Impact of gemcitabine and cisplatin with radiotherapy in locally advanced or metastatic transitional cell carcinoma of urinary bladder

The primary object of this study is to evaluate the efficacy and safety of Gemcitabine and Cisplatin along with radiotherapy in transitional cell carcinoma of urinary bladder. Patients and Twenty patients with locally advanced or metastatic TCC of urinary bladder were enrolled during the 22-months period from January, 1999 to October, 2000 and followed up till March 2002.Three patients received 4 cycles, five patients received 5 cycles and twelve patients received 6 cycles of Gemcitabine 1250mg / m2 on day 1 and day 8 and Cisplatin 80mg / m2 on day 1; administered every 3 weeks. No patient received prior chemotherapy, radiotherapy or surgery. However, four patients received prior intravesical chemotherapy. All patients received radiotherapy after completion of chemotherapy regimen. Nineteen patients achieved complete response at the end of the treatment. The complete response rate was 95%. The confidence interval was at 95%, level of confidence ranged from 85% to 100%. Median duration of clinical benefit was 21 months. Six patients [30%] were documented neutropenia, three patients [15%] documented thrombocytopenia. No life threatening toxicity was observed. Gemcitabine and Cisplatin along with radiotherapy in locally or metastatic Transitional cell carcinoma of urinary bladder, exhibited pronounced response rate among all the patients. The toxicity profile remained extremely low and disease free survival enhanced. The above investigation may further be continued at a larger scale encompassing a wide band of subjects

Value of ophthalmic examination in diabetics by house officers and patient awareness of complications

A cross-sectional, hospital-based study was conducted to assess the efficacy of ophthalmic examinations by house officers as part of the routine examinations of diabetic patients on a surgical ward. After obtaining a brief history of the illness, a questionnaire was completed, following which fundal examination of dilated pupils of each patient was made by the house officer. The patient was subsequently referred to the consultant ophthalmologist who also examined the patient in order to confirm or negate the house officer's findings. Of the 88 eyes examined by the house officer 50% were found to have an abnormality, of which 86% were successfully picked up by the house officer. The results of our study show that the sensitivity is high for the common presentations of diabetic retinopathy, such as background changes [right eye 88.8% and left eye 88.2%], and associated changes such as cataracts [right eye 86.6% and left eye 92.3%]. Sensitivity for the diagnosis of the normal fundus [right eye 85.7% and left eye 73.9%] was also high. The readings were not significant for the more difficult-to-detect changes, such as maculopathy, proliferarive retinopathy and previous laser therapy. Twenty one [47.7%] of the patients were aware of the effects of diabetes on the eye, while fifteen [34%] denied that diabetes had any effect and the rest were uncertain. Ophthalmic examination of the dilated eye should form part of the routine examination of diabetic patients. Every effort should be taken to screen and educate patients with diabetes

Age of natural menopause in Pakistani women

A study on 300 menopausal women from different parts of Pakistan was carried out. The average age of menopause was found to be 47.4 years. Women with early menarche had late menopause [52.1 years] as are the women with high parity [49.2 years]. Women belonging to a low socio-economical group had early menopause [46.6 years]. This study also showed that only 7% of women in the country are aware of hormone replacement therapy