Clinical utility of ¹⁸F FDG-PET/CT in the detection of bone marrow disease in Hodgkin's lymphoma

OBJECTIVE

The aim of the study was to evaluate the potential role of fludeoxyglucose (FDG)-positron emission tomography (PET)/CT in the detection of bone/bone marrow disease in patients with Hodgkin's lymphoma (HL).

METHODS

We retrospectively reviewed ((18)F)-FDG-PET/CT scans of 122 newly diagnosed, biopsy-proven cases of HL performed between November 2009 and June 2010. All the patients were staged before treatment by both PET/CT and bone marrow biopsy (BMB). Patients were subdivided into three groups based on the findings of FDG-PET/CT. Group A consisted of patients showing diffuse FDG uptake, Group B consisted of patients showing unifocal FDG uptake and Group C patients showed multifocal FDG-avid foci on PET/CT scans. Bone marrow results were also reviewed and considered positive if lymphomatous involvement was detected on bone marrow trephine biopsy. BMB results were correlated with FDG-PET/CT findings.

RESULTS

There were 122 patients in total-81 (66.4%) were male and 41 (33.6%) were female. The age range was from 6 years to 78 years (mean 35.70 years). PET/CT was reported as negative for bone/bone marrow involvement in 85 (69.7%) patients, while the remaining 37 showed abnormal FDG uptake. The sensitivity of FDG-PET/CT was calculated to be 100%, the specificity was 76.57%, the negative predictive value was 76.57%, the positive predictive value was 29.72% and the diagnostic accuracy was 78.62%.

CONCLUSION

(18)F-FDG-PET/CT and BMB are complementary in the evaluation of bone marrow disease.

Direct and indirect anthelmintic effects of condensed tannins in sheep

Anthelmintic activity of condensed tannins (CT) was evaluated both in vitro and in vivo. In vitro tests included egg hatch test and paralysis/mortality assay on adult Haemonchus contortus. In vivo anthelmintic effect was determined by faecal egg count reduction test in lambs. To this end, 18 lambs were divided into three groups (low tannin, high tannin and control). The lambs of low and high tannin groups were fed diets containing 2 and 3% CT while the control group was fed on diets without CT. In vitro trials showed a dose-dependent inhibition of nematode egg hatching; whereas, there was no effect of CT on adult H. contortus. In vivo trials indicated reduction in faecal egg counts in lambs fed diets containing CT. Feed intake and nutrient digestibility of CT-fed sheep was lower and nitrogen balance was higher as compared to control. Maximum weight gain was observed in animals fed diets containing 3% CT. The direct anthelmintic effect of CT, therefore, was evidenced by inhibited egg hatching; whereas, faecal egg counts reduction in sheep was through improved nutrient utilization.

Fifteen-year follow-up of conversion disorder

The terms 'conversion', 'hysteria' and 'conversion hysteria' were used interchangeably to describe a condition characterised by a single somatised symptom, often pseudo-neurological in nature. DSM-III (American Psychiatric Association, 1980) expanded the concept of conversion to generalised symptoms involving loss or alteration of physical functioning suggestive of a physical disorder, along with a clinical indication that the conversion was an expression of psychological conflict or need. The type of symptom or deficit should be specified as: with motor symptom or deficit, with sensory symptom or deficit, with seizure or convulsions, or with mixed presentation (Kaplan & Sadock, 2004).

Prevalence of mental health problems in acne patients

BACKGROUND

Acne is the most common of all skin diseases. The condition affects young people at the time when they are undergoing maximum social and physical change and can produce significant psychological scarring. This study was done to determine the Mental Health problem in Patients suffering from acne and to determine significant difference of mental health problems in acne patients in comparison to seborrhic dermatitis patients as a control group.

METHODS

50 subjects with acne and 50 with seborrhic skin problems (13-25 yrs age) were included in this study through Psychiatry OPD of Lady Reading Hospital, Peshawar. The period of study was from March 1998 to August 1998. The patients were assessed for psychiatric problems by using WHO Guide to mental health in primary care ICD 10 chapter V primary care. The statistical significance was determined by chi square.

RESULTS

The data shows that out of 50 acne patients 19 (38%) were suffering from Depression, with a female predominance. The control group (seborrhic) presented lower prevalence of Depression i.e. 57% in females. Similarly Anxiety problem in particular social anxiety were overall more in acne group (34%) as compared to seborrhea group (10%). A statistically significant difference was observed between the two groups indicating that depression and social anxiety was more in the acne group. A consistent finding in the study over six months depicted the difference between gender i.e. more females presenting with depression. Total Depressed Patients were 19, while total with suicidal Thoughts were 4 (21%).

CONCLUSION

The importance of this study is to highlight depression among such patients.

Psychiatric comorbidity in substance abuse (opioids)

OBJECTIVE

To find the prevalence of psychiatric disorders among the opioids dependents and to assess the severity of their addiction profile.

METHOD

Sample comprised of fifty patients admitted in drug treatment and rehabilitation center at Psychiatry Department of Lady Reading Hospital, Peshawar, between March to August 1997. DSM-IV diagnostic criteria were applied to diagnose substance dependence and associated psychiatric morbidity, while Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale and Addiction Severity Index were used to assess severity of anxiety, depression and dependence respectively.

RESULTS

The major co-morbid psychiatric conditions were major depression (30%), personality disorder (6%), generalized anxiety disorder (4%), phobic disorder (4%), panic disorder (2%), dysthymic disorder (2%).

CONCLUSION

The overall findings in this study lends support to the hypothesis, that there is substantial psychiatric co-morbidity amongst the opioid abusers and dependents in our population, as is found in studies from the West.

Community programme in Pakistan aimed at preventing and reducing drug abuse

A voluntary organization called the Green December Movement was established in December 1983 to make better use of the resources available at the community level for the prevention and reduction of drug abuse in the North Western Frontier Province of Pakistan. As a result, two major treatment and rehabilitation centres have been set up, one in Peshawar and another in Mardan, that provide free treatment for drug addicts, including those from other parts of the province. To cope with the recent increase in heroin abuse in the province, the Green December Movement has succeeded in involving both men and women in community efforts to reduce drug abuse. Emphasis has been placed on the involvement of religious leaders in drug abuse prevention activities, particularly in alerting the population to drug problems, as well as in providing spiritual and psychosocial support for detoxified addicts, which helps them to stay away from drugs. The Green December Movement has recently gained national status, and branch offices have been established in Karachi and Quetta. In addition, the Green December Movement provides drug information adapted for various target groups and encourages students, teachers and out-of-school youth to participate in community activities aimed at preventing drug abuse. To this end, the Green December Movement closely co-operates with government agencies and non-governmental organizations concerned with drug problems in the community and has undertaken research on various aspects of the nature and extent of drug abuse, as well as on its prevention and treatment. An evaluation of the Green December Movement activities carried out so far has revealed positive results.