BACKGROUND About 95% of the leg ulcers are due to vascular aetiology 1 and venous ulcers account for up to 90% of cases. 2,3 Arterial disease accounts for 5% -10%, others are due to neuropathy, usually diabetic or a combination of these diseases. 4 Diabetic ulcers are common on the toe and the heel. 5 Aims and Objectives- To compare and analyse the distribution of age, sex, systemic disease and location of the ulcer among the study group. To study the clinical features of various types of leg ulcers.  To study the usefulness of applied investigations for the effective management.  To study the order of aetiological prevalence of various leg ulcers in India, particularly in Sri Venkateshwaraa Medical College Hospital and Research Centre, Ariyur, Puducherry. MATERIALS AND METHODS RESULTSAbout 48% of leg and foot ulcers are due to vascular aetiology and arterial ulcers alone account for 32% and venous ulcers 16% in our study. Traumatic ulcer constituted next major category (24%). Diabetic ulcers constituted 18.67% among leg ulcers in our study. CONCLUSIONThis is unlike other studies, about 95% of leg ulcers are due to vascular aetiology and venous ulcers account for upto 90% and 5%-10% arterial ulcers. Diabetic ulcers constituted 18.67%, a relatively higher number as compared to western countries (5%-10%). Gay and Spencer's in 1868 wrote two important books on venous ulcers, which stressed the role of deep vein thrombosis and other lesions of arteries and veins (both superficial and deep) in the aetiology of leg ulcerations. Gay also described perforating ankle veins and suggested use of the term venous ulcerations. 2 Linton drew attention to incompetence of communicating calf veins as potential cause of venous ulcerations. 3 'Financial or Other Competing Interest': None. Submission 24-01-2018, Peer Review 18-02-2018, Acceptance 23-02-2018, Published 05-03-2018. Corresponding Author: Ganesan Vinayagam, 216, Cuddalore Road, Mudaliarpet-605004, Pondicherry. E-mail: ganeshvinayag@gmail.com DOI: 10.14260/jemds/2018 From the 10 th and 18 th centuries various physicians including Halu, Abbas, Avicenna, Falopio and Pare attributed ulceration of the leg to accumulation of black bile and believed that ulcerations of the leg served useful purpose in getting rid of those live substances. 4 The prevalence of leg ulcer is probably between 0.18% and 1% of the population. 5 The site of ulceration is analysed, around 90% of the ulcers were present in the gaiter area, 2% in the foot and 8% in the leg. 6 During the past three decades considerable knowledge has been gained regarding the anatomy, physiology, pathology and management of chronic leg ulcers. Despite all this, the management of leg ulcers is a fertile field for experimentation. Various studies have been conducted and a number of procedures and techniques have evolved with varying degree of success. It is common to see patients with different types of ulcers due to various aetiology and underlying systemic diseases. Moreover, leg and foot ulcers form ...

Congenital diaphragmatic hernia consists of a defect of the diaphragm that allows the passage of abdominal viscera into the thorax. Congenital diaphragmatic hernia most commonly present in infancy and childhood due to respiratory distress. However, a few of them may escape into adulthood. A very few of these adult cases may be identified during a routine medical checkup for various other reasons without any cardio-respiratory problems. In our case report, we have diagnosed incidentally an asymptomatic left diaphragmatic hernia with cardio-mediastinal shifting in a 38 years old female admitted for left breast fibroadenoma excision during a routine pre-anesthetic check-up and underwent breast surgery without any cardio-respiratory problems.

Kimura's disease (KD) is a chronic inflammatory disease, a rare variety. It usually presents as non-tender subcutaneous swelling in head and neck region, predominantly in preauricular and submandibular area and is often associated with cervical lymphadenopathy, marked peripheral eosinophilia and an elevated immunoglobulin E (IgE) level. Renal involvement is the only systemic manifestation.4 Nephrotic syndrome is the most common manifestation of renal disease in KD. Diagnosis through Fine needle aspiration cytology (FNAC) is misleading and can easily be mistaken as a malignant disease. So, diagnosis is therefore only established by histopathological examination. The treatment of KD involves one of three major approaches are surgical excision, irradiation, or steroid therapy. Surgical excision is recommended as the treatment of choice but carries recurrence rates of 33-50%. In our study, we are reporting a case of elderly female who presented with left sided cervical lymphadenopathy for which excision biopsy was done and the histopathology examination shown as kimura lymphadenopathy, a rare case.