Breast disease: causes for delays in presentation

It has been observed that patients with breast disease may delay consulting a doctor. The results are disastrous for patients ultimately diagnosed with malignant breast disease. This study is an observation of the factors which affect the time interval between symptom recognition in breast disease and medical consultation. All patients with breast disease presenting to the outpatient department of our unit between November 2003 and November 2005 and ultimately admitted were included in the study. They were divided into two groups based on whether they presented before or after 6 months of symptom recognition. They were interviewed about factors which had brought them to the hospital. Factors responsible for delays in presentation were also inquired about. Of the 133 patients with breast lumps, 51 [38.5%], presented within, and 82 [61.7%], beyond 6 months of noticing the swelling. Various factors which might have played a role in the delay to seek advice included poverty [52.4%], belonging to remote areas [44.9%], wrong beliefs and fears [67%], lack of education [58.5%] and shyness [18.3%]. Factors responsible for delays in seeking medical advice among patients with breast disease must be targeted to result in earlier presentation. This is especially important in breast cancer which is a curable disease in the early stages

Clinical aspects of primary hyperparathyroidism

We present 4 cases of primary hyperparathyroidism presenting with pathological fracture. All of them were females with age range of 26-37 years. The average time for which they remained symptomatic before diagnosis was made is 2 years. Ultrasound abdomen showed renal calculi in all. Serum calcium was in the normal range in 2 of the cases. Serum PTH assay was elevated and Para-thyroid Scinti-scan was positive in all cases. Bilateral neck exploration was the procedure carried out on all of them. Parathyroid adenoma was the underlying cause in all the cases as confirmed on histopathology