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Anorectal manometry is widely used to assess diagnose defecatory disorders (DD) and evaluate anorectal functions in patients with fecal incontinence (FI). [1][2][3][4][5] There is consensus that anorectal pressures should be measured at rest, during squeeze, simulated evacuation, and a Valsalva maneuver. 3,6,7 The rectoanal inhibitory reflex and rectal sensation are also evaluated during this test. Some centers also evaluate rectoanal pressures during a cough maneuver. 8 The equipment, the methods used to conduct anorectal manometry, and to analyze studies and interpret findings are not standardized. 9 The procedure can be performed with water-perfused, solid state, air-charged, or highresolution catheters. 1 High-resolution manometry (HRM) catheters provide better spatial resolution than non-HRM catheters. However, HRM catheters made by different manufacturers are not identical.The methods for HRM (e.g., the number and duration of squeeze

Haemophagocytic lymphohistiocytosis (HLH) in Human Immunodeficiency Virus (HIV) infected individuals can either be due to the disease itself or due to associated infections/malignancies. The treatment for HLH requires immunosuppressive therapy but administering immunosuppressive therapy to an already immunosuppressed patient (HIV infection) is complex. We present two such cases of HLH in patients infected with HIV. In the first case, no alternate cause for HLH was found even after extensive investigations and it was attributed to the uncontrolled HIV replication. Patient was started on dexamethasone for the same but succumbed to hospital acquired pneumonia. The second patient was diagnosed with Hodgkin's lymphoma but he succumbed to his illness before initiating immunosuppressive therapy for HLH. We report these cases to highlight the dilemma and a need for further research in this direction.