Retroperitoneal tumours are fairly common though they may present as a diagnostic puzzle as a result of non-specific clinical features. The study reviewed all patients who are clinically diagnosed and radiologically confirmed as retroperitoneal tumours and managed. A total of 25 patients were analyzed, age ranged from 25 to 70 years, with peak age group was 30 -40 years with male to female ratio of 1.27:1. The most common presentation is abdominal lump. Most of the retroperitoneal tumours are soft tissue sarcoma.

Neck swellings are common problems in our clinical practice. Neck swellings may be classified as congenital and acquired. Acquired may be inflammatory, neoplastic or others. In children the common neck swellings are congenital and inflammatory. In adults neoplastic lesions are more important. Tuberculous lymphadenitis is one of the common causes of neck swellings in our Indian population. The study was conducted at government general hospital, Kakinada during the study period July 2014 August 2015. Total 50 patients who presented with neck swellings other than thyroid were included in this study.

A middle aged man presented with evidence of right-sided heart failure in atrial fibrillation (AF) and was found to have severe Tricuspid Regurgitation (TR) with pulmonary artery hypertension (PAH), with normal left ventricular function. The common possible secondary causes of PAH were ruled out, but during investigation he was found to have elevated thyroid function tests compatible with the diagnosis of Graves' disease. The treatment of Graves' disease was started with anti-thyroid drugs and associated with a significant reduction in the pulmonary arterial pressure. This case report is presented to highlight one of the rare and underdiagnosed presentations of Graves' disease. Thyrotoxicosis can present with profound cardiovascular complications. In recent times, there have been few reports of secondary PAH with TR in patients with hyperthyroidism. Previously asymptomatic Graves' disease having the signs and symptoms of right heart failure is a rare presentation and the association could be easily missed. This case presentation emphasizes that the diagnosis of thyroid heart disease with heart failure secondary to Graves' disease should be considered in any patient regardless of age, gender with clinical features of heart failure of unknown etiology and timely initiation of anti-thyroid drugs is necessary to treat these reversible cardiac failures.

Sigmoid volvulus is abnormal rotation of sigmoid colon along it's mesenteric axis which may results in effects ranging from partial to complete obstruction of bowel to vascular compromise, culminating in gangrene of bowel. Sigmoid volvulus is responsible for about 4 -24% of all acute intestinal obstruction. Retrospectively for last 3 years all cases of acute intestinal obstruction admitted to surgery were reviewed and study of sigmoid volvulus cases done. We analysed 247 cases of acute intestinal obstruction retrospectively over a period of 3 years. 50 cases are due to sigmoid volvulus. Most of cases are around 41-60 years. Most of cases present with pain abdomen, abdominal distention, constipation. Diagnosis is made by plain x-ray abdomen. Most cases treated with Derotation, resection and anastomosis. Out of 50 cases 6 deaths occurred.

The diverticulum of the small bowel may be congenital or acquired. 80% of diverticula occur in the jejunum, 15% in the ileum and 5% in both. (1,2,3,4) Although it is often asymptomatic, it can lead to severe complications including perforation, haemorrhage, enterolith formation, diverticulitis, and intestinal obstruction (5,6,7,8) and occur in 10%-30% of patients. We have a male aged 30yrs old came with h/o recurrent colicky pain abdomen and bilious vomiting since past 6 months (9,10,11) o/e he is anaemic, malnourished and dehydrated. P/abdomengaseous distension present, no mass palpable and no free fluid, p/r-no abnormality, plain X-ray abdomen shows multiple air fluid levels. (12) On laparotomy there are multiple giant jenjunal diverticuli with bowel distension and there is a band found attached to the middle ileum. The band is excised and the jejunum which had giant diverticula has been resected and end to end anastomosis is done. Jejunal diverticula are rare and mostly asymptomatic. Patients may have nonspecific symptoms, such as chronic abdominal pain and change in bowel habits. However, the morbidity and mortality rates may increase due to perforation, obstruction, and bleeding. If acute abdomen in jejunal diverticulosis is suspected, a laparotomy and resection & anastomosis is considered and TB abdomen must be considered in the differential diagnosis