Outcome of partial cystectomy for non-urothelial urinary bladder malignancies  in a tertiary care urology unit in Sri Lanka

Introduction: Non-neoplastic urinary bladder lesions are not life threatening, but are an important source to cause clinical symptoms and signs. However, neoplasms of the bladder are a source of morbidity, mortality, and exhibit more clinical challenges. Cystoscopy provides overall information about an anatomical/pathological condition of the urinary bladder which will be helpful for patients' management. A cystoscopic biopsy is a primary diagnostic tool for diagnosing urinary bladder cancer. Objectives: The objective of the study was to find the frequency and histomorphological characteristics of urinary bladder lesions in Dhulikhel Hospital, to find the clinical presentation of urinary bladder lesions and to grade the urothelial tumors based on the World Health Organization (WHO)/ International Society of Urological Pathology (ISUP) classification 2004. Methodology: This was a retrospective, cross-sectional, observational study carried out in the Department of Pathology, Dhulikhel Hospital-Kathmandu University Hospital. Convenient sampling was done. All cystoscopy biopsies received from January 2014 to December 2018 were studied. All tissue blocks were retrieved, cut, and stained with Hematoxylin and Eosin. The stained slides were examined under a light microscope by the primary investigator. Result: A total of 70 cystoscopic biopsies were analyzed. The majority of patients 20 (28.6%) were in the age group between 60 and 69 years and males were predominant 43 (61.4%). The neoplastic lesions constituted 40 (57.1%) of all bladder lesions, among them urothelial carcinoma accounted for 38 (54.2%). Similarly, chronic cystitis 27(38.6%) was the most common non-neoplastic lesion. Conclusion: The study found that the neoplastic lesions were commonly encountered in urinary bladder lesions. Among them, lowgrade urothelial carcinoma was the most common bladder tumor. However, most of the non-neoplastic lesions were inflammatory in origin. Cystoscopy combined with histomorphological examination helps in the early detection of bladder lesions.

Download Full-text

Pediatric Autoimmune Encephalitis in Sri Lanka: A Single-Center Experience over 7 Years

Journal of Pediatric Neurology ◽

10.1055/s-0041-1739260 ◽

2021 ◽

Author(s):

Jithangi Wanigasinghe ◽

K. W. D. A. Anuradha ◽

Thashi Chang

Keyword(s):

Sri Lanka ◽

Tertiary Care ◽

Cerebral Performance Category ◽

Autoimmune Encephalitis ◽

Normal Function ◽

Substantial Improvement ◽

Older Children ◽

Surface Binding ◽

Delay In Diagnosis ◽

Single Center Experience

AbstractPediatric autoimmune encephalitis (AE) remains a diagnostic and therapeutic challenge in resource-poor settings. Minimizing delay in diagnosis and appropriate escalation of treatment will help reduce both the short- and long-term neurodisabilities. A retrospective observational study was performed on children consecutively diagnosed with possible AE and then prospectively followed up in a single tertiary care children's hospital in Sri Lanka. Serum and cerebrospinal fluid were tested for neuroglial surface-binding autoantibodies using cell-based assays in majority of these children. Twenty-five children (mean age 7.6 years, standard deviation = 4) were recruited. In these children, presenting symptom was psychiatric in 11 children (44%), seizures in 10 (40%), language regression in 2 (8%), and combination of psychosis and convulsions in 2 (8%). Psychiatric presentations were more common in older (>6 years) compared with young children (p = 0.001), while neurological presentations were more common in children aged ≤6 years (p = 0.001). N-methyl-D-aspartate receptor (NMDAR) antibodies were detected in 9 (45%) and unspecified voltage-gated potassium channel antibodies in 1 (5%) of the 20 tested. All received intravenous steroids and immunoglobulins; 19 (76%) plasma exchange; 7 (29%) rituximab. Complete/substantial improvement at 3 months occurred in 64%. Pediatric Cerebral Performance Category score at last review was 1 (normal function for age) in 43%. Higher proportion of younger children required less intense therapy and had better recovery (56%). Death (8%), incomplete recovery (71%), and relapses (8%) were more in older children. Clinical presentation and disease outcomes were different in children aged <6 years compared with older age group. NMDAR antibody encephalitis was the commonest AE syndrome identified in this cohort.

Download Full-text