Frequency of corneal dystrophies on the basis of histopathology in surgically removed corneas.

OBJECTIVE: To assess the frequency of corneal dystrophies on the basis of histopathology in surgically-removed corneas. METHODS: The descriptive study was conducted at Foundation University Medical College, Islamabad, and Al Shifa Eye Hospital, Rawalpindi, Pakistan, from May to October 2011, and comprised post-keratoplasty corneal specimen irrespective of age and gender. The surgically-removed corneas were processed according to the standard guidelines of histopathological processing. The histopathological sections were examined for various corneal dystrophies. Data was recorded on a proforma and was analysed using SPSS 17. RESULTS: Of the 63 patients in the study, 12(19%) were diagnosed as having corneal dystrophies. In these 12 patients, 6(50%)were diagnosed as stromal corneal dystrophies and 5(42%)had posterior corneal dystrophies, and 1(8%)had anterior corneal dystrophy. CONCLUSIONS: Histopathological examination of corneas is a reliable method to diagnose and classify corneal dystrophies.

The interobserver reproducibility of thyroid cytopathology using Bethesda Reporting System: analysis of 200 cases.

OBJECTIVE: To determine interobserver reproducibility of thyroid cytopathology in cases of thyroid fine needle aspirates. METHODS: The retrospective, descriptive study, was conducted at the Foundation University Medical College, Islamabad, using cases related to period between 2009 and 2011. A total of 200 cases of fine-needle aspirations were retrieved from the archives. Three histopathologists independently categorised them into 6 groups according to Bethesda reporting system guidelines without looking at previous reports. Kappa statistics were used for analysis of the results on SPSS 17. RESULTS: Of the 200 patients, 194 (97%) were females and 6 (3%) were males. The overall mean age of patients was 46 +/- 20 years. Kappa value calculated for observer-1 and observer-2 was 0.735; for observer-1 and observer-3, 0.841; and for observer-2 and observer-3, 0.838, showing substantial interobserver agreement. Histopathological correlation was available, for 39 (19.5%). Of these cases, 5 (13%) were 'non-diagnostic, 20 (51%) 'benign, 2 (5%) 'atypia of undetermined significance/follicular lesion of undetermined significance, 6 (15%) 'follicular neoplasm, 1 (3%) 'suspicious for malignancy, and 5 (13%) 'malignant. CONCLUSIONS: Good overall interoberver agreement was found, but discordance was seen when certain categories were analysed separately.

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.