Carcinoma breast; late presentation facts and factors

To evaluate the factors responsible for the late presentation of carcinoma of breast in Pakistani women. Prospective, Cross sectional, Interventional. Women Medical Complex Sialkot and Surgical Unit II. Aziz Bhatti Shaheed [Teaching] Hospital. Nawaz Sharif medical College, University of the Gujrat. Study. January 2009 to June 2012. A total of 87 patients of all age groups with carcinoma of breast were enrolled in this study. Mean age of presentation with breast cancer was 43 years. Stage III carcinoma breast was the most common presenting stage seen in 56 [64.36%] women. Socio economic status, delay in presentation and diagnosis, fear of mastectomy and its social consequences found to be major factors in the late presentation of carcinoma of breast. There is need to launch cancer public health campaign mechanisms, should include teaching of Breast Self Examination [BSE] to patients, Clinical Breast Examination [CBE] to health workers. Strenuous efforts should be made to break the vicious cycle of late presentation, poor treatment outcome and reluctance of patients to present to health facilities because of social mindset

Hemorrhoidectomy VS rubber band; comparison of post operative complications

To compare open hemorrhoidectomy and Rubber Band Ligation [RBL] in the management of 2nd and 3rd degree hemorrhoids in terms post operative and hospital stay. Experiential Randomized Control Trial. Department of surgery, Allied Hospital and Independent University Hospital Faisalabad. Dec 2008 to May 2009. 100 consecutive patients with second and third degree hemorrhoids were randomly divided into two groups. Group A [50 patients] were operated by open hemorrhoidectomy [Milligan morgan technique] while in group B [50 patients] rubber band ligations was performed. Open hemorrhoidectomy was performed under spinal anesthesia while rubber bands were applied with local xylocaine gel using Barron's rubber band ligator. All the three hemorrhoids were ligated in single session. Average hospital stay was 24 hours in patient operated by open hemorrhoidectomy as compared to one hour in rubber band ligation. 60% patients in group A developed moderate to severe pain requiring I/V morphine derivatives while 40% developed mild pain and treated with NSAIDS. In group B only 20% patients developed moderate pain and were dealt with I/M diclofenac sodium. Eightyeight percent patients in group A and 60% patients in group B developed mild to moderate bleeding in first postoperative week, which was self limiting. 6 patients developed severe bleeding after hemorrhoidectomy requiring blood transfusion. During six month follow up, two patients [4%] of open hemorrhoidectomy and 3 patients [6%] of RBL presented with recurrence and respective procedures were repeated. Rubber band ligation is safe, quick, economical and effective method for the treatment of 2nd and 3rd degree hemorrhoids

Hydrocele; surgery vs. sclerotherapy

A hydrocele is an abnormal collection of serous fluid within the tunica or processes vaginalis. It is treated by surgery and sclerotherapy. To compare the results of surgery and sclerotherapy in the treatment of scrotal hydrocele. Randomized control trial. Department of Surgery, Allied Hospital, Faisalabad; Period: April 2001 to March 2002. 50 consecutive male patients with provisional diagnosis of hydrocele. Patients stratified into three age groups and each stratum equally and randomly divided into two groups for sclerotherapy [A] or surgery [B]. 1% Sodium tetradecyle sulphate [STD] was used as sclerosant after aspiration of hydrocele. Surgical procedures used were Jaboulay's, Lord's and subtotal excision. Follow up done for three months. Age range was from 15 to 75 years. Hydrocele was right, left and bilateral in 56%, 42% and 2% patients. Postoperative complications included pain [24% and 20%], hematoma [8% and 12%], infection [8% and 12%], recurrence [40% and 12%] and complications related to anesthesia [0% and 36%] in group A and B respectively. Results of sclerotherapy and surgery for hydrocele are comparable with advantage of economy and convenience for sclerotherapy. However, larger study is recommended with comparison between different sclerosants to find the best one with high success rate and minimum complications