25 years old Lady with h/o few drops bleeding after defecation and an external swelling for 1 month but mild Pain , came to surgery opd. She also has a h/o constipation . Now she is taking Lactulose and isopagul and constipation is under control. But She complaints that swelling is increasing day by day.

Dx, Rx Please, Pt. M, Age 37, Such a pile like reddish blister is formed Near To Anus, Pain nd itching, During nd After Defecation. How to Treat? Nd DX.

50 female known diabetic and hypertension. Present with pain and fever since 2 days. Lesion at rt side of anal region.

Complicated Anorectal case *Chief Complaints* 26 Years old male patient C/o severe pain & burning while defecating and hours after that. On proctoscope examination reveal swelling in anal canal ( piles ? ) and TRUS report attached which suggest the same. No h/o constipation as such. However, irregular lifestyle with no fix times for meals or excretory activities. Eating outside because travelling job. *History* Patient took below prescription from a general surgeon for 10 days Cap. RBSON D BD Tab. Oflox Oz BD Tab. Xymoheal D BD replaced by SignoFlam in later 5 days Anobliss ( Nifedipine + Lignocaine ) Cream for LA Syrup. Cremafinn Plus 15 ML at bed time Tab. Hilo ( Ayurvedic Preparation ) But no improvement. Urine retention also there. Was admitted with Foley's catheter for 4 days since 5 days following the same. *Investigations* Blood reports including infective etiology including HIV 1 &2, HBSAG, HSV, VDRL Negative. Apart from creat 1.2 ( possibly due to urine retention ) Urine RM findings negative. Please suggest the diagnosis and best line of treatment. *Management* EDIT - I got USG abdomen done to rule out high Creatinine. USG is normal. Moreover Urine CS shows E COLI growth 40,000 CFU/ml after 10 days of Oflox Oz and other symptomatic course. It showed sensitive to Amoxyclav so have started augmentin BD for the last few days and urine retention complaint has improved. But lately he has developed blood drops ( clotted & liquid form ) while defecating which aren't that painful. Is there any agressive which needs to be done?

One year old child with hard stools and pain while defecating since 4 days.. Today presented with hemorrhoids like projection. Kindly Confirm diagnosis and its treatment .