Presbyopia is the age-related loss of near-distance focusing ability. The aim of this study was to identify patient-reported outcome measures (PROMs) used in clinical trials and quality-of-life studies conducted in individuals with presbyopia and to assess their suitability for use in individuals with phakic presbyopia. Literature searches were performed in Medline and Embase up until October 2017. Specific search terms were used to identify presbyopia studies that included a PROM. All clinical trials with PROM-supported endpoints in presbyopia were identified on ClinicalTrials.gov. Further searches were conducted to retrieve articles documenting the development and psychometric evaluation of the PROMs identified. A total of 703 records were identified; 120 were selected for full-text review. Twenty-one clinical trials employed PROMs to support a primary or secondary endpoint. In total, 13 PROMs were identified; a further 23 publications pertaining to the development and validation of these measures were retrieved. Most PROMs were developed prior to release of the Food and Drug Administration (FDA) 2009 patient-reported outcome guidance and did not satisfy regulatory standards. The Near Activity Visual Questionnaire (NAVQ) was identified as the most appropriate for assessing near-vision functioning in presbyopia. While the NAVQ was developed in line with the FDA guidance, the items do not reflect changes in technology that have occurred since the questionnaire was developed in 2008 (eg, the increase in smartphone use), and the measure was not validated in a purely phakic presbyopia sample. Further research is ongoing to refine the NAVQ to support trial endpoints related to changes in near-vision functioning associated with phakic presbyopia.

OBJECTIVE To evaluate the results of tubularized incised‐plate (TIP) urethroplasty for distal and midshaft hypospadias in adults, and to underline technical aspects to decrease complications. PATIENT AND METHODS From December 1999 to January 2004, 13 patients with hypospadias and aged 18–26 years had a TIP urethroplasty as a primary repair. Five had distal penile and eight had midshaft hypospadias. In all cases a TIP urethroplasty was used as described for children. Urinary drainage was by a urethral Nelaton catheter connected to a urine bag. RESULTS The catheter was removed after 10 days and the patients asked to attend a follow‐up at 1, 3 and 6 months and then 6‐monthly; the maximum follow‐up was 3 years and the minimum was 3 months. One patient developed a fistula after the repair of distal penile hypospadias, which closed spontaneously after a month. All patients with a successful repair voided with a single straight urinary stream in a forward direction. They had a normally situated slit‐like glanular meatus. CONCLUSION TIP repair in adults is associated good results. There is no difference in terms of wound healing, infection, complication rates and overall success between the TIP repair in children and adults. The cosmetic and functional outcome was comparable to that in children.

PURPOSE: To evaluate the safety and efficacy of a single instillation in a combination of povidone iodine with contrast agent under fluoroscopy guidance for the treatment of chyluria. MATERIALS AND METHODS: From December 1999 to July 2006 a total of 40 patients with chyluria were treated by renal pelvic instillation therapy (RPIS). The sclerosing solution was prepared using povidone iodine with contrast agent diluted with sterile water in a ratio of 1:1:3. It was instilled on the side having chylous efflux using a bulb tip ureteric catheter. Unilateral instillation was done in 26 cases, 10 on the right side and 16 on left. Fourteen patients had bilateral chylous efflux and RPIS was performed on both sides in the same session. Fluoroscopy was used to evaluate the complete filling of the pelvic calyceal system. The sclerosing solution was kept in the system for 5 minutes and the ureteric catheter was then withdrawn. RESULTS: Immediate clearance was observed in 39 patients. Recurrence occurred in five patients. They were treated again using the same procedure with satisfactory results. The longest follow-up was five years and the shortest five months. CONCLUSION: RPIS of chyluria using a single instillation a combination of povidone iodine with contrast agent is safe and effective. Use of fluoroscopy helps to determine the exact amount of sclerosing solution required to completely fill the system and therefore overfilling is avoided. Moreover, the complications, which arise due to pyelointerstitial backflow, are prevented

Percutaneous nephrolithotomy is a very commonly done procedure for management of renal calculus disease. Establishing a good access is the first and probably the most crucial step of this procedure. A proper access is the gateway to success. However, this crucial step has the steepest learning curve for, in a fluoroscopy guided access, it involves visualizing a three dimensional anatomy on a two dimensional fluoroscopy screen. This review describes the anatomical basis of the renal access. It provides a literature review of all aspects of percutaneous renal access along with the advances that have taken place in this field over the years. The article describes a technique to determine the site of skin puncture, the angle and depth of puncture using a simple mathematical principle. It also reviews the common problems faced during the process of puncture and dilatation and describes the ways to overcome them. The aim of this article is to provide the reader a step by step guide for percutaneous renal access.

Purpose This study aims to examine the challenges posed by COVID-19 restrictions for audit processes in India and explore the perceptions of the profession on how technology was leveraged to conduct audits during this period. The opinions of auditors on future changes in post-COVID-19 audit practices and processes are also explored. Design/methodology/approach Semi-structured interviews were conducted with senior auditors working in various audit firms in major business centers in India and subjected to content and thematic analysis using the institutional theory perspective. Findings The auditing profession used technology to respond to COVID-19-imposed disruptions of established audit process and practices while maintaining the legitimacy of audit reports. The findings indicate that auditors now seem to strongly support the integration of emerging technologies into their auditing practices post-COVID to ensure data accuracy and transparency. The interviewees displayed keen interest in continuing remote and in-person audits to maintain audit quality in the future. The experience of COVID-19 appears to have forced the auditing profession to overcome their reluctance to adopt technologies that were previously used by only Big 4 and large audit companies. Practical implications The results will be of particular interest to various stakeholders concerned with aspects of the acceptance of technology-assisted audit reports such as legitimacy, required infrastructure, cost involvement and resistance to change. The findings will also assist professional bodies and policymakers in both developed and developing economies in devising useful strategies to promote technology-aided auditing during and after COVID-19. Limitations posed by inadequate infrastructure and resistance to changes must be overcomed before implementation of technology-aided audits. Originality/value As COVID-19 pandemic is a recent phenomenon, to the best of the authors’ knowledge, this study is one of the first few studies that have examined the use of technology to facilitate audits during the COVID-19 period, more specifically from a developing economy perspective.