Background COVID-19 infection led to a substantial overhaul of the symptomatic breast services within the UK. Aim The purpose of this study was to evaluate the pattern of primary care referrals to the symptomatic one-stop clinic during the pandemic. This study also provides a snapshot of the workings of symptomatic breast services and the scope for improvements. Methods The data points were collected for 1 month during the peak of the pandemic (April 2020) and compared to corresponding data points for the same month in the previous year (April 2019). This was compared to the monthly data from Wales Cancer Network (WCN) data source. A hundred patients from each month over 2 years were evaluated to get a snapshot into the working of the breast clinic. Results A total of 516 patients were referred from primary care or General Practitioners (GPs), and were seen in the Hospital ‘one-stop breast clinic’ in April 2019. This number dropped to 330 patients during the peak of the pandemic in April 2020. Ninety percent of referrals from the GP were urgent suspected cancers or urgent referrals. This trend of referrals did not change over 2 years. There was a 5% and 7% cancer diagnosis rate in 2020 and 2019, respectively. Conclusions Most patients were referred from GP as ‘urgent’ or ‘urgent suspected cancer’. The cancer diagnosis rate reduced from 7 to 5% during the pandemic peak but the number of ‘worried well’ patients did not reduce. The total number of referrals reduced, which is predictive of increased demand in the future. The authors have suggested ways to meet this demand.

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BackgroundThalassemia is an inherited blood disorder characterized by reduced hemoglobin synthesis. Aim of our study is to assess the parental knowledge of thalassemia patients and their awareness regarding treatment and preventive measures against thalassemia. MethodsIt is an observational study done at Ali Zaib Foundation Thalassemia Center in Sahiwal, Pakistan, in May 2019. One hundred parents were enrolled in this study and a subjective questionnaire was used to collect data through direct structured survey method over a period of 30 days. ResultsThere were parents of 62 (62%) male patients and 38 (38%) female patients, with a median age of 8.5 ± 6.2 years. Forty-three (43%) parents were illiterate while eight (8%) parents were highly educated. Sixty-six (66%) patients were born to parents with consanguineous marriages. Eighty-two (82%) parents were aware of thalassemia, 72 (72%) were aware of the risk of thalassemia due to cousin marriages, 76 (76%) parents were aware of the importance of prenatal diagnosis (PND), while 88 (88%) believed that a PND was beneficial. Fifty-two (52%) parents knew about thalassemia treatment, 80 (80%) were aware of the importance of blood screening, and 14 (14%) patients were receiving iron chelation therapy. Seventy-eight (78%) parents were aware of thalassemia prevention. All parents believed that the public requires awareness of the importance of premarital screening and PND. ConclusionParental awareness regarding β-thalassemia, its treatment and prevention is fair but far from ideal. Premarital screening, provision of accurate information to the public by professionals, and adequate screening and PND of at-risk families can significantly reduce the rates of thalassemias.