Delusional parasitosis: A case series.

Delusional parasitosis (DP) is an infrequent psychotic illness, where the patient has a false but firm belief that his body is infested with parasites. It can be primary or secondary. Usually, these patients consult nonpsychiatric specialties from where they are referred to psychiatry. The presentation of DP varies among patients, although it typically manifests as a crawling and pinpricking sensation. Hallucinations are commonly seen. Antipsychotics show good remission of symptoms. A series of seven cases of DP have been described, and the condition is briefly discussed.

Suicidal behavior in schizophrenia: A case series.

Suicide/parasuicide is seen at a greater rate in schizophrenia than in the general population, yet the psychological basis of this risk is poorly understood. It is estimated that 10% of patients suffering from schizophrenia attempt suicide. The major risk factors implicated are male gender, chronic illness with multiple relapses, family history of suicide, past suicidal and impulsive behavior, negative attitude toward treatment, and concurrent substance use. Treatment must target the identified risk factors for prevention of suicide in these patients. Here, we discuss three cases with self-inflicted cuts over the anterior aspect of the neck and wrists. They were diagnosed to have paranoid schizophrenia and were treated with antipsychotics, on which they showed improvement.

Effectiveness of proprioceptive training and conventional physical therapy in treating adhesive capsulitis.

OBJECTIVE: To determine effectiveness of proprioceptive training and conventional physical therapy in managing patients with adhesive capsulitis. METHODS: A pre-test post-test control group study was conducted at Rehman Medical Institute from June to December 2019. Thirty-eight patients, aged 30 to 60 years, with diagnosis of adhesive capsulitis for more than four months were divided into two groups. Subjects in Group-I (conventional group; n=19) received conventional physical therapy protocols for one month while subjects in Group-II (proprioceptive group; n=19) received proprioceptive training along with conventional physical therapy for one month. Disability of Arm Shoulder & Hand questionnaire, Shoulder Pain & Disability Index and goniometer were used at baseline and post-treatment to assess functional activity level, pain & disability and range of motion respectively. Data was analyzed using SPSS version 20. RESULTS: The mean age of the participants was 53.13 ± 9.12 years. Baseline characteristics were balanced between the two groups. After the treatment, all measures (functional activity level, pain, disability, ROM) improved in both groups. Post treatment, between group analysis showed that functional activity (DASH) and pain (SPADI pain) significantly (P-value <0.05) improved in proprioceptive group as compared to conventional group. However, there were no significant differences (P-value≥ 0.05) in post treatment SPADI disability, SPADI total and ROM (flexion, abduction, external rotation) scores of both groups. CONCLUSION: Proprioceptive exercises along with conventional physical therapy are more effective in managing pain and improving functional activities in adhesive capsulitis patients as compared to conventional physical therapy alone.

Diagnostic Accuracy of Sonoelastography in the Non-Invasive Diagnosis of Malignant Breast Cancer Compared to Histopathology as a Gold Standard.

OBJECTIVE: To observe the diagnostic accuracy of elastography in detecting malignant breast lesion taking strain ratio of 4.8 and histopathology as gold standard. STUDY DESIGN: Descriptive cross-sectional study. PLACE AND DURATION OF STUDY: Department of Diagnostic Radiology, from March to September 2015. METHODOLOGY: Atotal of 137 patients aged 20 to 60 years with clinically palpable breast lump of any size for at least one month duration were included in this study. Patients with purely cystic lesions and those on chemotherapy or hormonal therapy were excluded. Each patient was subjected to sonoelastography followed by ultrasound guided trucut biopsy. The strain ratio cut off value of 4.8 was used to differentiate benign from malignant lesion. Consultant histopathologist's report upon the biopsy specimens was obtained. Results of sonoelastography were compared with histopathology reports. RESULTS: Mean age was 38.20 ±10.63 years. The size of the lesion ranged from 2.0 to 6.0 cm, a mean = 3.97 ±1.26 cm. The duration since the lump was noticed ranged from 12 weeks (3 months) to 20 weeks (5 months) with a mean of 15.09 ±2.56 weeks. Forty-one (29.9%) lesions were labelled malignant on sonoelastography while the actual number of malignant lesions was 35 (25.5%) on histopathology. When the results of sonoelastography were cross-tabulated with histopathology results, the number of TP(true positive), FN (false negative), FP(false positive) and TN (True negative) were 31, 4, 10 and 92 cases, respectively. It yielded 88.57% sensitivity, 90.20% specificity, 75.61% positive predictive value, 95.83% negative predictive value, 89.78% accuracy for sonoelastography in the diagnosis of malignant breast lesion taking histopathology as gold standard with an observed prevalence of malignant breast mass to be 25.55%. CONCLUSION: Using a strain ratio of 4.8, sonoelastography was found to be 88.57% sensitive, 90.20% specific, and 89.78% accurate in the diagnosis of malignant breast masses.