Swallowing of foreign body is a common problem in children. Although most foreign bodies in the gastrointestinal tract will pass spontaneously, passage of sharp and pointed object such as a long nail is unusual. We report a case of a 2-year old female who swallowed a 3-inch nail and passed the nail per rectum spontaneously without problems while preparations were being made for the removal of the nail. The rarity of this event makes it worthy of being reported.

A 34 year-old G2P1 woman at 23 weeks gestation was referred to The Fetal Center for abnormal findingson a routine prenatal ultrasound (U/S). Magnetic resonance imaging (MRI) confirmed a single male fetus with spina bifida (SB) extending from the L4 to the S1 level. Figure 1 Additional findings included ventriculomegaly (15 mm in each lateral ventricle), cerebellar herniation to the C2 level (Chiarimalformation), and a lemon sign, (concavity of the parietal bones). Figure 2 The family history was negative for SB and the only medication the mother was taking were the recommended prenatal vitamins.

The classic works of I.P. Pavlov shows strong communication mechanisms between the two most important life-supporting systems of the body - the nervous and the digestive. The role of the autonomic nervous system (ANS) in the occurrence of acute gastroduodenal erosions and ulcers has been proven [1]. The flow of sympathetic impulses causes an excessive release of mediators (catecholamines), which leads to disruption of tissue trophism. An important role in ulceration belongs to the parasympathetic nervous system.

Introduction; Appendectomy is the most common surgical emergency and negative appendectomy is a one of recognized consequence of appendectomy. Recently an increased use of radiology is seen in diagnosing appendicitis and it has significantly decreased the rate of negative appendectomy. Every effort should be made to establish an exact diagnosis. If, however, this is impossible and a suspicion of appendicitis exists, exploration is mandatory. It is far better to subject a moderate number of patients to a theoretically unnecessary operation than to let one patient suffer perforation. Aim; Recently we have seen an increased use of radiology in our department for diagnosing appendicitis. The idea of conducting this audit was to calculate our negative appendectomy rate by correlating it with use of radiology and to compare it with international figures and to set up guide lines for use of radiology in diagnosing appendicitis on basis of results of our audit . Methods; Records of all patients who underwent appendectomy in Dubai Hospital, UAE from jan 2018 to jan 2019 were retrospectively analyzed using electronic record system. Clinical diagnosis and radiological findings were compared with histopathology as gold standard for negative appendectomy rate. The sensitivity and specificity of different radiological procedures was calculated as well. Results; Total 165 patients underwent appendectomy in specified duration. Over all negative appendectomy rate was 17 % with male being 9.7 % and female rate 31% . CTSCAN was found to be 100% specific and 91.4 % sensitive in diagnosing appendicitis while clinical diagnosis was accurate in 88.5 % cases.

Primary B-Cell Non-Hodgkin Lymphoma of Breast is a rare presentation of breast malignancy and it is necessary to differentiate it from secondary breast lymphoma as prognosis and treatment varies based on the diagnosis. We report a case of 47-year-old female with bilateral PBNHL of Breast which is rare due to younger age of presentation than earlier reported cases of this malignancy, lump with “peau de orange” appearance seen in both the breasts which is usually seen with high grade lymphoma and complete recovery of the patient while bilateral PBL outlines poor prognosis. Mammosonography findings included dilated ducts with hypoechoiec areas. MRI showed altered signal intensity. Findings of the imaging studies are non-specific and vary widely from case to case which is why biopsy which is gold standard was done to confirm the diagnosis