parasite clearance can define infected versus cured. Urine-based dipstick test is simple, sensitive and above all noninvasive method that may help not only in active VL case detection but also to ascertain treatment response. It can therefore, be deployed widely for interventions in disease management of VL particularly in poor resource outskirts.

Spigelian hernia is a rare variety of abdominal wall hernia occurring through the spigelian fascia which is composed of the aponeurotic layer between rectus muscle medially and semilunar line laterally. Generally it is difficult to diagnose because of their location and non specific symptoms. Diagnosis is aided by ultrasonography and Computerized Tomography. Once the diagnosis is confirmed, it is repaired surgically as risk of incarceration is high. We reported this interesting case of spigelian hernia with associated port site hernia in a 53 year old female patient from Arwal district, Bihar who presented with occasional lower abdominal pain. The hernia was reduced and defect was repaired. Her recovery was uneventful.

Background: The aim of this study is to compare outcome of inguinal hernia repair by combined method of repair (Lichtenstein and Bassini repair) and its comparison with older techniques.Methods: A prospective study conducted on 158 patients reported in surgery OPD Patna Medical College and Hospital, Patna from July 2017 to June 2018 with inguinal hernia. All these patients were included in the study, operated by combined method of repair (Lichtenstein and Bassini repair) and followed up for 12 months. Data were entered and analyzed by SPSS version 10.0.Results: Study involved 158 patients who were operated by combined repair. Pain on 1st post-operative day was similar with previous study. Complication was erythema, scrotal swelling, neuralgia, superficial wound infection and seroma formation in the order of frequency. The average hospital stay was 5 days for combined approach. Recurrence rate was 0% in combined approach following 1 year of follow-up.Conclusions: As compared with previous studies of hernia repair by Modified Bassini’s and Lichenstein mesh hernioplasty, combined approach have comparatively better outcome.