Background: Acute appendicitis is one of the most common acute intra-abdominal infections seen in surgical departments, which can be treated easily if an accurate diagnosis is made on time. Otherwise, delay in diagnosis and treatment can lead to perforation of the appendix &diffuse peritonitis. Materials and Methods: A prospective study was conducted on 112 patients who were operated for acute appendicitis in department of General surgery, Bowring & Lady Curzon Hospitals, BMCRI, to determine the role and predictive value of the total leucocyte count (TLC), C-reactive protein (CRP) and percentage of neutrophil count in the diagnosis of acute appendicitis. Preoperative TLC, CRP and percentage of neutrophil count were determined and were compared with the results of the histopathology of the removed appendix. Results: Of all the patients studied, 94 had histopathologically positive appendicitis. The TLC was found to be significantly high in 82 patients who proved to have acute appendicitis, whereas CRP was high in 88 patients and neutrophil percentage was raised in 87 patients; 6 patients had a normal CRP level. Thus, TLC had a sensitivity, specificity &positive predictive value of 87.23%, 44.44% and 89.13% respectively. CRP had a sensitivity, specificity & positive predictive value of 93.61%, 77.77% and 95.65% respectively. Percentage of neutrophil count had a sensitivity, specificity & positive predictive value of 92.55%, 38.88%, 88.77% respectively. When used in combination, there was a marked improvement in the sensitivity, specificity and the positive predictive value to98.76%, 86.66% and 97.56% respectively. Conclusion: The inflammatory markers, i.e., TLC, CRP and neutrophil count can be helpful in the diagnosis when measured together as this increases their sensitivity, specificity & positive predictive value significantly.

Down syndrome is associated with rare hematological disorder like Transient abnormal myelopoiesis in infants. We report a case of preterm female baby with low birth weight born to 33 year old mother who is G2A1 at 34 weeks of gestation. Antenatal checkup revealed intermediate risk for Down syndrome. On the first day of birth CBC showed high WBC count of127000/ mm 3 and peripheral smear showed 13% of blast and the total count gradually decreased to normal of 20000/ mm 3 over a period of one month. The baby succumbed to death due to Congestive cardiac failure and late onset sepsis.

Hepatic cavernous hemangioma is the most common benign tumour of liver. Most of them are small in size and asymptomatic. Giant hepatic hemangiomas are uncommon with rare complications of rupture and haemorrhage. We report here a 41 year old female with asymptomatic giant cavernous hemangioma. Pre-operative findings was suspected on CT scan. Pathological findings of the resected mass were consistent with giant cavernous hemangioma. The patient was discharged post operatively without further complications and the patient condition was found to be improved during follow up.