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Vincent Kipkorir,1 Isaac Cheruiyot,1 Ibsen Ongidi,1 Fiona K Nyaanga,1 Bridget Neema,1 Elisha Harry Otieno,1 Roger R Baskaran,2 Bahadar S Srichawla,3 Jyotirmoy Biswas,4 Gopal Krishna Dhali,5 Arkadeep Dhali6 1Department of Human Anatomy and Physiology, College of Health Sciences, University of Nairobi, Nairobi, Kenya; 2Department of Critical Care, St. John’s Medical College, Bangalore, India; 3Department of Neurology, UMass Chan Medical School, Worcester, MA, USA; 4Department of General Medicine, College of Medicine and Sagore Dutta Hospital, Kolkata, India; 5Department of Gastroenterology, Institute of Postgraduate Medical Education and Research, Kolkata, India; 6Department of Internal Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UKCorrespondence: Arkadeep Dhali; Roger R Baskaran, Email arkadipdhali@gmail.com; rogerrathna@gmail.comBackground: This systematic review and meta-analysis aims to determine the prevalence of the retrorenal colon (RRC) and its implications in percutaneous nephrolithotomy with the overall objective of promoting the prevention of associated iatrogenic complications.Methods: A systematic search of literature was conducted on the electronic databases PubMed, ScienceDirect, and Hinari to identify studies eligible for inclusion. Search results were screened by title and abstract, and those potentially relevant were evaluated by full text. Studies were deemed eligible for inclusion if they reported clear extractable data regarding the prevalence of the retro-renal colon. A meta-analysis was completed using MetaX1 to calculate the pooled prevalence of the retro-renal colon. Sub-group analysis was performed based on geographical regions from which the studies originated, imaging modality, and patient position.Results: 174 records were screened and a total of 10 records included in the analysis with retrospective cohort studies being the most common study design. A male predominance was seen in most sample sizes that had reported data on gender demographics ranging from 41.5– 62%. The most common imaging modality utilized was computerized tomography (CT) scan followed by ultrasound. The range of the unweighted prevalence of retro-renal colon across all studies that had absolute numbers reported was from 3.5– 25%. One of the studies reported a colonic perforation rate of 0.3% in patients without CT images.Conclusion: The retro-renal colon is a relatively common finding with observed preponderance to females and left lateralization. The presence of RRC increases the likelihood of colon perforations while gaining percutaneous access to the kidney. Pre-procedural imaging can help detect its presence and choose an appropriate route of entry. USG and CT have both been found useful as a modality to pick up RRC.Keywords: colon, nephrolithotomy, retro-renal, urolithiasis

Ranju Kharel Sitaula,1 Anadi Khatri,2 MK Janani,3 Rajendra Mandage,4 Soumen Sadhu,5 HN Madhavan,6 Madan Prasad Upadhyay,7 Jyotirmay Biswas8 1Department of Ophthalmology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal; 2Birat Eye Hospital, Biratnagar, Nepal; 3Sankara Nethralaya Referral Laboratory, Medical Research Foundation, Chennai, India; 4Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India; 5Department of Optometry, The SankaraNethralaya Academy, Unit of Medical Research Foundation, Chennai, India; 6Larson & Turbo Microbiology Research Center, Sankara Nethralaya Referral Laboratory, Chennai, India; 7Children Hospital for Eye, Ear Nose Throat and Rehabilitation Services, Bhaktapur, Nepal; 8Department of Uvea and Ocular Pathology, Medical and Vision Research Foundations, Sankara Nethralaya, Chennai, IndiaCorrespondence: Anadi Khatri Department of Vitreoretina ServicesBirat Eye Hospital, Biratnagar, NepalTel +977841767205Email anadikc@gmail.comImportance: An observant Chinese doctor Li Wenliang became the first physician to alert the world about COVID-19. Being an ophthalmologist himself, he has put the additional onus on us. The fact that the ocular manifestation could be the first presenting feature of novel coronavirus pneumonia should not be ignored and the possibility of spread of SARS-CoV-2 through the ocular secretions cannot be ruled out. However, with breakthroughs still evolving about this disease, the calls are now louder for closer examination on the pathogenesis of conjunctivitis associated with it. Hence, we conducted a scoping review of all available literature till date to fill in the “potential” gaps in currently available knowledge on ocular manifestations of SARS-CoV-2 infection in an attempt to establish continuity in the “chain of information” from December 2019 till April 2020. We also summarize a possible hypothesis on much less understood and highly debated topics on regard to the etiopathogenesis of ocular involvement in SARS-CoV-2 based on either presence or absence of ACE2 receptor in the ocular surface.Methods: We conducted a scoping review search of published and unpublished SARS-CoV-2-related English language articles from December 2019 till mid of April 2020 from the online databases. The findings were summarized using text, tables, diagrams, and flowcharts.Results: The commonest ocular manifestation in SARS-CoV-2 infection is follicular conjunctivitis and has been the first manifestation of SARS-CoV-2 infection in 3 reported cases till date. The ocular surface inoculated with the SARS-CoV-2 leads to the facilitation of the virus to the respiratory system via the lacrimal passage. RT-PCR analysis of the ocular secretions has shown the presence of the SARS-CoV-2 nucleotides indicating the possibility of infection of ocular secretions. ACE2 receptors and its expression on the ocular mucosal surface are linked behind the etiopathogenesis of conjunctivitis.Conclusion: Conjunctivitis can be the presenting manifestation but may go unnoticed due to its mild nature. The ocular surface could serve as the entry gateway for the virus and ocular secretions could play a role in virus shed. The eye care personnel, as well as the general people, need to be more vigilant and adopt protective eye measures.Keywords: ACE2 receptor, conjunctiva, coronavirus, COVID-19 infection, ocular, ophthalmic, 2019-nCOV, SARS-CoV-2

Aruna Bhattacharya,1 Rama Saha,1 Jayanta Biswas,2 Jhuma Biswas,1 Biswajit Ghosh11Institute of Postgraduate Medical Education and Research, 2NRS Medical College and Hospital, Kolkata, West Bengal, IndiaAbstract: A collision tumor is one where histology shows the presence of two distinct primaries involving the same organ without intermixture of individual cell types, ie, a side by side pattern. Here we present three rare cases of collision tumors involving the stomach and transverse colon. There were two cases of collision tumors involving the stomach, one of which was a combination of adenocarcinoma and low-grade non-Hodgkin's (mucosa-associated lymphoid tissue) lymphoma, and the other showed the presence of non-Hodgkin's lymphoma involving the entire stomach wall along with adenocarcinoma infiltrating the muscle layer. The third case comprised a mucinous adenocarcinoma and carcinoid tumor in the large gut.Keywords: collision tumor, histology, gastrointestinal tract

Removal of the entire eyeball or a portion of it is required in many ophthalmic conditions. The gross features of such specimens provide valuable information. Gross photography of an intraocular tumour, ruptured eyeball or other pathological specimens including lid lesions, orbital tumors, intraocular lens implants, intraocular and extraocular parasites, retinal pathology such as haemorrhages and peripheral degenerations, establishes a permanent documentation. We herein describe the technique of gross photography of such valuable specimens, using a dissecting microscope with a special arrangement. This technique is currently used by us with gratifying results.

Highly active antiretroviral therapy (HAART) has changed the face of human immunodeficiency virus (HIV) acquired immune deficiency syndrome (AIDS) by leading to dramatic decreases in HIV-related morbidity and mortality in the developed as well as developing world. Since the introduction of HAART, the incidence of ocular opportunistic infections causing retinitis has dramatically decreased, and clinicians should be aware of changes in the clinical presentation of ocular manifestations of HIV. As studies of HIV disease after the introduction of HAART continue to become available, more thorough descriptions of treated patients with ocular opportunistic infections will include side-effects and toxicities of therapy. This review focuses on the impact of HAART on the ocular manifestations of HIV.