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Introduction: According to United Nations International Children's Emergency Fund (UNICEF) about 70% of the total population in Pakistan is at risk of developing thyroid diseases due to iodine deficiency. In Pakistan thyroid cancer is responsible for 1.2% cases of all malignant tumours. Ultrasound (U/S) is helpful in detecting cancer in thyroid nodules based on different features. Correct diagnosis of thyroid disease can minimize unnecessary surgery and removal of benign nodules. Objectives: To determine the ability of Fine Needle Aspiration Cytology (FNAC) and US independently and in combination in classifying thyroid nodules, keeping histopathology as gold standard. Study Design: Validation, cross-sectional study. Setting: Khyber Teaching Hospital, Peshawar, Surgical Department. Duration: From September 21,2020, to March 20,2021 Material and Methods: This was a cross sectional, validation study of234 patients. After taking approval from ethical committee of the hospital. Informed written consent was taken from the patients. Patients referred to Radiology Department, meeting the inclusion criteria were enrolled in the study after taking brief history and examination. Ultrasound followed by FNAC were performed and the biopsy was sent for histopathology. Results: 234 patients with solitary thyroid nodule diagnosed clinically and on ultrasound were observed, in which 52(22.22%) were male and 182(77.78%) were female patients. Average age was 41.18 years + 12.38SD. Accuracy of ultrasound, FNAC and their combination to detect malignancy in solitary thyroid nodule was 76.92%, 81.2% and 83.76% respectively. Conclusion: FNAC is superior in accurately identifying malignant thyroid nodules compared to ultrasound. The accuracy is increased when both modalities are used in combination. [ABSTRACT FROM AUTHOR]

Background: Cervical lymphadenopathy is a common medical problem. The objective of the study was to determine the frequency and distribution of different types of cervical lymphadenopathy in patients in D.I.Khan, KP, Pakistan. Material & Methods: This cross sectional study was conducted at Department of ENT, Gomal Medical College, Dera Ismail Khan from April 2013 to March 2016. Sample size was 80, selected through consecutive sampling technique. Patients having enlarged lymph nodes of either sex and of any age of at least 2 months duration were included. Patients having generalized lymphadenopathy were excluded from the study. Gender and age groups were the demographic variables. The research variables were types of cervical lymphadenopathy (tuberculous lymphadenopathy/reactive hyperplasia/metastatic carcinoma/lymphpoma) and side of the neck involved (right/left). All variables being categorical, the frequencies and percentages were calculated. descriptive statistical analysis was done using SPSS version 10. Results: Out of 80 patients, 42 were males and 38 females. Majority of the patients were in the first decade. Chronic granulomatous diseases especially the tuberculous cervical lymphadenopathy was the most frequent histological findings in 31 patients. Lymphoma was noted in 21, reactive hyperplasia in 18 and metastatic malignancy in 10 cases. Lymph nodes involvement on the right side was more common 36 than on the left side 32. Conclusion: Unilateral tuberculous cervical lymphadenopathy was most common found especially in young males. [ABSTRACT FROM AUTHOR]

Objectives: To determine frequency of malignancy in solitary thyroid nodule. Design: Case-series study. Place and Duration of Study: The study was conducted at Department of Surgery, Combined Military Hospital Rawalpindi, from April 2002 till April 2003. Patients and Methods: Sixty patients with clinical solitary thyroid nodule fulfilled the selection criteria and were included in the study. Thyroid function tests, ultrasonography and thyroid scanning was done. Finally FNAC and histopathology were done in all the operated cases and record was evaluated. Results: Out of 60 cases studied, 8 (13.33%) were found to have malignant lesions. The remaining 52 (86.67%) cases had benign pathology. Male patients with solitary thyroid nodule showed a higher incidence of malignancy 17.65% as compared to females 11.63%. Maximum malignant cases (50%) were found between the ages of 31 to 40 years. Papillary carcinoma was the most common malignancy (50%) found in our study. Conclusions: The incidence of malignancy in solitary thyroid nodule is quite high (13.33%). So people should be educated to attend thyroid clinics for early diagnosis and adequate treatment. [ABSTRACT FROM AUTHOR]

Background: Quality of any service is the most important aspect for the manufacturer as well as the consumer. The primary objective of any nation's health system is to provide supreme quality health care services to its patients. The objective of this study was to assess the quality of diagnostic fine needle aspiration cytology service in a tertiary care hospital. As Patient's perspectives provide valuable information on quality of process, therefore, patient's perception in terms of satisfaction with the service was measured., Methods: In this cross sectional analytical study, 291 patients undergoing fine needle aspiration cytology in Mayo Hospital were selected by systematic sampling technique. Information regarding satisfaction of patients with four dimensions of service quality process, namely "procedure, sterilization, conduct and competency of doctor" was collected through interview on questionnaire. The questionnaire was developed on SERVQUAL model, a measurement tool, for quality assessment of services provided to patients. All items were assessed on 2- point likert scale (0=dissatisfied, 1=satisfied). Frequencies and percentages of satisfied and dissatisfied patients were recorded for each item and all items in each dimension were scored. If the percentage of sum of all item scores of a dimension was ≥60, the dimension was 'good quality'. Whereas <60% was 'poor quality' dimension. Data was analysed using epi-info-3.5.1. Fisher test was applied to check statistical significance. (p-value <0.05)., Results: Out of the 4 dimensions of service quality process, Procedure (48.8%), Sterilization (51.5%) and practitioner conduct (50.9%) were perceived as 'poor' by the patients. Only practitioner competency (67.4%) was perceived as 'good'. Comparison of dimensions of service quality scoring with overall level of patient satisfaction revealed that all 4 dimensions were significantly related to patient dissatisfaction (p<.05)., Conclusions: The study suggests that service quality of therapeutic and diagnostic procedures in public hospitals should be routinely monitored from the patients' point of view as most aspects of service quality in public hospitals of Pakistan, require improvements. In this manner patient's satisfaction regarding use of services in public hospitals can be made better.