Background Current year 2021, brought a hope for the world due to availability of various vaccines to prevent COVID 19. Researchers around the Globe, kept working around the clock to dig up various correlations of this infection. So, that morbidity and mortality rates can be reduced. In all this sprint, cases of black fungus came into light in India. The Indian researchers identified strong association of black fungus co infection in COVID patients resulting in high mortality rates. Objectives Therefore, this current systematic review was planned to identify the predisposing factors, clinical presentations and management options for black fungus in COVID 19 patients. Methodology: This ‘systematic review’ was carried out following preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines & various search engines. Total 20(N) articles were selected and included for study. After following PRISMA guidelines and based upon inclusion and exclusion criteria of study, total 05 (N) manuscripts, were included. Results Out of 05(N) selected articles, 80 %( 04) strongly supported strong association of black fungus with COVID 19 patients. The highlighted predisposing factors includes, immunosuppression, anti virals, prolong hospital stay, use of tocilizumab and steroids as management of COVID patients. Timely diagnosis and provision of anti-fungal can be helpful to reduce mortality form this co infection. Conclusion It is concluded that immunosuppression, anti virals, prolong hospital stay, use of tocilizumab and steroids as management of COVID predisposes to black fungus. Timely diagnosis and use of systematic anti fungals can reduce mortality rate form this co infection.

Background: PET CT Scan has been used on numerous occasions in the assessment and management of various malignancies but it is only occasionally used in the assessment management of carcinoma of the prostate gland globally. There is the need to establish whether or not PET/CT scan is a useful imaging technique which should be used more often in the investigation of biochemical failure following treatment of carcinoma of prostate gland with curative intent Aim: To investigate the suggestion that PET/CT scan would be a useful and reliable imaging option for the investigation of biochemical recurrence resulting following the treatment of prostate cancer with curative intent by reviewing the literature relating to the use of PET / CT scan in carcinoma of the prostate gland. Method: Various internet data bases were searched including: Google, Google Scholar, Yahoo, and PUBMED. The search words that were used included: PET/CT Scan in carcinoma of the prostate, PET/CT scan in prostate cancer, PET/CT scan and prostate cancer, PET/CT scan and carcinoma of the prostate. Results: Fifty two manuscripts that have been published relating to the use of a form of PET/CT scan in relationship to investigation of carcinoma of the prostate gland were utilized to write the article. One of the articles published in Dutch was a review article. Another paper reported the use of PET CT scan in the diagnosis of Hurtle tumour (a benign tumour) in association with carcinoma of the prostate gland. The remaining manuscripts contained case reports and studies regarding the use of various types of PET/CT scan in the investigation of biochemical failure as well as in the treatment and follow-up of some cases of metastasis. On the whole almost all of the papers had confirmed the high sensitivity and high specificity of PET/CT scan in detecting localized and distant metastatic lesions in the scenario of slight elevations of serum PSA. There have been reports of PET/CT scan being able to detect localized and distant metastasis when conventional computed tomography scan and isotope bone scan failed to detect metastases. In one case when the serum PSA level was high isotope bone scan and CT scan failed to detect bone metastases but PET/CT scan detected bone metastases. Conclusions: PET/CT Scan is a very useful imaging modality that detects localized and distant metastases in biochemical recurrence of prostate cancer and this modality of imaging should be used more often from now onwards. CT scan would usually detect nodes/lesions that measure 1 cm or larger but PET/CT scan would detect smaller sized lesions at slightly raised levels of serum PSA. The detection of small localized metastasis at a slightly elevated serum PSA values would make it easier for the undertaking of a second-line treatment of curative intent in the form of salvage lymphadenectomy or salvage radiotherapy targeted at the lesion. Perhaps PET/CT scan should be the first-line imaging modality which should be used in investigating biochemical recurrence and this should be done when the serum PSA is slightly elevated.

Introduction: This study aimed to define the clinical features and laboratory findings that may be associated with COVID-19 pneumonia in patients with suspected COVID-19 pneumonia who presented to the emergency department in order to be able to recognize the disease early until molecular tests are available, and thus to isolate sick people as soon as possible. Patients and Methods: We retrospectively examined patients who were evaluated with the suspicion of COVID-19 between March 2020 and August 2020. We used the patient information management system to record patient demographic and clinical features, laboratory findings, and CT results. In subgroups with and without pneumonia, we compared these characteristics in confirmed COVID-19 patients. Results: Our study included 1,277 patients who were evaluated for suspected COVID-19. COVID-19 pneumonia was detected in 71.2% (n=210) of a total of 295 (23.4%) patients with a diagnosis of COVID-19 who were confirmed by RT-PCR positivity. Although 56.2% (n=18) of those with pneumonia were men, no statistically significant relationship was detected between gender distribution and CT findings (p=0.449). When we compared the patients in 3 subgroups according to age groups, it was observed that 59.4% (n=38) of those with negative CT findings were in the 18-44 age group, and 44.8% (n=94) of those with positive CT findings were 65 and over age group, and this distribution was found to be statistically significant (p<0.001). Pneumonia was detected in 58.3% (n=49) of COVID-19 cases (n=84) with a suspected exposure history (p=0.008). The most common symptoms in patients with positive CT findings (n=210) were fever (40.5% n=85) and fatigue (40.5% n=85), cough (32.9% n=69), and shortness of breath (28.6% n=60). The most common comorbidity in cases diagnosed with COVID-19 was HT (33.9%; n=100/295), followed by AF (19.3%; n=57/295), and the rates of HT and AF in those with COVID-19 pneumonia were statistically significantly higher compared to the CT-negative group (p<0.001 and p=0.002, respectively).COVID-19 pneumonia was more common in hospitalized patients (n=124), and hospitalization lengths were longer in both emergency and ICU admissions (p<0.001 and p=0.008). In our analysis in terms of the survival relationship, it was observed that 87.5% (n=35) of the COVID-19 cases who died had pneumonia (p<0.042). Low saturation and high respiratory rate per minute at the time of admission were associated with COVID-19 pneumonia (p<0.001). In the group with COVID-19 pneumonia, haemoglobin, GFR, and pCO2 values were recorded lower at the time of admission compared to patients with negative CT (p<0.001, p<0.001, p<0.05, respectively), while leukocytes, neutrophils, CRP, D-dimer, LDH, hs-troponin, AST and bilirubin were recorded as higher (p<0.05, p<0.01, p<0.001, p<0.001, p<0.001, p<0.001, p=0.01, p=0.01, respectively). Conclusion: Identifying patient features linked with COVID-19 pneumonia at the time of admission may influence our decision to have CT scans in emergency departments, regardless of the RT-PCR result, and may result in early disease identification and treatment.

COVID-19 infection does affect males and females. Even though the commonest manifestations of COVID-19 infection tend to be related to symptoms associated with the respiratory tract, many other organs of the body also tend to be affected and COVID-19 infection of these other organs could manifest contemporaneously with symptoms of the respiratory tract system in addition to symptoms of the affected organs. At times COVID-19 may initially manifest solely related to non-respiratory tract organs and because the symptoms are non-specific without a high index of suspicion, the diagnosis of COVID-19 infection may be missed initially or there may be delay in the diagnosis which would tend to lead to spreading of the disease. Some of the manifestations of COVID-19 infection of the urinary bladder may include: Lower urinary tract symptoms of urinary frequency, and or urinary urgency, and or nocturia, and or urinary incontinence, or on rare occasions non-visible or visible haematuria, or acute retention of urine. The aforementioned symptoms may occur as De novo (new-onset) symptoms alone or they may be associated with or without fever, with or without respiratory tract symptoms. Some individuals who already have lower urinary tract symptoms could experience worsening of their previous lower urinary tract symptoms and if the clinician does not have a high index of suspicion for the possible development of COVID-19 infection, and the clinician does blame the symptoms on benign prostatic hyperplasia then the diagnosis could be missed or delayed. If the COVID-19 cystitis is associated with COVID-19 infection of the male genital tract then some of the patients could experience scrotal discomfort, swelling of the scrotum, erythema of the scrotum, or low-flow priapism or clinical and radiology imaging features of acute orchitis, or acute epididymitis, or acute epididymo-orchitis. However, if the lower urinary tract symptoms are associated with respiratory tract symptoms all clinicians globally are aware of the fact that a high index of suspicion for COVID-19 infection should be exercised. What is important is that every clinician and every individual should be made aware of the fact that the development of De novo lower urinary tract symptoms or sudden onset of worsening lower urinary tract symptoms should be regarded as possibly due to COVID-19 infection and appropriate tests should be undertaken to confirm or negate the diagnosis of COVID-19 infection quickly. Diagnosis of COVID-19 infection of the urinary bladder can be confirmed the undertaking of various COVID-19 infection tests but COVID-19 PCR test has tended to be a common test that most people use globally.

Hydatid cyst of the breast is a rare infection of the breast that tends to be reported sporadically in Echinococcus infection endemic areas; nevertheless, because of increasing global travel hydatid cyst of the breast may be encountered in a non-endemic area of the world where clinicians may not be familiar with the manifestation and biological behaviour of the disease. Hydatid cyst of the breast has been reported sporadically in females whose ages have ranged between 16 years and 87 years and these cases only represent 0.27% of all cases of hydatid cyst encountered globally. Hydatid cyst of the breast does present as a lump/mass in the breast which quite often tends to be painless but it could be associated with pain/discomfort. Hydatid cyst of the breast tends to present insidiously and the lump tends to be present for a long time before attention is sought by the patient because it had behaved innocuously and had either been growing slowly with a recent noticeable increase in size over a few months. A history of previous contact with dogs and sheep as well as present or previous residence in an echinococcus endemic area tends to be helpful in alerting the clinician to the possibility of the diagnosis of hydatid cyst. A past history of treatment for echinococcal infection elsewhere in the body would also be helpful in alerting the clinician to the diagnosis of the disease. There tends to be no family history of breast cancer, and no history of previous hormone replacement therapy. The general and systematic examinations of most of the patients tend to be normal unless they have other non-related medical conditions. Clinical examination usually tends to reveal a swelling that tends to be well-circumscribed with clear margin that may be non-tender but at times there may be tenderness associated with the lump. The clinical examination findings tend to be non-specific and would usually mimic fibroadenoma, phyllodes tumour, or intra-cystic carcinoma of the breast. Usually the results of routine haematology and haematology blood tests would tend to be normal unless there is a non-related disease but there could be eosinophilia. Echinococcus hemagglutination test and Elisa test for Echinococcal IgE test would tend to be positive in cases of hydatid cyst of the breast. Various radiology imaging modalities tend to be utilized to assess hydatid cyst of the breast including mammogram, ultrasound scan of the breast, computed tomography (CT) scan of the breast, thorax, and abdomen, magnetic resonance imaging (MRI) scan of breast, thorax, and abdomen. Diagnosis of hydatid cyst of the breast tends to be diagnosed by undertaking fine needle aspiration biopsy of the breast lesion for cytology/histopathology examination or histopathology examination of excised hydatid cysts of the breast. Successful treatment of hydatid cyst of the breast requires complete excision without spillage of the hydatid cyst and additionally to minimise recurrence of disease Albendazole medication tends to be given. When there is spillage of the hydatid cyst or rupture of the hydatid cyst during the process of the excision, a thorough lavage of the operating field and excision of the surrounding tissue to ensure any possible residual daughter cysts are completely removed and utilization of Albendazole medicament would help to minimize or avoid development of recurrence. Because of the possibility of recurrence of disease a period of follow-up assessment with clinical examination and radiology imaging assessment as well as echinococcus hemagglutination tests would be recommended.