A retrospective study of complications of total thyroidectomy; is it a safe approach for benign thyroid conditions.

OBJECTIVE: To assess frequency of complications of total thyroidectomy for benign thyroid diseases. METHODS: The retrospective descriptive study was conducted at Shifa College of Medicine, Islamabad, Pakistan, and comprised patient data from March 2016 to March 2018 of all patients who had undergone total thyroidectomy at the centre. Operative findings and post-op complications were documented in a self-generated proforma. Followup visits documented in the charts were also reviewed. Patients who did not keep the follow-up appointment were interviewed over the phone. Data was analysed using SPSS 20. RESULTS: Of the 96 patients, 78(81.2%) were female and 18(18.7%) were male. The overall mean age was 32.9 } 9.84 years. Hypocalcaemia was the most common complication in 4(4.1%) cases, transient in 3(3.1%) and permanent in only 1(1.04%) case. Haemorrhage occurred in 1(1.04) patient, and recurrent laryngeal nerve injury in 2(2.08%). . CONCLUSIONS: Simple multi-nodular goitre was effectively treated with total thyroidectomy with minor complications.

Factors influencing delayed presentation of breast cancer at a tertiary care hospital in Pakistan.

BACKGROUND: Breast cancer is the leading cause of death despite the continuous development of newer and more effective modalities of treatment for breast cancer. In Asia, Pakistan has the highest rate of breast cancer. Breast cancer treatment shows better prognosis when it is diagnosed at an early stage, but mortality increases significantly with delayed diagnosis and advanced stage of disease. Delay in diagnosis and nonavailability of treatment are the major factors responsible for advanced stage and low survival. AIMS: The objective of our study was to identify the factors responsible for delayed presentation of patients with breast carcinoma. METHODS AND RESULTS: A cross-sectional study using a questionnaire method was conducted at the Foundation University Medical College from January 2015 to December 2016. A total of 89 patients gave consent and were interviewed using a prestructured questionnaire during the study. Age ranged from 25 to 64 years. Majority of patients were in stage T3N1M0 (31.5%). Second most common stage was T4N0M0 (14.6%). Thirteen patients (12.4%) were in stage T3N0M0, and 10 patients (11.2%) were in T3N2M0. Delay ranged from 3 months to more than 1 year; 43.8% presented with delay of 3 to 6 months. The reasons for delay were lack of knowledge about breast cancer (41%), lack of availability of health care services (32.6%), purdah and religious reasons (6.7%), and fear of being diagnosed with cancer (10.1%). CONCLUSION: The main reasons for delay identified in our study were lack of knowledge and availability of appropriate health care facilities. In order to improve outcome of breast cancer, more focus is needed on spreading awareness and improving health care services in rural areas.