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Background: The latter half of 2019 saw the spread of a highly contagious and fatal respiratory tract disease originating in the Hubei province of Wuhan in China which was labelled as COVID 19. Although a multi organ disease, it is seen to spread through the respiratory tract with lung being the primary target. Aims and Objective: The study was conducted to correlate the severity of lung involvement as assessed by the HRCT severity, with the Viral Severity index, laboratory parameters, duration of hospital stay, viral clearance and resolution of lung symptoms. Materials and Methods: An observational retrospective study was carried out from the laboratory records of consecutive 208 patients admitted to the tertiary care hospital between March 2020 to May 2020. Results: Out of a total of 208 patients, 200(96%) recovered and 8(4%) expired. The expired patients showed a higher average age (50.79 + /- 17.42;62.25 + /-12.37) years in the recovered & expired patients respectively (p = 0.06). A longer duration of hospital stay was seen in the expired patients (15.05 + /-9.55&18.62 + /-10.22) days in the recovered & expired patients respectively. A low average (Hemoglobin) Hb values (12.17 + /-2.01&10.9 + /- 2.31) g/dl in the recovered and expired patients respectively along with a higher total WBC count was seen in the expired patients (8.62 + /-3.81& 16.86 + /-12.79) k/U in the recovered and expired patients with a highly significant p value of < 0.001). Higher CT severity scores were seen in the expired patients (10.74 + /-5.57&17.12 + /-6.55) in the recovered and expired patients respectively (p = 0.0018). None of the expired patients had a normal D Dimer level. HRCT values and the Rising D Dimer levels tend to show a positive correlation with the disease outcome and progression. The Higher Viral severity and HRCT score was associated with a longer duration of hospital stay reflecting a higher duration of viral clearance. Conclusion: The Chest CT scores along with the laboratory parameters like the total WBC count and the D Dimer levels can together act as important parameters to monitor the Covid 19 disease course. [ABSTRACT FROM AUTHOR] Copyright of Asian Journal of Medical Sciences is the property of Manipal Colleges of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. Forgotten ureteral stents (FUS) and stent-related symptoms (SRS) lead to increased postprocedural emergency department visits and add to the psychological and financial burden of the patients. Purpose. To review the usage and benefits of ureteral stent tracking and symptom monitoring through a single smartphone-based application (App) platform with 2-way clinician-patient communication. This study also compared the features with other smartphone apps used for stent tracking. Materials and Methods. 100 patients were included in this single-center prospective study conducted between September 2019 and December 2019. Patients who had metallic or long-term indwelling stents, noncomprehensible patients, and those not willing to share their data were excluded from the study. Results. Of 100 patients, 92 downloaded the Urostentz application, and 72 (78.2%) patients answered the pictorial symptom questionnaire. Symptom score analysis suggested that 62 patients (86.1%) had stent-related symptoms of which 3 required readmission and underwent early stent removal. The mean stent duration was 17.2 + 3.5 days (range: 11–23 days), with 69% of patients having their stent removed on the scheduled date and 25% of patients requesting a change of their appointment via the App. Conclusion. In this study, there was no case of FUS encountered. The “Urostentz” App is a freely available patient safety stent tracking application that provides a secure and simplified interface, which can significantly reduce the incidence of FUS and provide digital remote assistance in the management of stent-related symptoms.

Rosai-Dorfman Disease (RDD) is an idiopathic lymphohisticyocytic disorder characterized clinically by massive painless cervical lymphadenopathy, fever and weight loss. Extranodal involvement has been recognized. Central nervous system (CNS) manifestations are rare. Intracranial localization of the disease without involvement of other sites is very rare and needs to be differentiated from various mimicking lesions especially meningioma. A radiological and histological confirmation followed by complete resection of the lesion is the treatment of choice.

INTRODUCTION AND OBJECTIVE:Introduction and objective: To minimize stent-related symptoms (SRS), the distal part of the conventional double J (DJ) stent was replaced and a modified complete intra-u...

Endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) is preferred for evaluating malignant lymph nodes and staging of lung cancer. Nevertheless, larger tissue samples are increasingly needed, particularly for molecular analysis. We describe the feasibility, technical details, and complications of EBUS‐guided transbronchial cryo‐node biopsy (TBCNB) in four patients with mediastinal adenopathy. The samples obtained by EBUS‐TBCNB in all cases were adequate for histopathological examination (HPE) and immunohistochemistry (IHC) staining. In case 1, HPE showed non‐caseating epithelioid granuloma with giant cells and fibrosis consistent with sarcoidosis. Case 2 was diagnosed with adenocarcinoma with positivity for ROS1(D4D6). Case 3 showed features of metastatic adenocarcinoma from the breast (positive for Her2, ER, and GATA3). Case 4 was diagnosed with tuberculosis (necrotizing granuloma in histopathology, stain with Ziehl–Neelsen that showed few rod‐shaped bacilli). Only one patient had minimal bleeding at the puncture site controlled with cold saline. There were no adverse events such as major bleeding, pneumomediastinum, or pneumothorax., We describe the feasibility, technical details, and complications of endobronchial ultrasound‐guided transbronchial cryo‐node biopsy (EBUS‐TBCNB) in four patients with mediastinal adenopathy.

Objective To compare stent-related symptoms (SRS) associated with conventional ureteric JJ stent (CUS) placement and SRS associated with placement of a modified complete intra-ureteric stent (CIUS) with extraction suture, designed to minimize SRS, using the validated Ureteral Stent Symptom Questionnaire (USSQ). Materials and methods We randomized 124 patients who had undergone uncomplicated ureteroscopic lithotripsy into a CIUS and a CUS placement group. USSQ scores were evaluated on postoperative days 1 and 7 (just before stent removal) and 4 weeks after stent removal (control values). Pain scores on a visual analogue scale (VAS) after stent removal were also recorded. Subdomain analysis of all SRS and stent-related complications were also compared. Results No significant intergroup differences were found in the domain scores for urinary symptoms (P = 0.74), pain (P = 0.32), general health (P = 0.27), work (P = 0.24), or additional problems (P = 0.29). However, a statistically significant difference was noted in VAS scores (P = 0.015). Analysis of subdomains of USSQ item scores showed the CIUS group had significantly better scores for urge incontinence (1.21 vs 1.00; P ≤ 0.001), discomfort on voiding (2.07 vs 1.50; P ≤ 0.001), difficulties with respect to light physical activity (1.131 vs 1.00; P ≤ 0.001), fatigue (1.84 vs 1.57; P = 0.002), feeling comfortable (3.68 vs 3.16; P = 0.003), need for extra help (1.96 vs 1.00; P ≤ 0.001), and change in duration of work (4.27 vs 1.86; P ≤ 0.001). However, the patients in the CIUS group were sexually inactive for the time during which the stent was indwelling (mean: 7.34 days). There was no difference in complication rates between the two groups. Conclusion The use of a CIUS with strings after Ureteroscopy decreases SRS.

Recent advances in artificial intelligence (AI) have certainly had a significant impact on the healthcare industry. In urology, AI has been widely adopted to deal with numerous disorders, irrespective of their severity, extending from conditions such as benign prostate hyperplasia to critical illnesses such as urothelial and prostate cancer. In this article, we aim to discuss how algorithms and techniques of artificial intelligence are equipped in the field of urology to detect, treat, and estimate the outcomes of urological diseases. Furthermore, we explain the advantages that come from using AI over any existing traditional methods.

Objective: To develop a decision support system (DSS) for the prediction of the postoperative outcome of a kidney stone treatment procedure, particularly percutaneous nephrolithotomy (PCNL) to serv...

The COVID-19 pandemic has had a significant impact on all domains of urology. Annual educational conferences by prominent urological bodies were suspended, due to the inability of conventional conference to adhere to social distancing stipulations. Innovative methods of healthcare delivery were therefore required to mitigate some of financial, health, training and research implications. Webinars is now a very popular method of communication and dissipation of knowledge with increasing adoption in medical education, training and also has been included in the curriculum of elite universities. The term ‘webinar’ is a combination of web and seminar, meaning a presentation, lecture, or workshop that is transmitted over the web. Webinars have proven to be convenient, flexible, cost-effective and reduce the carbon footprint. Furthermore, it is likely that webinars have a wider global audience reach and individual delegates have the ability to access more meetings from the comfort of their homes. The Urology community has been one of more prominent adopters of webinars in delivering educational activity during the pandemic. An estimated 400 urology webinars have been listed on DocMeetings since the onset of the COVID-19 pandemic. However, webinar is not without limitations. The didactic nature of webinars allows for minimal interpersonal interaction and constructive debate with the audience. It is however likely with potential technological advancements this going to be less of an issue in the future. It seems that the journey of webinars has just begun and will have an impact on training, education, communication and conferences for the foreseeable future.

Introduction: Treatment of nonmuscle invasive bladder cancer (NMIBC) usually requires piecemeal resection of the tumor. En bloc resection emerges as a promising technique for small bladder tumors

Background: Transurethral resection of bladder tumour (TURBT) is the traditional technique of choice for endoscopically suspected bladder tumours. Cold En Bloc Excision (CEBE) using novel Zedd scissors is proposed for endoscopic treatment of patients with non-muscle invasive bladder cancer (NMIBC). The aim of this study was to evaluate feasibility and safety of CEBE of bladder tumours using Zedd scissors. Methods: A pilot prospective study of patients who underwent a CEBE of suspicious bladder tumours using Zedd scissors was conducted. A total of 23 patients underwent CEBE for suspected bladder tumours using Zedd scissors. New and recurrent tumours Results: There was no ONR or bladder perforation and none of the patients had any complications. DM was present in 21 patients (91%). There was no tumour identified at the circumferential margins. There was no cautery artefact reported in any case. No patients had a recurrence at first follow up cystoscopy and two patients had out of field recurrence at subsequent cystoscopies. Conclusion: CEBE with Zedd scissors is a promising en bloc excision technique for bladder tumour. It is a safe and feasible for excision of tumours less than 3 cm. The early oncological outcomes are comparable with existing en bloc resection techniques (ERBT) for NMIBC.

Objective Artificial intelligence (AI) is used in various urological conditions such as urolithiasis, pediatric urology, urogynecology, benign prostate hyperplasia (BPH), renal transplant, and uro-oncology. The various models of AI and its application in urology subspecialties are reviewed and discussed. Material and methods Search strategy was adapted to identify and review the literature pertaining to the application of AI in urology using the keywords "urology," "artificial intelligence," "machine learning," "deep learning," "artificial neural networks," "computer vision," and "natural language processing" were included and categorized. Review articles, editorial comments, and non-urologic studies were excluded. Results The article reviewed 47 articles that reported characteristics and implementation of AI in urological cancer. In all cases with benign conditions, artificial intelligence was used to predict outcomes of the surgical procedure. In urolithiasis, it was used to predict stone composition, whereas in pediatric urology and BPH, it was applied to predict the severity of condition. In cases with malignant conditions, it was applied to predict the treatment response, survival, prognosis, and recurrence on the basis of the genomic and biomarker studies. These results were also found to be statistically better than routine approaches. Application of radiomics in classification and nuclear grading of renal masses, cystoscopic diagnosis of bladder cancers, predicting Gleason score, and magnetic resonance imaging with computer-assisted diagnosis for prostate cancers are few applications of AI that have been studied extensively. Conclusions In the near future, we will see a shift in the clinical paradigm as AI applications will find their place in the guidelines and revolutionize the decision-making process.

INTRODUCTION AND OBJECTIVE:The presence of detrusor muscle (DM) is essential for the adequacy of bladder tumor resection. En bloc resection using electrocautery or laser is the standard of care for...

Introduction: Thyroid stimulating hormone secreting pituitary adenoma (TSHoma) is a rare cause of thyrotoxicosis, which manifests with features of thyrotoxicosis along with neurological manifestations of pituitary tumour. Biochemically, it is characterized by elevated thyroid hormone (T3 and T4) levels with unsuppressed TSH levels. It accounts for 1-2% of all pituitary adenomas. Mixed TSHomas account for 30% of these cases, among which mixed TSHoma/LH(luteinizing hormone)oma is very rare (

Supratentorial ependymomas are rare and are usually intra axial in location. We report a case of extra axial supra tentorial ependymoma in a girl which mimicked a falcine meningioma. Imaging, pathological features and management are described in this case report along with review of the literature. The possible origin of these tumors is discussed.

Metastatic tumors to the heart usually involve right sided chambers. We report a rare case of malignant phyllodes tumor of breast with metastatic involvement of left atrium occurring through direct invasion from mediastinal micro-metastasis and presenting as a left atrial mass causing arrhythmia.

Large cell neuroendocrine carcinoma of the uterine cervix is a rare and aggressive malignancy with poor prognosis even in its early stage, despite multimodality treatment strategy. We describe a 37-year-old woman with a large cell neuroendocrine carcinoma admixed with adenocarcinoma of the uterine cervix. These highly aggressive tumors have a prognosis that is much worse than that for stage comparable poorly differentiated squamous cell carcinoma of the cervix. Aggressive initial multimodality treatment with radical hysterectomy, bilateral pelvic lymph node dissection and adjuvant chemotherapy is recommended.

We report clinical details and imaging findings of a case of giant pseudocyst occurring in the anterior abdominal wall as a late complication following mesh repair of incisional hernia in a 36-year-old female. Findings included a giant well encapsulated cyst lacking an epithelial lining filled with brownish coloured fluid and histopathology confirming an inflammatory reaction.

Introduction: Meckel’s Diverticulum is the most common congenital anomaly of the gastrointestinal tract (incidence: 0.6%-4%). Gastro Intestinal Stromal Tumors originate from multipotential stromal cells of Cajal (pacemaker cell of gastrointestinal tract). The GISTs of Meckel’s diverticulum are extremely rare,especially if you consider that only 2% of the population has this kind of diverticula confirmed by autopsy studies, with a percentage that varies between 0.4 and 4.5%. Case Reports: We report two cases, a 53 year old post menopausal lady and a 45 year old peri menopausal lady, both clinico radiologically diagnosed as ovarian masses, found to have a tumor arising from Meckel’s Diverticulum intraoperatively, that were histopathologically proven to be Gastro Intestinal Stromal Tumors. A thorough literature review was done and all the previously quoted case reports are listed. Our literature search revealed a total of 42 case reports of GIST of Meckel’s Diverticulum including ours. Perforation is the most common presentation of a Meckel’s GIST (13 case reports). Meckel’s GIST presenting as a pelvic mass mimicking an ovarian pathology has been reported in the literature (6 case reports). Conclusion: Meckel’s diverticular tumours, though rare, may mimic other pathologies of the abdomen, therefore should be taken into consideration during the differential diagnosis of abdominal and pelvic tumours, especially in cases where imaging modalities doesn’t pinpoint adefinitive diagnosis.

Warthin tumor is a well-recognized benign salivary gland neoplasm consisting of an epithelial as well as a lymphoid component. Malignant transformation in Warthin tumor is rare and its reported incidence is up to 1%. The more common types of carcinomas described in Warthin tumor are the squamous and mucoepidermoid types, with high-grade adenocarcinoma being extremely rare. A high-grade adenocarcinoma (ductal type) arising in the Warthin tumor in a 72-year-old man is presented for its rarity and diagnostic difficulties.