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Introduction: Dacryocystitis is a threatening ophthalmic problem, which affects patients of every age. It is an inflammation of the lacrimal sac and duct. Acute dacryocystitis, experience severe morbidity while chronic dacryocystitis is rarely associated with morbidity unless caused by a systemic disease. Objective: This study was done to identify and isolate the causative agents of dacryocystitis, detect their antimicrobial susceptibility pattern and determine the contributing risk factors. Materials and Methods: This prospective study was conducted for a period of 112 years. Pus samples from 100 patients with dacryocystitis were obtained and processed in the Microbiology laboratory in a tertiary care center. Results: The most common aerobic Gram-positive bacteria were Staphylococcus epidermidis (29.7%) and Staphylococcus aureus (20.3%). The common Gram-negative bacteria were Pseudomonas aeruginosa (9.4%) and E coli (9.4%). Gram-positive isolates were most sensitive to vancomycin. Gram-negative isolates were most sensitive to colistin. Conclusion: Higher culture positivity emphasizes the clinicians about the significance of this disease and the need to investigate for the presence of the symptom of nasolacrimal obstruction. The knowledge of bacteriology and antimicrobial susceptibility is necessary for implementation of a management protocol to reduce the cost burden and emergence of drug resistant strains. Keywords: Dacryocystitis, Dacryocystorhinostomy, Epiphora, Staphylococcus epidermidis, Vancomycin.

Self-inserted urethral foreign bodies (FBs) are rare. Neither reported case was the self-inflicted FB due to a lack of financial resources nor was either case complicated by Fournier's gangrene. We present a 54-year-old male who inserted a household pipe to relieve his urine retention. Unfortunately, the FB became stuck inside, perforated the urethra, and required perineal exploration. After it was removed, the urethra was closed over a 16F urethral catheter. The wound was complicated by severe infection and resulting Fournier's gangrene. This required an additional surgery for debridement and urine diversion. Retrospectively, it would have been better if the urethra had been left open with SP tube only. We are sharing a clinical lesson learned by the practicing urologist and surgeons. Conclusively, self-inserted FBs in the urethra may lead to a series of complications. Patients with limited financial resources need more attention and care because they may hurt themselves unintentionally.

Rosai-Dorfman disease is an extremely rare disorder characterized by proliferation and accumulation of histiocytes in lymph nodes, usually in the cervical region. In approximately 43% cases, this accumulation occurs in extra nodal sites such as the skin, nasal sinuses, central nervous system, kidney and gastrointestinal tract. We report such a case of extra nodal (cutaneous) Rosai Dorfman disease in a young female patient.

Trichilemmal carcinoma is a rare hair follicle tumour which develops from the outer root sheath of the hair follicle. It is thought to occur from a malignant transformation of a benign Trichilemmoma and is usually found on sun-exposed areas such face, ears, scalp of elderly women. It is a low-grade tumour with low metastatic potential. We present the case of an elderly female patient with low grade Trichilemmal carcinoma of the scalp with cervical lymph node which was clinically and histopathologically proven to be insignificant.