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Introduction/Background*Inflammatory myofibroblastic tumours (IMT) are rare spindle cell neoplasms of indeterminate malignant potential, commonly found in the lungs, but also originating from various organs ranging from head and neck, gastrointestinal to the genitourinary system. IMTs of the female gynaecological tract are rare and may mimic benign leiomyoma in both clinical presentation and appearance on imaging. We describe a case of uterine IMT, diagnosed after a laparoscopic myomectomy with in-bag morcellation.MethodologyResult(s)*A 37-year-old woman was on follow-up for uterine mass on pelvic ultrasound, slowly enlarging to 3.3cm, presumed to be a fibroid. Although she did not have significant pressure symptoms or menorrhagia, she requested for removal and underwent laparoscopic myomectomy with morcellation-in-bag.Intra-operatively, a 6cm mass was seen on the uterine posterior wall, macroscopically and morphologically consistent with that of benign leiomyoma. However, immunohistochemistry and molecular sequencing were positive for ALK-1 hence a diagnosis of IMT was made. Diffuse staining for desmin, H-caldesmon and ER was also noted. Following a multi-disciplinary tumour board, consensus was for a CT scan of the thorax, abdomen and pelvis(which showed no extra-uterine spread) and for regular surveillance scans.A review of the literature shows no universal consensus as to optimal treatment of uterine IMT. Majority of cases have been treated with surgical excision – open, laparoscopic or hysteroscopic. While most cases have a benign course with no recurrence/relapse, local recurrences are a known complication.Given controversies in recent years over power morcellation potentially leading to dissemination of undiagnosed uterine leiomyosarcomas, morcellation-in-bag has become standard practice for all laparoscopic myomectomies or hysterectomies requiring morcellation. There is little data regarding outcomes of other types of uterine tumours, or IMT specifically, with regards to outcomes following morcellation. The only two documented cases in the literature specifically involving morcellation resulted in local recurrences requiring further treatment.Conclusion*We present a case of uterine IMT diagnosed following laparoscopic myomectomy and in-bag morcellation. While the patient has no sign of extrauterine spread at present, further follow-up will be required to monitor for any progression or recurrence. Outcomes following morcellation or specific other treatment options will need to be further studied.

Introduction/BackgroundSentinel lymph node (SLN) mapping with indocyanine green (ICG) is emerging as a feasible alternative to pelvic lymphadenectomy in endometrial cancer staging. Although ICG SLN mapping is well established in robo-laparoscopic surgery, there is little literature validating its use in laparotomy.MethodologyThe technique, effectiveness and feasibility of SLN mapping with ICG during laparotomy for endometrial cancer is discussed. For each patient, intra-cervical ICG injection at the 3 and 9 o’clock positions was performed. Following peritoneal dissection, lymph node chains were inspected in near infrared mode using the Karl Storz Vitom(R) camera system. In each hemi-pelvis, if SLN mapping was not achieved, ipsilateral pelvic lymphadenectomy was performed. Full pelvic lymphadenectomy was also performed if there were suspicious nodes, large tumour size or extensive myometrial invasion.ResultsBetween March 2016 and February 2019, 37 patients with endometrial cancer underwent laparotomy. Average operating time was 133 minutes Median blood loss was 200 mls. There were no complications related to the use of ICG dye. The detection rate of SLNs was 92%. Bilateral pelvic SLNs mapping was achieved in 81% of patients, whereas 11% of patients had mapping to unilateral pelvic nodes. The median number of SLNs was 3. SLNs were mapped most commonly to the external iliac nodes, followed by the obturator and internal iliac nodes. In 3 patients (8.1%), SLNs were positive for metastases, resulting in a higher surgical stage and influencing the decision for adjuvant therapy. One patient also had mapping to a para-aortic node, which was positive for metastasis. Full pelvic lymphadenectomy was performed in 17 patients (46%). The sensitivity of SLN mapping in these patients was 100%, with no falsely negative SLNs.ConclusionSLN mapping with ICG is accurate and feasible in patients with endometrial cancer requiring laparotomy, and has a high detection rate and sensitivity comparable to that of robo-laparoscopic surgery.DisclosureNothing to disclose.

Statins may reduce a cytokine storm, which has been hypothesized as a possible mechanism of severe COVID-19 pneumonia. The aim of this study was to conduct a systematic review and meta-analysis to report on adverse outcomes among COVID-19 patients by statin usage. Literatures were searched from January 2019 to December 2020 to identify studies that reported the association between statin usage and adverse outcomes, including mortality, ICU admissions, and mechanical ventilation. Studies were meta-analyzed for mortality by the subgroups of ICU status and statin usage before and after COVID-19 hospitalization. Studies reporting an odds ratio (OR) and hazard ratio (HR) were analyzed separately. Thirteen cohorts, reporting on 110,078 patients, were included in this meta-analysis. Individuals who used statins before their COVID-19 hospitalization showed a similar risk of mortality, compared to those who did not use statins (HR 0.80, 95% CI: 0.50, 1.28; OR 0.62, 95% CI: 0.38, 1.03). Patients who were administered statins after their COVID-19 diagnosis were at a lower risk of mortality (HR 0.53, 95% CI: 0.46, 0.61; OR 0.57, 95% CI: 0.43, 0.75). The use of statins did not reduce the mortality of COVID-19 patients admitted to the ICU (OR 0.65; 95% CI: 0.26, 1.64). Among non-ICU patients, statin users were at a lower risk of mortality relative to non-statin users (HR 0.53, 95% CI: 0.46, 0.62; OR 0.64, 95% CI: 0.46, 0.88).

Go is an open source programming language that is designed to scale and support concurrency at the language level. This gives you the liberty to write large concurrent web applications with ease. From creating web application to deploying them on Amazon Cloud Services, this book will be your one-stop guide to learn web development in Go.

According to a recent World Bank study of remittances, Bangladesh, India, Pakistan and Sri Lanka are all among the top 20 receivers of remittances, with estimated receipts of US3.2 billion, US8.4 billion and U.S 1.5 billion respectively. Migrant Labor Remittances in South Asia identifies and discusses the key issues affecting the remittance industry in South Asia. It examines the development and implementation of policies, processes, and infrastructure to foster a development-oriented transfer of financial resources between migrants in developed economies and their families in the region. Rather than duplicate previous remittances work, this title only focuses on the region’s distinguishing characteristics, namely: A large migrant population of semi-skilled and unskilled workers largely concentrated in the Arabian Gulf countries, particularly Saudi Arabia and the United Arab Emirates.; The presence of dedicated public institutions and government financial incentives aimed at facilitating and providing incentives for temporary migration and remittance inflows; The existence of large state bank branch networks with immense potential for a more effective and efficient remittance financial market.; The widespread usage of trade related informal remittance channels by both legal and illegal migrants. The book is intended for policymakers who legislate and regulate the financial sector, as well as for researchers and providers of remittance services.