International Research Journal of Medicine and Medical Sciences

13-26

Authors: Ashraf Elyamany, Mohamed Aboziada and Hamza Abbas

Cancer bladder represents the fourth most common cancer in men and ninth most common cancer in women. It is the second most prevalent cancer in men 60 years of age or older in United States. Radical cystectomy is the most widely used treatment for invasive bladder cancer. Radical cystectomy and urinary diversion has long-term effects on urinary, gastrointestinal and sexual function, and changes the body image of patients who use incontinent urinary diversions. Five-year specific and overall survival rates are 68% and 40 to 60%, and that is probably dependent upon the existence of micrometastases at the time of diagnosis. Clinical trials in the adjuvant setting require large numbers of patients to detect a survival advantage. It has been difficult to demonstrate a survival benefit from adjuvant chemotherapy. Neo-adjuvant cisplatin-based combination chemotherapy resulted in a significant 14% reduction in the risk of death, which translated into a 5% absolute improvement in five-year OS (from 45 to 50%). In appropriately selected patients, bladder preserving treatment with transurethral resection, radiation therapy and concurrent chemotherapy offers a probability of long term cure and overall survival at 5-years is comparable to cystectomy-based approaches (49 to 63% at 5 years) in patients of similar clinical stage and age. Five-year survival with bladder preservation is 40 to 45%. In addition, these selective bladder-preserving approaches result in approximately 80% of the long-term survivors maintaining a normal functioning bladder. Keywords: Bladder cancer management, bladder preservation, cystectomy, chemotherapy bladder cancer.

34-39

Authors: Mohammed Hegazy and Eman Taher

Child resuscitation requires actual weight measurement if possible. Multiple pediatric weight estimations are now available. Garwood and McEwen developed a new formula (age in months/4) +6. The aim of the study is to validate this formula versus advanced pediatric life support formula and Shann formula among pediatric cancer patients. Cross sectional study was conducted in 508 pediatric patients aged 1 to 16 years attending outpatient clinic at the children cancer hospital (57357 hospitals). Their age and actual weight were recorded. Accuracy of weight estimation was done using mean bias, 95% agreement, mean percent error, and estimation within 10 and 20% from actual weight. The mean bias from actual weight of the new formula was 1.3 kg versus -2 kg for Shann formula. The new formula outperformed the other two formulae in the age group 11 to 16 with a mean bias 0.8 kg and percent error -5.9% versus 8% for Shann formula. The new formula is among the more accurate age-based weight estimation formulae especially for older children. It is an acceptable option for estimating children's weight. Keywords: Advanced Pediatric Life Support formula, Garwood and McEwen formula, pediatric weight estimation, Shann formula.

43-50

Authors: Mohamed Abd El Ghafar

The aim of this study is to compare electric vacuum aspiration (EVA), manual vacuum aspiration (MVA) and uterine curettage (D&C) for first trimester abortions, in terms of the efficiency of eliminating ovular remnants, frequency of complications, duration of the procedure, and duration of patients' hospitalization. In a prospective study, 50 patients in EVA group, 50 patients in the MVA group and 50 in the D&C group were randomly included. Inclusion criteria were: spontaneous abortion, gestational age less than 12 weeks, patent cervix, endometrial thickness >15 mm, afebrile state, and hemoglobin >9 g/dl. Blood samples were collected before and after surgical procedures for control of hemoglobin levels. Anesthesia was performed in all cases. The time required for each surgical procedure was recorded. Groups were similar regarding gestational age and endometrial thickness before surgery. Durations of the procedure and of hospitalization were significantly shorter in the EVA and MVA group compared to the D&C group. EVA group showed the least incidence of complications regarding the amount of blood loss, uterine perforation and cervical laceration. Regarding the incomplete evacuation, both the EVA and MVA groups showed the same results. EVA caused less blood loss, was less time consuming, and resulted in shorter hospitalization. Keywords: Abortion, electric vacuum aspirations, manual vacuum aspiration, dilatation and curettage.