Endourological Society Report from the Secretary General
December 2021
President Adrian Joyce, M.D. President-Elect Margaret Pearle, M.D. Past-President Jorge Gutierrez-Aceves, M.D. Secretary General Li-Ming Su, M.D. Treasurer Chandru Sundaram, M.D. Director of Education Brian Matlaga, M.D. Associate Director of Education Bradley Schwartz, D.O. Research Chair Ben Chew, M.D.
Historian Stephen Nakada, M.D. Founding President Arthur Smith, M.D. Journal of Endourology Editor Jaime Landman, M.D. Video Urology Editor Mantu Gupta, M.D.
It is a great honour and privilege to serve as the new President of the Endourological Society, following in the hallowed footsteps of Jorge Gutierrez-Aceves and Glenn Preminger. I have to thank Jorge and before him Glenn for their significant contributions to the Society at a very difficult time in our history with the pandemic. Similarly, one must recognize the enormous sacrifice and efforts of Prof Andreas Gross who tried diligently to have the WCET meeting in Hamburg this year but in the end was beaten by the system.
In the last year we have said fond farewell to our conference organisers, Urology Management Services under the leadership of Janet Skorepa and Leslie Hettenbach, as they wished to go in a different direction and we welcome Sue Holle and Mike Whittington as our new conference organisers. They are well known in Urological Circles as great conference organisers and have had to hit the ground running with our plans for the 2022 meeting in Seoul. We are very appreciative of their support and plans at this difficult moment in time.
The aim of Endourological Society is to improve the lives of patients with both benign and malignant urological conditions by reducing the morbidity of invasive treatments through novel technology, innovative techniques, and non-invasive medical management relevant to our discipline. These aims can be achieved by the promotion of successful scientific dialogue amongst urologists worldwide through the format of international meetings, circulation of scientific literature, innovative research and surgical skills training courses.
These aims would not be possible without the support and contributions from you the members and for the expertise and advice that we have in our Executive Committee under the able leadership of Secretary General – Li-Ming Su, assisted by the legend that is Peggy Pearle who stays on as President-Elect for one year. Peggy was a tremendous Secretary for the Society and it is a tribute to her corporate knowledge of all things Endourology that the Society is and continues to be, the dynamic force in our specialty.
The implications of the current pandemic have forced many Urological Societies to re-evaluate their aims and ambitions in a time when we have a reduced ability to meet face to face and share those novel techniques and innovative ideas which could have a huge benefit to patients. However, we continue to be proactive and the Society has to recognise the incredible contributions of our Society Treasurer - Chandru Sundaram, in keeping us on a stable financial footing and for the ideas and innovations of our Director of Education – Brian Matlaga, Brad Schwartz the Associate Director of education and Research Chair - Ben Chew. They remain committed to expanding our educational and research profile by promoting cutting edge research of new and innovative technologies whilst looking to new sources of funding through working to enhance our industry partnerships.
We are committed to ensuring that the Society meets the highest standards of Diversity and Inclusivity and I am very grateful to the taskforce that took on this review for the Society earlier this year which has highlighted several areas where we can make significant improvements going forward and my commitment is to give them every support to fulfil this process for the Society.
Endourology has evolved enormously over the last 30 years and the Society is very honoured to have the Society of Urologic Robotic surgeons (SURS), the Focal Therapy Society and the Engineering and Urology Society as part of the Endourology Society portfolio, thus covering all facets of our subspecialty.
As President I remain thoroughly committed to the continuing success of the Society and am invigorated to further expand the reach of the Society through education, research, and training opportunities which will all benefit our patients.
Finally, I wish you and your family warm wishes for a joyous holiday season and a very happy and healthy new year and look forward to welcoming you all to Seoul in September – a meeting which I promise is not to be missed !!
Adrian D Joyce, M.D. President
Report from the Secretary General
Happy holidays to each of you across the globe! I sincerely hope that you, your colleagues, and your families are remaining safe and healthy as we all continue to persevere through the COVID-19 pandemic and its variants.
As the new Secretary General of the Endourological Society, I want to first start out by expressing my sincere thanks and appreciation for Peggy Pearle, MD, who has for six years done an absolutely outstanding job as our society’s Secretary General and performed admirably through trying times especially as a result of the current pandemic. Having shadowed Peggy this past year, I gained a deeper appreciation for her unwavering dedication and passion for our society, carrying out her duties with such grace, diplomacy, good will, and inclusiveness. We all owe a huge debt of gratitude to Peggy for her time, commitment, and tireless efforts at making our society better. She now moves to the President-Elect position with Adrian Joyce, MD now serving as our President.
As you are all aware, the Executive Committee had to pivot last minute to a virtual session format this past year with the unfortunate cancellation of the Hamburg WCET meeting. Andreas Gross, MD and his planning committee need to be thanked (again) for their tireless efforts at planning the Hamburg meeting. We share in his disappointment that our meeting could not be held in person in his beautiful city and wonderful meeting venue. Certainly Dr. Gross’ hard work and contributions will not go unrecognized by society’s leadership and members. In lieu of the planned in person meeting and as a sign of our society’s unwavering commitment to spreading our educational efforts worldwide, our virtual WCET sessions have run from October-December 2021 with both live and on-demand viewing options and were based upon the planned 2021 WCET Semi-Live surgical program. We have had an excellent viewership with over 500 attendees and 2312 views to date. I want to give a special thanks to many of you who agreed to serve in various capacities within our 8-part virtual WCET program, whether as a surgeon, moderator or discussant. We would not have been able to carry out this virtual program without your time, expertise and assistance.
We hope that our virtual sessions will build momentum as we look forward to our next WCET meeting in Seoul, Korea in September 30 – October 4, 2022. It will be at this time that we will recognize this past year’s WCET Award Winners including Ali R. Kural, MD (Ralph Clayman Mentor Award), Ardeshir Rastinehad, DO (Arthur Smith Award), Tadashi Matsuda MD (Karl Storz Lifetime Achievement Award) and Katy Lyall (Industry Award). On the topic of awards, the society was recently informed that four of our members were recognized for their contributions to the field through receipt of a 2022 American Urological Association award including Glenn M. Preminger, MD (Ramon Guiteras Award), Chandru Sundaram, MD (Distinguished Contribution Award), Christian Chaussy, MD (Presidential Citation), and Inderbir Gill, MD (Presidential Citation). Lastly, our society’s Past President Jorge Gutierrez, MD was appointed the Assistant Secretary of the AUA for South America. A big congratulations to each of these outstanding members for their contributions and exemplary representation of our society.
Continuing the theme of education, the society continues to build upon its prior success with the Masterclass webinars, which were originally initiated by our current President Adrian Joyce, MD and further expanded upon by our Education Director, Brian Matlaga, MD, MPH and Associate Director, Brad Schwartz, DO. We thank Drs. Matlaga and Schwartz for putting together an outstanding schedule that will begin in the new year, covering all aspects of our society including Endourology, Laparoscopy and Robotics, Focal Therapy, BPH as well as Diversity, Equity and Inclusion topics. The success of this program would not be possible without our long-standing as well as newer industry partners who have stood by our side and shared in our society’s commitment to spreading endourology and uro-technology throughout the world.
As we enter the new year, our society is pursuing several initiatives that are worthy of mention. The Diversity and Inclusion Taskforce, led by chair Michelle Jo Semins, MD, met this past November to discuss web-based programming to tackle the topics of unconscious bias, “manels”, gender and racial equity, and mentorship, all of which are germane to our society. A Speaker and Committee Portal will be launched on our society website to increase engagement and as a means of gathering information from society members who may be interested in getting involved as a future educational speaker and/or society committee member. With these two proactive and intentional efforts, I remain confident that our society will continue to become a stronger, and more inclusive and diverse group. Our society continues to seek greater membership worldwide. Thanks to generous donations from both Ash Tewari, MD and Ali Kural, MD, along with matching funds from the Executive Committee and Board of Directors, a Membership Initiative is being rolled out to help support underprivileged countries and underrepresented minorities. As our society has expanded beyond endourology, laparoscopy and robotic surgery to now include focal therapy and BPH, it is time that we revisit our society’s longstanding logo. As such a logo contest has been launched to seek creative designs from our membership to better represent our ever-expanding field. We look forward to seeing your creativity!
Lastly, I would like to acknowledge Chandru Sundaram, MD our Treasurer, who has helped our society weather the financial storm as a result of the pandemic by making thoughtful and measured decisions that has led to our sustainability. Despite the financial loss of two cancelled WCET meetings, our society has remained committed to supporting our educational scholarships. The society is currently accepting applications for our Summer Student Scholarship, which has remained a mainstay of our mission to increase medical student involvement in endourology. I am also pleased to relate the fact that my own institution, the University of Florida Department of Urology, was finally able to host our 2019 International Traveling Scholar awardee, Musliu Tolani from Nigeria, during the month of November. Dr. Tolani’s visit was rewarding for all involved as we exposed him to the broad range of adult and pediatric, as well as open and MIS urologic surgery and shared in the similarities and differences in practice patterns between our centers. His time even included attending his first Thanksgiving dinner, first college basketball game (yes, the Florida Gators won!), as well as a trip to a nature preserve where we saw several wild Florida alligators up close. What an incredible opportunity to develop a new friend and colleague in the field.
In closing, on behalf of the Endourological Society leadership I wish everyone good health and good fortune in the coming year. We all look forward to seeing our friends and colleagues from across the world in 2022 (hopefully)!
Demonstrate your creative design skills and win a prize!! We are looking for a logo that will reflect the mission and vision of the Endourological Society.
2021 has been very eventful in many ways for our Society from a programmatic and financial standpoint. The cancellation of two in-person WCET meetings in Hamburg has resulted in significant loss of revenue. Despite this, the Society has remained viable by cutting costs and increasing member benefits.
We have decreased expenses with several measures including a 20% reduction in the already minimal stipends to the officers of the Society. In 2021, the new 7-year contract with Mary Ann Liebert Inc, the publishers of the Journal of Endourology has resulted in significant revenue thanks to the work of the Editors, Drs. Arthur Smith and Jaime Landman with the reliable assistance of Debbie Caridi and Michele Paoli. The expenses incurred for the CROES research projects have been eliminated with industry support due to the hard work of Drs. Jean De La Rosette and Ben Chew. The Masterclasses continue to be very successful and an important source of revenue. Please visit the new website which has a lot of educational resources.
Drs. Ash Tewari and Ali Kural donated $10000 and $5000 respectively to create a membership fund to promote the growth of membership among young promising endourologists especially from underrepresented countries. Matching donations from the members of the Executive Committee have been received. We are requesting you to contribute to this fund to grow the Society and help minimally invasive urologists.
There are several initiatives started in 2021 that will continue in 2022, including the Endo Census (Dr. Averch and Data Committee), the Endo History project (Dr. Nakada and the History Committee). Looking forward to seeing you in Seoul during the 2022 WCET. The Society remains financially strong and will continue to work for you. I acknowledge the wonderful contributions of the Finance Committee- Drs. Li-Ming Su, Hassan Razvi and Evangelos Liatsikos.
It has been my privilege to have worked with Dr. Peggy Pearle during her last 3 years as Secretary General. Her steady leadership, hard work and attention to detail has helped us all, especially me. I am looking forward to an equally productive tenure with our new Secretary General, Dr. Li-Ming Su, who has already been phenomenal.
Happy Holidays.
Chandru Sundaram
Treasurer
Chair of Research, Endourology Society
The goal of our committee is to improve research for our members by increasing collaborative efforts and to put like-minded researchers together. If you have an idea and need help, please contact us. We can help you develop your idea, find collaborators and help with infrastructure such as data capture and analysis. On our research website (www.endourology.org/research/current-tower-trials), you can find out more about the studies we have looking at the quality of life in kidney stone surgical treatments. Without looking at complications, or stone free rates, the simple question is –what is the QOL in patient who undergo shockwave lithotripsy vs ureteroscopy vs percutaneous nephrolithotomy? We have recently published a TOWER Atlas of stone nomograms with Mr. Bhaskar Somani (PMID: 33878937). Other meeting abstracts from our collaborative efforts have identified a 5.5% rate of urosepsis after ureteroscopy (Bhojani N et al.), and that this costs between 2-3x more than non-septic ureteroscopy cases (Bhojani N et al), and an international shockwave lithotripsy registry using the Storz SLX-F2 machine yields a 70% stone free rate (Gabrigna Berto G et al). Dr. Justin Ziemba and Dr. Joshua Stern have spearheaded our Quality of Life in stone studies and presented 2 abstracts at WCET 2021: the pain scores comparing ureteroscopy to percutaneous nephrolithotomy were similar and the social impact of ureteroscopy lasted <14 days while in PCNL, lasted >14 days. Finally, Dr. Kymora Scotland, Mr. Daron Smith, Dr. Thomas Tailly and Dr. Naeem Bhojani performed a DELPHI process to come up with international guidelines on how to handle kidney stones during a pandemic. Look for these publications coming out soon and please join us in our research endeavors.
On behalf of the Education Committee, we would like to wish you a Happy New Year! Reflecting on the year past, we were disappointed that the WCET in Hamburg did not come to pass. However, we were able to fill that void through a larger virtual experience that engaged our membership in different ways. The Masterclass programming continues to be a very popular educational endeavor. Although we did see synchronous attendance begin to decline as the year wore on (perhaps from “Zoom Fatigue”) the classes are still very well attended and there are large numbers of downloads for all of the programming on the Society website. The Podcast series continues to be very popular as well, and allows for more in depth conversations on topics of interest across the pillars of the Society (stones, robotics, focal therapy, and BPH).
As we look forward to the upcoming year, we are eagerly anticipating a return to an in-person WCET in Seoul. In the months leading up to the planned meeting, we will continue our virtual offerings. The Masterclass series will continue with novel topics and diverse panels. The Masterclass programming is also aligning with the newly established Diversity, Equity, and Inclusivity Committee and will feature Masterclasses devoted to topics generated from that Committee.
It is important that the Education Committee’s programming satisfies the needs and goals of the Society. To that end, your ideas on novel programming subjects, faculty, and formats are always welcome!
Brian Matlaga, M.D. Director of Education
Brad Schwartz, D.O. Associate Director of Education
Society of Urological Robotic Surgeons Report
Dear Friends and Colleagues,
As 2021 draws to a close and we reflect on the year gone by- I am filled with immense pride and honor at my association with SURS. What a year it has been and what amazing accomplishments!
Let me start first by noting that our Masterclass webinar series has been an outstanding success. SURS currently organizes one webinar per month, drawing an average of 250 to 300 participants per webinar. It would not have been possible without the sheer hard work, dedication and leadership of our team. During these webinars, we have focused on newer developments in techniques, instrumentation and education. In the future events, we intend to focus on quality improvement with value based care in a patient centric approach.
The Spotlight Series led by Dr. Ketan Badani provided an added dimension to the webinars by highlighting core elements and holding a discussion with faculty.
The YOUNG SURS soared on to new heights with increased participation in scholarly activities under the SURS umbrella.
It’s my pleasure to announce that our webinars are undergoing a peer review process in preparation for inclusion in Videourology in the Robotic section. The initiative, led by Professor Mantu Gupta, opens exciting possibilities for the year ahead which will provide an opportunity to residents, fellows and community surgeons to learn the tips of specific procedures and impart value and better care to their patients.
I stay committed to advancing our mission to increase SURS membership and launch our global chapter initiative. This year, we have sponsored the membership of 100 resident/young endourologists. In our efforts to disseminate educational and technical expertise across the world, we have held meetings in the Middle East, India, Southeast Asia and Europe, which has given worldwide recognition to SURS.
We have planned several meetings in the near future during AUA, World congress of Endourology and Urotechnology and in collaboration with different societies all across the world. We are also working on planning an Annual meeting of SURS – Global, most likely launched in late 2022 in NYC.
Please allow me to thank you for your dedication, loyalty and support which have enabled me to advance the SURS mission & WCET in a meaningful manner in the year 2021. It has been a great honor to serve as the President of SURS and working with each and every member of this esteemed organization.
I look forward to your continued support and an exciting New Year as we step into 2022.
Here is wishing you and your family a very joyous holiday season and a very Happy New Year!
Ashutosh Tewari, M.D. President, Society oSocial Media Committee Reportf Urologic Robotic Surgeons
Focal Therapy Society Report
Dear friends and colleagues
In the absence of in-person symposia this year, the Focal Therapy Society (FTS) has provided virtual educational content and worked to further strengthen the society. In partnership with the Endourological Society, FTS has participated in the Zoom Masterclass educational series hosting a dozen programs spanning topics on imaging, treatment and post-therapy surveillance. The FTS also provided educational presentations at the SIU and the UroVivo Symposium hosted in Buenos Aires. Newly created in 2021, Dr Jack Tay launched the quarterly International FTS Tumor Boards whereby interesting cases are discussed in terms of patient and treatment selection, optimization of therapy and also post-ablation surveillance. The FTS plans to continue our commitment to education and training in 2022 organizing Masterclass instruction on Multi-parametric Prostate MRI Interpretation as well as targeting lesions. This is an endeavour led by Drs Art Rastinehad and Jelle Barentz, to include hands-on teaching and expert guidance.
Two Delphi consensus panels that took place at our recent in-person symposium in February 2020 were published in peer-reviewed journals: "Potential of Biomarkers and Prostate Focal Therapy" chaired by Dr Rafael Sanchez-Salas and “Discontinuing Active Surveillance: Focal Therapy’s Sweet Spot“ led by Dr. Thomas Polascik. In 2022, FTS is currently exploring the possibility of publishing a white paper or systematic review on best practices for both active surveillance and on the outcomes of ablation for prostate cancer.
Finally, we have launched the International FTS Registry, that will track clinical outcomes of all types of ablative modalities and treatment configurations for partial prostate gland therapy. FTS aims to launch a multi-center clinical trial for members to participate. Please join the FTS - your membership in the Endourological Society and FTS offers many opportunities to develop and implement image-guided therapies for prostate and kidney cancer.
The FTS is indebted to Michele Paoli and Debra Caridi who have been invaluable assisting the Focal Therapy Society to get up and running. Many thanks to the leadership of the ES for supporting and nurturing our growth.
Happy Holidays!
Thomas Polascik, M.D. Chair, Focal Therapy Society
Social Media Committee Report
In this time of virtual meetings and long-distance education, the Social Media Committee has been committed to helping the endourology community stay connected. Discussions that have started during the yearlong Masterclass series and recent World Congress of Endourology and Uro-Technology virtual sessions have frequently continued on Twitter, allowing direct engagement and meaningful exchange between experts and our global audience. These discussions are also preserved online, and we encourage you to follow us @Endo_Society and search the hashtag #WCET21 to view the discussions. Our committee plans to continue bringing Society members together in 2022 through live meeting coverage, crowdsourcing initiatives, and enhanced virtual education. We encourage your participation and look forward to a productive year ahead. Happy holidays to all!
Brian Eisner, M.D. Kevin Koo, MD, MPH, MPhil Co-chairs, Social Media Committee
Data Committee Report
Season’s Greetings from the Data Committee!
It has been a crazy, crazy year, but hopefully y’all have stayed safe and sound! The Endourology Society Data Committee has been hard at work over this last year putting together the first ever Endourology Society membership census. We were overwhelmed with the responses we received from over 500 Society members, so our thanks to all of you! We are currently in the process of assembling and interpreting the data, so stay tuned for the formal report.
We were also busy adding some structure to the survey-of-the-membership requests that we have been receiving. This structure creates standard operating procedures for anyone who has an interest in utilizing the Endourology Society membership database for surveys. Ideally, we then look forward to all that excellent work querying our membership to be submitted for presentation at the WCET and publication in the Journal of Endourology.We will look forward to the days that we can all be together again; fingers crossed for Seoul!Please have a happy and healthy holiday season and an awesome 2022!
Timothy Averch, M.D. Chair, Data Committee
The Endourological Society extends several privileges to its members:
Online access to Journal of Endourology and Part B, Videourology, Journal of Endourology Case Reports and the Atlas of Minimally Invasive Urologic Surgery
Membership Directory (consenting members)
Online surgical education via Videourology Journal, the Atlas of Videourology and Masterclasses in Endourology and Robotics
Meeting Highlights from the World Congress of Endourology & Technology
Reduced registration for the WCET meetings
Reduced registration for the World Congress of Videourology
Information regarding upcoming events including WCET, Skills Courses in Endourology, Laparoscopy & Robotics and SURS (Society of Urologic Robotic Surgeons) masterclasses and resident preceptorships
International Traveling Scholarships
Medical Student Summer Research Scholarships
To learn more about the Endourological Society, please visit our website: www.endourology.org
The Endourological Society and the Society of Urologic Robotic Surgeons are excited to continue its online educational platform entitled “Masterclass in Endourology & Robotics” in 2022. Our aim is to deliver high-quality content dedicated to concepts and surgical techniques in Endourology & Robotics. The Masterclass will include moderated webinars focusing on surgical techniques using semi-live videos, edited videos demonstrating “tips and tricks” from leaders in the field, podcasts, on-line journal clubs, panel discussions and more.
The Covid-19 Pandemic has been an unprecedented challenge both personally and professionally for all of us. We have all learned how to adapt. The Endourological Society is no different. Fortunately, our website has served as an ideal platform for a variety of novel programs. As mentioned by Doctors Matlaga and Schwartz, the Masterclass Webinar Series has been a tremendous success. Urologists and patients across the world have had the opportunity to learn from pioneers and experts in the field of minimally invasive urology from the safety of their homes. In addition, access to the journals has been streamlined with highlighted articles and videos being front and center on the main page.
In the spirit of inclusiveness and diversity, the Endourological Society will soon be rolling out the Speaker and Committee Portal. The portal was created to help the Endourological Society engage and promote future leaders within our society. In additional, the portal will provide the society with a better understanding of the unique practices and specialties of our membership. Members will be able to submit profiles specifically designed to voice their interest in participating in the annual WCET meeting as a speaker, moderator or educational course faculty member. The portal will also allow members to apply for vacant committee positions. The Speaker and Committee Portal is just one of several projects we are working on, which we hope will add continued value to our members.
Lastly, I would like to wish each of you a happy holiday season!
Sincerely, Brian Duty, M.D., MBA Chair, Website Committee
World Endo Committee Report
The World Endo Initiative was first put forth by Dr. Ralph Clayman with the spirit of advancing Endourology in the developing world by means of education and providing opportunities that might not always be available for urologists from such countries.
It has been said that, “In our diversity, lies our strength.” The strength of the Endourology Society can only be enhanced by making a collective effort to bring leaders to the developing world to teach and to educate.
The importance of humanitarian and volunteerism well established by the members of the society be it in their backyard or across the oceans. The society through the generosity of stalwarts like Dr Raju Thomas has collaborated with Urology Care Foundation to establish the endowment to support these efforts.
The spirit and desire to achieve these goals remains gated by the world pandemic. Each quarter I make plans, as do many others to embark on a mission, only to cancel the plan as the date approaches.
Our hope is 2022 will bring a new era where in we can strive to achieve our mission
Gopal Badlani, M.D. Chair, World Endo Committee
WorldEndo: Help us to make the Endourology Society truly GLOBAL!
The WorldEndo Initiative was initially established in 2010 to support the participation of urologists from countries that were unrepresented at the annual meeting. The role of WorldEndo is now being expanded to contribute to education and training in underdeveloped countries, with the development of courses and other initiatives. Through your philanthropy and ongoing support, our Endourology Society will continue to grow much to the benefit of urologists worldwide and the people seeking their care. You can make a difference!!
Endourology Society International Traveling Scholarship Report
A VISIT TO THE GATOR CITY:
MY EXPERIENCE WITH DR. LI-MING SU
I arrived in Gainesville on a cold and cloudy morning in late October 2021 to the very warm hospitality of Dr Li-Ming Su, the David A. Coffin Professor and Chairman of Urology at the University of Florida College of Medicine. Over the next four weeks, I had the privilege of observing his practice of advanced endourological techniques in robotic-assisted prostatectomy and robotic-assisted partial nephrectomy as a visiting scholar. Watching these, “I further appreciated the significance of clear anatomical contextualization during every stage of these procedures“, I told Dr Su. He reiterated the importance of this practice in grooming trainees and fellows as they work towards independence in their practice. I also found the video-based review of surgical operations during the pre-theatre session and his practical approach to teaching non-technical skills in surgery highly educational.
With him, I also attended the University of Florida Gators Basketball Game of November 1st 2021 and visited the Sweetwater Wetlands Park where I saw seven alligators during a two-hour nature trail. Apart from facilitating a seamless experience in the hospital, I also had several sessions of cultural exchange with his family at different fora including during the thanksgiving holiday.
I quite appreciate Dr Su’s sacrifice in making my visit memorable. Thank you!
Dr. Musliu Adetola Tolani MBBS PGCertPH (Liv), FWACS, FMCS Lecturer / Consultant, Division of Urology, Department of Surgery, Ahmadu Bello University / Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
