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Adult Hirschsprung disease is a rare disorder of the hindgut that is frequently misdiagnosed as refractory constipation. About 94%of Hirschsprung disease cases are diagnosed before the patient reaches 5 years of age, however, on a rare occasion, mild cases may go undiagnosed until he or she reaches adulthood. We are presenting the case of an 18-year-old male who came with acute intestinal obstruction with a history of refractory constipation since childhood. Exploratory laparotomy with sigmoid diversion colostomy was done along with full-thickness rectal biopsy. Rectal biopsy showed the absence of ganglion cells. The patient got symptomatically relieved. Therefore, a high suspicion of Hirschsprung disease should be kept in adults having a history of repeated episodes of obstruction since childhood.

A 52-year-old male presented to surgery emergency with acute retention of urine. Patient was relieved in the emergency setting by catheterization and bladder irrigation. Urine was sterile; however, microscopy revealed field full of RBCs (>50/high-power field) and pus cells (>20/hpf). Cystoscopy revealed fungal balls in the urinary bladder which upon histopathological examination showed Aspergillus species. Patient was managed with systemic voriconazole and bladder wash with diluted povidone iodine. Predisposing factors diabetes mellitus and benign prostatic hyperplasia were medically managed, and patient recovered well. This case stresses the importance of considering isolated fungal urinary infections in predisposed individuals.

Spontaneous gastric perforations are usually seen in patients with untreated peptic ulcer disease. Mucormycosis, an uncommon, opportunistic, life-threatening fungal infection, rarely causes gastric perforation in immunocompetent adults. Here, we present a case of young female who was admitted to hospital for acute pain abdomen and distension with 5 days history of fever. She was operated and was found to have multiple perforations in the stomach with transmural necrosis. Despite adequate surgical excision and intravenous amphotericin B, patient succumbed to sequelae of infection.

Background: Complicated inguinal hernia is a common problem faced by surgeons across the world. Various methods of surgical repair have been described. It is important to identify the best repair technique of inguinal hernia to have better post-operative outcome.Methods: This randomised controlled study consisted of 84 cases of complicated inguinal hernias presenting to surgical emergency department of Maulana Azad Medical College. Patients were randomly allocated to two repair groups- Desarda and Bassini and various intra/post-operative parameters were compared.Results: Duration of surgery and postoperative pain scores were less in Desarda group. Time to return to strenuous daily activities was also less with Desarda repair. Desarda repair was associated with less incidence of chronic inguinodynia and post-operative complications.Conclusions: Desarda repair was found to be superior to Bassini group due to shorter duration of surgery. Patients required less analgesics following Desarda repair as compared to Bassini group. There was no recurrence in any group at four months follow up.

Background: Lower urinary tract symptoms (LUTS) are frequently associated with inguinal hernias. It is important to recognise and treat bladder outlet obstruction in patients before inguinal hernia repair to prevent recurrence of hernia.Methods: This prospective study was conducted at Maulana Azad Medical College. Hundred patients who presented with inguinal hernia repair were evaluated for LUTS using AUA scoring for urinary symptoms, uroflowmetry (Qmax) and post voidal residual urine using ultrasonography along with urine routine microscopic examination and urine culture and sensitivity.Results: Eleven patients out of 100 who came for hernia repair had clinically significant LUTS due to benign enlargement of prostate (BEP) and required treatment for BEP but none of these 11 patients had urinary symptoms as primary complaint. Ten patients were found to have urinary tract infection without any urinary symptom. Three patients had urethral stricture out of which 2 had Qmax of