Potential health and economic impacts of dexamethasone treatment for patients with COVID-19

Acknowledgements We thank all members of the COVID-19 International Modelling Consortium and their collaborative partners. This work was supported by the COVID-19 Research Response Fund, managed by the Medical Sciences Division, University of Oxford. L.J.W. is supported by the Li Ka Shing Foundation. R.A. acknowledges funding from the Bill and Melinda Gates Foundation (OPP1193472).Peer reviewedPublisher PD

Burnt out benign splenic cyst mimicking intra-abdominal malignancy - case report and review of literature.pdf

The spleen performs important immunological function. Benign cysts, neoplasms and abscesses are identifiable cystic lesions of the spleen. Splenic cysts are very rare, and consist of Type 1 (parasitic) and Type 11 (non-parasitic) cysts. Very few cases of huge splenic cysts have been reported in literature. The most common symptoms are due to pressure effects on contiguous organs, causing pain, abdominal swelling and change in bowel habit. Management of these splenic cysts iscontroversial. Indications for surgical intervention, include symptomatic or large diameter cysts (>5cm). We report a 57 year old lady with an 18 year history of recurrent left abdominal pain, progressive weight loss, easy satiety, and recurrent low grade fever. She neither had change in bowel habit, nor haematuria. Therewas no history of abdominal trauma. On physical examination, there was a left hypochondriac swelling, extending to the midline of the abdomen. She has been transfusedseverally in the past on account of recurrent anaemia. Ultrasound revealed multiple well circumscribed oval and rounded cysts of the spleen. Her haemoglobin level at presentation was 6g/dl. She had neutrophilia. She subsequently underwent total splenectomy with good surgical outcome

Intractable haematuria secondary to pedunculated median lobe of the prostate - a diagnostic dilemma.pdf

Benign prostatic hyperplasia is a common disease in the ageing male. Obstructive solitary and pedunculatedintra-vesical enlargement arising from the median lobe of the prostate is rare. The enlarged median lobe, juts into the bladder base, and occasionally occludes the internal urethral opening during voiding (ball valve effect). The clinical diagnosis can be difficult, as digital rectal examination and ultrasonography can be inconclusive. Intractable haematuria associated with benign prostatic obstruction (BPO) is a urological emergency necessitating emergency surgical intervention. We report a 54 year old man, who presented with a 3 year history of worsening severe lower urinary tract symptoms (LUTS) that culminated inintractable haematuria of 7 days duration and acute urinary retention. Digital rectal examination revealed a flat prostatic fossa with no nodules. PSA was 11.7ng/ml. Ultrasonography revealed a huge prostate with a prominent median lobe (grade-3 IPP) and a post void residual of 176mls. He underwent emergency open transvesical prostatectomy with good surgical outcome

Efficacy of single dose ciprofloxacin versus ceftriaxone in the prevention of prostate biopsy related infection.pdf

Background: Prostate cancer is a major health concern world over, being the second most common neoplasm in men and the sixth commonest cause of cancer related death in the entire world. Trans-rectal ultrasound guided prostate biopsy is the gold standard technique for prostate cancer diagnosis. Prostate biopsy is associated with risk of urinary tract infection. Objective: This study aims to compare efficacy of ciprofloxacin with that of ceftriaxone in reducing post-prostate biopsy infection. &nbsp

Synchronous bilateral ureteral ligation and urinary bladder injuries following emergency hysterectomies: Early surgical intervention is a resuscitatory measure.

Synchronous iatrogenic ureteral and bladder injuriesfollowing emergency pelvic surgeries, thoughuncommon, cause morbidities and mortalities. Theyare potential causes of severe and debilitatingobstructive nephropathies as well as avoidablelitigations in surgical practice. Delay at initiatingsurgical treatment worsens outcome. Management isextremely challenging with attendant complications.We report two cases of iatrogenic bilateral ureteralligation with synchronous posterior urinary bladderlacerations. Both patients developed anuria at theimmediate post-operative period, with worseningbilateral flank pains, abdominal distension, leakageof urine per vaginam and poor performance status.Both patients were uremic. Emergency exploratorylaparotomies were done, with release of ligatures,stenting of both ureters and repair of bladder wall.Accurate diagnosis with early surgical intervention islifesaving