ABSTRACT
Objectives: this study was designed to estimate the value of a second transurethral resection of bladder tumor in patients with initially diagnosed T1 High-grade bladder cancer
Material and Methods: between October 2008 and November 2015, a total of 350 patients were diagnosed with T1 high grade non-muscle invasive bladder cancer. These patients were divided into two groups. Group A: 150 patients who underwent an early reresection. Group B: 200 patients who did not undergo early re-resection. Data were collected retrospectively which included patient's history, physical examination, and investigation, histological parameters including presence of detrusor muscle at initial TUR and at second TUR, recurrences and progression rates
Results: the detrusor muscle was present in 90 patients out of 150 patients [60%] in Group A and in 158 patients out of 200 patients [79%] in Group B, at initial TUR. At early re-resection, detrusor muscles were present in 76.67% of patients. The residual tumor was present in 55% of re-resected patients. The overall incidence of tumor recurrence was 34.66% and 42% in Groups A and B, respectively. There was a significantly higher rate of tumor progression in patients who did not undergo early re-resection during follow up. [Group 14.28% v. s. Group 3.85% P<0.05]
Conclusion: a second TUR should be routinely advised in all patients with T1 high grade bladder cancer, to achieve a complete resection and to identify patients who may need to undergo radical cystectomy
ABSTRACT
Carcinoma of the Breast is the commonest carcinoma in the females; the incidence being one woman out of every 11 women. The disease can also develop bilaterally, rarely. In this report we are presenting the case of a bilateral carcinoma breast in a female aged 35 years
ABSTRACT
Screening for cancer of the cervix remains a neglected health care issue in Pakistan. To provide baseline data for future efforts to improve screening, we conducted a retrospective analysis of cervical smears taken in the obstetrics and gynaecological clinics of the Aga Khan University Hospital, Karachi, Pakistan. Method: We collected data on cervical smear cytology for cervical smears taken from January 1, 1990 to December 31,1996. We assessed risk factors for dysplasia, including age, age at first marriage, and number of pregnancies. The overall prevalence of abnormal smears in our study was 0.5%. Of 20,995 cervical smears, 12,451 [59.3%] smears showed non-specific inflammation, 7302 [34.8%] were reported as normal, 809 [3.85%] showed monillial infection, 148 [0.71%] showed atypia, 105 [0.5%] had dysplastic cytology, and 52 [0.25%] samples were inadequate. The highest incidence of dysplastic smears was seen in the age group 35 to 44 years. Of 105 patients with dysplasia, 12 were pregnant, and all were asymptomatic, while in 93 non-pregnant women, 33 were symptomatic. The low prevalence of abnormal smears, compared with data from Western populations, could be due to the inherent bias of health awareness in the women who attended our hospital. The results of this study may serve as a baseline for future comparisons. A larger community-based study may establish the exact prevalence of malignant and premalignant lesions so as to plan for future screening