Diagnosis of tuberculosis in children is challenging because of variable clinical symptoms and no specific signs. We report a case of tuberculous osteomyelitis of the ribs, which demonstrates difficulties associated with the diagnosis of generalized tuberculosis in an 8-year-old child (correct diagnosis was established after 1.3 years). Diagnostic procedures included: Mantoux test, skin test with recombinant tuberculosis allergen, computed tomography, pathomorphological and bacterioscopic testing. The patient presented with disease progression and lesions to the lung tissue, pleura, and ribs and did not respond to antibacterial therapy, hormones, and cytostatics. This required repeated diagnosis revision. The diagnosis of tuberculosis of the right 4th and 5th ribs was confirmed after surgery using bacterioscopic and immunohistochemical examinations. The child received comprehensive treatment in a specialized tuberculosis hospital and had positive dynamics. Despite the correct routing, low suspicion for tuberculosis in primary and secondary healthcare institutions has led to an insufficient use of currently available diagnostic methods and late diagnosis of tuberculosis in a child residing in a megapolis. Key words: generalized tuberculosis, children, tuberculosis of the rib, immunodiagnostics, diagnosis of tuberculosis, immunohistochemistry

Background: Carcinoma cervix is the most common cancer among women in developing countries. The objectives of the study were to study the sensitivity and specificity of visual inspection of  the cervix with acetic acid (VIA) and Lugol's iodine (VILI) for cervical cancer screening. To study the correlation of demographic data like age, socioeconomic status, education residential area, parity, age at marriage in premalignant lesion of  the cervix.Methods: The present study was conducted in the department of Obstetrics and Gynecology  at a Tertiary Medical Care Center over a period of two years. Five hundred fifty women between 20-65 years of age who fulfilled the selection criteria were enrolled in our study. Positive tests for VIA was opaque aceto white lesion on applying 5% acetic acid or detection of definite yellow iodine non uptake areas with Lugol's iodine in the transformation zone or close to touching the squamocolumnar junction. Positive cases were scheduled for cervical biopsy. Ethical approval of the study protocol was obtained from the ethics committee of the institute.Results: On down staging 7.2% (40/550) of cases  had an unhealthy cervix and 0.36% (2/550) with a suspicious cervix. VIA positive in 4.55% (25/550), VILI positive in 2.73% (15/550). Biopsy was taken from positive with VIA and VILI. On histology 2.9% (16) were chronic cervicitis, CIN I had (1), 0.2%, CIN II (2) 0.4%, CIN III (4) 0.7% and squamous cell carcinoma (2) 0.4% VIA sensitivity 72.22%, specificity 97.74%. VILI sensitivity 100%, specificity 98.89%.Conclusions: VIA and VILI are simple, inexpensive, low resources technique. Both have high sensitivity and specificity.

BACKGROUNDWe are presenting a case of a 38-year-old multiparous woman who presented to the emergency unit with a huge infected mass protruding per vaginum, bleeding per vaginum, foul smelling discharge, fever and severe pallor. After careful investigation, it was labelled as a case of pedunculated cervical fibroid polyp. The polypectomy was carried out, and the patient had an uneventful postoperative stay.