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Urothelial bladder carcinoma (UBC) is the most common among urinary bladder neoplasms. We carried out a preliminary study to determine the genetic etiology of UBC in Pakistani population, for this 25 sequence variants from 17 candidate genes were studied in 400 individuals by using polymerase chain reaction-based techniques. Multivariate logistic regression analysis was performed for association analysis of the overall data as well as the data stratified by smoking status, tumor grade and tumor stage. Variants of GSTM1, IGFBP3, LEPR and ACE were found to be associated with altered UBC risk in the overall comparison. CYP1B1 and CDKN1A variants displayed a risk modulation among smokers; IGFBP3 and LEPR variants among non-smokers while GSTM1 polymorphism exhibited association with both. GSTM1 and LEPR variants conferred an altered susceptibility to low grade UBC; GSTT1, IGFBP3 and PPARG variants to high grade UBC while ACE polymorphism to both grades. GSTM1 and LEPR variants exhibited risk modulation for non-muscle-invasive bladder cancer (NMIBC); GSTT1 and PPARG variants for muscle-invasive bladder cancer (MIBC), and ACE variant for NMIBC as well as MIBC. In general, the susceptibility markers were common for low grade and NMIBC; and distinct from those for high grade and MIBC indicating the distinct pathologies of both groups. In brief, our results conform to reports of previously associated variants in addition to identifying novel potential genetic predictors of UBC susceptibility.

Altered DNA repair capacity may affect an individual's susceptibility to cancers due to compromised genomic integrity. This study was designed to elucidate the association of selected polymorphisms in DNA repair genes with urothelial bladder carcinoma (UBC). OGG1 rs1052133 and rs2304277, XRCC1 rs1799782 and rs25487, XRCC3 rs861539, XPC rs2228001, and XPD rs13181 were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 200 UBC cases and 200 controls. We found association of OGG1 rs2304277 [odds ratio (OR) = 3.55, 95% confidence interval (CI) = 1.79-7.06] and XPC rs2228001 (OR = 2.38, 95% CI = 1.43-3.94) with UBC. In stratified analysis with respect to smoking status, OGG1 rs2304277 and XPC rs2228001 exhibited increased risk in smokers [(rs2304277 OR = 4.96, 95% CI = 1.51-16.30) (rs2228001 OR = 2.19, 95% CI = 1.02-4.72)] as well as nonsmokers [(rs2304277 OR = 2.95, 95% CI = 1.26-6.90) (rs2228001 OR = 2.57, 95% CI = 1.31-5.04)]. These polymorphisms were also associated with both low-grade [(rs2304277 OR = 3.73, 95% CI = 1.72-8.09) (rs2228001 OR = 2.18, 95% CI = 1.21-3.92)] and high-grade tumors [(rs2304277 OR = 3.45, 95% CI = 1.52-7.80) (rs2228001 OR = 2.81, 95% CI = 1.48-5.33)] as well as with non-muscle-invasive bladder cancer [(rs2304277 OR = 4.03, 95% CI = 1.87-8.67) (rs2228001 OR = 2.14, 95% CI = 1.20-3.81)] and muscle-invasive bladder cancer [(rs2304277 OR = 3.06, 95%CI = 1.31-7.13) (rs2228001 OR = 2.95, 95%CI = 1.51-5.75)]. This is the first study on DNA repair gene polymorphisms and UBC in the Pakistani population. It identifies OGG1 rs2304277 and replicates XPC rs2228001 as significant modulators of UBC susceptibility.

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Urinary stone disease or nephrolithiasis, the third most common disease of the urinary tract, is a major health issue due to its high prevalence, occurrence, and recurrence. The hallmark of a stone that obstructs the ureter or renal pelvis is excruciating, intermittent pain that radiates from the flank to the groin or to the inner thigh. Stone size influences the rate of spontaneous stone passage.Our aim was to compare the efficacy & the frequency of stone-free patients after intervention at 1 week after extracorporeal shock wave litho-tripsy (ESWL) and ureterorenoscopic (URS) manipulation for proximal ureteric stone (10–15 mm size).This randomized control trial was done in the department of Urology, KRL Hospital Islamabad from 18th Nov 2019 to 18th May 2020. After meeting the inclusion criteria, 100 patients were enrolled and were divided into two groups. The first group was treated with ESWL and the other with URS. Then, procedures were done. Follow-up was noted after 1 week in the stone clinic.The average age of the patients was 39.71 ± 10.17 years. Efficacy in the ESWL group was found in 68% cases while in the URS group, efficacy was noticed in 76% cases (P > 0.05). Male patients were three times at a higher risk of recurrence as compared to females.This study concluded that both ESWL and URS are equally effective statistically in terms of the frequency of stone-free patients at 1 week for proximal ureteric stone (10–15 mm size).