A large number of men are suffering from erectile dysfunction (ED). In the last decades, patients are more willing to talk about ED and also physicians are more aware of the problem and address it during medical consultation. A growing body of evidence shows that ED is often not an isolated problem but can be a precursor or sign of various other underlying diseases.

Hemangioblastoma (HB) is a vascular tumour of the central nervous system mostly located in the cerebellum; the supratentorial location is rare, and meningeal attachment is even exceptional. A few cases were reported in the literature. We report the case of a 20-year-old male without personal or familial past medical history, who presented deep visual field amputation; imaging objectified supratentorial solid tumour attached on the occipital falx, the patient was operated on and the lesion was completely removed; pathology examination was in favour of HB, further exploration found no other systemic anomalies. There was no recurrence during 7 years of control imaging. We also reviewed the literature, and we found another 31 articles describing supratentorial meningeal HB; this topographic form seems to have epidemiologic, pathologic, imaging and management particularities that we discuss to better understand this rare pathology.

Background: Prostate-specific antigen (PSA) screening is a routine clinical practice in the geriatric clinical practice– often intended to pick up early cases of prostate cancer. Multiple studies done across the world have demonstrated population-specific normative values of PSA with varying thresholds for prostate cancer. Universal application of the normative values results in false-positive screening results thus leading to unnecessary apprehension and invasive follow-up for the same– often unnecessary. Objectives: a. To study the PSA values of geriatric patients and postulate the possible normal values of PSA in different age groups of elderly. b. To correlate the PSA values with biopsy reports, wherever available, thus hypothesising the acceptable limits of PSA, beyond which prostatic biopsy may be indicated. Methods: This was a retrospective, cross-sectional study done at Amrita Institute of Medical Sciences, Kochi, India, where PSA of patients registered for the Comprehensive Geriatric Health Checkup Package between January 2012 and June 2013 were studied (n = 1038). Results: a. 105 patients were found to have an elevated PSA, of which 24 underwent biopsy after serial estimations as per protocol. Only 7 were proven to be malignant. b. Mean PSA values were found to be 1.55, 1.4 and 1.20 in the 60–69 years, 70–79 years and 80+ categories, respectively. Conclusion: a. Age-specific ranges of PSA are essential in interpreting PSA of the elderly and our study showed values that are similar to the expected. b. The study also demonstrates that roughly 10% of the elderly population in all age subsets has PSA values over the normal. Routine PSA testing puts roughly 1 in 10 patients at risk for biopsy and also places them at risk of probably unnecessary worry about a possible prostatic malignancy. c. Only 7 malignancies were picked up by the routine use of PSA testing in the study population of 1038, i.e., 6.7/1000. This brings us to the question of the cost effectiveness and utility of routine PSA screening, particularly when it places roughly 10% at risk for biopsy. d. Malignancies were detected in patients with falling PSA values and also who had unsuspicious findings on PR, hence questioning its relevance.

Purpose: The main purpose of the study was to describe a new technique for bilateral orchiectomy (BO) in men with metastatic prostate cancer. The research questions are is the subinguinal orchiectomy an effective method for orchiectomy? What is the surgical site infection rate? Materials and Methods: This was a retrospective review of men with clinical, radiological and histological diagnosis of osseous metastatic adenocarcinoma of the prostate who were counselled for the procedure. The written informed consent was obtained per patient and recorded. The satisfaction of wound healing was assessed on a scale of 0–10 through interview between day 7 and 10 after surgery. The complications of the surgery were documented. The data were analysed with simple statistics of mean and percentages. Results: Twenty-five patients underwent subinguinal orchiectomy, of which 17 had bilateral subcapsular and eight had bilateral total orchiectomy. The mean age was 75.7 years and mean prostate-specific antigen was 492.6 ± 48 ng/ml. The Gleason's prognostic groups scores were 5, 3 and 1 in 17, 6 and 2 patients, respectively. The mean operation times for bilateral subcapsular and bilateral total orchiectomy were 45 and 30 min, respectively. The complications were hematoma (13.3%) and surgical sites infection 12.5% for bilateral subcapsular and BO. Patients were discharged within 4 h of surgery and seen on postoperative days 3 and 10. 100% of the patients were satisfied with the wound healing. Conclusion: The subinguinal orchiectomy for prostate cancer is easy to perform, low surgical site infection, rate and excellent patients' satisfaction.

Context: Water is a scarce and precious resource in many parts of the world. The COVID-19 pandemic has reemphasised the importance of handwashing and sanitisation. The world is moving back to opening the surgical procedures once again. Aims: The aim is to analyse the impact of water consumption and the cost associated with surgical hand sanitisation. Settings and Design: Quality Improvement Project. Subjects and Methods: This is a quality improvement project; members of the surgical team were asked to scrub and amount of flowing water for 5 min was collected in a measuring bucket. The hospital sinks are equipped with either manual or automatic motion sensor taps. This was reflected in the total amount of water and cost that was calculated for the operative cases of 2019. Statistical Analysis Used: Descriptive statistics, calculating the mean. Results: Three minutes was the average scrub time for the six participants. Thirty litres of water were consumed using a manual tap with continuous flow for 5 min. In comparison just 7.5 L of water were consumed using a motion sensor tap. A total of 7060 cases were operated in the year of 2019 with an annual cost that ranged from 1.8 to 7.5 million United Arab Emirates Dirham. Conclusions: The surgical handwashing technique is associated with a considerable amount of water. Motion sensor taps have the advantage to decrease wasting with water flowing only during actual washing. Techniques to decrease that amount are available and can be considered to preserve the water.

Objective: Most of the people in our region with high socioeconomic status cannot live without housemaids. Some of them have more than one in addition to a driver. Unfortunately, this leads to changes in their lifestyle and makes them more dependent on others. Study Design: This study is designed to find if generations of children could be affected by growing up with a dependency on a housemaid and driver, consequently affecting both their attitude and behaviour within our society. Methods: A prospective case–control study was conducted at private and governmental schools between October 2013 and December 2015. Results: The present study included 369 students. The students were questioned about their attitude and the degree of their dependency on housemaids. Ninety-seven per cent reported that they had live-in housemaids. Most of the students reported having 1–2 housemaids at home. Conclusion: The hiring of housemaids had an impact on the attitude of adolescents. They had developed dependency behaviour, but they had good relationship skills with family and friends.

Background: TAVI is an alternative to SAVR in patients older than 65 years old. Its the only treatment option in patients with prohibited risk for surgical intervention. Patients undergoing TAVI procedures are usually older and sicker than the typical patient undergoing other types of standard angiographic procedures. Acute kidney injury (AKI) is a frequent complication following TAVI, and it influences patient's outcomes and survival. Methods: This is a retrospective, observational study, aimed to investigate the prevalence of AKI and its relation with different parameters such as age, sex, diabetes, hypertension, laboratory parameters, the need for blood transfusion and others, among patients who underwent TAVI procedure and the impact of AKI on overall mortality and morbidity. Results: A total of 108 patients underwent TAVI procedures included in this analysis. Their median age (minimum–maximum) was 75 years (50–93 years); 52 were females (48%); 62 cases (57%) were diabetic; 79 (73%) cases were hypertensive; 73 (68%) had heart diseases other than aortic stenosis; 8 cases (7.4%) had cerebrovascular disease and 6 cases (5.6) had peripheral vascular disease. Thirty-five cases (32.4%) out of the 108 developed AKI. Three patients (8.5%) required dialysis. Independent predictors for AKI in our analysis were reduced baseline kidney function, blood transfusion and thrombocytopenia, whereas gender, reduced cardiac functions, diabetes and hypertension did not influence the risk of AKI. The 30-day mortality rate was 0.9%, whereas the cumulative late mortality was 0.9% at 6 months and 1.9% at 9 and 12 months of followed up patients. Conclusion: AKI is a frequent complication post-TAVI, leading to increased morbidity, mortality and hospital stay; therefore, it necessities more attention to risk factors, early diagnosis and appropriate timely intervention.

The emergence of extensively drug-resistant (XDR) strains of Salmonella enterica serovar Typhi-resistant to multiple first-line antibiotics started in the Sindh Province in Pakistan is a cause of concern in the management of typhoid fever. Recently, we experienced a case of XDR typhoid fever in a 4-year-old unvaccinated girl who contracted it during her visit to Pakistan in the summer of 2019, improved with meropenem and azithromycin. This is the first reported case of paediatric XDR typhoid diagnosed and treated in the UAE. Awareness of the on-going outbreak of XDR typhoid fever in Pakistan is very important for clinicians in the evaluation and management of febrile illnesses in a child with a history of travel to Pakistan.

SARS-CoV-2 is a novel virus with novel complications. The commonly reported symptoms include fever, body aches, fatigue, shortness of breath and loss of smell similar but not exclusive to infections of the respiratory system. Other mentioned extrapulmonary symptoms pertaining to the gastrointestinal (GI) tract are abdominal pain, diarrhea and vomiting. Many complications have been documented in relation to the above-mentioned symptoms. In this paper, we report a complication of extrapulmonary disease of COVID-19 in relation to the GI manifestations of this novel virus. Still, in the race of developing and distributing a working vaccine, we should keep on monitoring different manifestations and complications of COVID-19 and treating and managing the millions of patients that are infected daily throughout the world.

Systemic lupus erythematosus (SLE ) as an autoimmune disease causing widespread inflammation and tissue damage in several organs. Nonspecific constitutional symptoms are the most common presentation in new cases and flares. We present a young male who presented with finger discoloration found to have SLE without fulfilling the criteria of antiphospholipid syndrome. The aim of this case is to emphasize on early identification of SLE to proper diagnosis and commence management.