Peritoneal Lymphomatosis: The Great Mimicker.

Peritoneal lymphomatosis (PL) is defined as intraperitoneal dissemination of lymphoma. Although rare, it is associated with high-grade lymphomas and can be easily mistaken for peritoneal carcinomatosis (PC) on imaging, which is a common condition associated with gastrointestinal and gynecological malignancies. Both PL and PC share similar radiographic features, however, they differ considerably in terms of prognosis and management. We present a case of a 58-year-old male with abdominal distention and ascites, initially reported as having PC on imaging. A subsequent peritoneal biopsy revealed PL secondary to a low-grade follicular lymphoma. Since PL responds well to chemotherapy, its prompt diagnosis and differentiation from PC helps avoid unnecessary surgery.

A Rare Case of Mycobacterium Monacense Osteomyelitis: A Case Report.

Mycobacterium monacense (M. monacense) is a yellow-pigmented, rapidly growing non-tuberculous mycobacterium (RGM). It is a rare pathogen in humans, and only a very few cases of skin and lung infection related to it have been reported. In this report, we present the case of a 70-year-old Hispanic male who was brought to the hospital with back pain for 11 months. His physical exam on admission showed point tenderness in the lumbar and thoracic spine. MRI demonstrated severe spinal stenosis, discitis, and adjacent osteomyelitis at the T11-T12 vertebral bodies. Mycobacterium culture with fluorochrome smear from thoracic spine T12 tissue revealed mycobacterium species, but not Mycobacterium tuberculosis (M. tuberculosis). The final culture report led to the identification of M. monacense, which was confirmed by DNA sequencing. This case illustrates the rare manifestations of M. monacense and highlights the use of molecular biologic techniques to reach a definitive diagnosis in suspected cases. Infections caused by M. monacense are rarely reported in humans. Even though a few cases have reported M. monacense isolated from human samples, the clinical importance of it is not fully understood. A drug susceptibility test for antibiotic therapy is essential for this patient population. The interpretation of these cultures often generates unclear results. However, the aggravation of the disease on imaging and isolation of M. monacense alone from the cultured specimens obtained suggested that this pathogen may have caused the infection presented in this case.

A Rare Presentation of Angina and Arrhythmia in Absent Left Main Coronary Artery.

Coronary artery anomalies (CAAs) are congenital disorders with multiple variations in the number, shape, and location of the Ostia of the coronary arterial system. The congenitally absent left main coronary artery (LMCA) is a rare anomaly that can present with benign or fatal complications ahead in life. Diagnosis and management of CAAs are sometimes challenging in low-risk patients. We present a unique case report of a 69-year-old Hispanic female who presented to the hospital with exercise-induced arrhythmia and angina symptoms. The patient complained of several episodes of chest pain, dizziness, and palpitations for a duration of two months. Electrocardiogram (EKG) and nuclear stress tests were equivocal. The angiogram revealed the separate origin of the left anterior descending artery (LAD) and left circumflex coronary artery (LCX) from the left coronary sinus. This anomaly should be considered in differentials when evaluating patients with angina symptoms. Congenital absence of LMCA is a rare condition that remains asymptomatic in the majority of the cases. It can present with exertional chest pain, palpitations, syncope, and sudden cardiac death (SCD). Occurrences of angina and arrhythmia should be carefully evaluated, and symptoms should be followed up closely. A coronary angiogram and electrophysiological testing can assist in the diagnosis.

A hospital-based comparative study of the knowledge, attitudes and practices of family planning among women belonging to different socio-economic status.

OBJECTIVE: To assess the knowledge, attitudes and practices of family planning among women belonging to different socio-economic status. METHODS: A cross sectional study was conducted in the outpatient department of three hospitals of Ziauddin University based on the socioeconomic divide. Total 351 married females of reproductive age group with at least one child were selected after informed consent through non probability convenience sampling. Data was analyzed by using SPSS version 21. RESULTS: The preferred method of contraception in all three groups was a male condom30.9%. The upper socioeconomic group relied more on the modern methods of contraception 92% while the middle socioeconomic group relied on modern 71.7% as well as natural methods of contraception 28.3%. Use of contraceptives was comparatively lower in the low socioeconomic group 19.5%. Lower socioeconomic group also had the most children per family with mean and standard deviation of 3.6±2.3 and also had the highest number of desired children with mean and standard deviation of 4±1.4. The general reasons for avoiding contraceptives were difficulty in getting pregnant (11.1%), the want for more children (10.2%), infrequent sexual intercourse (10.0%) and fear of side effects (6.9%). CONCLUSIONS: Awareness of contraception was found lowest in the lower socioeconomic class, with the elite class using a high percentage of contraceptives.