Risk Factors for Bladder Cancer: Results of a Survey of Hospital Patients

Introduction: Several risk factors have been identified in the occurrence of bladder cancer. These include genetic and hereditary factors, smoking and tobacco use, increased body mass index, occupational exposure to certain chemicals and dyes, medical conditions such as chronic cystitis and infectious diseases such as schistosomiasis. This study aimed to evaluate risk factors in patients with bladder cancer. Materials and Methods: All patients presenting to the uro-oncology department of the hospital with imaging and histology confirmed bladder cancer were included in the study. Age- and gender-matched patients presenting to the department of urology with benign disorders were prospectively included as controls. All the study subjects and the controls completed a self-administered structured questionnaire. Results: Seventy-two (67.3%) of the participants with bladder cancer were males. The mean age of participants with bladder cancer was 59.24 ± 16.28 years. Most participants with bladder cancer worked as farmers (35.5%) or industrial workers (24.3%). Recent history of recurrent urinary tract infections was seen in 85 (79.4%) of the participants with bladder cancer and 32 (30.8%) of controls. Diabetes mellitus was more common among participants with bladder cancer. A significant number of participants with bladder cancer used tobacco and smoked compared to controls. Conclusions: This study highlights numerous potential biological and epidemiological factors that may act as a risk factors for bladder cancer. These factors could explain the gender differences observed in the incidence of bladder cancer. In addition, the study indicates the intense

Diagnosis of Oral Cancers by Targeting VPAC Receptors: Preliminary Report

Introduction: Oral cancer is a major health problem. The study of exfoliative cytology material helps in the differentiation of premalignant and malignant alterations of oral lesions. The objective of this study was to assess the feasibility of detecting oral cancer by targeting genomic VPAC (combined vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase-activating peptide) receptors expressed on malignant oral cancer cells. Patients & methods: All patients with suspected oral cavity cancers/lesions formed the study group. The samples from the oral cavity lesion or suspicious area were collected with a cytology brush. The harvested material was examined for malignant cells by 1. the standard PAP stain and 2. targeting the VPAC receptors on the cell surface using a fluorescent microscope. Similarly, malignant cells were identified from cells shed in oral gargles. Results: A total of 60 patients with oral lesions were included in the study. The histopathological diagnosis was squamous cell carcinoma in 30 of these. The VPAC receptor positivity both on the brush cytology staining as well oral gargle staining was more sensitive than the brush cytology PAP staining. The accuracy of the various techniques was as follows, brush cytology PAP staining at 86.67%, brush cytology VPAC staining at 91.67% and oral gargle VPAC staining at 95%. Conclusions: This preliminary study validates our belief that malignant cells in the saliva can be identified by targeting the VPAC receptors. The test is simple, easy, non-invasive and reliable in the detection of oral cancers

Outcome of management of patients with BPH and vesical calculi

INTRODUCTION: The complications of benign prostatic hyperplasia (BPH) among others include bladder stones. The prevalence of vesical calculus is eight times higher in men having BPH (3.4%) as compared with men without BPH (0.4%). The guidelines suggest that BPH obstruction should be managed along with removal of bladder stones. The objective of the study was to study the outcome of surgery in patients with BPH and bladder calculi. MATERIALS AND METHODS: This prospective study included all patients undergoing surgical treatment for BPH with vesical calculi. Outcomes were measured in terms of blood loss, operating time, days of hospitalization, postoperative urinary flow, postvoid residual, and complications. RESULTS: Five (13.51%) patients underwent perurethral cystolitholapaxy, 17 (45.94%) underwent percutaneous suprapubic cystolitholapaxy, and the remaining 15 (40.54%) underwent open cystolithotomy for bladder stones. The prostate (BPH) was managed by monopolar transurethral resection of prostate (TURP) in 14 (37.83%), bipolar TURP in 12 (32.43%), and laser prostatectomy (Holmium enucleation) in the remaining 11 (29.72%). At the time of discharge, all patients were free of bladder stones and voided well. At 3-month follow-up, the mean Q-max was 18.65 mL/s. CONCLUSIONS: Simultaneous management of BPH and bladder stones is safe and effective. The procedure chosen for managing bladder stones depends on the size, number, and experience of the surgeon. Smaller stones can be easily managed by minimally invasive procedures such as perurethral cystolitholapaxy and percutaneous cystolitholapaxy

Diagnosis of cancer of the cervix by targeting VPAC receptors on exfoliated cervical cells

Introduction: Cervical cancer is a major cause of cancer morbidity and mortality in women. Screening for cervical cancer reduces mortality through early detection and treatment. The success of the screening for cervical cancer has been largely attributed to the use of Pap smear (Papanicolaou). The objective of this study was to assess the feasibility of detecting cervical cancer by targeting genomic VPAC receptors and compare the results with those of Pap-test. Material and Methods: Women ≥40 years of age underwent routine screening for cervical cancer. The cellular material obtained from the cervix was gently smeared on a clean glass slide. The slides were then stained according to Papanicolaou’s technique. Similarly, another set of prepared smears were used for VPAC receptor detection. Histopathological examination of the cervical biopsy was done and the results of all three tests were compared. Results: A total of 114 women attending the Gynaecology outpatient department of our hospital were included in the study. Histopathological examination (HPR) of the cervical biopsy revealed that 25 patients had cervical cancer and the remaining 89 were negative for cervical cancer. The Pap smear gave positivity for malignant cells in 20 (80%) of cases reconfirmed on HPR. The false positive rate and false negative rates were 4.5% and 20%, respectively. The VPAC receptors were positive in 23 (92%) of the 25 cases with cancer of the cervix. The false positive and false negative rates were 2.2% and 8%, respectively. Conclusions: Diagnosis of cancer of the cervix can be reliably made by targeting the genomic VPAC receptors. The test is simple to perform, reliable, reproducible and with minimal false positivity having a higher diagnostic accuracy