Immuno-therapy involvement in bladder urothelial malignancies is growing very fast. The use of Immuno-therapy with check-point inhibitor has greatly developed since it was first approved as a second-line treatment for cases who had formerly failed platinum-based chemotherapy. There are recognized applications for first-line metastatic illness in platinum-ineligible or cisplatin-ineligible PD-L1 diagnosed cases, as well as a label for BCG-refractory high-risky non-muscle invasive bladder cancer (NMIBC). It is now being studied in neo-adjuvant and adjuvant muscle invasive bladder cancer (MIBC) clinical trials. This review discusses the clinical trials that led to these FDA agreements, as well as prospective and ongoing trials. Current clinical guidelines support Bacillus Calmette-Guérin (BCG) as the primary treating option for intermediate to high-risk NMIBC. Despite the intra-vesical BCG-instillation, intra-vesical relapse occurs in a considerable number of individuals with intermediate to high risk NMIBC. Furthermore, treating BCG-nonresponsive NMIBC is still difficult. For these individuals with BCG-nonresponsive NMIBC, there are no viable therapy alternatives other than radical cystectomy, which has been shown to have excellent oncological results. In this regard, for the care of BCG-nonresponsive NMIBC, safe and reliable noninvasive or lesser-invasive therapeutic alternatives with adequate oncological results are needed. Regarding the latest introduction of immuno-therapeutic medications, the treatment of progressive or metastatic urothelial cancer has substantially advanced. These developments have sparked a surge in interest in immuno-therapeutic medications for NMIBC, particularly BCG-nonresponsive NMIBC. The goal of this literature review is to provide and debate the most up-to-date information on the function of Immuno-therapy in BCG-nonresponsive NMIBC and the presently accessible treatment options. Furthermore, this page highlights the current research in this topic. We wanted to convey the current state of Immuno-therapy in NMIBC and discuss future directions.
Bosniak was the normal radiological assessment procedure for cystic renal lesions.Originally, it relied on computed tomography (CT) scan results and subsequently extended to magnetic resonance imaging (MRI).Renal cell carcinoma (RCC) surveillance was not enhanced in the past 20 years.Bosniak classifications depend on different morphological modifications in renal cysts such as septa development, wall thickening of nodal elements, wall and/or septa calcification, hyperdense cystic composition and contrast enhancement following intravenous contrast injection.Bosniak group comprised four categories, I and II lesions normally benign, Group III possibly malignant and IV mostly malignant.Recently, Category IIF (BIIF) was added, including cysts that cannot be easily differentiated from either Class II or III.The aim of this study was to investigate the surveillance and clinical outcome of Bosniak IIF renal cysts.We searched for retrospective evidence of Bosniak IIF renal cysts, cystic renal lesions, Bosniak IIF lesions, Carcinomas, Renal Cell, and Malignant Neoplasms obtainable up to April 2019.We selected articles published in English.The following databases were searched; PubMed and Google Scholar.The discovery of Bosniak Category IIF is considered as a successful method in renal cyst diagnosis and treatment possibly resulting in nephron-sparing during complicated renal cyst care.
Development of intra-abdominal fat is associated with poor dietary habits and a sedentary lifestyle.The aim of this review was to analyse the relationship between central obesity and erectile dysfunciton (ED).The presence of a metabolic syndrome, associated with ED, is not characterized by a BMI value alone, but also takes into consideration an individual's waist circumference, body fat percentage, circulating levels of triacylglycerols, levels of low density lipoprotein (LDL) and high-density lipoprotein (HDL)-cholesterol, glycemic control and blood pressure.Of these factors, waist circumference (WC) was shown to be important in the diagnosis and treatment of both abdominal obesity and ED.WC is a strong indicator of an accumulation of visceral fat and a high WC in men is a risk factor for erectile dysfunction (ED), suggesting that ED is a complication of obesity, although the exact mechanisms of how obesity impacts ED on a molecular level are not well understood.
Virtual Reality (VR) allows users to interact with intuitive environments to manipulate games, applications and even other Internet of Things (IoT) devices. VR devices have been brought to users by different vendors, supporting different development platforms and features. Many VR applications, however, do not support simultaneous VR devices from different vendors. The few applications that support this feature are not open to developers, with little information on their implementation and application performance. Using VRTK and Unity, this paper intends to present a VR application that supports multiple VR hardware platforms with the use of the VRTK SDK along with the appropriate VR hardware SDKs. This application supports multiple users in a VR environment where they can interact with each other and with objects in the VR space. Other features such as file transfer over the VR application are also supported. Such an application is important to allow developers to design future applications that support multiple devices regardless of the vendor, creating convenient multiuser VR applications with less limitations.
Background: Percutaneous Nephrolithotomy (PNL) is a well-established technique for the removal of renal stones.Large and complex renal stones are difficult stones to deal with.Aim of Study: This study is to evaluate our results of PNL for the treatment of large and complex renal stones concerningstone-free rates (SFR) and complications.Patients and Methods: From From 2012 to 2022, four hundred and four renal units with large and/or complex renal stones were subjected to PNL.Eightynine per cent were males and 11% were females.The average stone surface area (SA) was 872mm 2 .Results: Stone-free rate (SFR) was 79% for cases submitted to PNL alone and 88.4% for those managed with auxiliary procedures.Hospital stay ranged from 2 to 21 days (Av.3.6 days).The overall complication rate was 8% and was managed conservatively. Conclusion:PCNL is a safe and effective procedure for the management of large and complex renal stones.There was a significant decrease in the overall stone-free rate and increased complication rates with increased stone surface area.Stones >1500mm2 are difficult stones for any modality.A multimodal approach should be thought of for large and complex renal stones.
The objective of this research is to identify the mediating effect of strategic intelligence in the relationship between strategic management practices and entrepreneurship in Iraqi universities. The data was collected from the university professors and the questionnaire was used as a tool for data collection. The data were analyzed using the structural equation modeling (SEM) with SmartPLS 3 software. The research results indicated that the relationship between variables was positive significant relationship while strategic intelligence leads to more effective strategic management practices in order to achieve entrepreneurship.
Background: Renal pruritus is a distressing disease, often overlooked condition in patients with chronic kidney disease and end-stage renal disease that adversely affect the quality of life (QOL) and medical outcomes of patients and therapy with antihistamines has been unsuccessful. Objective: The purpose of the study was to evaluate the efficacy of low-level laser on renal pruritus in hemodialysis patients. Patients and methods: Thirty patients who established diagnosis of chronic renal failure with age ranged 35-60 years were selected randomly from Hemodialysis Unit of Al-Galaa military Hospital. Patients were randomized into two groups of equal number, 15 each. Group (A) received low level laser therapy 3times/week for 8 consecutive weeks and antihistamine and their conventional medical care. Group (B) who only received antihistamine and their conventional medical care. Parameters: Itching visual analogue scale (VAS) and 5-D Pruritus scale. Results: Compared to the results before and after low level laser (LLLT) treatment. Our study showed that there was a statistically significant decrease in the results of VAS and 5-D pruritus; but the results of group (A) were superior to that of group (B) when comparing the group results together. Conclusion: It can be concluded that low level laser therapy (LLLT) relieves itching pain and lowers progression of renal pruritus in patients undergoing hemodialysis.