The study was conducted to study the occurrence and clinical presentation of allergic fungal rhinosinusitis (AFRS), characterize the same, and correlate with the microbiological profile. Clinically suspected cases of fungal rhinosinusitis (FRS) depending upon their clinical presentation, nasal endoscopy, and radiological evidences were included. Relevant clinical samples were collected and subjected to direct microscopy and culture and histopathological examination. 35 patients were diagnosed to have AFRS. The average age was 28.4 years with a range of 18–48 years. Allergic mucin was seen in all the AFRS patients but fungal hyphae were detected in only 20%. 80% of cases were positive for IgE. All the patients had nasal obstruction followed by nasal discharge (62.8%). Polyps were seen in 95% (unilateral (48.57%) and bilateral (45.71%)), deviated nasal septum was seen in 28.57%, and greenish yellow secretion was seen in 17.14%. Direct microscopy and septate hyphae were positive in 71.42% of cases. 91.4% of cases were positive by culture. 5.7% yielded mixed growth of A. flavus and A. niger. Prompt clinical suspicion with specific signs and symptoms along with timely sampling of the adequate patient specimens and the optimal and timely processing by microscopy and culture and histopathological examination is a must for early diagnosis and management.

Torsion of epididymal cyst (EC) is an exceedingly rare cause of acute scrotum in both children and adults. We add our case as the ninth case to literature which was an 8-year-old child presented with features of acute scrotum with history of EC on conservative management. Doppler sonography showed perfused normal bilateral testes and a 4.1 × 1.7     cm septate cystic lesion of right epididymis. On scrotal exploration, we found a haemorrhagic cystic lesion attached to the upper pole of right testis and twisted for 540 degrees with normal testis and appendage. Cyst was excised, and histopathology revealed a haemorrhagic EC. Our case was peculiar due to, presenting as acute scrotum in a child of 1-10 years age group who was conservatively managed for right-sided EC and presence of 540 degrees torsion.

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Invasive fungal rhinosinusitis (IFRS) is a challenging condition and the mortality of IFRS in immuno compromised patients is very high. 75 patients of suspected FRS were included to study the burden and the clinicopathological and mycological profile of invasive fungal rhinosinusitis (FRS) in these patients. The samples collected were exudate from nasal debri, discharge and intraoperative tissue sample and were subjected to direct microscopy to histopathological examination and direct microscopy (KOH and calcofluor white) and culture on Sabouraud dextrose agar. Identification of molds and yeasts were done by conventional methods. 25 cases were suspected to have IFRS were confirmed by microbiological and histo pathological examination, comprising 56% of AIFRS (acute IFRS), 36% CIFRS (chronic IFRS) and 8% CGFRS (chronic granulomatous FRS). Rhizopus arrhizus (64.2%) was the most common isolate followed by Aspergillus flavus (35.7%). Mucor species were solely isolated from AIFRS (14.3%). In CIFRS, Aspergillus flavus (44.4%) seemed to be the major isolate with Aspergillus niger, Alternaria spp., Penicillium spp. and Candida albicans. Necrosis of submucosa, bone, vascular tissue was seen in 96% of cases with aseptate hyphae in 78.5% AIFRS and 77.7% in CIFRS. Radiological features help in presumptive diagnosis of FRS. Direct microscopy along with culture conformation is important for diagnosis and early initiation of treatment.

Background: Ventral hernias are a common problem encountered by the surgeons. Patients developing hernias become restricted from work or usual activities as the hernia enlarges and this demands surgical repair. The objective of this study is to evaluate the predisposing factors, the different modes of presentation, the different methods of surgical repair including the newer methods.Methods: A prospective random study done at Alluri Sita Rama Raju Academy of Medical sciences, Eluru, where in 50 cases of ventral hernias were randomly selected. A thorough case history taken as per the proforma enclosed and relevant investigations were done following which a selective surgical treatment such as anatomical repair and mesh repair were used. Anatomical repair was mainly considered in pediatric and infected cases and the remaining with open and laparoscopic mesh repair.Results: Majority of ventral hernias were seen in the age group of 21 to 60 years with a major female preponderance in umbilical, paraumbilical and incisional hernias, and epigastric hernias common in males. The common predisposing factors identified were previous surgeries, followed by anaemia, multiparity. Majority patients presented with mass or swelling over the abdomen which were reducible. The lower midline incisions were the most common cause for incisional hernias. Most of the patients had a fair preoperative presentation. In this study anatomical and mesh repair (open and laparoscopic) were done. 7 cases lost follow up and no recurrences noted.Conclusions: Among the ventral hernias infraumbilical incisional hernias were common with majority being gyneacological and obstetric procedures. Maximum cases were repaired with Open mesh repair (onlay >inlay) followed by laparoscopic and anatomical repair. With the good knowledge of anatomy, good relaxed anaesthesia and improved surgical skills, the use of synthetic suture and prosthetic material, coverage with antibiotics, post-operative care the outcome of treatment for hernia has improved with insignificant recurrence.