Background (SARS-COV-2) infection, led to a pandemic affecting many countries, resulting in hospitals diverting most of their resources to fight the pandemic. Breast cancer, already a healthcare dilemma, is also affected in this scenario. Our aim was to find out the impact of COVID-19 on presentation of breast cancer stage and its effects on overall onco-surgical management. Methods This cohort single-centered retrospective review was carried out at our hospital, over a period of 18 months. Females with known breast cancer were included in the study. Data was collected on performas by a single researcher. Effect of COVID pandemic on presentation stage and its impact on overall management was studied. SPSS 23.0 used for data analysis. A 95% CI was used. Descriptive statistics were presented as range/means. Categorical data was analyzed by Fisher exact test, t -test was applied to numerical data, p value ≤ 0.05 was considered significant. Results Out of 87 patients presenting with suspicious lump, 69 who had malignancy on histo-pathology were included in study. Twelve out of 69 were COVID positive. Sixty patients presented with advanced stage (≥stage 2b) out of which 21 underwent upstaging of disease due to delay in presentation/management. We found that 9 out of 12 (majority) Covid positive patients had disease upstaging. Overall main reason for delay in presentation was found to be unawareness of disease. Conclusion We concluded that COVID-19 pandemic had no impact on presentation delay, breast cancer management/treatment and disease upstaging as compared to figures available for our population before the pandemic. However, our study showed significant correlation between disease upstaging and COVID status. This led us to reconsider our preformed protocols for COVID positive breast cancer patients. Our results can be used by future researchers to investigate if COVID itself can contributes in patho-physiology of upstaging in breast cancer or not.
Objective: To evaluate the validity of ultrasonography in patients who have obstructive jaundice. Design: Descriptive study.Place and duration of study: The study was carried out from September 2006 to May 2008 in department of Radiology Combined MilitaryHospital Quetta. Patients and Methods: A total of 30 patients; 14 male and 16 female underwent operation for obstructive jaundice. All of themhad preoperative ultrasonography. The site and nature of biliary obstruction were noted and the accuracy was determined with per-operativefindings / histological diagnosis as gold standard. Results: The cause of obstructive jaundice identified by ultrasonography with reasonablesensitivity of 90% and specificity of 90% for choledocholithiasis and sensitivity of 55.5% and specificity of 95.2% for pancreatic head tumours.Conclusions: Ultrasonography should be the first and best initial imaging procedure in patients who have obstructive jaundice and showsreasonable sensitivity and specificity to identify causes of obstruction in obstructive jaundice.
Mastalgia is a common clinical symptom experienced by up to 70% of women at some stage of their life. A wide varietyof therapeutic agents are available for the treatment of mastalgia. Both evening primrose oil and non steroidal anti-inflammatory drugs havebeen assessed in randomised controlled trials and demonstrated to be effective. The objective of this Quasi experimental study was tocompare the efficacy and safety of topical nonsteroidal anti-inflammatory drugs with evening primrose oil in the treatment of mastalgia. Westudied 90 female patients presenting with breast pain from 25 July 2006 to 25 July 2007 at the surgical outpatient department of CMHKharian. The patients were divided into three groups. Group-1 was given capsule Effamol (evening primrose oil), group-2 topical brufen geland group-3 topical Vaseline for two months. Patients were followed every two weeks for two months. Response was assessed using Cardiffbreast pain score. Side effects of drugs were recorded at each follow up. Out of 30 patients of group-1,14 (46.6%) had clinically significantresponse at the end of 8 weeks treatment as compared to 27 (90%) in group-2.5 (16.6%) patients of group-1 showed mild side effects whilenone in group-2 had any side effect, p- value was < 0.0001 showing highly significant statistical difference between 2 groups. Topicalnonsteroidal anti-inflammatory drugs are safe and effective as compared to evening primrose oil in the treatment of mastalgia.
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