UNASSIGNED: COVID-19 has an increased burden on the delivery of services because the measures taken by the governments forced hospitals to cancel most of their elective procedures and led to the shutting down of outpatient clinics. This study aimed to evaluate the impact COVID-19 pandemic on the volume of radiology exams based on patient service locations and imaging modality in the North of Jordan.
UNASSIGNED: The imaging case volumes that were performed at the King Abdullah University Hospital (KAUH), Jordan, from 1 January 2020 to 8 May 2020, were retrospectively collected and compared to those from 1 January 2019 to 28 May 2019, to determine the impact of the pandemic of COVID-19 on the volume of radiological examinations. The 2020 study period was chosen to cover the peak of COVID-19 cases and to record the effects on imaging case volumes.
UNASSIGNED: A total of 46,194 imaging case volumes were performed at our tertiary center in 2020 compared to 65,441 imaging cases in 2019. Overall, the imaging case volume in 2020 decreased by 29.4% relative to the same period in 2019. The imaging case volumes decreased for all imaging modalities relative to 2019. The number of nuclear images showed the highest decline (41.0%) in 2020, followed by the number of ultrasounds (33.2%). Interventional radiology was the least affected imaging modality by this decline, with about a 22.9% decline.
UNASSIGNED: The number of imaging case volumes decreased significantly during the COVID-19 pandemic and its associated lockdown. The outpatient service location was the most affected by this decline. Effective strategies must be adopted to avoid the aforementioned effect on the healthcare system in future pandemics.

Digital images are becoming more readily available and possibilities for image processing are developing rapidly. This opens the possibility to use digital images to monitor and detect diseases in animals. In this paper we present 1) a generic facial feature scoring system based on seven facial features, 2) manual scores of images of Holstein Frisian heifers during foot-and-mouth disease vaccine efficacy trials and 3) automatic disease scores of the same animals. The automatic scoring system was based on the manual version and trained on annotated images from the manual scoring system. For both systems we found an increase in disease scores three days post infection, followed by a recovery. This temporal pattern matched with observations made by animal caretakers. Importantly, the automatic system was able to discern animals that were protected by the vaccine, and did not develop blisters at the feet, and animals that were not protected. Finally, automatic scores could be used to detect healthy and sick animals with a sensitivity and specificity of 0.94 on the second and third days following infection in an experimental setting. This generic facial feature disease scoring system could be further developed and extended to lactating Holstein Frisian dairy cows, other breeds and other infectious diseases. The system could be applied during animal experiments or, after further development, in a farm setting.

Solitary fibrous tumors (SFTs) are rare neoplasms commonly arising from the pleura. Multiple extra-pleura occurrences have been established by the literature. CT scan and MRI with IV contrast serve as the steppingstone for early detection and diagnosis, and to evaluate disease burden. Surgical resection is most of the time curative. SFTs carry a malignant potential and may recur or metastasize thus long-term follow-up is of utmost importance for patients diagnosed with this tumor. We discuss the case of a 47-year-old male patient who presented with urinary retention, caused by a large pelvic tumor pathologically proven to be a solitary fibrous tumor.

Bacille Calmette-Guerin (BCG) vaccine is administered worldwide to neonates and considered safe. Serious complications like disseminated BCGosis are extremely rare occurrences (<1 per million vaccinations). A 6 months male was brought to paediatric outpatient department with fever and swelling over the dorsum of the left hand for 5 days. On examination, he was febrile and had hepatosplenomegaly. X-ray of the hand showed lytic lesions in the first and second metacarpals. Provisional clinical diagnosis included Langerhans cell histiocytosis, congenital syphilis, and haematological malignancy. Fine Needle Aspiration Cytology (FNAC) was done from the swelling and showed diffuse sheets of histiocytes with both intracellular and extracellular rod-shaped unstained structures along with inflammatory cells. These ghost images stained positive with ZN stain. A cytological diagnosis of atypical mycobacteria vs leprosy was made. Child was revisited and found to have an active BCG scar. Further investigations showed low serum IgM and positive AFB culture. These bacilli were confirmed by GenoType MTBDR plus test as Mycobacterium bovis. Despite Antitubercular therapy, the patient succumbed to death. This case highlights the variable clinical presentation of BCGosis. Its occurrence may unmask any underlying immunodeficiency. If unfamiliar with the above cytological features and in absence of routinely performed special stains, the cytopathologist may miss these notorious organisms and treat such cases like suppurative lesions. To conclude, an early and definitive diagnosis of BCGosis can be established on FNAC which would ensure timely management and better outcome in this highly lethal entity.

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