Introduction: Studies on bladder cancer in Sri Lanka have shown varying results in relation to clinicopathological characteristics and data on outcomes is limited. This study was aimed to describe the clinicopathological characteristics and outcomes of histologically confirmed urothelial bladder malignancies and to compare with previous studies.
Methods: A retrospective analysis of prospectively collected data of 314 newly diagnosed primary bladder malignancies between January-2007 and January-2017, was performed. After excluding the non-urothelial cancers, 289(92%) urothelial cancers (males=245, 84.8%, mean age = 65.4±SD10.9 years) were analysed. Data on clinical presentation, cystoscopic findings, histopathology and outcomes were studied.
Results: The majority (87.9%, n=254) presented with haematuria with a median duration of symptoms of 1 month. Non-muscle invasive cancers were seen among 64.4% (pTa:n=87(30.1%),pT1:n=99(34.3%)). The pT1 high grade (pT1-HG) tumours were seen in 17.5%. Muscle invasive bladder cancer (MIBC) were seen in 35.6%(n=103). The majority were high grade tumours (n=156,54%). Urothelial MIBC were significantly associated with solid tumours (p<0.001), high grade (p<0.001) and size>3cm (p<0.001). Comparison with previous studies showed a decline in the proportion of MIBC while the pT1-HG tumours are on the rise. Of those followed up, 52.5% developed recurrences with a median duration of 4 months (interquartile range (IQR): 3-12 months). Eighteen (9%) progressed to a higher stage with a median duration of 17 months (IQR:3.75-41.75).
Conclusions: Urothelial cancer in the study population was 92%. Higher proportion of MIBC, high grade tumours and pT1-HG tumours were noted. The recurrence rate was high. Future studies should focus on the causative factors for this trend.
Background: Arishta have been used in Ayurveda medicine for over thousands of years in Sri Lanka to treat various diseases. Ashwagandharishta, Balarishta and Dashamoolarishta are usually prescribed to obtain an anabolic effect, and Ashwagandharishta and Dashamoolarishta for androgenic effect in males. Thus, these arishta have been shown to have similar effect as anabolic androgenic steroids and stimulants in Western medicine. Therefore, arishta could potentially be used by athletes to improve their performance in sports leading to unintentional doping. Additionally, ethanol develops in-source during arista fermentation, which can affect athletes health.
Objective: The aim of this study is to investigate whether the anabolic androgenic steroids or stimulants banned by World Anti-Doping Agency are present in these arishta, and to determine their ethanol content.
Methods: Methanol extractions of Ashwagandarishta, Balarishta, Dashamoolarishta from four different manufacturers were screened for 21 stimulant and 22 anabolic androgenic steroids banned by World Anti-Doping Agency, using Gas Chromatography Mass Spectrometer. Ethanol content of the twelve Arishta samples were also measured.
Results: Anabolic androgenic steroids or stimulants were not present in the tested Arishta samples, and percentage volume / volume ethanol content of all Arishta was between (5.80-8.35) ±0.5.
Conclusion: The tested brands of Ashwagandharishta, Balarishta and Dashamoolarishta did not contain stimulants or anabolic androgenic steroids banned by World Anti-Doping Agency.