ABSTRACT
Background: Transurethral resection of bladder tumour (TURBT) is the primary treatment modality for Non-muscle invasive bladder cancer (NMIBC). Restaging transurethral resection of bladder tumour (RETURBT) is indicated to reduce risk of residual disease and correct staging errors after primary TURBT. The aim of the study is to evaluate the risk of residual tumour and upstaging in NMIBC after TURBT and to investigate the risk factors for the same.Methods: A prospective observational study was carried out over 4 years and 87 patients were included in the study. Patients with NMIBC underwent RETURBT after 2-6 weeks of primary TURBT. The incidence of residual tumour and upstaging in RETUBRT was correlated with various histopathological and morphological parameters in primary TURBT.Results: Out of 87 patients, who underwent RETURBT, residual disease was present in 51 patients (58.6%) and upstaging occurred in 22 patients (25.2%).On univariate analysis, T1 stage (p=0.01), high grade (p=0.01), Carcinoma in situ(CIS) (p=0.01) and multifocality (p=0.05) were predictive for residual disease in RETURBT. High grade (p=0.01), CIS (p=0.01) and absence of detrusor muscle in specimen (p=0.03) were risk factors for upstaging in RETURBT.Conclusions: NMIBC have high incidence of residual disease and upstaging after primary TURBT. T1 stage, high tumour grade, CIS, and multifocality are risk factors for residual disease after primary TURBT. High tumour grade, CIS and absence of detrusor muscle are strongly associated with upstaging during RETURBT.
ABSTRACT
Background: The main cause for most of the old age complication is due to derangement of cardiovascular and autonomic nervous activity. This study was proposed to record and asses the HRV in elderly population involved with respect to Body mass index to predict and prevent further deterioration and thereby help the elder to lead more normal, healthy and active life. Materials& methods: 80 normal volunteers were selected, with ages between 55 to 85 years. They were evaluated clinically for Heart rate variability (HRV) and body mass index. Based on BMI, subjects were divided in to two groups. Group I with 40 subjects whose BMI was ≤25 and group II with 40 subjects whose BMI was 25 to 30. To assess the autonomic changes, in this study different parameters of HRV were recorded in both the groups and compared during normal (N), deep breathing (DB) and cold pressor test (CPT) conditions. Results showed that the SDANN, Time domain HRV was more in subjects with high BMI when compared to subjects with normal BMI during normal condition, in CPT condition parasympathetic activity was more in subjects with high BMI compared to subjects with normal BMI. Conclusion; This study showed in old age higher the BMI more the HRV and the degree of parasympathetic activity was more in higher BMI.
ABSTRACT
A transnasal endoscopic dacryocystorhinostomy was performed as a definitive treatment for a post-traumatic nasolacrimaI duct obstruction. This approach avoids external scarring and trauma to the medial canthal region which accompanies external dacryocystorhinostomy.A brief description of the procedure and review of relevant literature is presented