To identify the features differentiating peritoneal tuberculosis from carcinomatosis on CT scan abdomen taking omental biopsy as a gold standard

OBJECTIVE: To differentiate peritoneal tuberculosis from carcinomatosis on computed tomography scan of abdomen, taking omental biopsy as the gold standard.. METHODS: This retrospective diagnostic accuracy review of cases was conducted at Aga Khan University Hospital, Karachi, and comprised patient\u27s medical record files from February 2007 to February 2016. Computed tomography scan findings were compared with diagnosis made on the basis of histopathology. Multiple logistics regression analysis was done and sensitivity and specificity were tested through Pearson chi square test. RESULTS: Of the 98 patients identified, 62(63.2%)were found to be cases of disseminated tuberculosis and 36(36.7%) were diagnosed as malignant on histopathology. Computed tomography features were significantly specific to differentiate abdominal tuberculosis from carcinomatosis (p=0.004). On computed tomography,4 findings showed statistical significance: Smooth thickening of the peritoneum (p\u3c0.001), abdominal mass (p=0.03), lymph node necrosis (p=0.024) and high-density ascitic fluid (p\u3c0.001). Out of these, smooth thickening of the peritoneum (sensitivity=77%; specificity=86.1%) and high-density ascitic fluid (sensitivity=68.9%; specificity=72.2%) were more specific findings. Overall, the sensitivity and specificity of computed tomography was found to be 88.5% and 83.3%, respectively. CONCLUSIONS: Although no single finding on a computed tomography scan was diagnostic proof of peritoneal tuberculosis, a combination of findings could reliably distinguish between peritoneal tuberculosis and carcinomatosis

Evaluation of Severity of Schizophrenia in Tobacco Addicts

BACKGROUND: Nicotine use is reported more in Schizophrenic patients as compared to general population, which results is decrease efficacy of psychotropic medicines, thus increased severity of illness. OBJECTIVE: The objective of this study is to evaluate the severity of schizophrenia following tobacco use. METHODOLOGY: This cross-sectional study was conducted at department of Psychiatry Civil Hospital Karachi, Pakistan. Patients were recruited using convenience sampling technique. Clinical symptoms in patients were measured by the 18-item Brief Psychiatric Rating Scale (BPRS), scored 1–7 on each item. RESULTS: Out of the 276 patients included in the study, more than half of the participants were tobacco addicts (n=150, 54%). The statistical analysis showed significant relation (p value=0.04) between the Brief Psychiatric Rating Scale (BPRS) and tobacco addiction. CONCLUSION: This study found that schizophrenia patients with tobacco addiction had worse psychiatric symptoms as compared to those who are not addicted to tobacco

Corneal Collagen Cross-Linking Combined with an Artiflex Iris-Fixated Anterior Chamber Phakic Intraocular Lens Implantation in a Patient with Progressive Keratoconus

We present here the case of a 24-year-old male who experienced progressive keratoconus and vision loss which adversely affected his ability to carry out everyday tasks. This landed him in the Hashmanis Hospital for consultation. He had a preoperative best corrected visual acuity of 6/12. He underwent multiple Oculus Pentacam examinations, which showed progressive keratoconus. Corneal collagen cross-linking (CXL) was performed to stabilize his cornea and, subsequently, an Artiflex anterior chamber iris-fixated phakic intraocular lens (ACIF-PIOL) was implanted to alleviate his refractive errors. The patient achieved a postoperative uncorrected visual acuity of 6/12. This report shows that CXL combined with ACIF-PIOL can be safe and effective in those with progressive keratoconus