Sonographic Incidence and Characteristics of Thyroid Nodules in Various Age Groups and Gender

Background: Thyroid nodules (TNs) are among the common diseases of the endocrine system, with 3%–7% prevalence by palpation. The prevalence by high-resolution ultrasonography among randomly selected individuals is 19%–67%, with annual increasing trends worldwide. 5% to 15% of TNs is thyroid cancer, which has become the fastest growing cancer.1 Ultrasonography has become an indispensable tool in the evaluation of thyroid nodular disease, and most patients will have had a thyroid ultrasound prior to initial surgical evaluation.9 Objective: To characterize thyroid nodules in various age groups and gender.  Methodology: In this descriptive study, among 179 patients of thyroid nodule were selected with age and gender discrimination by convenient sampling, at Department of Radiology, Lahore General hospital and Inmol Cancer hospital Lahore. Mindray Z5 and Toshiba xario 100 with linear probe of 7.5-11MHz ultrasound machine was used. Results: Out of 179 collected, 105 were females and 74 were males who visited radiology department due to thyroid nodule. It shows 58.7% females and 41.3% males patients diagnosed. Out of 179 patients 106 patients 59.2% came with irregular margins thyroid nodules and remaining 73 patients 40.8% had thyroid nodules with regular margins. 127 patients 70.9% had hyperechoic thyroid nodules and 52 patients 29.1% had hypoechoic thyroid nodules. Out of 97 patients 54.2% developed (Multi Nodular Goiter) MNG, 66 patients 36.9% developed right thyroid nodules and 16 patients 8.9% developed left thyroid nodules. Females developed 56.2% MNG, 33.3% right thyroid nodule and 10.5% left thyroid nodule while males developed 51.4% MNG, 41.9% right thyroid nodule and 6.8% left thyroid nodule. Out of 179 patients 109 (60.9%) patients shows no perfusion of blood while remaining 70 (30.1%) shows some perfusion of blood on USG. Minimum age was 5 years and maximum were 90 years while their mean was 43. Age group between 41 to 50 years most likely develop thyroid nodules.  Conclusion: In this study we conclude that females most likely develop thyroid nodules than males.  Both males and females mostly develop multi nodular goiter and least develop left thyroid nodule. Patients in 4th decade most likely develop thyroid nodules. Key words: Thyroid nodules, Ultrasonography DOI: 10.7176/JHMN/80-15 Publication date:September 30th 202

Career Choices and Preferences of Saudi Pharmacy Undergraduates: A Cross Sectional Study

Background: Despite the increasing number of pharmacy schools and their graduates, the healthcare workforce shortage has increased in Saudi Arabia’s pharmacy sector, especially with the opening of new retail pharmacies, industries and pharmaceutical companies, which means that more pharmacist positions have been created with expanded working hours. However, very limited data are available regarding the views and preferences of pharmacy students regarding their future job choices in Saudi Arabia, which may create concerns for licensing organizations, employers and institutions and also gaps between what students want and the vacancies for pharmacists. Therefore, this study aims to identify pharmacy students’ career choices and examine the factors that influence their choices across different pharmacy schools in Saudi via a cross-sectional survey. Materials and methods: A cross-sectional survey was carried out of undergraduates at all education levels at different colleges of pharmacy across Saudi Arabia from October 2017 to March 2018. The questionnaire gathered students’ characteristics and covered the importance of general job considerations for students, their choices and the factors influencing their future career choices and finally the students’ opinions regarding different work settings. The data were analysed using the Statistical Package for the Social Sciences (SPSS). Results: Hospital pharmacies were the preferred area of practice (n = 212: 51.6%), followed by academia and research centres (n = 102: 24.8%), while the pharmaceutical industry and community pharmacies were the least preferred, at 7% and 2%, respectively. Based on the respondents’ characteristics and preferred future career, a multivariate logistic regression revealed that the pharmD students were 4 times more likely to prefer hospital pharmacy posts (odds ratio (OR) = 4.554, p = 0.033) compared with the B-pharm students. Among the factors that influenced the students’ choices were personal interest, in addition to training experience and organizational reputation. The most important job considerations, according to the students, was moving up the job ladder (n = 346; 84.2%), and job openings in a certain field (n = 341; 83%). The Kruskal-Wallis test for nonparametric ordinal data declared detected several significant differences among different pharmacy settings for each item measuring the pharmD and B-pharm students' attitudes and opinions. Conclusion: By identifying these gaps and pharmacy students' goals and needs, we aim to draw the government’s attention to these to ensure a future balance between supply and demand and effective pharmacy workforce planning, which is mandatory. Keywords: Pharmacy undergraduates, Education, Career choice, Saudi Arabi

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population