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Hydatid disease is endemic in many parts of the world and caused by echinococcus granulosus. It develops most commonly in the liver and lungs. We present an unusual case of hydatid disease which was located in the left thigh. Although the diagnosis is suggested by clinical examination supported by ultrasound but confirmation is on macroscopic and histological examination. Hydatid disease should be considered in the differential diagnosis of all cystic masses in all anatomic locations especially in endemic areas.

Background: Rubber band ligation is considered one of the most popular non-surgical procedures available, representing the most reasonable balance between efficacy, pain and potential of complication. The present study was a controlled double blinded randomized study to compare Single versus double versus triple site band ligation for haemorrhoids in single treatment visit with special regards to its safety and efficacy in our patient population.Methods: There were 78 patients equally randomized in three groups by closed enveloped method. The number of patients in each group was 26, In Group A, a single, in Group B, two, and in Group C three major haemorrhoidal groups were rubber band ligated, in a single treatment visit on outpatient basis under topical anaesthesia with lignocaine 2% jelly.Results: Rubber band ligation was effective with significant symptom improvement seen in all patients with 88% patient satisfaction at end of 30 days period. Post ligation pain score and number of analgesic requirement in immediate post band ligation period, at 12 hours, at 1,7,14, 21 and 30 days post band ligation were similar in all three groups with p value >0.05. Multiple site haemorrhoidal bandings was done safely at single session without severe discomfort, pain or bleeding or severe complications requiring hospitalization.Conclusions: The study finding shows that triple site band ligation in a single session is a safe way of treating symptomatic haemorrhoids with similar post-procedure pain and patient satisfaction as conventional single or double site band ligation.

Background: Thalassemia is a hereditary autosomal recessive haemoglobinopathy that remains a major health problem throughout the world. Aims and Objectives: The aim of this study was to evaluate knowledge of the relatives of Thalassemia patients regarding different aspects of Thalassemia with special emphasis on the role of splenectomy. Material and Methods: This was a cross-sectional study conducted at a Government Tertiary Thalassemia day care centre. Initially, 131 relatives of Thalassemia patients were interviewed. Excluding 10 relatives, 87 (66.4 %) relatives having knowledge of splenectomy were further interviewed regarding various aspects of splenectomy. Result: In our survey, 67.2 % relatives had knowledge about the congenital origin of the disease. The knowledge about premarriage counselling, risk of consanguineous marriage, antenatal screening and medical termination of pregnancy was 55%, 29.8%, 70.2% and 64.1% respectively. Although all (100%) relatives knew about regular blood transfusion and iron chelation, only 74% and 63.4% of the relatives had the knowledge about splenectomy and bone marrow transplant as a treatment modality, respectively. In 87 relatives interviewed further, 37.9 % came to know about splenectomy from other relatives. The indications of splenectomy known were: splenomegaly (98.8%), increased blood transfusion (68.9%), low platelet count (20.6%) and low TLC (4.6%). Only 47.1% were aware about the optimal age of splenectomy. Awareness about serious complication of OPSI, its prevention by preoperative vaccinations and postoperative chemoprophylaxis was only 48.3%, 62% and 46% respectively. Around 59% knew about role of blood transfusion and 74.7% were aware about the need of regular follow up after splenectomy