Background: Approximately 70% of urinary bladder cancer are non-muscle invasive at presentation. It is notorious for its high incidence and recurrence rate. The five-year recurrence rate varies between 30 and 60%. The intravesical treatment evolved out of need to prevent tumour recurrence after local surgical resection.Objectives: To compare intravesical Mitomycin C and BCG therapies in the prevention of recurrences and severity of their side effects.Materials and Methods: 40 patients with superficial bladder cancer were studied in urology unit of surgery department of North Bengal Medical College, Darjeeling from June, 2012 to May, 2013. They underwent transurethral resection of bladder tumour. Post operatively 19 patients were treated by intravesical Mitomycin C and 21 patients with BCG. Post intravesical therapy, patients were monitored 3 monthly for recurrence and side effects.Results: No recurrence was observed at the 3rd month follow up, two recurrences were observed at the end of 6th month in the Mitomycin C group. Regarding side effects, cystitis had no significant difference between the two groups but fever, hematuria and retention of urine were found significantly in BCG group during the study period.Conclusions: In the prevention of recurrences, intravesical Mitomycin C and BCG therapies have comparable efficacies at the end of 6 months. A further follow up period is required to see and compare the long term results. The incidence of the side effects although mild was much higher with intravesical BCG therapy.Bangladesh Journal of Medical Science Vol.15(1) 2016 p.74-77
Abstract:Background: Definitive diagnosis of acute appendicitis preoperatively is sometimes difficult. Failure to make a diagnosis is the main reason for persistent rate of morbidity and mortality. Various scoring systems are devised to aid diagnosis of acute appendicitis. In some studies the modified Alvarado score was helpful, reliable and practical in minimizing unnecessary appendectomy. Objective: The purpose of this study was to evaluate the usefulness of modified Alvarado score for the diagnosis of acute appendicitis. Materials and Method: A prospective study of 89 adult patients, admitted with abdominal pain suggestive of acute appendicitis, from July 2011 to June 2012, was conducted. Data including clinical signs and symptoms and laboratory findings were recorded in modified Alvarado score record form. All 89 patients underwent appendectomy. Final diagnosis was confirmed by histopathological examination. Reliability of scoring system was assessed by negative appendectomy rate and positive predictive value. Results: Out of 89 patients who underwent appendectomy, 85 had acute appendicitis on histopathology. Positive predictive value was 95.5% and negative appendectomy rate was 4.5%. 52.8% had score 7 or above and 47.2% had score less than 7. From score it is difficult to predict which patient warranted appendectomy and who may be safely observed or discharged. Conclusions: Diagnosis of acute appendicitis remains mainly clinical evaluation and it is more helpful than modified Alvarado scoring system in adults.
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