Aborted sudden nocturnal cardiac death in young man with structurally nomal heart

Sudden cardiac death is a devastating event, particularly when it occurs to young, otherwise healthy individuals. We report here a young Burmese male who survived sudden cardiac death with structurally normal heart. His electrocardiogram revealed features consistent with Brugada syndrome. He was referred for intra-cardiac defibrillator implantation. In this article, in addition to the case presentation, a review of Brugada syndrome medical literature is also presented

Superficial bladder cancer PT1G3: management controversies

To evaluate and identify high risk patients having superficial bladder cancer and to assess the role of radical cystectomy as primary treatment modality. An eight-year retrospective analysis of bladder cancer patients presenting to SlUT was undertaken. After clinical evaluation and routine laboratory investigations, IVU, sonography, CT Scan/MRI, cystoscopy, histopathology, were performed when indicated. A follow-up cystoscopy was carried out at regular intervals [3-6 months] up to a maximum of 8years. Of the 550 [59.7%] patients diagnosed as urothelial tumours, 61/330 [18.4%] had pT1G3 disease, with a male to female ratio of 14:1. Most of the cases [81.7%] were between 41-70 years of age. Haematuria was the presenting symptom in every case, followed by frequency 82.4%, dysuria 32.7% and clot retention 32.7%. There was no significant occupational association, however 25 [40.9%] were smokers for over 25 years. Filling defect on IVU was seen in 52 [85.2%] cases whereas Sonogram revealed echogenic masses in 44 [72.4%]. The morphological site, as per CT scan and cystoscopy was 72.1% lateral wall, 6.6% dome, 3.3% base and 18% were multicentric disease. Growth less than 1 cm was seen in 27%, 1.5 cm in 41% while greater than 5 cm in 32% of cases, All patients underwent endoscopic resection. Intravesical Mitomycin C was given to 27 and BCG to 15 cases. Of the high risk patients, 12 were primarily treated by radiation therapy whereas 22 underwent primary radical cystectomy and 16 had a salvage cystectomy and ileal conduit. Recurrence of the carcinoma was seen in 12 patients who had received intravesical chemo/immunotherapy, in 8 treated initially with radiotherapy and 8 subjected to radical cystectomy. The management of pT1G3 is still a controversial area of carcinoma bladder treatment. In view of the high cost of therapy, fast progression, high recurrence rate and metastasis, we in our setup recommend an early radical surgery in pT1G3 disease. This not only eliminates the lesion but is also cost effective

Prevalence of genitourinary tuberculosis

The purpose of study was to diagnose and treat genitourinary tuberculosis in the Pakistani population and to save the organs before they were irreversibly damaged. Patient and methods: A total number of 45 cases were included in the two year study. All the cases were treated as out patients unless some surgery was required. Diagnosis was based on positive urine cultures for tuberculosis, typical histological findings or both. In few cases diagnosis was presumptive and subject to response to empirically given anti-tuberculosis therapy, was diagnostic. Chemotherapy was given for 6 months. Of the forty five cases 29 were males and 16 females. The commonest clinical presentation were non-specific bladder symptoms. Low grade pyrexia was not very common. Pyuria was present in 78% of cases, and of these 49% had sterile pyuria. In 47% urine stain for AFB was possible while urine culture for AFB was positive in 38% cases. Genitourinary tuberculosis should be suspected in presence of sterile pyuria, chronic cystitis, epididymitis, haemospermia and chronic discharging scrotal sinuses