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Objectives: This study aims to investigate cases of acontractile bladder as the initial presentation of benign and malignant spinal conditions. The focus is on the challenges in making a diagnosis and the importance of a thorough neurological evaluation. Methods: We conducted a retrospective case series involving three patients who exhibited symptoms of acontractile bladder. Detailed clinical histories, urodynamic studies, and imaging techniques such as lumbosacral magnetic resonance imaging (MRI) were analyzed. Histopathological findings from relevant biopsies were also taken into account. Results: Case 1 : A 14-year-old female presented with urinary retention, back pain, and an acontractile bladder on urodynamic study. Further examination, including lumbosacral MRI and histopathology, confirmed a diagnosis of metastatic Ewing's Sarcoma. Case 2 : A 39-year-old female with urinary incontinence and elevated post-void residual exhibited delayed bladder sensation. Lumbar spine MRI revealed a grade I Schwannoma after surgical resection. Case 3 : A 15-year-old male with lower urinary tract symptoms and an acontractile detrusor on urodynamic study was found to have a Tarlov cyst on lumbosacral MRI. Conclusion: Atonic or Underactive bladder syndrome may be the initial presentation of a serious spinal condition. Complete neurological evaluation is mandatory if no obvious clinical cause. [ABSTRACT FROM AUTHOR]

Introduction: Calyceal diverticula (CD) are traditionally diagnosed by contrast studies. However, non-contrast CT is the standard imaging modality for kidney stones. Therefore, we aimed to determine if the lack of contrast imaging affected outcomes of the management of symptomatic CD with stone. Materials and Methods: This is a retrospective study of patients diagnosed with CD with intracalyceal stone from 2000 to 2017 analyzing demographics, clinical data, and success of different treatment options. The timing of CD diagnosis is correlated to the success of the first treatment. Results: Forty-eight patients were found. CD was diagnosed prior to intervention in 20 (42%) cases and intraoperatively during flexible ureteroscopy in 17 (35%) and 11 (23%) cases were diagnosed after failed intervention, mainly ESWL. We found that the success rate of treatment was highly affected by the timing and modality of diagnosis. Preoperative diagnosis of CD was associated with 69% success rate of the first intervention. In contrast, there was a 0% success rate of first treatment if CD was not diagnosed with contrast imaging. Furthermore, univariate analysis showed no significant association between sociodemographics and clinical variables and success treatment (p > 0.05). Conclusions: The delay in diagnosing CD with stone contributes significantly to the success rate and the number of treatments. [ABSTRACT FROM AUTHOR]

We report the case of a 9-year-old girl who presented to our hospital at the age of 6 years with recurrent febrile urinary tract infections started at 6 months, associated with nocturnal enuresis, daytime urinary frequency, and urge incontinence. Initial evaluation revealed a routine physical exam with no evidence of neurological abnormalities. Urinary tract ultrasound failed to demonstrate structural abnormities; micturition cystourethrogram documented the absence of vesicoureteral reflux. Accordingly, the urodynamic study demonstrated the presence of low bladder compliance and reduced bladder capacity. A whole spine magnetic resonance imaging showed isolated syringomyelia extending from T4 to T12 and measuring about 2.7mm in anterior-posterior (AP) diameter at the D8D9 level. After the failure of initial management of bladder overactivity using anticholinergic medications, the patient was managed by repeated cystoscopic injections of 200 international units of OnabotulinumtoxinA, with good symptomatic relief. After three years of follow-up 3 years, investigations and clinical findings failed to demonstrate neurological or urodynamic deterioration. [ABSTRACT FROM AUTHOR]

Paediatric ureteric calculi are an uncommon conditions encountered occasionally by adult urologists. Endoscopic treatment is the mainstay treatment of such cases. Nevertheless, a significant percentage of children with ureteric calculi present with other comorbidities which is usually overlooked by urologists. In this article, we describe a rare case of paediatric ureteric calculi associated with deep venous sinuses thrombosis of the brain evaluated through a multidisciplinary approach that led to the final diagnosis of Behçet's disease which is also a rare condition in paediatrics. The complexity of the case in view of the rarity of both diseases encouraged us to report it. We present an eight-year-old male referred to a tertiary centre as a case of mastoiditis, complaining of severe headache, diplopia, and high-grade fever. Magnetic resonance venography "MRV" with intravenous "IV" contrast showed left transverse sigmoid and internal jugular dural venous sinus thrombosis but no evidence of mastoiditis. Computed tomography "CT" scan of the abdomen and pelvis showed a large left distal ureteric stones up to 4 cm collectively associated with hydronephrosis in addition to a few stones in the left kidney. He was managed by different teams such as urology, otorhinolaryngology, neurology, and ophthalmology to sort out his mysterious presentation over a lengthy hospital admission. Upon further evaluation and multi-disciplinary approach, a diagnosis of Behçet's disease has been made. Paediatric ureteric calculi are an uncommon problems and frequently presented with other comorbidities. Multi-disciplinary team approach to such cases is recommended and may uncover a serious underlying disease or concomitant comorbidities. [ABSTRACT FROM AUTHOR]

Several guidelines and algorithms have been established since the declaration of Coronavirus disease 2019 (COVID-19) pandemic to organize work across surgical departments and face the enormous demands on health care facilities without affecting patient's health and safety. Pediatric ureteric calculi is an uncommon condition that may be encountered and requires appropriate triage and management. However, pediatric urologists are not available in all centers, mandating adult urologists to deal with such cases despite the small volume, especially during COVID-19, where patients transfer is restricted. We have reviewed pediatric ureteroscopy outcomes at our tertiary center as adult urologists did all cases. We retrospectively reviewed the files of all pediatric patients who had endoscopic management of symptomatic ureteric calculi between 2013 and 2020. Patient demographics, stone characteristics, operative details, hospital stay, and complications were recorded and analyzed. Twenty-one patients were included, 13 males and eight females. The mean age was 8.4 ± 2.9 years. The mean ureteral stone size was 9.9 ±3.6 mm. 28.6% (n=6) of patients known to have other comorbidities, 33.3 %( n= 7) of patients required pre-operative double J stent (JJ) stent insertion. One lithotripsy session was sufficient for complete stone clearance in most patients, 76.2 %( n=16), while the remaining patients required two sessions. None of the patients developed postoperative urinary tract infection (UTI) or gross hematuria with clots. All patients except one were discharged home on the same day. Daycare pediatric ureteroscopy is a feasible and safe option to be considered by adult urologists in order to treat pediatric ureteric stone disease, especially in the current era of COVID-19 pandemic where the number of beds is limited, and patients transfer is restricted. [ABSTRACT FROM AUTHOR]

Background and Objectives: Coronavirus disease-2019 (COVID-19) is an emerging disease threatening the world with a rapid increase in cases and deaths since it was first identified in December 2019. Adequate knowledge, practice, and attitudes (KPA) toward COVID-19 among physicians at the frontline defense against the COVID-19 pandemic may enhance their ability to avoid the risk of self-infection, decrease mortality, and provide adequate medical care service in this pandemic. This study aimed to assess KPA toward COVID-19 among physicians in Jordan and Palestine. Methods: This is a cross-sectional study using an online survey conducted from 10 April to 26 April 2020 among Jordan and Palestine physicians. Invitations were sent to physician groups on Facebook and WhatsApp. This survey contains 36-items, divided into four main sections to assess the participants' socio-demographic characteristics, knowledge, practice, and attitude about COVID-19. Results: A total of 454 physicians participated in this study. The mean score of basic knowledge was 4.4 ± 0.8 (range 2– 4). There were significant differences between basic knowledge mean scores among physicians in different professional degrees and physicians in various health sectors (P=0.0315, P=0.0137, respectively). The mean scores of self-protection measures, were 6.1 ± 1.1 (range 3– 7) and measures if physician self-suspected of COVID-19 were 9.9± 1.1 (range 5– 11). The mean score of attitudes toward COVID-19 was 41.5 ± 3.3 (range 21– 45) and significantly related to the age and different experience years (P=0.0022, P=0.0077, respectively). Conclusion: As the global threat of COVID-19 continues to emerge, physicians from Jordan and Palestine showed adequate KPA toward COVID-19. There was a significant difference in knowledge level and attitude between physicians. Policymakers and physicians should keep continuous educational activities, training, and follow-up updates during this pandemic. [ABSTRACT FROM AUTHOR]

Background: Hypertension (HTN) is a prevalent and impactful health concern associated with cardiovascular morbidity and mortality. This research delves into the intricate relationship between HTN and lower urinary tract symptoms (LUTS), acknowledging the multifaceted nature of these conditions and their potential impact on individuals' quality of life., Materials and Methods: This cross-sectional study, conducted in Nablus, Palestine, employed convenient sampling to recruit hypertensive patients from the Ministry of Health clinics between September and December 2023. The inclusion criterion involved confirmed hypertensive patients, while the exclusion criterion included individuals with specific health conditions. The collected data included demographic, comorbidity, and lifestyle factor data. The study utilized the urogenital distress inventory 6 (UDI-6) and Incontinence Impact Questionnaire (IIQ)-7 short forms to assess urinary distress symptoms and the impact of urinary incontinence on quality of life. All the statistical analyses, including Pearson, Chi-square, Fisher's exact, Kruskal-Wallis, and Mann-Whitney tests, were performed with various tests for significance, and the significance level was set at P < 0.05., Results: Among the 351 participants meeting the inclusion criteria, females (62.1%) and married individuals (83.5%) were the predominant participants. The majority were aged 58-67 (42.5%), had a high school education (39.0%), and had a body mass index (BMI) of 30-34.9 (30.2%). Significant correlations were found between UDI-6 scores and sex, age, marital status, education level, employment status, and comorbidities. The IIQ-7 score was significantly correlated with female sex, marital status, age, comorbidities, duration of HTN, employment status, and education level. Both the UDI-6 and IIQ-7 scores revealed considerable impacts on urinary symptoms and quality of life. A significant negative correlation (r = -0.579) between the IIQ-7 score and UDI-6 score emphasized the interconnectedness of urinary distress symptoms and their impact on quality of life ( P < 0.001). These findings underscore the multifaceted nature of LUTS and their profound effects on hypertensive patients' well-being., Conclusion: Our study revealed a significant association between HTN and LUTS, especially among females and specific demographic groups. This emphasizes the need for comprehensive management. The observed negative impact on quality of life emphasizes the significance of adopting holistic approaches to address both conditions., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Family Medicine and Primary Care.)

Background: Nonalcoholic fatty liver disease (NAFLD) is a liver condition that is prevalent worldwide and associated with significant health risks and economic burdens. As it has been linked to insulin resistance (IR), this study aimed to perform a bibliometric analysis and visually represent the scientific literature on IR and NAFLD., Aim: To map the research landscape to underscore critical areas of focus, influential studies, and future directions of NAFLD and IR., Methods: This study conducted a bibliometric analysis of the literature on IR and NAFLD indexed in the SciVerse Scopus database from 1999 to 2022. The search strategy used terms from the literature and medical subject headings, focusing on terms related to IR and NAFLD. VOSviewer software was used to visualize research trends, collaborations, and key thematic areas. The analysis examined publication type, annual research output, contributing countries and institutions, funding agencies, journal impact factors, citation patterns, and highly cited references., Results: This analysis identified 23124 documents on NAFLD, revealing a significant increase in the number of publications between 1999 and 2022. The search retrieved 715 papers on IR and NAFLD, including 573 (80.14%) articles and 88 (12.31%) reviews. The most productive countries were China ( n = 134; 18.74%), the United States ( n = 122; 17.06%), Italy ( n = 97; 13.57%), and Japan ( n = 41; 5.73%). The leading institutions included the Università degli Studi di Torino, Italy ( n = 29; 4.06%), and the Consiglio Nazionale delle Ricerche, Italy ( n = 19; 2.66%). The top funding agencies were the National Institute of Diabetes and Digestive and Kidney Diseases in the United States ( n = 48; 6.71%), and the National Natural Science Foundation of China ( n = 37; 5.17%). The most active journals in this field were Hepatology (27 publications), the Journal of Hepatology (17 publications), and the Journal of Clinical Endocrinology and Metabolism (13 publications). The main research hotspots were "therapeutic approaches for IR and NAFLD" and "inflammatory and high-fat diet impacts on NAFLD"., Conclusion: This is the first bibliometric analysis to examine the relationship between IR and NAFLD. In response to the escalating global health challenge of NAFLD, this research highlights an urgent need for a better understanding of this condition and for the development of intervention strategies. Policymakers need to prioritize and address the increasing prevalence of NAFLD., Competing Interests: Conflict-of-interest statement: The authors have no financial disclosures or conflicts of interest to declare., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Introduction: Urinary incontinence (UI) is a common condition that affects females with variable incidence. Factors like age, obesity, weak pelvic floor, and pregnancy contribute to UI pathogenesis. Our study aimed to determine the prevalence of UI and identify associated risk factors., Methods: A cross-sectional study recruited females aged 18-65 attending primary health care (PHC) centers. The collected data included demographic information and questionnaire scores for urinary incontinence diagnosis (QUID), International Consultation on Incontinence Questionnaire-Urinary Incontinence (ICIQ-UI), and Incontinence Impact Questionnaire-Short Form (IIQ-7) scores., Results: Three hundred and eleven females met our inclusion criteria, with 162 (52.1%) participants aged ≥ 42 years. Approximately 41.5% were college/university graduates, and 23.2% had an education level less than high school. Moreover, 108 (34.7%) participants were smokers, 223 (71.7%) drank coffee, and approximately 212 (68.2%) drank tea. Only 125 (40.2%) participants engaged in exercise at variable frequencies, and most of them exercised once per week. Approximately 27.3% of the participants had chronic medical illness with hypertension or diabetes mellitus (40 (12.9%) or 25 (8%), respectively). Stress urinary incontinence (SUI) was found among 152 (48.9%) participants, while urgency urinary incontinence (UUI) was found among 114 (36.7%) participants. Age ≥ 42, marital status, low educational level, unemployment, lack of physical activity, and chronic medical illnesses were significantly correlated with both SUI and UUI. There was a strong correlation between UI and the severity of symptoms and between UI and quality of life (QoL)., Conclusion: The prevalence of UI is relatively high among Palestinian women. Many factors contributing to UI included age, marital status, the presence of other chronic medical diseases, and a lack of physical activity. Early detection and diagnosis are necessary to provide effective treatment and improve UI symptoms and QoL., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Abushamma et al.)