Treatment of muscle invasive bladder tumor comparison between chemotherapy and cystectomy

Bladder Tumor is the second most common cancer of the genitor-urinary tract. Male to Female ratio: has been demonstrated as 3.5:1. To compare the efficacy of combined chemotherapy/or radical cystectomy with or without urinary diversion. The present study was conducted on 26 consecutive patients of either age and sex having histologically proven muscle invasive transitional cell carcinoma of the bladder .These patients were selected from different hospitals in Lahore including Lahore General Hospital, Mayo Hospital, Shaikh Zaid Hospital, and Services Hospital from 1994-1996. These patients were thoroughly investigated. At the initial diagnosis 18-30% of patients of bladder tumors are muscle invasive and 70% superficial. Although radical cystectomy is the treatment of choice for invasive bladder tumor, bladder-sparing technique are more often being used e.g. TURGB and Intra-vesicle chemo/immunotherapy in superficial bladder cancer, TURGB and Systemic chemotherapy in muscle invasive tumor. The use of combination Chemotherapy in advance disease is routine e.g. CMV and MVAC. In our present study a total of 26 consecutive patients of either age or sex having histologically proven muscle invasive tumor of bladder were included. These patients were collected from different hospitals at Lahore, from 1994 to 1996. Out of these 26 patients, 13 patients were included in group-A, [they were given MVAC chemotherapy] and the remaining 13 patients were included in group B, [in these patients cystectomy and urinary diversion were done]. It is concluded that the result using combined Chemotherapy MVAC are better [20%] as compared to total cystectomy/urinary diversion [12.23%] after one year follow up

Efficacy and safety of intra-vesical B.C.G in superficial bladder tumor after TURGB

To determine the effectiveness, safety and side effects of intra-vesicle B.C.G immuno-therapy in superficial bladder tumor after TURGB. Observational study / Quasi-experimental. Bolan Medical College Teaching Hospital Quetta, from August, 2004 to July, 2008. Patients age ranges from 40 to 75 years.21 males and 4 females, with proven superficial bladder tumor [Ta-Tl]were included after TURGB in this study. These 25 patients underwent intra-vesicle immunotherapy [BCG.].These patients were followed up for two years and extent of improvement in presenting symptoms, recurrence of tumor, side effects and complications were noted. Out of 25 patients 23 patients [92%] received BCG immunotherapy after TURGB. Out of these 23 Patients 15 patient [65.2%] showed complete response and 6 patients [26.08%] showed partial response while remaining 2 patients [8.69%] had constant progression in disease and underwent cystectomy. It was concluded that B.C.G immunotherapy is very effective and save patients from recurrence and cystectomy

Evaluation of Different Medicinal Plants [Species] at KARINA Juglote [Sai] Northern Areas Gilgit

Northern Areas of Pakistan are rich in flora comprising huge quantities of medicinal plants. Thousands of medicinal plants are unidentified due to lack of research and financial resources. At the KARINA, research work is underway with respect to identification, collection and cultivation methodology to grow these valuable medicinal plants from high altitude to low altitude to see their adaptability in farmers fields. After successful cultivation of medicinal plants; this technology will he transferred to the end users/farmers

Evaluation of low ligation and high ligation procedures of varicocele

To describe the mode of presentation of varicocele and to compare the low ligation [Inguinal approach/Ivanissevich's procedure] and high ligation [Retroperitoneal approach / modified Palomo's procedure] of varicocele repair regarding efficacy and postoperative complications. Design: Institutional-based randomized comparative clinical trial. Place and Duration of Study: This study was conducted at the Urology Department, Bolan Medical College and Sandeman Provincial Teaching Hospital, Quetta from December 1996 to November 2001 [5 years]. Subjects and A total of 213 patients of varicocele who underwent treatment in the department and completed 6 months follow-up were included in the study. The mode of presentation of varicocele was recorded for all patients. For treatment purpose patients were randomly divided into two groups: in group I [n: 115] varicocele was ligated by inguinal approach [Ivanissevich's procedure] while in group II [n: 98] by retroperitoneal approach [modified Palomo's procedure]. The efficacy and postoperative complications of the two procedures were carefully recorded and compared between the two groups. The mean age of the patients of group-I and group-II was 27.2 and 27.5 years respectively. More than 50% patients of both groups presented with feeling of heaviness/ dragging sensation on ipsilateral side. Presentation with infertility/sub fertility in group-I and group-II was 16.5% and 15.3% respectively. Majority of patients of both groups had grade III varicocele with visible deformity. The rate of postoperative complications was very low in both groups of patients. Recurrence of varicocele and postoperative hydrocele formation were slightly more common in group-II as compared to group-I but the difference was statistically not significant [p>0.05]. An extremely significant improvement occurred postoperatively in both sperms density and motility in infertile /sub fertile patients of both groups. Both procedures of varicocele repair are equally effective and have a low rate of complications. There is no significant difference in postoperative complications. An extremely significant improvement occurs in semen parameters of infertile/sub fertile patients postoperatively, irrespective of method / technique of varicocelectomy

Retrocaval ureter

Two cases of retrocaval ureter are reported. A 22 years old male patient presented to us with the complaints of right flank pain and hematuria and a child of 2 years referred to us for evaluation of right side moderate hydronephrosis detected on ultrasound. The diagnosis was confirmed on intravenous urography and retrograde pyelography. Both the ends were transected and anastomosed above a JJ stent in front of the inferior vena cava. Postoperatively the patients remained asymptomatic and the hydronephrosis improved