Glioblastoma multiforme (GBM) carries dismal prognosis and cannot be eradicated surgically because of its wide brain invasion. The objective of this prospective randomised controlled trial was to evaluate ALA and Photofrin fluorescence-guided resection (FGR) and repetitive photodynamic therapy (PDT) in GBM. We recruited 27 patients; 13 were in the study group and 14 were in the control group. The mean survival of the study group was 52.8 weeks compared to 24.6 weeks in the control group (p<0.01). The study group gained on average 20 points on the Karnofsky performance score (p<0.05). There were no differences in complications or hospital stay between the two groups. The mean time to tumour progression was 8.6 months in the study group compared to 4.8 months in the control group (p<0.05). Therefore, ALA and Photofrin fluorescence-guided resection and repetitive PDT offered a worthwhile survival advantage without added risk to patients with GBM. A multicentre randomized controlled trial is warranted to confirm these results.

• The median age of the patients was 14 (0-92) years. 51% ( n = 89) had testicular torsion, 24% ( n = 42) had torsion of testicular appendages, 9% ( n = 16) had epididymo-orchitis, and other pathology made up 5%.• No obvious pathology was seen in 10% ( n = 17).• Patients with Torsion of Appendages were significantly younger than other patients with scrotal pain ( P < 0.0001).• Age was not useful in discriminating between patients with Testicular Torsion from other patients with scrotal pain. 9% ( n = 16) of all patients required an orchidectomy.• Frequency of Testicular Torsion was higher during the colder half of the year ( n = 0.02). CONCLUSIONS• Testicular torsion was the most common finding at surgical exploration, followed by torsion of testicular appendages.• Age had limited value in diagnosing the cause of acute scrotal pain.• Testicular torsion was associated with cold weather.• Our findings support the practice of surgical exploration for acute scrotal pain suspicious of testicular torsion in patients of any age.

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