Breast diseases; spectrum in Wah Cantt; POF hospital experience

To find out the magnitude of breast diseases and their distribution in different age groups among the patients attending surgical OPD for surgical consultation at POF Hospital Wah Cantt. This is a retrospective observational type of study. Patients attending surgical OPD for breast problem from January 2000 to December 2007 were included. They were assessed clinically and their diagnosis was confirmed by cytological [FNAC] or histopathological [biopsy] examination. Records were taken from pathology and surgery department and the patients were retrospectively reviewed. 954 cases of breast disease were diagnosed. These include 905 female and 49 male patients. Benign breast diseases [BBD] were the most common lesions of the breast found in this study [71.5%] whereas malignant lesions were on the rise with each passing year [28.5%]. Among BBD, the most common lesion was fibroadenoma [49%] followed by breast abscess [13%], Fibrocystic disease [9.3%] and gynecomastia [6.8%]. 271 cases [28.5%] were malignant lesions. This includes 269 female and 2 male cases. The common ages for BBD were, 12-30 years for fibroadenoma, 15-40 years for breast abscess, 18-40 years for fibrocystic disease and 15-29, 50-59 for gynecomastia respectively, whereas carcinoma breast was seen in the age group of fifties initially, getting more common in forties, in the later part of study. We conclude from this study that BBD is the most frequent breast ailment. Among the BBD, fibroadenoma was the most common lesion. Breast carcinoma cases were becoming more frequent but reached hospital at a late stage of the disease. Infiltrating ductal carcinoma was the most common malignancy noted

Surgical management of peptic ulcer disease in proton pump inhibitor era

To evaluate the important risk factors involved in complications of peptic ulcer disease and the need, timing, extent and outcome of surgery with the evolution of proton pump inhibitors. Descriptive study. POF Hospital Wah Cantt, from December 2006 to December 2008. All the patients presenting with complications of peptic ulcer disease [perforation, bleeding duodenal ulcers and gastric outlet obstruction] were included in this study. A total of 46 patients were included in this study. Thirty five patients had peptic ulcer perforation, 8 patients presented with bleeding peptic ulcer that failed to respond to medical and endoscopic treatment and 3 patients presented with gastric outlet obstruction. Smoking was the most common risk factor followed by the use of non streroidal anti inflammatory [NSAID] drugs and steroids. Ramadan fasting was also a factor in patients with history of dyspepsia. Peptic ulcer perforation was more common in patients in second and third decade of life as compared to bleeding which was more prevalent in fourth decade. Modern medical and endoscopic therapy has caused a decline in complications of peptic ulcer disease but they are still prevalent in developing world. Smoking is one of the most common and important risk factors