Background and Objective: Patients with schizophrenia are more prone to develop metabolic syndrome (MetS) with its related complications, including cardiovascular diseases and diabetes mellitus compared to the general population. In this study, we aim to evaluate the effect of low-carbohydrate diet on MetS Z score, weight status, and symptomatology of patients with schizophrenia in Bahrain. Materials and Methods: This single-group pretest–posttest study was executed while considering an ethical approach of volunteer participants, a sample size of 35 patients with schizophrenia. The participants were instructed to follow a low-carbohydrate moderate-fat diet for 8 weeks. Anthropometric measurements, mean arterial pressure, basal metabolic index, body fat percentage (BFP), body surface area (BSA), and MetS Z score and Clinical Global Impression (CGI) Scale were collected before and after the diet intervention. Descriptive statistics, including the mean and standard deviations, were used for continuous variables and percentages for the categorical variables. Paired t-tests and effect size were used to analyze the mean difference of the values before and after the diet intervention. Results: A statistical significance in the mean difference was observed among the following variables: MetS Z score, weight, body mass index (BMI), high-density lipoproteins (HDL), low-density lipoprotein (LDL), thrombin generation test, waist circumference (WC), BFP, BSA, and CGI-improvement (CGI-I). Weight, BMI, TG, BFP, BSA, and CGI-I had a large effect size of the mean difference, whereas LDL, HDL, and WC had a moderate effect size. There was no statistically significant difference in the MetS Z score between male and female after the diet intervention (P = 0.274). Conclusion: Dietary modification with low-carbohydrates restriction is a workable approach in the management of schizophrenia and its related metabolic complications. Clinical trials need to be conducted to corroborate the implementation of dietary intervention as a co-treatment of schizophrenia.

Gallbladder disease is a very common condition that encompasses a heterogeneous group of diseases with a wide range of severity and clinical manifestations. Gallbladder disorders include biliary colic, acute cholecystitis, chronic cholecystitis, choledocholithiasis, Mirizzi syndrome, and gallstone ileus. We report the case of a 70-year-old man who presented to the emergency department complaining of worsening abdominal pain, located in the right upper quadrant and radiating to the right shoulder. It was aggravated by food intake and relieved with the use of antacid medications. The medical history of the patient was significant for stable angina, hypertension, diabetes mellitus, hyperlipidemia, and sickle cell trait. Examination of the abdomen revealed generalized tenderness with guarding. Abdominal computed tomography scan demonstrated the presence of significant diffuse thickening of the gallbladder wall with poor contrast enhancement. Complete resection of the gallbladder was performed because of suspected gallbladder carcinoma. Histopathological examination revealed xanthogranulomatous cholecystitis, which is a rare form of chronic cholecystitis. The differentiation between gallbladder carcinoma and xanthogranulomatous cholecystitis may not be easy and histopathological examination is the most accurate way to make the diagnosis.

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