JUNE 2015

Presidential Message

May-June 2015

I must admire Dr. Kudchadkar's tireless efforts & enthusiasm to organize Silver Jubilee WZUSICON at Goa. I can describe only in one sentence –Never before & never again will be the experience at Goa – in terms of Stay, academic program, hands on training stalls, ladies activities, Nursing update, so on & so forth. There will be so many things happening for the first time in Goa. One of them will be Nursing update. None of the conferences so far – be a zonal or national – have organized parallel nursing update. In Goa full day nursing program is planned. I am personally looking into the contents of it to make sure that everyone who attends will be benefited. For details visit our web site. I request you to register your OT technicians, Nurses for this update. I have no doubt it will very useful to them & in turn to you as well. A very attractive package is worked out for them.

Our web site is now revamped & fully functional. Please keep visiting www.usiwz.org You will find all details there.

I must give my special thanks to our secretary Dr. Kandarp Parikh for keeping good rapport with all members through social media&WhatsApp. I also appreciate his sincere efforts to make West Zone vibrant. Dr. Bhandarkar has managed web site well & is putting lot of efforts to make sure that directory is updated. All council members have taken their share of responsibility. I am very lucky to have such dream council to work with me.

I had told in the beginning of the year that we have to come out with 3 news- letters of which first 2 will

rdbe e-newsletters & 3 in print format I must thank Dr. PankajMaheshwari for accepting this task & completing it so well.Hope to see you in Surat and then at Goa

Dr Ravindra Sabnis

One more program is being planned – Uro-gynac

update at Surat. After that all our focus of attention

will be towards our annual conference at Goa.

West zone USI has reputation of being a very

cohesive group. We have lot more understanding,

we work together, we share our sorrow & happiness

with equal intensity and when it comes to enjoying

the event we are always together. This spirit of

togetherness, sharing & caring has made our

overseas meeting so popular & so well attended.

When others are still struggling to have their first

zonal foreign trip, we have already finished 5

successful trips. Recently concluded Japan tour was

one more memorable event. Apart from sight

seeing, even academic content was of high quality &

I have received letters from many Japanese

urologists appreciating the meeting. I must thank

Dr. Sanjay Nabar for putting so much hard work to

ensure the success of the tour.

I request all members to come in large number to

Surat for Uro-Gynac update. The program has lot of

practical relevance. Topics of Day to day importance

are being discussed. We are starting new concept of

“Semi Live surgery transmission”. This will happen

for the first time in the history of USI – so be part of

it. Incidentally, Surat is hosting a zonal event for the

first time. It is our duty to encourage them by

attending in large number.

Dear friends,

W e a r e m i d - w a y through this year. So f a r w e h a d t w o excellent programs – one on live surgery workshop on stone & other recently held l a p a r o s c o p i c workshop at Indore.

Details of which are in this newsletter.

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May-June 2015

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Secretarial Message

Dear west zone family members, Greetings from Dr. Kandarp Parikh.

“Newly electedcouncil is

determined towork hard at thebest of abilities”

It is always a pleasure to communicate with the west zone family. I am happy to present to yo u o u r m i d - ye a r report card. The newly e lected counci l i s committed to work endlessly to provide t h e b e s t o f t h e academic conferences to the members. Our second program of this year in this quarter on " L a p a r o s c o p y i n

Urology” was splendidly organized by Indore Urology group under the leadership of Dr.Anil Bandi.

All the invited faculty demonstrated live surgeries which were appreciated by the participating audience. Now we have a Uro-Gyanaec meet at Surat on 20-21st June and I am sure that the enthusiastic South Gujarat Urology association will leave no stone unturned to make it a conference of the highest quality. On behalf of the council,I assure all the members of high standards of conferences organized by the west zone.Friends, we are gradually marching towards our Silver jubilee celebration of our annual conference at Goa. I request all of you to register at the earliest to avoid last minute disappointment of not getting accommodation at the venue.I request you to submit the abstract for the papers and posters in prescribed time limit. This time the council has taken a decision to stick to the time schedule strictly and no presenter will be permitted to present from his own laptops in order avoid technical problems related to electronic devices.

I request all of you to put forward innovative ideas to make the academic content of this conference interesting. Your active participation is desired and welcome. Please feel free to contact me with any constructive ideas.

Friends,under the leadership of our dynamic president Dr.RavindraSabnis, we are committed to bring lot of transparency to our zone related activities. For the West Zone gold medal and the award for the social services,the council has laid down a set of criteria for selecting the most deserving contributer. You will find details of this in this news bulletin.

Friends, I am indeed greatful to Dr.RavindraSabnis, President USI-WZ and all the council members for their whole-hearted support to me and giving me strength to carry on all the good work you expect me to do. We believe that our work will speak more than our words.Feel free to contact me for any suggestions.

West-Zone USI Council

President : Dr.Ravindra Sabnis

President Elect : Dr. Janak Desai

Past President : Dr.Umesh Oza

Hon Secretary : Dr.Kandarp Parekh

Hon Treasurer : Dr. Ajay BhandarkarCouncil Members : Dr. Lalit Shah

Dr. Sujata PatwardhanDr. Sanjay NabarDr.Pankaj N. Maheshwari

Ex Officio Members: Dr.Shailesh RainaDr.Jaideep Date

Dr. Kandarp ParikhMch, DNBSecretary USI-WZ

May-June 2015

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Any full member of the West Zone of more than 10 years standing can apply or be nominated for this award. Please send the application to any council member or directly to the secretary Dr Kandarp Parikh at by 15th July 2015'

Kindly submit CV and following contribution documents with the application. Please stress on:

pkandarp@hotmail.com

a. Individual services like conducting camps or individual participation.

b. Heading social organisation or social projects.

c. Conducting social activities through organizations like Rotary, Lions or other clubs.

d. Years of contribution.e. Financial contribution.f. It's impact or benefit to the common

man.g. Any contribution or project done for West

Zone-USI.h. Awards received for social work.

Necessary certificates or documents to substantiate various claims should be added.

Council will select the awardee and their decision will be final and binding.

L e t m e b e g i n b y thanking the West Zone Council and especially the President Dr. Sabnis and the Secretary Dr. Kandarp Parikh for bestowing on me the pleasant responsibility of being editor of the West Zone News Letter. I thank you all for appreciating the first newsletter we released in February this year.

It is really nice to know and note the amount of work that is happening in our zone. Our members are flourishing in academic, scientific, national and international forums. In this newsletter we have attempted to give you a glimpse of the happenings in our vibrant zone. Dr. Yuvaraja gives us his insights on management of grey zone PSA while Dr. Rajendra Lahoti takes us to a trip to a completely unchartered territory of Antarctica. The silver jubilee meeting at Goa would be an event to look forwards to. I am sure we are all geared for a great meeting.

I request you to kindly write to us on editor.newsletter.wz.usi@gmail.com to share all your successes and achievements so that they can be included in the subsequent issues. We would also welcome your constructive criticism regarding our efforts in this newsletter. We look forwards to an enlightening time ahead. Pankaj N Maheshwari

Editorial Message

Dear Friends, Warm Greetings.

“Celebrate thecamaraderie in thezone through the

newsletter”

Social Service Award of West Zone USI

May-June 2015

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Under ages of WZ USI and GK Hospital Indore a workshop “Basis and Beyond” on Laparoscopic urological surgery was conducted at GK Hospital and Hotel Radisson on 25th and 26th April 2015. It was attended by 150 delegates from various states of central India. The prominent faculty to grace the meeting were Dr. PP Rao, Dr. Rabindra Sabnis, Dr. Pankaj Maheshwari, Dr. Kandarp Parikh, Dr. Arvind Ganpule, Dr. C Mallikarjun, Dr. Sayyed Jamal Rizvi, Dr. Anup Ramani and Dr. Shrenik J Shah. This eminent Indian performed flawless procedures with interactive discussions. Radical Nephrectomy, Retroperitoneal and Trans peritoneal Nephrectomy, Pyeloplasty (Three procedure including one in a two year old child) and VVF repair.There were lectures delivered by Dr. Anup Ramani on Efficacy of Robotic Surgery, Dr. C Mallikarjun and Dr. R Kukreja presented on various energy sources. Dr. Mallikarjun presented collection of problems encountered during laparoscopic procedure and how to deal with them. Dr. Pankaj Maheshwari presented paper on novel technique for laparoscopic insertion for CAPD catheter.

Audiovisual communication was uninterrupted and efficient. Conference was well appreciated by all delegates and faculty enjoyed demonstrating skills to all urologists.

‘Basis and Beyond in Laparoscopic Urology'

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‘Urogynaecology Update at Surat'

It gives me great pleasure to invite on behalf of South Gujarat Urology A s s o c i a t i o n f o r a n Urogynecology Update on 20th& 21st June 2015 with blessings & guidance from urological society of India, west Zone

We are living in rapidly advancing world of technology and robots and we hear a lot about something we may not need during day-to-day practice. Urogynecology is a subject, which is of day-to-day use for Urologist and Gynecologist. We poorly understand many aspects of female urology, its workup and treatment. Many times a breech in simple protocol leads to major catastrophe.

During this Urogynecology Update 2015, we will address issues related to Urogynecology by experts of this field like Dr ShirishYande from Pune, Dr Anita Patel & Dr Ajit Vaze from Mumbai, Dr Mrs. LaxmiShrikhande from Nagpur & Dr Sanjay Sinha from Hydrabad, starting from anatomy to workup of case to operative procedure. We introduce the concept of semi-live surgery during this meet under guidance of Dr R B Sabnis, Chairman, board of education, Urological society of India. We wish to cater the needs of Gyneacologist, surgeon & urologist involved in care of female urology.

Let me explain what semi live operative workshop is. Operating surgeon will come with unedited video of operative procedure as is transmitted in live surgical demonstration. He will run the video, high lighting important steps of surgery. He has freedom to pause, discuss relevant points to the satisfaction of audience, fast forward unimportant steps, rewind missed part in a predetermined time.

Operating surgeon has the flexibility to choose case with correct indication with good quality & adequate recording of important points i n h i s f a m i l i a r atmosphere of his own theater.

Dr Jignesh Ghevaria

Dr Kaushik shahHe is not under stress of multitasking like understanding the question, answering to audience & creating no mistake in surgery. Organizer does not have to worry of collecting cases, uncertainty of live transmission & delegates does not have to waste time till everything is over to see the next case. We plan to show TVT, TVT-O, VVF repair and others. We are excited to see how it goes.

Our local organizing team Dr Vijay Agarwal, Dr. Kaushik Shah, Dr.Jayant Patel, Dr.Kapil Thakkar, Dr.Jignesh Ghevaria, Dr.Dhawal Naik, Dr.Ashwin Gabani, Dr.Rishi Grover, Dr.Sumeet Mhaskar & Dr. Narendra Parekh is doing best to make you comfortable.

Registration for the update can be done by paying a cheque or Demand draft of Rs. 2500 for delegate &Rs 1000 for accompanying person in favor of south Gujarat urology association payable at Surat. You can send at Excel hospital, 3rd floor, Sheetal Plaza, old Elbee Cinema, Bhatar Road, Surat-395001, Gujarat.Hoping to see you all in large numbers for this academic feast and make it a grand success.

In the Cherry Blossom land…..A report By Dr Sanjay Nabar, Organizer for the WZ Japan tour

May-June 2015

The overseas conference tours organized by USI – WZ are always a big hit, enjoyed and appreciated by all the participants. It is a perfect venue for our members to relax with their families and friends away from their routine monotonous activities, mingle with the nature, step into the past and think about the future.

Our overseas conference tour to Japan was no exception. Japan, an island nation in the Pacific in the Far East, is remembered for two things: the revival from atomic bomb disaster and the ever-reliable electronic goods. Japan has a wonderful conglomeration of modern cities filled with high-rise buildings, imperial palaces, national parks and gardens and thousands of shrines and temples.

One of the famous Japanese Poet Kobayashi Issa had said, “What a strange thing! To be alive beneath cherry blossoms.” Thirty-seven of our member famil ies (total 82 persons) experienced thisunforgettable phenomenon. This springtime Japan tour was timed to see the Cherry blossom trees (Sakura) in full bloom and streets carpeted with pink-white cherry blossom flowers.

The tour began with visit to Tokyo city monuments, shrines, palace and the famous Kamakura Temple with the huge sitting Buddha. Tokyo is a crowded capital with neon skyscrapers and fashionable POP culture. In contrast Nara and Kyoto offered us Buddhist temples, Shinto shrines and beautiful gardens.

Donald Richie in an essay on contemporary Japan said, “Japan never considers time together as time wasted. Rather, it is time invested.” We invested 3rd April 2015 in a conference with Urologists Dr. Takahiro Kimura, Dr. Shunsuke Tsuzuki and Dr. Akira Furuta from Department of Urology, Jikei School of Medicine, Tokyo. There was an exchange of ideas where our invited faculty presented their work, while the Indian work was showcased by Dr. Kaushik Shah, Dr. HemantTongaonkar, Dr. SuhasSalpekar, Dr. Deepak Kirpekar, Dr. Ajay Bhandarkar, Dr. ShirishYande and Dr. Gaurang Shah. Our Japanese guests were amazed to see the amount of work we do in India and the innovations we make. The conference ended on a high note with cocktails that were arranged by our tour operator.

Hakone, a sleepy town located in the mountain ranges was another scenic location crowned by Mt. Fuji. We cruised in Lake Ashi, wandered in Gotemba Park, visited hot springs and ate 'black eggs' boiled in hot springs. We stayed in a traditional hotel (Ryokan Inn), having inhouse hot water spring spa 'Onsen,' as the area is volcanically active. Many of us took 'Onsen bath' in traditional Japanese way.

The 320km/hour bullet train ride from Hakone to Hiroshima was very exciting. Visit to Hiroshima Bomb Museum and the bomb dome brings tears to your eyes as the history of World War II unfolds before you.

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Report of the Japan tour

May-June 2015

Visit to Osaka castle will always be remembered.

The path that leads to the castle was lined by fully

bloomed Sakura trees forming a canopy. It was fun

to get into traditional dresses of Samurai warriors

and Japanese ladies and click photographs.

Food in Japan is a gourmet delight and the national

dish Sushi should not be missed. People from Japan

are hardworking, polite and courteous. We Indians

for our 'Swach Bharat Abhiyan' should keep Japan,

the land of the rising sun as a benchmark for

neatness and tidiness.

Sayonara !

Suggestions for Program and participation in the West Zone meeting at GoaSend your suggestions and interest of participation to Secretary on

by 15th June 2015 pkandarp@hotmail.com

Election Announcement Posts:President Elect: one postCouncil member: one postLast date for sending Nominations/ Application: 30th JulyLast date for withdrawal of application: 31st August Send applications to the Chief Election Officer Dr Janak Desai at Samved Hospital, Near Stadium Circle, Navrangpura, Ahmedabad, Gujarat, 380009drjanakdesai@gmail.com

Submit your Abstracts for presentation at the WZ-USICON, GoaDate for submission of abstracts: 15th July 2015. Abstracts as soft copy only in the format provided on WZ-USICON website.Send to secretaryusiwz@gmail.com

AGM At the West-Zone USICONDate: 12th September 15Time: 530 PMVenue: Hotel Raddison Blue, Goa, Hall A

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Conferences and Academic events in near future.

National & Zonal Conferences

West Zone USICON 2015Dates :10th - 13th September 2015Venue :Hotel Radisson Blu , GoaOrganizing Secretary :Dr. Jayant KudchudkarKindly motivate your OT staff to participate in nursing training course at Goa during west zone conference.

South Zone USICON 2015Dates :10th - 12th July 2015Venue :VisakhapatnamOrganizing Secretary : Dr. SubbaRaoChodisetti

North Zone USICON 2015Dates :17th - 19th September 2015Venue : SKICC, CheshmaSahi, Srinagar, Jammu & KashmirOrganizing Secretary :Prof. Baldev Singh

East Zone USICON 2015Dates :30th October 1st NovemberVenue :Sambodhi Resort, BodhgayaOrganizing Secretary : Dr.Amitabh Kumar Sinha

Reconstructive Urethral Surgery Workshop Dr.SanjayKulkarni 20 June, Madras Medical CollegeContact: Dr.Ramesh 09894599845

USICON 2016Dates :7th - 10th January 2016Venue :Hyderabad International Convention Centre, HyderabadWebsite : www.usicon2016.com

International Meetings

BAUS 2015 – Annual Conference of The British Association Of Urological SurgeonsDates :15th -18th JuneVenue :Manchester, UKEmail :events@baus.org.uk

13Th UAA Congress – Annual Conference of Urological Association Of AsiaDates :3rd 6th SeptemberVenue :Shanghai, ChinaWebsite :

WCE 2015 – 33rd World Congress Of Endourology & SWLDates :1st-4th OctoberVenue :LondonWebsite : www.wce2015.comConcessional registration fees of 150 pounds for Indian delegates.

10th Men's Health World Congress 2015 - MHWC 2015Dates :9th - 11th October, 2015, Pre Congress Workshop on 8th OctoberVenue :New DelhiWebsite : www.mhwc2015.com

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Faculty at the west-zone meeting

Dr Liu ChunxiaoChairman of UrologyZ h u j i a n H o s p i t a l , Guangzhou, ChinaArea of Interest: BPH, Ca Bladder

Dr Xu Abai Department of UrologyZ h u j i a n H o s p i t a l , Guangzhou, ChinaArea of interest: Ca prostate

Dr Arun PherwaniVascular surgeon, North Staffordshire Hospital, United KingdomArea of interest: Vascular access

Dr Dinesh AgrawalConsultant UrologistRoyal Melbourne Hospital P a r k v i l l e V i c t o r i a , AustraliaArea of interest: Robotic Laparoscopic surgery, reconstructive urology

D r . T h o m a s R W Herrmann, FEBUDirector of Endourology & LaparoscopyHanover, GermanyArea of interest: Laser surgery of prostate, En Bloc Resection of bladder tumor

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The recently concluded AUA at New Orleans had a big representation from the Urology society of India. Nearly 99 Indian members attended the meeting. A lot of our members showcased their work at this world forum and was hugely appreciated.

One very interesting presentation happened from MPUH, Nadiad where four PCNL stalwarts presented their innovations in the percutaneous technology during the prime plenary session of the AUA. This goes to show the huge developments that have happened in the field of PCNL and India has taken a lean in this.

The show started with our President Dr.Sabnis demonstrating the micro-PCNL. This was followed by Dr. Janak Desai showing his popular ultra-mini-PCNL. Dr. Kaushik Shah displayed his new 'super PCNL' while Dr. Madhu Agrawal ended the show on a high note with mini-PCNL. Looking at it from the audience perspective, it was a huge show and a great learning experience for those who attended this session.

This was indeed a proud moment for USI and the West zone

PCNL show at the AUA World Urology Presidents at AUA 2015, New Orleans

Dr Percy J Chibber, President USI (5th from left in front row)

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Evaluation of grey-zone levels Authors: Dr. T B Yuvaraja Dr. Harshavardhan, Dr. Kalyan

PSA levels have also been shown to correlate with prostate volume and the age of the patient. The “normal” PSA serum concentration ranges between 0-4ng/ml. Rather than consider the PSA range in terms of "normal or abnormal," it is more useful to consider it as a means of assessing the risk that prostate cancer would be found on a biopsy. According to the American Cancer Society, the estimated sensitivity of a PSA cutoff of 4.0 ng/mL is 21% for detecting any prostate cancer and 51% for detecting high-grade cancers (Gleason >8).Several factors have been reported to affect the measured level of serum PSA thus affecting the specificity of the PSA blood test.

These include BPH, diagnostic examinations such

as DRE, physical exercise, ejaculation, age, race, 5

alpha reductase inhibitors and prostatitis. In

infection PSA level falls after using antibiotics

The choice of a PSA threshold for recommending a

prostate biopsy is controversial. Today, the

dilemma is probably to find an accurate test

(biological and/or radiological) to define when we

really need to perform biopsy in order to limit

unnecessary biopsy on asymptomatic men

especially if PSA is in Grey Zone of 4-10ng/ml.

Thus, the indication of prostate biopsies leans on

interpretation of PSA, urinary markers like PCA3,

and the results of imaging studies especially

multimodal MRI which has been developed for 10

years and nomograms combining all these results.

FREE PSA AND PERCENT FREE PSA.

Men with prostate cancer have a greater fraction

of serum PSA complexed to ACT and a lower

percentage of total PSA that is free compared with

men without prostate cancer.The role for %f-PSA is

more applicable to PSA levels less than 10 ng/mL,

because the positive predictive rate of total PSA

above 10 to 20 ng/mL has been demonstrated to

be as high as 80%. Currently, %f-PSA is approved

for use to aid biopsy in men with benign DRE and

with PSA within the diagnostic gray zone of 4 to 10

ng/mL.

A free/total PSA cutoff of 0.18 (18% free/total PSA)

significantly improved the ability to distinguish

between subjects with andwithout cancer

compared with use of total PSA alone. As many as

20% to 65% of unnecessary biopsies may be

avoided when using %f-PSA cutoff values ranging

between 14% and 28%, while maintaining

sensitivity rates from 70% to 95% within the t-PSA

range of 4 to 10 ng/mL

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VOLUME-BASED PSA PARAMETERS

Volume-based PSA parameters (with prostate

volume typically determined by ultrasonography)

have been evaluated to reduce confounding from

BPH. These include PSA density (PSAD, PSA divided

by prostate volume), complexed PSA density

(complexed PSA divided by prostate volume), and

PSA transition zone density (PSA divided by

transition zone volume)

PSAD of 0.15 or greater was proposed for

recommending prostate biopsy in men with PSA

levels between 4 and 10 ng/mL and a normal DRE

(Seaman et al, 1993; Bazinet et al, 1994).

PSA TRANSITION ZONE DENSITY

Kalish introduced PSA density of the transition zone

(PSA-TZ) as a refinement to the original PSAD. The PZ

fraction can be calculated by using the following

formula:tPSA × (total prostate volume – TZ

volume)/total prostate volume

PROSTATE-SPECIFIC ANTIGEN VELOCITY.

The rate of change in PSA (PSA velocity, or

PSAV)—PSA corrected for the elapsed time between

measurements (Carter et al, 1992)—is associated

with the risk of prostate cancer. Carter and

colleagues (1992) showed that a PSAV more than

0.75 ng/mL per year was a specific marker for the

presence of prostate cancer in men with PSA levels

between 4 and 10 ng/mL.PSA-V is calculated by i/2

[(PSA2 – PSA1/time 1 in years) + (PSA3 – PSA2/time 2

in years)]. A PSA-V of 0.75 ng/mL or greater per year

was suggestive of cancer (72% sensitivity, 95%

specificity).

PCA3

PCA3 measurement in urine specimens is a

prostate-specific marker associated with the

likelihood of biopsy prostate cancer detection,

considered as a promising new biomarker because

PCA3 codes for a messenger RNA highly

overexpressed by prostate cancer cells.

Usually, PCA3 measurement is proposed as a

second-line diagnostic test after a previous

negative biopsy result. In this group, PCA3 score

can help the decision of whether or not to re-

biopsy regarding the high specificity of the test

around 70%.

Role of MRI

Multiparametric MRI has shown a potential value

in prostate detection, and its role is now

increasing. Multiparametric MRI includes standard

T2- weighted sequences, dynamic contrast-

enhanced magnetic resonance imaging (DCE-MRI)

and diffusion-weighted imaging sequences (DWI

sequences). Targeted biopsy using fusion of 3D

transrectal ultrasound and MRI images can

optimize detection of significant cancer and

different equipment are already available in order

to improve biopsy strategy (Urostation ®,

Targetscan ®).

4K Score Test

The 4Kscore Test is new test to reduce the number

of unnecessary biopsies, by providing information

to improve decision making before ordering a

prostate biopsy. The test uses four blood-based

measures: total PSA, free PSA, intact PSA, and

human kallikrein 2 (hK2). These results are

combined along with a patient's age, digital rectal

exam results, and history of a prior negative biopsy

into a single algorithm.

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PHI (Prostate Health Index) Test

The PHI test measures total PSA (tPSA) in addition to

two special forms of the protein: free PSA (fPSA),

and pro2PSA.The Prostate Health Index (phi) is a

new blood test that results in a score, or “phi

score.”The phi results are intended to be used as an

aid in distinguishing prostate cancer from benign

prostatic conditions in men 50 years of age and

older with total PSA results in the 2 – 10 ng/mL

range and negative digital rectal examination (DRE)

findings. If phi score is less than 27 there is 10%

chance of having cancer and if it is more than 55

there is more than 50% chance of having cancer

Clinical Algorithm – PSA 4-10ng/ml

After we reached Antarctic Peninsula, we were asked to dress for expedition. We wore 5-6 layers of synthetic and woolen clothing with outermost layer of windproof and waterproof coat& pant. There were two layers of knee high sox, a neck gaiter and two layers of caps to cover head. Sunscreen lotion and sunglasses are a must. Finally you put on rubber gumboots, and carry life jacket, camera and binoculars.

At Antarctica there are numerous small islands, which are places of visit. There are large glaciers, crevasses and icebergs. Icebergs were uncountable in numbers, shapes and sizes. They are the pieces broken from glaciers and then they float in sea. Their beauty cannot be described. They are carved in different designs by water and air currents. Besides icebergs the main attraction is wild life. First time we saw couple of Gentoo Penguins and few fur seals.

Antarctica has a lot of places to see. Danco Island is spectacular due to the heavily crevassed glaciers in the surrounding mountains.Port Lockroy is a sheltered harbor and one of the most visited sites in Antarctica. It is a home to numerous nesting Gentoo penguins and blue-eyed shags. The Museum with its souvenir shop there is worth a visit.

Having travelled far and wide all across the globe, I thought this was one of my most memorable visits ever. The time spent nearly alone in company of unruffled nature with exotic penguins and whales is something I would suggest all my friends to savor in this lifetime.

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We, a group of five Indians, boarded the expedition ship'SELVER EXPLORER' with 107 passengers of 22different nationalities. The journey on this small ship started with Captain's welcome party. Here we were introduced to the other explorers and were explained all rules, regulations and precautions for the voyage. The ship crossed the beagle channel and came in open sea. The doctor on the ship gave us instructions to avoid injury when the ship crossed turbulent waters. During the next two days when we crossed the Drake Passage, we were given multiple talks by expedition team on Geology and weather, marine animals, photography and history of previous expeditions. On the ship we had access to vegetarian menu and tea, coffee were available round the clock.

Antarcticais the coldest, windiest and driest continent. Weather is very variable and can change suddenly. Temperatures of -89 degree C and winds up to 350 Km/hour have been recorded here. Day light lasts 20 hours during summerand 80% of sunrays are reflected back because they fall oblique. The average height in Antarctica is around 6000 feet above sea level.

Miles to go before I sleep….Dr R K Lahoti, Indore

Which is a place b i g g e r t h a n E u r o p e a n d Australia, a place that doubles in winter increasing at rate of 5 km a day, not a country

but a continent, and does not need Visa to visit? Yes, that's ANTARCTICA, a relatively new tourist destination visited by about 20 -30 thousand people each year. Although Antarctica can be reachedfrom Australia, New Zealand, South Africa and Chile but most ships start from Ushuaia, Argentina (southern most city of world).