Lichtenstein repair; A community based teaching hospital experience

To describe our experience of Lichtenstein repair in a community based teaching hospital. This prospective study included patients presenting to the surgical outpatient department of Fatima Hospital for elective hernia repair over a 2 year period. Sixty four patients underwent hernia repair. All were males. Most common [67%] were indirect inguinal hernias. Fifty-seven percent had no symptoms. Chronic constipation was present in 22% and cough in 11% patients. Eighty six percent of the patients had no co-morbidities and 84% patients belonged to ASA class I. Eighty seven percent procedures were performed under spinal anesthesia. Mean operating time was 57 +/- 18 minutes with no operative complications. Four patients had scrotal hematoma and 3 had seromas, while one patient each had wound infection, spinal headache and urinary retention. None of the patients required surgical intervention or mesh removal. Average cost per patient was 3204 +/- 510 rupees. Our outcomes of Lichtenstein repair were comparable with the international and local literature. Further reductions in costs can be achieved by performing the procedure under local rather regional anesthesia

Knowledge, attitudes and practices regarding breast cancer screening in women of various social strata

To find out knowledge, attitudes and practice related to breast cancer among women. A convenience sample of 179 women living in Karachi age 20 years and above was studied. Proforma were filled by interviews. Questions related to breast screening knowledge, attitude and practices in different social class were asked. Out of the total of 179 female respondents, 19% [34] belonged to affluentsocial class, 64% [115] were of middle social class and 17% [29] were poor. There was no significant difference in the age, marital status, occupation and number of children of the respondents of the three groups. There was a significant difference in educational level in between three social groups [p<.000]. Among the graduates 65% represented the middle social class and 69% of the illiterate belonged to poor class.Only 50% [90] of the females knew that breast cancer runs in the family, out of which 56 correct response [p<.005] were from middle class i.e. 62% and of the total only 13% were aware that it was linked with grand mothers history with insignificant inter group variation [p<.086]. Furthermore 55% of poor women, 76.5% of middle class women and 88% of affluent class admit the importance of screening of breast cancer for its prevention [p<.000]. Overall 46% were aware of mammogram, of whom 10% were poor, 48% from middle class and 73% rich [p<.019]. Higher the social class better is the level of education, knowledge, attitude and practice towards the breast cancer screening