Subarachnoid lavage following inadvertent intrathecal injection of tranexamic acid

Tranexamic acid (TXA) is a commonly used antifibrinolytic drug during surgical procedures to reduce blood loss. An Inadvertent intrathecal injection of TXAmay lead to serious side effects including seizures and ventricular fibrillation with reported fatalities. We report a case of an inadvertentintrathecal injection of TXAwhich occurred as a result of similarities in appearance between TXAand heavy bupivacaine ampoules. The patient had subarachnoid lavage after experiencing back pain, systemic hypertension followed by generalized tonic clonic seizures

Effect of health education on long lasting insecticidal nets utilization among mothers of under five children in Yamaltu Deba Lga, Gombe State, Nigeria

Background: Malaria remains a major global public health challenge. It is the leading cause of death among children below the age of five years and constitutes 10% of the continent's disease burden. The objective of this study was to determine effect of health education on utilization of long lasting insecticidal nets (LLINs) among mothers of under five children in Yamaltu Deba LGA of Gombe state: Objective: This study was aimed at determining the effect of health education on LLINs utilization among mothers of under five children in Yamaltu Deba LGA of Gombe State. Method: The study was a community-based quasi-experimental intervention where 240 mothers of under five children were selected from two communities using a multi stage sampling technique. Health education was given in the study community and withheld in the control community. Data was collected from both communities before and after the intervention using an interviewer administered structured questionnaire. Data was analyzed using EPI-INFO 3.7.1 and Micro soft Excel software. Result obtained was presented using proportion, Chi-square test was used to assess the relationship between categorical variables and decision taken at p<0.05. Results: The mean ages of respondents in study and control communities were 28.9±6.2 and 27.9±6.7 years respectively. At pre-intervention, LLIN ownership was found to be 86.6% and 76.3% while its utilization was 45.4% and 38.1% in both communities. After health education intervention, (LLINs) improved significantly in study community from 42.9% to 89.9% compared with control community which increased from 33.9% to 60.9% and the difference was statistically significant(P=0.0001). Conclusion: This study concludes that health education significantly improved utilization. We recommended continuous health education on LLINs utilization in communities especially among mothers of under five children

Relationship between serum level of ionized calcium, magnesium, phosphate, vitamin D and parathyroid hormone with stages of CKD

Background: Chronic kidney disease is defined as either damage or a decreased Glomerular Filtration Rate of less than 60ml/min/1.73m2 for 3 or more months. There is destruction of renal mass with irreversible sclerosis and loss of nephron leading to a progressive decline in GFR.Secondary hyperparathyroidism hyperphosphataemia, hypocalcaemia and vitamin-D deficiency are common complications of CKD. Objective: To determine relationship between serum level of ionised calcium, magnesium, phosphate, vitamin-D and parathyroid hormone with stages of CKD. Method: This study was conducted at ABUTH Zaria. 125 consecutive adult patients in various stages of CKD who presented were enrolled and 125 apparently healthy matched for sex and age controls were also recruited. Results: 9% of patients were in stage-1, 16% in stage-2, 22% in stage-3, 12% in stage-4 and 41% in stage-5. Serum ionised calcium, vitamin-D and eCrCl showed a progressive decline as the stage of CKD advances, while serum phosphate, creatinine and iPTH showed a progressive increase as the stage of CKD advances. Changes in serum magnesium showed a slight change with advancing stages of CKD. The difference in mean serum levels of calcium, phosphorus, vitamin-D, parathyroid hormone, creatinine and eCrCl with different stages of CKD were statistically significant. eCrCl correlated negatively with phosphate and iPTH while serum creatinine correlated negatively with calcium and positively with phosphate and iPTH. Conclusion: Majority of CKD patients were in late stage. Correlation of analytes with stages was more in late stages and biochemical derangements occurred in late, rather than early stages of CKD

Workplace assault and its' impact to service delivery amongst dental professionals at Tertiary Hospitals in Northern Nigeria

Objective: The growing global public health concern of workplace assaults has necessitated that workers' health and safety be given same priority as patient's safety. The study assessed the prevalence of workplace assault and its' impact on service delivery among dental professionals at tertiary hospitals in Northern Nigeria. Methods: A cross-sectional survey of 60 dental professionals working in tertiary hospitals actively involved in undergraduate and postgraduate trainings for dental workforce in Northern Nigeria. Multi-stage sampling technique was used in selection of respondents and participation was voluntary. Data was collected using structured self-administered questionnaire. Statistical analysis was done using SPSS version 23.0 and p-value ≤ 0.05 was considered statistically significant. Ethical approval was received. Results: Sixty percent dentists and 40.0% dental auxiliaries participated in the study. Assault prevalence was 38.3% observed more among dental professionals (44.0%) in their first year in practice. Types of assaults experienced were; non-physical 19 (82.6%) with loud shouting and threats as most frequent, physical 3 (13.0%) with bullying and mobbing most frequent, and combination was 1 (4.4%). Patients (60.9%) and relatives (52.2%) were major culprits, and long appointment (65.2%) and treatment cost (60.9%) were main reasons for assault. Respondents (39.1%) expressed impact on their productivity and 69.6% respondents were ill-prepared to handle it. Conclusion: The prevalence of workplace assaults on dental professionals was fairly high and those in their first year in practice suffer more assault than others. Assault preventive programs should however specifically target this group in consideration with the unique nature and varied needs of each healthcare institutions

Intra-articular dexmedetomidine with bupivacaine versus bupivacaine alone for postoperative analgesia after knee arthroscopy

Background: Optimal relief of pain after knee arthroscopy is essential for early rehabilitation and mobilisation and to minimise postoperative morbidity. This study's aim was to assess dexmedetomidine as an additive to intra-articular (IA) bupivacaine in terms of analgesic duration and postoperative rescue analgesic consumption following arthroscopic knee surgery. Methods: A total of 70 patients, ASA physical status I and II, undergoing knee arthroscopy under general anaesthesia were enrolled in this double-blinded randomised controlled study, after Pan African Clinical Trial Registry (PACTR201507001048242) approval was obtained. Patients were randomly assigned into two groups; the bupivacaine group (B) received IA 19 ml bupivacaine 0.5% + 1 ml normal saline, bupivacaine dexmedetomidine group (BD) received IA injection of 19 ml bupivacaine 0.5% + dexmedetomidine 100 µg (1 ml). Postoperative visual analogue pain score (VAS), duration of analgesia and postoperative analgesic requirement were assessed. Results: VAS scores at rest and on mobilisation were significantly lower in the BD group at 4 h, 6 h and 8 h postoperatively in comparison with group B (p < 0.05). VAS scores were comparable between studied groups during the first 2 h, and at 12 h and 24 h postoperatively. Duration of analgesia was significantly longer in group BD (458.9 ± 93.5 min) than in the B group (229.1 ± 83.7 min) (p < 0.05). Postoperative analgesic consumption was lowered in the BD group compared with the B group (p < 0.05). Conclusions: Adding dexmedetomidine to IA bupivacaine after knee arthroscopy prolongs analgesic duration and decreases postoperative analgesic requirement

Prevalence of rotavirus among children under five years of age with diarrhea in Kaduna State, Nigeria

Rotavirus (RV) is a major etiological agent of acute infantile gastroenteritis and is associated with 20%-25% of diarrhea cases in infants. Nigeria continues to be among the first five countries with greatest number of RV disease associated deaths per year. The objective was to determine some demographic factors that might be associated with rotavirus diarrhea among children in Kaduna State. From September 2013-August 2014, 401 diarrheic stool samples were collected from children under 5 years of age in Kaduna State, Nigeria and analyzed for RV antigen using ELISA. An overall RV prevalence of 32.2% (129/401) was obtained with the infection occurring throughout the study period. The infection was higher in males (33.0%:63/111) compared to females (31.4%:66/210). The highest burden was detected in children 25 -36 months of age (37.3%:22/59). Highest prevalence was detected in children whose parents had primary education (35.8%:19/53) and those whose parents were civil servants (35.6%:36/101). There was no statistically significant association between breast feeding and RV infection (P> 0.05). The study has revealed that rotavirus remains an important cause of acute diarrhea in children under five years in Kaduna State, Nigeria. Hence the need to introduce the vaccines into the childhood immunization program in the country

Concomitant Outbreaks of Yellow Fever and Hepatitis E Virus in Darfur States; Sudan; 2012

Introduction: Yellow fever (YF) is a vector-borne disease transmitted to humans by infected Aedes mosquitoes; while hepatitis E virus (HEV) is a waterborne disease that is transmitted through the fecal-oral route. Both diseases have very close clinical presentation; namely fever; jaundice; malaise; and dark urine; they differ in severity and outcome.Methodology: In this cross-sectional; laboratory-based study; an attempt was made to measure the correlation of concomitant YF and HEV infection in Darfur States during the previous YF outbreak in 2012.Results: Results found concomitant outbreaks of YF and HEV at the same time with very weak statistical correlation between the two infections during the outbreak period; with Cramer's V correlation 0.05 and insignificant p value of 0.86.Conclusions: This correlation indicates that clinicians and care providers in tropical areas have to deal with clinical case definitions used for disease surveillance very carefully since prevalence of HEV infection is relatively common and this increases the possibility of misclassification and missing YF cases; particularly initial index cases; in a season or outbreak

Rationale and Design of the Pan-African Sudden Cardiac Death Survey: the Pan-African SCD Study : Cardiovascular Topic

Background: The estimated rate of sudden cardiac death (SCD) in Western countries ranges from 300 000 to 400 000 annually; which represents 0.36 to 1.28 per 1 000 inhabitants in Europe and the United States. The burden of SCD in Africa is unknown. Our aim is to assess the epidemiology of SCD in Africa. Methods: The Pan-Africa SCD study is a prospective; multicentre; community-based registry monitoring all cases of cardiac arrest occurring in victims over 15 years old. We will use the definition of SCD as 'witnessed natural death occurring within one hour of the onset of symptoms' or 'unwitnessed natural death within 24 hours of the onset of symptoms'. After approval from institutional boards; we will record demographic; clinical; electrocardiographic and biological variables of SCD victims (including survivors of cardiac arrest) in several African cities. All deaths occurring in residents of districts of interest will be checked for past medical history; circumstances of death; and autopsy report (if possible). We will also analyse the employment of resuscitation attempts during the time frame of sudden cardiac arrest (SCA) in various patient populations throughout African countries. Conclusion: This study will provide comprehensive; contemporary data on the epidemiology of SCD in Africa and will help in the development of strategies to prevent and manage cardiac arrest in this region of the world

Pattern of Blood Transfusion Request and Utilization at a Nigerian University Teaching Hospital

Introduction: Provision of adequate safe blood is challenging in developing countries due to paucity of voluntary blood donors; poor facilities for storage and blood component preparation as well as inappropriate blood ordering and utilization. Appraisal of pattern of blood transfusion requests and utilization helps highlight shortcomings that could be addressed toward judicious use of blood. Aims: To determine the pattern of blood transfusion requests and utilization at a Nigerian Teaching Hospital. Materials and Methods: Blood request forms and cross-match worksheets at the blood bank of Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto were analyzed over a 3-month period. Number of blood units requested; cross-matched; or transfused and the cross-match to transfusion ratio (CTR) for clinical units were computed. Results: Of the 1703 units of blood requested for 986 patients; 94.42 (1608) were cross-matched but only 34.51 (555) were transfused giving a CTR of 2.90 for the hospital. The CTR for the various clinical units were: O and G - 3.40; Surgery - 3.11; Trauma center - 2.74; Emergency - 2.61; Medicine - 2.02; and Pediatrics - 1.97. Conclusions: The overall CTR of the hospital is high indicating suboptimal transfusion practice. Introducing transfusion guidelines and type and screen with abbreviated cross-match method can help toward apt requisition and utilization of blood thereby reducing wastages

Breastfeeding and Weaning Practices among Nigerian Women

Background: Infant feeding is an important determinant of child well­being. The practice of exclusive breastfeeding over the years is declining despite efforts at all levels to improve it; and with globalization there is concern of possible drift in the traditional weaning practices among Nigerian women. This study, therefore, seeks to determine the breastfeeding and weaning patterns among mothers attending two health facilities in the northern and southern parts of Nigerian.Materials and Methods: This was prospective cross­sectional study involving mothers seen in Paediatrics Outpatient and Child Immunization Clinics. This study involved two hospitals in northern and southern Nigeria respectively. Results: Two hundred breastfeeding mothers were recruited into this study. 75% of the mothers were in 25­40 years group and the majority of them (40.0%) commenced breastfeeding after 60 min of delivery. 83% of the mothers were aware of exclusive breastfeeding, but only 40.5% practiced it; their main reasons were that: Breastfeeding was not enough for the growth and development of the child (26.1%) and that breast­milk did not contain enough water; however most mothers' breasts fed for >12 months. About 44.5% of the mothers introduced complementary feeds between 4 and 6 months, and most complimentary meals (53.5%)were maize­based. 61½% of the mothers abruptly stopped breastfeeding, and the practice of separating the child from the home during weaning was reported in only 16% of the mothers.Conclusion: Exclusive breastfeeding is still unacceptably low among Nigerian women despite anincreased level of awareness

Effect of Plasma Storage on Prothrombin Time and Activated Partial Thromboplastin Time at a Nigerian Public Laboratory

Background: Prothrombin time (PT) and activated partial thromboplastin time (APTT) are the tests used in the investigation and monitoring of hemostatic disorders. Plasma is used to perform these tests immediately or stored for later use. The time and storage temperature have been shown to affect the results of these tests. Thus; all coagulation laboratories need guidelines for plasma storage to ensure reliable results. Objective: To determine the effect of varying storage times and temperatures on plasma PT and APTT. Materials and Methods: PT and APTT were run on plasma from 40 healthy adults using a semi-automated coagulometer. PT and APTT were measured at 0; 4; 6; and 24 h on samples stored at room temperature; refrigerated samples; and frozen samples. The values at 0 h were compared with the values at 4; 6; and 24 h. Results: PT and APTT values were within the reference ranges at 0 h. For refrigerated plasma; PT values at 4 h were within normal; but at 6 and 24 h; they were significantly deranged (P 0.05). PT was significantly different at 4; 6; and 24 h for both room temperature and frozen plasma (P 0.05). The APTT showed significant differences between 0 h value and values at 4; 6; and 24 h for all the varying temperature conditions. Conclusion: For reliable PT and APTT results; samples should be processed and run immediately after collection. However; plasma for PT can be stored at 2o-4oC for only 4 h

Incidence of Adverse Drug Reactions in Patients on Antiretroviral Therapy: A study of Pharmaceutical Care in HIV Interventions in Nigeria

Background: Over 415;000 HIV-infected patients are receiving antiretroviral therapy (ART) in Nigeria but studies documenting their adverse reactions are limited. Objectives: This study determined the incidence and type of ADRs of severity grades II to IV in ART patients following pharmaceutical care directed active ADR surveillance program in Nigeria. Methods: This was a longitudinal study. A study-specific pharmaceutical care daily work sheet and national ADR reporting form were used for ADR screening and reporting respectively. Study population included 73;589 ART patients who were screened for ADR from April 2009 to December 2010 in 69 HIV treatment centres. All individual case safety reports (ICSRs) of severity grades II to IV in these patients were collated and analyzed. Chi-square was used to test the association between groups of variables at 95 Confidence Interval. Results: A total of 4600 ICSRs of severity grades II to IV reported were analyzed. Mean age of patients was 35.5(95CI; 35.2-35.9) years; 68.1 were females; and 7002 ADRs were reported; an average of 1.5 ADR perpatient. ADR incidences were 18.2 for d4T/3TC/EFV; 13.9 for d4T/3TC/NVP; and 4.4 for AZT/3TC/NV Pregimens; however overall incidence was 6.3. Major reported ADRs included skin rash (16.5); peripheral neuropathy (12.7); and headache (9.4). ADR occurrence was associated with specific ART regimens; concomitant medicines and age groups (p0.05); unlike gender. Lipodystrophy was associated withd4T/3TC/NVP [OR

Outcomes and Rates of CD4 cells decline among HIV-positive patients in Pre-Antiretroviral Therapy Care

Background: The CD4 cells count is a marker of HIV disease progression and a criterion for initiation of antiretroviral therapy (ART). Objectives: This study evaluated the outcomes and CD4 cells decline rates among HIV-positive patientsenrolled into pre-ART care in Nigeria. Methods: In a five-year retrospective cohort assessment; 1;098 patients were randomly selected from 1766 HIV positive patients who were ineligible to start ART and enrolled into pre-ART care during 1st March to 31st December 2007 in two health facilities. Routine clinical and immunologic data were extracted from patients'hospital records starting from pre-ART care enrolment and ending April 30; 2012. Paired sample t-test and Chi-square were used for inferential statistics; and P0.05 indicated statistical significance. Results: The patients' mean age was 33.1 (95 CI; 32.6-33.6) years old; and 65.1 were females. Patients' follow-up in pre-ART care was 512.6 person-years. During the 5-year observation period; there was a3 significant decline in CD4 cells count (cells/mm ) at months 3; 6; 12; 18; 30 and 42 (P0.05). The mean CD4 cells3 count decline rate was 2.5 (95CI; 2.1-2.9) cells/mm per annum. Pre-ART outcomes included 56.1 started ART; 39.7 loss to follow up; 2.6 transferred-out; 0.9 active in pre-ART care and 0.5 were dead at the endof observation period. The outcomes were associated with baseline WHO clinical stage and CD4 cells count (P0.05). Conclusion: Majority of patients started ART. There was a significant decline in CD4 cells count of pre-ARTpatients; and the decline rate was very low compared to previous reports

A comparison study of histochemical staining of various tissues after Carnoy's and formalin fixation

Background: The potential problems related to the use of formalin in histopathology; such as health hazards; deterioration of nuclei acids are well-known. The aim of this study was to evaluate the utilization of a Carnoy's solution fixation in comparison with formalin on subsequent tissue sectioning and histochemical staining. Materials and Methods: Corresponding sections of 25 tissue biopsies of rabbit's different organs were fixed in Carnoy's solution and in 10neutral buffered formalin. Samples were processed using the conventional method and then stained applying five histochemical methods. The degree of the quality of the staining was assessed for each method by scoring system (1-10) depending on comparison of the stained tissue sections with illustrated photomicrographs. Results: For the quality of cutting; the best quality was obtained by Formalin (mean = 4.76) then Carnoy's fixative (mean =3.84). The best quality of Haematoxylin and Eosin staining was obtained by formalin (mean =5.28) then Carnoy's (mean = 4.00). For Alcian blue and Perl's Prussian blue; the best staining qualities were obtained by Formalin (mean = 4.76 and 5.64 respectively) followed by Carnoy's (mean = 2.88 and 3.92 respectively). For periodic Acid Schiff's the best staining quality was obtained following Carnoy's fixation (mean = 4.52) then; the formalin (mean = 3.76). Conclusion: Although; Carnoy's fluid is a safe fixative and can rapidly penetrate the tissues; but it can't be a substitute for formalin

Thyroid Cancers in Nodular Goiters in Kano; Nigeria

Cancer is an occasional incidental finding in nodular goiter; but there has been no formal study on this disease in our locality. To determine the occurrence of histologically diagnosed malignancy in patients who presentwith nodular goiters. This is a 7- year (2000-2006) retrospective study of all histologically diagnosed malignancies within nodular goiters atAminuKanoTeachingHospital;Kano There were 160 multinodular goiters during the study period; out of which 24 (15.0) had histologically diagnosed cancer; and 1 out of the thirteen patients with solitary thyroid nodule (7.6) had carcinoma. The ages of the patients with carcinoma ranged from 16 to 65 years; with amean age of 38.8 years. Eighteen (72) were females; and 7(28) were males. Six out of the 25 cases of carcinoma were detected preoperatively by fine needle aspiration cytology. Well differentiated follicular carcinoma was the predominant histological type in 13(52) cases; followed by papillary in 10(40); medullary carcinoma in 1(4) and anaplastic carcinoma in 1(4) patient. One-seventh of nodular goiters in our center harbouredmalignancy; and follicular carcinomawas the prevalent histological type. This is consistent with the findings elsewhere in endemic goitrous regions. Ultrasound guided fine needle aspirationwould improve preoperative diagnosis and guide appropriate surgical management

The effect of aqueous extracts of Hibiscus sabdariffa (Sorrel) calyces on heamatological profile and organ pathological changes in Trypanasoma congolense ­ infected rat

Abstract: The effects of aqueous extract of Hibiscus sabdariffa calyces on haematology and pathological changes in some selected organs during experimental Trypanosoma congolense infection of rats were investigated. Three groups of rats were intraperitoneally infected with T. congolense (Karu stock). One group was administered with the aqueous extract and another given a solution of vitamin C in drinking water; the remaining infected group was left untreated. Data from these groups were compared with those of two groups of healthy rats, one of which was similarly treated with the aqueous extract. The experiment was terminated three weeks, post-infection (pi). The uninfected and infected rats administered the extract consumed the equivalent of 9.94 mg ­ and 9.61 mg ascorbic acid / 100g / day during the experiment. Consumption of the extract significantly (p<0.01) retarded the rate of weight gain in both healthy and infected rats; even though the feed-intake was not significantly affected. After two weeks of infection the extract and vitamin C kept the parasitaemia significantly (p<0.01) lower than the untreated infected group. The anaemia in the untreated infected group was significantly (p<0.01) more severe than that of the corresponding extract- or vitamin-treated groups. Trypanosoma congolense infection caused significant (p<0.01) decreases in serum total proteins and albumin; serum and organ ascorbic acid as well as significant (p<0.01) elevation of serum alanine amino transferase levels in untreated rats. Consumption of the extract or vitamin C, however, prevented these disease­induced anomalies in the treated infected rats. Serum creatinine and urea levels were not affected by infection but the extract elevated these parameters significantly (p<0.01) above infection levels. It was concluded that consumption of the extract ameliorated the pathological changes in blood and organs of T. congolense-infected rats

Kaposi's sarcoma in the northern part of Nigeria: pre-aids era

Background: In the last two decades; the incidence of Kaposi's sarcoma has increased due to acquired immune deficiency syndrome epidemic. This study was designed to highlight the characteristic features of Kaposi's sarcoma in our centre before this epidemic. Method: In a retrospective study; all histologically diagnosed cases of Kaposi's sarcoma at Pathology Department; Ahmadu Bello University Teaching Hospital; Zaria; before acquired immune deficiency syndrome epidemic (1971 - 1980) were retrieved from histopathology register and analysed. Results: A total of 37 cases of Kaposi's sarcoma were diagnosed during the period of study; constituting 0.73of the total number of histologically verified cancers from all sites during the same period. Male to female ratio was 5:1. Two cases occurred in children while the peak age of occurence was the third and fourth decades. Lower limb and the lymph node were the most frequently involved site by the disease. Conclusion: Kaposi's sarcoma was relatively rare in the Northern region of Nigeria in the pre-acquired immune deficiency syndrome epidemic and could present clinically as lymphadenopathy

Cancer in Nigeria: a 10-year analysis of the Kano Cancer registry

Background: Cancer is a major health problem in developed countries and epidemiological evidence shows the emergence of a similar tend in developing countries; particularly in sub-Saharan Africa where HIV/AIDS is predicted to augment the cancer burden. The present study analyses the profile of cancers recorded in the first decade (1995-2004) of establishment of the Kano cancer registry (KCR) a histology/ cytology-based registry in Kano; Nigeria. Methods: Records of cancer cases diagnosed based on histology or cytology and entered into the registry were retrieved and categorized by type/ organ sites affected according to International Classification of Diseases for Oncology.Results: There was a steady rise in frequency of cancer over the period where a total of 1990 cancer cases were recorded comprising of 1001 (50.3) males and 989 (49.7) females. Cancers of the cervix (22.9); Breast (18.9); Ovary (8.2); non-melanoma skin cancer (6.3); and Uterus (6.2) were the most frequent female cancers. In males; cancer of the prostate (16.5); bladder (10.2); non-melanoma skin (9.9); colorectum (9.3) and connective tissue (6.3) were most common.Burkits lymphoma (31.4); other lymphoreticular cancers (23.8) and retinoblastoma (20) predominated in children. Conclusion: The KCR supports existing predictions of an increase in incidence of cancers in developing countries. There is need for establishment of comprehensive cancer control programmes in developing countries for the common cancers of the cervix; breast; prostate; bladder; skin and colorectum which are amenable to prevention; early detection and cure

Radical Cystectomy for Locally Advanced Carcinoma of the Bladder in Kano; Nigeria

Objective: Bladder cancer is the second most common genito-urinary malignancy worldwide. The objective of this study was to assess the benefit of radical cystectomy on locally advanced bladder carcinoma in terms of improved quality of life and survival in our environment. Patients and Methods : The records of 58 patients with bladder carcinoma managed at Aminu Kano Teaching Hospital over a 5-year period (May 2000 to April 2005) were reviewed and analysed. Excluded were 28 patients with distant metastatic disease discovered during clinical investigation. Results: Thirty patients (25 males and 5 females) with a mean age of 50.5 years and variable symptoms underwent radical cystectomy for locally advanced carcinoma of the bladder. Urinary drainage was achieved by orthotopic ileal neobladder in 15 patients (50); continent cutaneous reservoir in 11 patients (36.7) and non-continent drainage in 4 patients (13.3). A 40survival was achieved at 6-60 months. Conclusion : Radical cystectomy is a worthwhile procedure in locally advanced carcinoma of the bladder and cure may be achieved in selected patients