Background: In Western countries, middle-aged women are more vulnerable to breast cancer. Globally, almost a million new cases were identified in 1998. One in 12 women in England and Wales will get the disease at some point.1 Even 5,000 years after it was first reported, the etiology of breast cancer is still unclear, and effective preventative measures are even further off. Aim: To characterize the varied ways in which breast cancer has presented itself among patients at Bahawal Victoria Hospital in Bahawalpur. Methods: This investigation employed a descriptive case series research design. This research was conducted at Bahawal Victoria Hospital's Surgery Department in Bahawalpur (Pakistan). From March 13th, 2020 through March 12th, 2021, the study was conducted (12 months). With their assent, 100 women with definite cases of breast cancer were enrolled in the study. Results: Cancer of the breast most commonly affected women between the ages of 31 and 50 (59%). Seventy-six patients arrived from the outlying rural areas of Bahawalpur and the neighboring districts. Only 18 patients had completed high school after 10 years and 5 patients were discovered to be college graduates. The single rate was 12%, with 12 patients. Eighty-one percent of patients reported having a breast lump. 56% of breast cancers involve the left breast, while 43% involve the right. One patient alone had breast cancer that had spread to both of her breasts. Illness duration varied from 1 month to 5 years. Stage III was the most prevalent presentation, with 46 instances, and Stage IV was the least common, with 16 patients. The histological hallmark most frequently attested by examination of slides was infiltrating ductal carcinoma, and this was the case in 87% of the cases. Conclusion: Breast cancer is very common cancer in the females, and most commonly it presented as a lump in the breast, because of some social aspects, lack of awareness, poverty, no proper screening programs and above all the fear of diagnosis, females try to hide this problem and often it presented at late and more advance stage. Keywords: Breast, Nipple, Cancer, Lump, Surgery, Tumor

Background: In Western countries, middle-aged women are more vulnerable to breast cancer. Globally, almost a million new cases were identified in 1998. One in 12 women in England and Wales will get the disease at some point.1 Even 5,000 years after it was first reported, the etiology of breast cancer is still unclear, and effective preventative measures are even further off. Aim: To characterize the varied ways in which breast cancer has presented itself among patients at Bahawal Victoria Hospital in Bahawalpur. Methods: This investigation employed a descriptive case series research design. This research was conducted at Bahawal Victoria Hospital's Surgery Department in Bahawalpur (Pakistan). From March 13th, 2020 through March 12th, 2021, the study was conducted (12 months). With their assent, 100 women with definite cases of breast cancer were enrolled in the study. Results: Cancer of the breast most commonly affected women between the ages of 31 and 50 (59%). Seventy-six patients arrived from the outlying rural areas of Bahawalpur and the neighboring districts. Only 18 patients had completed high school after 10 years and 5 patients were discovered to be college graduates. The single rate was 12%, with 12 patients. Eighty-one percent of patients reported having a breast lump. 56% of breast cancers involve the left breast, while 43% involve the right. One patient alone had breast cancer that had spread to both of her breasts. Illness duration varied from 1 month to 5 years. Stage III was the most prevalent presentation, with 46 instances, and Stage IV was the least common, with 16 patients. Practical implication Community based effective awareness and prompt screening programme will improve better outcomes in breast cancer management. Conclusion: Breast cancer is very common cancer in the females, and most commonly it presented as a lump in the breast, because of some social aspects, lack of awareness, poverty, no proper screening programs and above all the fear of diagnosis, females try to hide this problem and often it presented at late and more advance stage. Keywords: Breast, Nipple, Cancer, Lump, Surgery, Tumor

Objective: To evaluate the efficacy of ligature sealing versus standard suture sealing for multinodular goiter patients after thyroidectomy. Method: The aim of our study is to evaluate the efficacy of ligature sealing versus standard suture sealing for multinodular goiter patients after thyroidectomy. The research was done in the Mayo Hospital in Lahore, Pakistan, specifically in the General Surgery Division. Ligasure-sealed patients made up Group A, while those in Group B were treated with traditional suture-ligation. The average duration of surgery, the average amount of discomfort felt by the patient afterward, and the average amount of drain fluid collected aftersurgery were all recorded. Results: Eighty people in total participated in the study. Patients in Group-Ahad an average operation time of 67.3±6.9 minutes, while those in Group-B averaged 85.6±8.3 minutes; this difference was statistically significant (p0.000001). Patients in group Areported an average of 2.6±1.3 units of pain, while those in group B reported 1.7±0.7 units of pain; this difference was statistically significant (p 0.001). Patients in Group-A had a mean drain output of 53.5±4.9 ml following surgery, while those in Group-B had an output of 68.2±7.3 ml; this difference was statistically significant (p = 0.0001). Conclusion: Thyroid surgery using ligature sealing is an effective and safe alternative to the standard approach, resulting in significantly less downtime, less discomfort, and less drainage after the procedure.

Amongst the most frequent illnesses in civilised nations of West is chronic venous insufficiency (CVI). It is believed that 40-50 percent of all individuals have superficial venous insufficiency of the leg, which manifests primarily as varicose veins. Individuals with varicose veins typically complain of leg pain at the conclusion of the day following extended walking. Ankle edoema, itch, hemorrhage, superficial thrombophelibitis, dermatitis, lipodermatosclerosis, and open wounds are some of the additional manifestations. Methods: In this cross sectional study, conducted at the surgical floor, Mayo Hospital, Lahore. Varicose veins were defined as dilated, tortuous, subcutaneous veins usually seen in upright posture. Any case of suspected chronic venous insufficiency was assessed on clinical examination by unbiased consultant surgeon. The severity of varicose vein was assessed by clinical grading from CEAP (Clinical-Etiological-Anatomical-Pathophysiological) system in which there are six classes. Results: Patients in our study were mostly males; male to female ratio of patients of varicose veins is 3:1, most of the male patients had class 2 or class 5; Association of class of varicose veins and gender was also insignificant (p-value calculated for the class of varicose veins and gender was 0.25). Conclusion: In our study population, male patients suffered worse than female patients. The occurrence rate was comparable between people of different ages. There was a higher prevalence of varicose veins in classes 2 and 3. To further understand the causes of varicose veins, larger-scale studies focusing on female gender-related risk factors and occupation-related risk factors are needed. Additional measures, such as patient education, can aid in lowering the frequency of varicose veins. Keywords: Varicose Veins, DVTs, Ankle edema, Thrombophelibitis, lipodermatosclerosis