Background: Polycystic ovary syndrome (PCOS) is the most common endocrinological disease affecting women in the reproductive age. Non-alcoholic fatty pancreas disease (NAFPD) can promote many aspects of pancreatic dysfunction. The present study aimed to determine the prevalence of NAFPD and to identify its association with clinical and biochemical parameters in PCOS patients. Methods: The present study included 150 patients with PCOS and 150 age-matched healthy controls. All patients were submitted to careful history taking and thorough clinical examination. Performed laboratory investigations included fasting and postprandial blood glucose, lipid profile, liver function tests, serum prolactin and total testosterone. Fatty pancreas was diagnosed using abdominal ultrasound. Results: Among PCOS women, NAFPD was diagnosed in 57 women (38.0%) in contrast to 18 women (12.0%) in the control group (p < 0.001). Patients with NAFPD were significantly older [median (IQR): 38.0 (35.0– 43.0) versus 29.0 (25.5– 33.0) years, p = 0.001] with higher BMI [median (IQR): 31.5 (29.1– 34.7) versus 30.4 (28.6– 32.4) kg/m², 0.042]. Moreover, they had significantly higher frequency of metabolic syndrome (84.2% versus 54.8%, p = 0.001), insulin resistance (68.4% versus 26.9%, p < 0.001) and severe NAFLD (22.8% versus 2.2%, p < 0.001). NAFPD patients had significantly lower sex hormone binding globulin (SHBG) [median (IQR): 36.0 (30.8– 40.7) versus 38.1 (35.15– 42.7), p = 0.002] and significantly higher free androgen index (FAI) [median (IQR): 4.08 (3.3– 4.92) versus 3.47 (3.12– 4.05), p < 0.001]. Conclusion: NAFPD is prevalent PCOS. It is related to metabolic syndrome, insulin resistance, dyslipidemia and hyperandrogenism.

Introduction and Objectives: Percutaneous nephrolithotomy (PCNL) is the standard treatment of renal stone >2 cm. Ultra-mini-percutaneous nephrolithotomy (UMP) had emerged in the past decade as a new technique in treating renal stones <2 cm. In this study we compared between the outcome of UMP in prone position with the outcome of UMP in modified flank free supine position (FFSP). Materials and Methods: A prospective randomized study was conducted between January 2016 and April 2020, including 122 patients, divided into two matched groups. Group A included 61 patients who underwent UMP in FFSP, and Group B included 61 patients who underwent UMP in a prone position. All patients had a single renal pelvic stone 1–2 cm. Patients with a single kidney, renal anomalies, body mass index ≥40 kg/m ² , history of ipsilateral renal surgery, and age <18 years were excluded. In both groups, the dilatation was done up to 13F; a holmium laser was used through a 9F ureteroscope for fragmentation. Nephrostomy tube and ureteral stent were used only when indicated. Results: In total, 122 patients were divided into two groups. The mean age was 40.09 ± 13.63 and 39.67 ± 13.80 years in both groups, respectively. The operative time was 63.64 ± 9.22 and 78.48 ± 9.55 minutes in Groups A and B, respectively ( p = 0.0001). The fluoroscopy time was 3.47 ± 0.56 and 4.45 ± 0.39 minutes in Groups A and B, respectively ( p = 0.0001). No significant difference was shown between both groups regarding operative and postoperative complications. Shift to mini-PCNL was needed in one patient in Group A and four patients in Group B because of impaired vision. The hospital stay was 25.36 ± 4.23 and 26.13 ± 4.76 hours in both groups, respectively. The initial stone-free rate was 95.1% and 91.8% in both groups, respectively. Conclusions: UMP in modified supine position shows comparable results with UMP in the prone position regarding stone-free rate, hospital stay, and perioperative complication, with significantly shorter operative and fluoroscopy time

Background: In March 2020, the World Health Organization declared coronavirus 2019 (COVID-19) a global pandemic. We aimed to assess the ability of COVID-19 screening to detect preprocedural infection at the gastrointestinal units. One hundred and three patients indicated for gastrointestinal tract interventional procedures were included. All patients surveyed for COVID-19-related symptoms and COVID-19 rapid IgM/IgG antibodies. Symptomatic and COVID-19 antibody-positive patients further tested for COVID-19 reverse transcriptase by polymerase chain reaction (RT-PCR). All patients contacted, 14 days after the procedure and asked about the possible development of COVID-19. All health care workers (HCWs) (n=18) were screened weekly for COVID-19-related symptoms. Results: The mean age was 46.11 ± 17.16 years of them 58.25% were males. 2.9% patients had COVID-19-related symptoms and 97.1% were asymptomatic. All symptomatic patients tested positive for COVID-19 IgM antibody and RT-PCR. Among asymptomatic patients 23% had positive COVID-19 antibodies, of them 56.5%patients had positive RT-PCR. One HCW developed COVID-19 during the study. None of the included patients developed new onset of COVID-19 infection, two weeks after the procedure. Conclusion: COVID-19 antibody test may be a reasonable preprocedural screening method for low-income countries and COVID-19 RT-PCR screening for symptomatic patients and those with positive COVID-19 antibody test.

Background and study aim: During COVID-19 pandemic majority of non-emergency endoscopic procedures has ‎been deferred. ERCP is required to address both elective as well as emergency causes ‎such as biliary obstruction with cholangitis. Our aim to explore the status of ERCP in ‎different endoscopy units from different countries and to report the characteristics of ‎patients presented to these units and their procedure details‎.‎ Patients and Methods: ‎‎‎ Representatives of main endoscopy units in different countries were invited to ‎participate. Patient demographics, COVID-19 status, ERCP indications, laboratory ‎findings, radiology findings, pre procedural preparation and post procedure ‎complications were collected‎‎‎.‎ Results: Data of 352 patients from 11 countries were collected. Average age of patients was ‎‎57.80 (SD ±16.88) years and 182 (51.7%) were females. Majority of patient 332 ‎‎(94.3%) did not have COVID-19 infection. Most centers reported a decrease in ‎procedure volume, staff number and duration of ERCP procedure during COVID-19. ‎The most common indications for ERCP were choledocholithiasis (51.7%) and ‎suspected malignant biliary stricture (30.1%). Deep biliary cannulation was achieved in ‎‎324 (92%) cases. The most common therapeutic interventions carried out were CBD ‎stone extraction. Complications were observed in 20 (5.6%) cases with bleeding being ‎the most common immediate complication that was reported in 4.3% of patients. Post ‎ERCP pancreatitis (PEP) was reported in 2.8% of cases and it was managed ‎conservatively. The most common final diagnoses were choledocholithiasis (57.4%) ‎and benign biliary strictures (10.8%)‎‎‎‎‎. Conclusion: COVID-19 pandemic negatively impacted ERCP procedure volume, training ‎opportunities and was associated with decrease staff number and shorter procedure ‎time‎‎.