Objectives: The aim of this work is to study the effects, adverse effects and recovery time of IV mixed propofol and ketamine (ketofol) in 3:1 ratio as a sedative analgesic in children with acute lymphoblastic leukemia undergoing bone marrow aspiration Methods: This was a prospective, observational pilot study of twenty patients; 3-12 years with ALL requiring sedation for BMA were included. Mixture of ketofol (3:1) was administered intravenously in a dose of 0.5 mg⁄kg at 30-second to 1-minute intervals aiming to achieve a sedation level of 3 or 4 on Ramsay scale to start the procedure. Patient satisfaction was the primary outcome in our study. Faces pain scale-revised (FPS-R) was used to assess the degree of analgesia. Secondary outcomes included sedation time, recovery time, adverse events and safety. Results: 20 patients were enrolled for the study. The median dose of ketofol is 3 mg/kg of propofol and 1 mg/kg of ketamine with no patients required extra doses. The median score on the pain faces scale was (comfortable) (1-3; 95% CI 1.08-2.92). Median recovery time was 22 minutes (16-30; 95% CI 14.08-29.32). The cardiorespiratory adverse events were transient, tolerable and easily corrected. Conclusion: Combination of ketamine and propofol in the same syringe in this pilot study produced effective sedation, which is illustrated by the degree of satisfaction shown by patients. Moreover, rapid recovery and absence of clinically significant adverse events were noticed among children requiring procedural sedation and analgesia for bone marrow aspiration. A high recommendation of using large sample size should be considered for further assessment and verification of our results.

Objectives: The aim of this work is to study the effects, adverse effects and recovery time of IV mixed propofol and ketamine (ketofol) in 3:1 ratio as a sedative analgesic in children with acute lymphoblastic leukemia undergoing bone marrow aspiration Methods: This was a prospective, observational pilot study of twenty patients; 3-12 years with ALL requiring sedation for BMA were included. Mixture of ketofol (3:1) was administered intravenously in a dose of 0.5 mg⁄kg at 30-second to 1-minute intervals aiming to achieve a sedation level of 3 or 4 on Ramsay scale to start the procedure. Patient satisfaction was the primary outcome in our study. Faces pain scale-revised (FPS-R) was used to assess the degree of analgesia. Secondary outcomes included sedation time, recovery time, adverse events and safety. Results: 20 patients were enrolled for the study. The median dose of ketofol is 3 mg/kg of propofol and 1 mg/kg of ketamine with no patients required extra doses. The median score on the pain faces scale was (comfortable) (1-3; 95% CI 1.08-2.92). Median recovery time was 22 minutes (16-30; 95% CI 14.08-29.32). The cardiorespiratory adverse events were transient, tolerable and easily corrected. Conclusion: Combination of ketamine and propofol in the same syringe in this pilot study produced effective sedation, which is illustrated by the degree of satisfaction shown by patients. Moreover, rapid recovery and absence of clinically significant adverse events were noticed among children requiring procedural sedation and analgesia for bone marrow aspiration. A high recommendation of using large sample size should be considered for further assessment and verification of our results.

Background: We conducted a retrospective analysis to evaluate overall survival (OAS) and disease free survival (DFS) rates in patients with squamous cell carcinoma of the urinary bladder according to different prognostic factors. Methods: This retrospective study analyzed the medical records of patients with non-metastatic squamous cell carcinoma of the urinary bladder. All men underwent radical cystectomy and women underwent anterior pelvic exentration. Most patients had postoperative radiation therapy. The log-rank test examined differences in OAS and DFS rates. Results: The medical records of 106 patients were analyzed. The median followup from the date of enrollment was 30 months and ranged from 2 to 73 months. For the entire group, three-year OAS rates were 46.9% and DFS rates were 44%. For patients with P2 (tumor invasion into the muscularis propria) the three-year OAS rate was 53%, for P3 (tumor invasion into perivesical fat) it was 45% and 9% for P4 (tumor invasion into adjacent organs, pelvic wall or abdominal wall) The OAS rate was statistically significant in favor of P2 disease (P=0.0041). The three-year DFS rate was 50% for P2, 45% for P3 and 9% for P4 disease (P=0.0125). Administration of post-operative radiotherapy did not result in statistically significant improvement in three-year OAS and DFS rates. Conclusion: Survival rates were statistically significant and higher in patients with P2 and P3 disease compared to P4 disease. Adjuvant radiotherapy did not result in statistically significant survival improvement. Keywords: Survival analysis, Squamous cell carcinoma, Bladder Received: February

Background: We conducted a retrospective analysis to evaluate overall survival (OAS) and disease free survival (DFS) rates in patients with squamous cell carcinoma of the urinary bladder according to different prognostic factors. Methods: This retrospective study analyzed the medical records of patients with non-metastatic squamous cell carcinoma of the urinary bladder. All men underwent radical cystectomy and women underwent anterior pelvic exentration. Most patients had postoperative radiation therapy. The log-rank test examined differences in OAS and DFS rates. Results: The medical records of 106 patients were analyzed. The median followup from the date of enrollment was 30 months and ranged from 2 to 73 months. For the entire group, three-year OAS rates were 46.9% and DFS rates were 44%. For patients with P2 (tumor invasion into the muscularis propria) the three-year OAS rate was 53%, for P3 (tumor invasion into perivesical fat) it was 45% and 9% for P4 (tumor invasion into adjacent organs, pelvic wall or abdominal wall) The OAS rate was statistically significant in favor of P2 disease (P=0.0041). The three-year DFS rate was 50% for P2, 45% for P3 and 9% for P4 disease (P=0.0125). Administration of post-operative radiotherapy did not result in statistically significant improvement in three-year OAS and DFS rates. Conclusion: Survival rates were statistically significant and higher in patients with P2 and P3 disease compared to P4 disease. Adjuvant radiotherapy did not result in statistically significant survival improvement. Keywords: Survival analysis, Squamous cell carcinoma, Bladder Received: February