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001), especially in RMPP group (p = 0.021). Therefore, the elevated expansion of TFH cells and the increased secretion of IL-21 cytokine may contribute to the pathogenesis of childhood MPP, while its excessive response may be associated with the development of childhood RMPP. Key Words TFH cells, IL-21, Children, Mycoplasma pneumoniae pneumonia.Most pathology of the thymus gland warrant its surgical removal; and this requires significant expertise and adequate medical set-up. This study aimed to audit the results of thymectomies performed in a specialised tertiary level centre in a resource-poor country. The outcomes of open and minimally invasive video-assisted thoracoscopic surgery (VATS) thymectomies were also compared. Out of 58 patients operated at Department of Thoracic Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, Maharajgunj, Kathmandu, Nepal between October 2012 and January 2019, 33 patients underwent open thymectomy and 25 had VATS thymectomy. We conducted a retrospective search to look at operative time, blood loss and length of postoperative hospitalisation. The open surgery group was followed for an average of 32 months, and the VATS cohort for 38 months. No significant differences were found in mean operative times and overall survival between groups. In selected cases, thymectomy via VATS is safer and comparable to open thymectomy in terms of operative safety and oncological completeness. Key Words Thymus, VATS, Thymectomy, Outcome.The aim of the study was to determine the result of conservative management of Graves ophthalmopathy in a multi-disciplinary setting by a team of ophthalmologists and endocrinologists. Twenty-seven patients of thyroid eye disease were included in the study who underwent complete ocular examination and complete thyroid biochemical profile. Each patient was advised lubrication with artificial tears, cool compresses, sleeping with elevated head at bed, taping of the eyelids while sleeping and avoidance of smoking. Follow-ups were done at one and six months. EUGOGO classification was used to classify severity of the disease in mild, moderate, severe, and very severe; whereas, clinical activity score (CAS) was implied to categorise the disease activity. Mild to moderate Graves ophthalmopathy responded very well to conservative management. Moderate cases required additional steroids. Whereas, severe and very severe cases require additional surgical intervention. Key Words Graves ophthalmology, Conservative management, Lubrication, Multidisciplinary approach.Orbital teratoma is a rare tumour that is composed of tissues derived from all three germ cell layers. It presents, in otherwise, healthy neonates with unilateral proptosis that progresses rapidly, threatening vision through optic nerve compromise or exposure keratopathy. IOX1 datasheet Globe conservation may be difficult too in advanced cases. Mature teratomas are benign, but the immature ones can sometimes become malignant. We report a case of a six-month female infant who presented with mature orbital teratoma since birth. Vision could not be salvaged; but following complete surgical excision, good cosmesis was achieved. Key Words Mature teratoma, Orbit, Congenital tumour, Surger.Posterior scleritis is an underdiagnosed condition due to its rarity and is frequently misdiagnosed due to its varied presentation.1 Therefore, it is imperative to know that it can present clinically as exudative retinal detachment, proptosis, disc oedema, choroidal folds, subretinal mass, and myositis. We report a case of 48-year female who presented with gradual, progressive loss of vision in left eye. There were multiple exudative retinal detachments with choroidal folds and disc oedema. Ultrasonography (USG) B scan and contrast enhanced magnetic resonance imaging (MRI) orbit revealed the classic T-sign. With oral steroids, she improved clinically. Posterior scleritis is a painful condition, but the patient did not report any pain in or around the globe, which makes this case a unique experience. Key Words Posterior scleritis, Exudative retinal detachment, T-sign.Retention of an orbital prosthesis plays a key role in treatment success and patient acceptance as does aesthetics. Though numerous retentive aids are available such as implants, adhesives, etc, the cost, surgical aspect, difficulty of use and allergic potential may compromise efficiency. This report describes the case of an 11-year post-enucleation poor retinoblastoma patient, in whom an unfavourable defect leads to a major prosthetic challenge (from point of view of retention and camouflage). This report describes a simple, economical, and user-friendly approach to obtain satisfactory retention and camouflage for such patients with spectacle cords and customised spectacles. Key Words Oculo-orbital prosthesis, Spectacle, Cord.Radical cystectomy and orthotopic neobladder are the most preferred surgical approaches for the treatment of invasive bladder cancer. Secondary tumour of ileum on neobladder is very rare. We report a 67-year man complaining of hematuria with the history of ileal neobladder for 19 years. An ileal adenocarcinoma of neobladder was detected with transurethral resection. He also had a non-functioning right kidney. A neobladderectomy. with right nephroureterectomy and ureterocutaneostomy was performed. An adenocarcinoma invading subserosal layer was reported. At six months postoperatively, patient was free of recurrence and progression. Seconder tumour of neobladder is a very rare condition. Early diagnosis and excision of neobladder may provide cure. Key Words Bladder cancer, Urinary diversion, Cystectomy, Ileum, Adenocarcinoma.The coexistence of intracerebral aneurysm and meningioma is a rare occurrence. There is no consensus about the treatment options. We aim to present a case of a 61-year female admitted to this clinic with persistent headache and loss of vision in both eyes, especially on the left. Radiological images demonstrated a para-ophthalmic saccular aneurysm coexisting with an extra-axial homogenously enhancing mass in the right cavernous sinus, which was possibly a meningioma. A flow diverting stent, following the coil embolisation of the aneurysm, was placed. Then the patient underwent stereotactic radiosurgery for the cavernous sinus meningioma. Diagnosis and treatment of such pathologies are easily achieved with the technological advancements of imaging techniques. The hypothesis of increased hemodynamic pressures, due to meningioma causing intracranial aneurysms, may explain this coexistence. Endovascular surgery, followed by stereotactic radiosurgery, may be a reliable approach for a patient with coexistent meningioma and aneurysm.