RESUMO
Pelvic-peritoneal tuberculosis is a common extrapulmonary site in young females mimicking an advanced ovarian malignancy. We present 2 cases with the classical triad of advanced-stage ovarian carcinoma-ascites, abdominopelvic masses and elevated serum CA-125 levels. Laparoscopic examination revealed peritoneal nodules which on biopsy showed granulomatous inflammation and no malignant cells. Patients were started on anti-tuberculous therapy and on follow-up their symptoms as well as CA-125 levels normalized. Medical awareness of peritoneal tuberculosis is lacking and many young women with this disease undergo unnecessary extended surgery. Diagnostic laparoscopy combined with peritoneal biopsy seems to be a sufficient and safe method to provide a definitive diagnosis for this curable infection. If left untreated, the disease may disseminate and result in significant organ dysfunctions particularly infertility
RESUMO
To assess the prevalence and severity of malnutrition among COPD patients along with the effect of dietary intervention on the disease outcome. This was an interventional, Quasi- experimental study. The study was conducted at Department of Medicine and Department of Chest Diseases, Jinnah Hospital, Lahore. Total duration was one year from April 2009 to March 2010. Sample Size: 100 patients with COPD were investigated. Purposive Non-probability sampling. Majority of the patients were in the age range 50 - 70 years with more males than females. 97% patients had a positive tobacco smoking history. 57 - 78% of the patients included in the study were found to be malnourished, out of which 65 - 68% were moderately malnourished and 10% were severely malnourished according to SGA rating and BMI. There was a strong correlation between COPD staging and malnourishment. 54% patients with stage III COPD were malnourished while 90% patients with stage IV were found to be malnourished. Malnutrition is invariably observed in COPD patients and is more frequent and more severe in patients with advanced stage disease. Patients with COPD might benefit from a dietary intervention both in terms of pulmonary functions and nutritional state, which might have beneficial effects on prognosis