Muscle-invasive bladder cancer is an aggressive disease associated with high morbidity and mortality. Radical cystectomy is the mainstay of treatment and has evolved since the first reported cystectomy in 1887 to include pelvic lymph node dissection and the creation of increasingly sophisticated urinary diversions, such as neobladders and pouches, which enable patients to maintain continence. Pioneering work in the 1970s established the therapeutic activity of cisplatin in patients with bladder cancer and resulted in the introduction of cisplatin-based neoadjuvant chemotherapy, which led to the first improvement in survival outcomes in decades. Other notable advances include the development of bladder-sparing protocols, which combine surgery, chemotherapy, and radiotherapy. Molecular profiling of bladder cancer has helped to enhance our understanding of tumour biology and identify several therapeutic targets, such as programmed death (PD-1) and its ligand programmed cell death ligand 1 (PD-L1). Over the past 3 years, immune checkpoint inhibitors targeting the PD-1-PD-L1 axis have demonstrated the ability to achieve durable objective responses in trials of patients with metastatic disease. If the current momentum continues, immunotherapy is poised to change the landscape of muscle-invasive bladder cancer treatment, promising improved survival outcomes for patients with this disease.

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Optimal NAC resulted in a better RFS and OS when compared with suboptimal or no NAC. Suboptimal and no NAC were associated with worse OS and RFS. These findings will facilitate improved patient counseling and treatment selection.

A total of 155 prostitutes inhabiting 4 different districts in Mogadishu, Somalia, were enrolled in a 6 month prospective study of syphilis and HIV infection. Blood samples were taken on entry, at 3 months and at 6 months. Differences were seen between the prostitutes in the 4 districts regarding possible risk factors for the acquisition of STDs. Initially 107 (69%) were found to have syphilis serum markers and 47% had active syphilis as judged by positivity in both Treponema Pallidum Haemagglutination (TPHA) test and non-treponemal (VDRL and RPR) tests. TPHA positivity was correlated to the number of sexual partners. Sixty-nine prostitutes were followed for 6 months. Two of the 16 initially TPHA negative women seroconverted for syphilis during the follow-up. HIV antibodies were detected in one (0.6%) of the 155 prostitutes at the start of the study and one out of 68 seroconverted during the 6 months follow-up. To control the spread of HIV infection health education targeting the risk groups like prostitutes must be given a high priority.

We developed a method to estimate operative times for RARC based on patient, disease, and institutional metrics that can help operating room scheduling for RARC.

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Background: placenta praevia is an obstetric complication in which the placenta is inserted partially or completely in the lower uterine segment, A significant proportion of these cases is associated with life threatening hemorrhage during delivery, often by caesarean section in the vast majority of cases, many procedures introduced to overcome this problems, none of them is completely successful. Aim of the work: this study aimed to compare between local vasopressin injection in the placental bed and bilateral internal iliac artery ligation on the blood loss during caesarean section for placenta praevia. Patients and Methods: this a randomized-controlled prospective trial included 60 pregnant women with a diagnosis of placenta praevia, they were categorized into 3 equal groups according to methods to control blood loss during cesarean section for placenta praevia. Group 1 included 20 pregnant women who underwent vasopressin injection at placental site. Group 2 included 20 pregnant women who underwent bilateral internal iliac artery ligation. Group 3 included 20 pregnant women who underwent caesarean section without internal iliac artery ligation or local injection of vasopressin (The control group), comparison between groups were done and statistically analyzed. Results: there were statistical significant differences between the intervention and the control groups as regard estimated blood loss, P value was <0.001; group 3(Control) had more amounts of blood loss, there were no statistical significant differences between group 1 and group 2 as regard estimated blood loss, P value was > 0.05. Comparison between group1 and group 2 showed that internal iliac artery ligation was significantly associated with prolonged operative time than vasopressin injection(P value was <0.001). Conclusion and Recommendation: local injection of vasopressin at placental site seemed to be a promising modality for reducing blood loss during cesarean delivery for placenta praevia and was associated with similar reduction of blood loss and less operative time when compared with internal iliac artery ligation, may be done first before trying internal iliac artery ligation and needs no experience.

Carbohydrate antigen 125 (CA125) is an antigen used in the diagnosis of epithelial nonmucinous ovarian cancers. CA125 may be elevated in many benign and malignant conditions, so elevated levels can cause confusion over patient management. The multidisciplinary team is important when planning care for patients with suspected ovarian cancer. Learning objectivesTo know the factors leading to CA125 production and its mechanism of action.To understand how CA125 is used as a diagnostic tool and to assess the treatment response of ovarian cancer. To appreciate patient care options in cases of falsely elevated CA125. Ethical issuesIs the CA125 blood test being used in patients appropriately and safely? In patients with elevated CA125 levels, does this lead to unnecessary investigations and invasive treatments? Keywords: CA125 / gynaecological causes of raised CA125 / nongynaecological causes of raised CA125 / ovarian cancer / ovarian cancer follow-up