The World Health Organization labelled the new COVID-19 breakout a public health crisis of worldwide concern on 30 January 2020, and it was named the new global pandemic in March 2020. It has had catastrophic consequences on the world economy and well-being of people and has put a tremendous strain on already-scarce healthcare systems globally, particularly in underdeveloped countries. Over 11 billion vaccine doses have already been administered worldwide, and the benefits of these vaccinations will take some time to appear. Today, the only practical approach to diagnosing COVID-19 is through the RT-PCR and RAT tests, which have sometimes been known to give unreliable results. Timely diagnosis and implementation of precautionary measures will likely improve the survival outcome and decrease the fatality rates. In this study, we propose an innovative way to predict COVID-19 with the help of alternative non-clinical methods such as supervised machine learning models to identify the patients at risk based on their characteristic parameters and underlying comorbidities. Medical records of patients from Mexico admitted between 23 January 2020 and 26 March 2022, were chosen for this purpose. Among several supervised machine learning approaches tested, the XGBoost model achieved the best results with an accuracy of 92%. It is an easy, non-invasive, inexpensive, instant and accurate way of forecasting those at risk of contracting the virus. However, it is pretty early to deduce that this method can be used as an alternative in the clinical diagnosis of coronavirus cases.

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Context:In India, there are a large number of end-stage renal disease (ESRD) patients waiting for renal transplant. Deceased donor organ transplantation (DDOT) is the possible solution to bridge the disparity between organ supply and demand. The concept of expanded criteria donors (ECDs) was developed to combat the huge discrepancy between demand and organ availability. However, ECD kidneys have a higher propensity for delayed graft function (DGF), and therefore worse long-term survival. We present our experience of deceased donor renal transplantation.Aims:We report single centre experience on DDOT including ECDs vis-à-vis patient/graft survival, graft function in terms of serum creatinine (SCr), rejection episodes, and delayed graft function in 44 DDOTMaterials and Methods:Between August 1998 and April 2011, 44 renal transplants from 35 deceased donors were performed, of which 37.2% were expanded criteria donors. Results were analyzed in terms of age of donor, terminal SCr, graft ischemia time, graft function, post-transplant complications, and graft and patient survival. All recipients received sequential triple drug immunosuppression and induction with rabbit antithymocyte globulin (rATG). The induction is commenced by giving first dose of rATG intraoperatively (dose 1.5 mg/kg) and subsequent rATG infusions were administered daily for a minimum of 5 and maximum of 7 doses depending on initial graft function.Results:We have been able to achieve a mean cold ischemia time of 6.25 ± 2.55 h due to the coordinated team efforts. Delayed graft function occurred in 34% patients and 31.8% had prolonged drainage. There were no urinary leaks. Seven (16%) patients had biopsy-proven rejection episodes, all of which were reversed with treatment. Two patients underwent graft nephrectomy. One of these was due to hyperacute rejection and another due to anastomotic hemorrhage. One-year graft survival was 92.4% and the patient survival was 83.8%.Conclusion:Deceased donor renal transplants have satisfactory graft function and patient survival despite the high incidence of delayed graft function. Retrieving kidneys from marginal donors can add to the donor pool.

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Introduction:We evaluated the utility of botulinum toxin in functional female bladder outlet obstruction.Materials and Methods:A total of 7 consecutive female patients with bladder outlet obstruction were included. Patients with neurogenic bladder were excluded. All were previously treated with periodic dilations. Diagnosis was based on symptomatology, cystometry, and micturating cystograms. A total of 2 patients had been in chronic retention with residual volumes more than 400 ml. All were managed with an injection of botulinum toxin, 100 units in 2 ml of saline injected with a flexible cystoscopic needle. The site of the injection was deep submucosally, 0.5 ml in each quadrant at the level of the most prominent narrowing seen endoscopically. All the procedures were done as day care procedures under local anaesthesia. After the procedure, no catheter was placed. Patients were followed up for changes in IPSS scores and post void residual urine measurements. In all cases, multiple injections were used.Results:The follow-up period ranged from 48–52 weeks. The IPSS reduced by an average of 12 points. Post void residual urine reduced by 62%. Improvements commenced 4.85 days (average) after the procedure and lasted for an average of 16.8 weeks (range: 10.8–28 weeks).Discussion:There is a gradual improvement in symptoms over time and the maximal effect occurred at 10–14 days. The duration of improvement was approximately 16.8 weeks. All patients were satisfied by the degree of improvement felt.Conclusions:Botulinum toxin proved successful in improving the voiding characteristics. It possibly acts at the zone of hypertonicity at the bladder neck or midurethra. The only disadvantage is the high cost of the drug.