Summary The data on the predictors and prognosis of acute liver injury (ALI) among patients in coronavirus disease 2019 (COVID‐19) patients are limited. The aim of this study was to determine the prevalence, predictors and outcomes of ALI among patients with COVID‐19. A systematic review was conducted up to 10 June 2021. The relevant papers were searched from PubMed, Embase, Cochrane and Web of Science, and the data were analysed using a Z test. A total of 1331 papers were identified and 16 papers consisting of 1254 COVID‐19 with ALI and 4999 COVID‐19 without ALI were analysed. The cumulative prevalence of ALI among patients with COVID‐19 was 22.8%. Male and having low lymphocyte levels were more likely to be associated with ALI compared with female and having higher lymphocyte level, odds ratio (OR): 2.70; 95% confidence interval (CI): 2.03, 3.60 and mean difference (MD) −125; 95% CI: −207, −43, respectively. COVID‐19 patients with ALI had higher risk of developing severe COVID‐19 compared with those without ALI (OR: 3.61; 95% CI: 2.60, 5.02). Our findings may serve as the additional evaluation for the management of ALI in COVID‐19 patients.

The acute scrotum is a common urological emergency and has a broad differential diagnosis. There is no clear consensus on a particular algorithm to follow in the diagnosis of testicular torsion. Testicular Workup for Ischemia and Suspected Torsion (TWIST) Score, a risk scoring system based on signs and symptoms, can be invaluable in managing patients with the acute scrotum, specifically testicular torsion. This study aimed to evaluate the effectiveness of the TWIST scoring system for differential diagnosis of acute scrotal patients. The study was conducted using secondary data, medical records from 111 male patients diagnosed with acute scrotum in Saiful Anwar General Hospital Malang between January 2015 and December 2018. Data about the onset of pain, first contact, history, physical examination findings, any adjunct test performed, and intra-operative findings were collected. The effectiveness of the TWIST score in diagnosing testicular torsion was determined by calculating the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Of the 111 patients, 43 patients (38.7%) had testicular torsion. The mean age was 17.49 (6.69) years. A total of 39 patients were classified as high risk as per the TWIST Score with cut point 5 had 83.7% sensitivity, 95.6% specificity, 92.3% positive predictive value (PPV), and 90.3% negative predictive value (NPV). The area under the curve was 0.93. The use of the TWIST Score in clinical practice can accurately determine high-risk patients who can proceed straight to the operating theatre without the need for an ultrasound.

Foreign bodies inserted into or externally attached to genitourinary tract can be varied and defies presentation. The rare incidence of this case makes this an important concern in urology. Many different techniques have been described in the literature to remove genital foreign objects, but no techniques can be used universally. Each case needs individual handling in removing the object. It requires no particular skill but requires further thought to perform the removal simply and effectively. We report six cases of foreign body on male genitourinary tract that occurred in Saiful Anwar General Hospital Malang during January 2015 to January 2018. Three patients had corpus alienum in penile, two patients in urethra, and one patient on both. Most motives are caused by the sexual drive caused by the psychological disorder called parafilia (fetihistic). Most casses occured more than 12 hours in three cases. Removal of foreign objects in the penis is done with a metallic saw and cutting pliers in 4 cases. Endoscopy was done in 2 patients of intraurethral foreign body. Two patients need debridement and primary hecting. One patient performed a local flap and skin graft to cover the ulcer. Incidence foreign body most in mental disorder.