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

Normal shapes of liver: analysis of normal nuclear scans in Multan

Five hundred 'Normal' liver scans were analysed to find out the incidence of various shapes of normal liver. There were differences between our series and the series reported in the literature. The differences may be due to selection criteria or geographical variation

Radionuclide evaluation of the superior vena cava and upper thoracic veins in mediastinal syndrome

Radionuclide studies of the superior vena cava are non-invasive and simple to perform. These studies give information about the patency of the superior vena cava, innominate and the obstruction can be determined. Since this technique is non-invasive or minimally invasive, it can be repeated as often as required. The anatomic and physiologic basis of this investigation and methodology of the procedure is given. Two cases are described in detail. The only other investigation giving comparable clinical information is contrast venography which is uncomfortable and carries a definite risk of allergic reaction