.......................................................................................5 List of tables .................................................................................... 7 List of figures .............................................................................. 8 Objectives of the study...................................................................................... 9 Introduction ...................................................................................................... 10 Problem with clinical education...............................................................13 Training on animal models...................................................................... 15 Simulation-based medical education....................................................... 16 Virtual Reality (VR) simulations............................................................. 19 VR simulations – background and history...............................................23 VR simulation in health professional’s education.................................. 23 Medical education research on VR training........................................... 27 Methods .......................................................................................................29 Framing the research question................................................................30 Search of the literature............................................................................31 Assessment of study eligibility...............................................................33 Appraisal of included studies..................................................................34 Results................................................................................................................ 40 Summary results from included studies.................................................. 42 Types of simulators.................................................................................78 Emergent themes from the studies appraised......................................... 84

Effectiveness of Virtual Reality Based Immersive Training for Education of Health Professionals: a Systematic Review

Aim: To evaluate the role of virtual cystoscopy (VC) comparing it with cystopanendoscopy (CPE) for detecting bladder tumor(s). Material and Methods: Ethical clearance was obtained from the Institutional ethics committee. After an informed consent 30 patients fulfilling the inclusion criteria were enrolled in the prospective non-randomized clinical study and were evaluated as per protocol with VC performed by a qualified radiologist who was blinded to the findings of CPE performed by a qualified urologist. The results so obtained were analyzed using appropriate statistical tools. Results: The mean age of the patients was 56 years. Sensitivity of VC in detecting bladder lesions was 92%. However, when axial images were also interpreted along with VC, the sensitivity increased to 96% for detecting bladder lesions. The specificity of VC with axial CT was 40% in respect of detecting bladder lesions.VC with axial CT was 85.7% sensitive in identifying multiple bladder tumors. There were no complications on account of performing VC. Minor problems were encountered with VC and CPE in 16.7% and 13.3% patients respectively. Conclusions: VC with axial CT is 96% sensitive in detecting bladder lesions and 85.7% sensitive in detecting the multiplicity of the tumors. VC may be a useful complementary diagnostic tool for the workup of select patients with suspected bladder lesions. However, larger randomized controlled studies are needed to better define the precise clinical and diagnostic role of VC in routine practice. Settings and Design: Prospective Clinical Comparative Non Randomized Clinical Study.

Virtual cystoscopy (pneumo-cystoscopy)-Its utility in the prospective evaluation of bladder tumor.

Primary squamous cell carcinoma is a rare, aggressive disease with historically poor outcomes and no established treatment guidelines. Case reports are limited but describe multiple treatment approaches. Seeking to identify practice patterns and treatment outcomes, we used the US National Cancer Data Base to identify 66 males with locoregional primary squamous cell carcinoma of the prostate treated with surgery, chemotherapy, and/or radiotherapy between 2004 and 2015. Patients were stratified into treatment groups consisting of local therapy alone (n = 40; 61%), local therapy and chemotherapy (n = 13; 20%), chemotherapy alone (n = 7; 11%), and observation (n = 6; 9%). Patients with clinical stage T3–T4 disease were significantly more likely to receive combined chemotherapy and local therapy on multivariable analysis. Median survival was 20 mo for patients treated with local therapy alone, 37 mo with local therapy and chemotherapy, and 11 mo with chemotherapy alone. Overall survival was not significantly different between treatment groups. Despite limitations in sample size, these data suggest that addition of chemotherapy to local therapy is a reasonable treatment approach for select patients. Patient summary Squamous cell carcinoma of the prostate is an extremely rare disease. Our review of patterns of care using data from the National Cancer Data Base shows inconsistent use of combined local and systemic therapy. The small sample size for this rare disease limits any conclusions regarding survival differences, but the data suggest that a combination approach using chemotherapy in addition to surgery or radiation is a reasonable treatment option for disease confined to the prostate.

Patterns of Care and Treatment Outcomes in Locoregional Squamous Cell Carcinoma of the Prostate.

Background: Squamous cell carcinoma (SCC) of the prostate has limited treatment choices and portends a dismal prognosis with an average survival time of ~14-months. This study provides a descriptive overview of SCC of the prostate in Saudi Arabia. Materials and Methods: A retrospective cohort study of patients diagnosed with prostatic SCC between 1 January 2008 and 31 December 2017. Information on demographic and tumor characteristics and the survival of patients was collected from the Saudi Cancer Registry. Survival was depicted through Kaplan–Meier plots. Fisher’s exact test was used to assess the association between categorical variables and death, while a Wilcoxon rank sum test was applied for numerical variables. Results: Out of a larger subset of 3607 patients, 16 patients were diagnosed with prostatic SCC, of which half resided in the Central region (50.0%) and most (81.2%) were aged greater than or equal to 60 years. Most patients (62.6%) had poorly differentiated (grade III, 43.8%) lesions, and 50% of cases were metastatic at diagnosis. 62.5% of patients died, all residing in the Eastern and Central regions. Regional extension (75.0%) and distant metastasis (87.5%) were significantly associated with death compared to localized lesions (0.0%) (P=0.022). The 5-year survival rate in our study was 33%. Conclusion: The present study is the first to describe the characteristics of prostatic SCC in Saudi Arabia. Our results are consistent with prior studies showing that prostatic SCC is often high-grade and metastatic at diagnosis, conferring a poor prognosis.

Beyond the norm: Exploring the uncommon squamous cell carcinoma of the prostate using a Saudi Tumor Registry

Poster: "ECR 2012 / C-1796 / CT cystoscopy capability in bladder tumor detection" by: "T. Nastasic1, T. Stosic-Opincal2, Ž. Markovic1, D. Masulovic1; 1Belgrade/RS, 2Beograd/RS"

CT cystoscopy capability in bladder tumor detection

Objectives: To determine the diagnostic performance of virtual cystoscopy in patients with bladder diseases in comparison with conventional cystoscopy.
 Methods: Fifteen patients with different bladder patho­logies underwent volumetric spiral CT of bladder after filling it with contrast media (GE medical system light speed multislice scanner). The data were transferred to Advantage workstation AW4.0-03 and virtual cystoscopy was performed using the special software (Navigator GE medical system). All the patients later underwent conven­tional cystoscopy and the findings of both investigations were compared.
 Results: Virtual cystoscopy detected all 10 lesions with >5mm size and missed I out of 3 lesions with 5 5mm size. The overall sensitivity was 90%, specificity was 100%, positive predictive value was 100% and negative predic­tive value was 83.3%. The average time taken per proce­dure was 8 minutes. No complications of virtual cystoscopy were encountered in our study.
 Conclusions: There seems to be good agreement as re­gards the site and size of lesions in both techniques. In the quest for a non-invasive investigation for assessment of bladder diseases, virtual cystoscopy is a promising tech­nology.

Virtual cystoscopy - a promising diagnostic technique

Squamous cell carcinoma of prostate - a case report

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Virtual cystoscopy - a promising diagnostic technique

Squamous cell carcinoma of prostate - a case report