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All our readers will agree that a routine ultrasonography for evaluation of pelvic haematomas following vaginal hysterectomy as suggested by Jignesh Kansaria et al, from Seth GS Medical College, on pg 406, is worthwhile in the modern days rather than the old fashioned PV examination.

Although Aditya Pareek from Doma Hospital, Saudi Arabia, on pg 411, has reviewed radio-nuclide imaging of prostate cancer, in great detail, it is worthwhile remembering that in private practice, a routine PSA blood test, if persistently high, followed by a 6 segment punch gun biopsy, is the best method to pick up cancer of the prostate.

Dr. Baheti from Bombay Hospital, on pg 414, writes on International Pain Management, which is interesting to read because many times in private practice, we have patients, whom we cannot help with drugs.

Although a few years back, allergy testing was abandoned in UK because of the risk of rare anaphylaxis death, there are some authorities, who still feel that in some resistant patients this still has some role. Thus it will be worthwhile reading a review on pg 419 by DM Tripathi from Bombay Hospital, who conceptualizes the role of allergy testing and immunotherapy in the management of respiratory allergic diseases.

It is good to know that Jyoti Borkar and Rochana Bakshi, from KEM Hospital, on pg 441, performed 3 cases of carotid endarterectomy, but it will take a long time before the advantages and disadvantages of this procedure are compared, before we can routinely advise this procedure like a coronary procedure.

Jagdish Nichani et al from KEM Hospital, on pg 446, describe a very interesting case of a carcinoid tumour which affected a very rare site, the rectum, although this site along with the appendix and ileum has been described in literature.

Bombay Hospital Journal has taken the lead amongst all the International Journals in publishing articles on tuberculosis affecting unusual sites. In this issue, BS Acharya et al, from KEM Hospital, on pg 451, describe a case of primary duodenal tuberculosis.

Avinash Kumar et al from SMS Medical College and Hospital, Jaipur, have helped to add one more cause of portal hypertension, while discussing a case of pancreatic tail adenocarcinoma on pg 453.

Sanjay Jain from PHC, Udaipur, on pg 457, describes a rare case of congenital amputation of hand, which is perhaps, the first such reported case from India.

Acute necrotising pancreatitis is the most dangerous surgical emergency with dreaded complication and heavy mortality. Acharya and Nagral, from KEM Hospital, on pg 462, add three more complications of acute necrotising pancreatitis.

Pranav Sinha et al from BYL Nair Hospital, on pg 465, describe an interesting case of a patient having chronic renal failure due to lupus nephritis, in which they could perform a mitral valve replacement successfully.

And finally, Arshead Khan et al, from Grant Medical College and JJ Group of Hospitals, on pg 481, describe a rare case of primary non-Hodgkins lymphoma of the breast, which is indeed, a very rare entity.


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