Depression is a common illness worldwide, with an estimated 3.8% of the population affected, including 5.0% among adults and 5.7% among adults older than 60 years.
Brain fag syndrome,hypochondriasis and conversion disorderDr.Emmanuel Godwin
Brain fag syndrome,hypochondriasis and conversion disorder are forms of somatoform disorder....This are disorders that present with Physical symptoms with an unexplained cause.
Depression is a common illness worldwide, with an estimated 3.8% of the population affected, including 5.0% among adults and 5.7% among adults older than 60 years.
Brain fag syndrome,hypochondriasis and conversion disorderDr.Emmanuel Godwin
Brain fag syndrome,hypochondriasis and conversion disorder are forms of somatoform disorder....This are disorders that present with Physical symptoms with an unexplained cause.
An interactive case presentation during the monthly meeting of Early-career psychiatrists in Jeddah, SA. Basically, a case managed and supervised clinically by Dr Shokry Alemam, MD
In this presentation I have tried to discuss in brief about obsessive compulsive disorder and its treatment both pharmacological and non pharmacological.
An interactive case presentation during the monthly meeting of Early-career psychiatrists in Jeddah, SA. Basically, a case managed and supervised clinically by Dr Shokry Alemam, MD
In this presentation I have tried to discuss in brief about obsessive compulsive disorder and its treatment both pharmacological and non pharmacological.
Diagnostic records /certified fixed orthodontic courses by Indian dental acad...Indian dental academy
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This is a case study on Viral Pneumonia where a patient came with fever, generalised bodyache and fatigue but was undiagnosed , but when she suddenly, developed respiratory distress, desaturated,then the whole story got changed.so, may this study be of some help to you all!
Ectodermal Dysplasia: a case report and overview Waikhom Singh
A rare case of Hypohydrotic Ectodermal Dysplasia afflicting a 14 year old male is described.The characteristic features related to teeth and hair is also highlighted .
Schizophrenia is a serious mental illness that affects how a person thinks, f...AmitSherawat2
Schizophrenia is a serious mental illness that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality, which can be distressing for them and for their family a
Delusional Misidentification syndrome is a group of delusional phenomena in which patients misidentify familiar persons, objects, or self, and believe that they have been replaced or transformed.
Delusion is defined as a psychiatric disorder of thought content characterized by a belief, usually false, that is held with utter conviction despite evidence to the contrary and it cannot be explained by the educational or socio-cultural background of the person who holds the belief.
2Assessing ClientsA comprehensive assessment of the patient who p.docxBHANU281672
2Assessing Clients“A comprehensive assessment of the patient who presents for psychotherapy is necessary to develop an appropriate treatment plan. This assessment is a relational process that sets the tone for subsequent sessions” (Wheeler, 2014, p. 131). As a future Psychiatric Mental Health Nurse Practitioner, it is essential to be able to accurately assess clients to determine whether yourtherapeutic approach would contribute to improved clinical outcomes. The purpose of this assignment is to select a client that was observed or counseled at my practicum site and completea comprehensive client assessment and genogram for the client selected.Comprehensive Client AssessmentDemographic information for the client chosen is as follows: The client is a 27-year-old African female who resides in Maryland. She is a single, heterosexual, mother of fraternal twins,a boy and a girl. She was referred by her psychiatrist to the current counselor for psychotherapy and is primarily followed by the psychiatrist for medication management. The client has been receiving psychotherapy for the past two years. Her presenting problem revolves around learning how to be independent while coping with her mental illness. She stated, “I need help with figuring out my finances.” History of present illness: Client has a history of bipolar and presented to the office with complaints about her “baby daddy” not wanting to help her out with their children and about how difficult it’s going to be when her cousin stops keeping her twins because daycare is expensive. She also expressed discontent towards her father interfering in herpsychiatric care because he shares the same Nigerian ethnicity as her psychiatrist and she wants to be on less medication and receives more psychotherapy. The client’s past psychiatric history includes two psychiatric hospitalizations for manic episodes with psychosis. Medical history includes a previous diagnosis of hypertension (HTN), but that diagnosis was later removed. The
3client never took any medications for HTN diagnosis, and HTN resolved through life modifiers. Currently takes Lithium and Cogentin. The client has no substance use history, and developmental milestones were reached as expected. No family psychiatric history reported. Psychosocial history: She currently lives with her father. Her youngest brother and cousin, who is married, also reside in the same house. She works a full-time minimum wage job and is recently single. She has been in contact with her ex-boyfriend who is trying to ‘hook up’ with her to have sex. She is the mother of fraternal twins, a boy and a girl. No history of abuse or trauma.Psychiatric Review of SystemsClient denies “shortness of breath, heart palpitations, panic attacks, sweating flushing, hyperventilation, sense of doom, fear of death or collapse, cold or clammy skin, and tingling sensations in extremities” (Wheeler, 2014, p. 140). Client denies feeling sad, irritable, tired, h.
Abnormal Psychology: Concepts of NormalityMackenzie
Notes for section 5.1 of my psych textbook for the option of "Abnormal Psychology" on the I.B. HL Psychology test. All about cultural norms, normal vs. abnormal, diagnosing processes,validity and whatnot.
“Epilepsy and mental disorder are two states of illness of the very closest relationship; they represent identical pathological conditions in two different areas of the nervous system”
Behavioral Disorder: Schizophrenia & it's Case Study.pdfSELF-EXPLANATORY
This pdf is about the Behavioral Disorder: Schizophrenia & it's Case Study.
For more details visit on YouTube; @SELF-EXPLANATORY;
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Thanks...!
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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3. Chief Complaint
• BRMC ED
– “My brother-in-law called the police”.
• PESP Outreach Report
– Agitation, unable to care for self at times
(unspecified duration), and passive suicidal
ideation without plan (unspecified duration) per
brother-in-law.
4. History of Present Illness
• Meningioma of brain 2001
– Resection 2002.
• Per collaterals (ex-husband, sister, brother-in-
law), px developed odd thoughts and behaviors
after her surgery which gradually intensified and
increased in frequency.
– Mood lability and agitation.
– Verbal arguments with family members and children.
– Unspecified suicidal ideations.
– Odd beliefs.
5. History of Present Illness
• Multiple psychiatric/psychological evaluations.
• Psychiatric hospitalization in 2006.
• Working psychiatric diagnosis made in 2009.
• Per collaterals, in 2013 px began to exhibit
rapid and further decline in daily functioning.
• Psychiatric hospitalization in 2013.
6. History of Present Illness
• Continued practicing as dentist.
• Poor compliance to therapy.
• No history of AH, VH, HI, or suicide attempts.
• 3/23/14 Ex-husband witnessed rapid change
in mood, verbal aggression, and unspecified
SI.
• 3/24/14 Called px guardian to report incident -
> PESP -> BRMC -> Admission.
9. Past Psychiatric History
• Evaluated & treatment attempted by several
psychiatrists beginning 2002 (NJ & NY).
• Psychotic d/o NOS.
• Refuses medical treatment.
• Psychiatric admission.
– 2006, SI, plan to jump off bridge(Englewood).
10. Past Psychiatric History
• Diagnosed with Capgras Syndrome in 2009 after
evaluation by forensic psychiatrist.
• Began treatment and followed on out-patient
basis by NY psychologist in 2013.
• Bipolar d/o NOS.
• Psychiatric admission.
– December 2013, SI, no plan (BRMC).
– Court ordered guardian (unable to care for self/$$$).
• Psychiatric admission.
– March 2014, SI, no plan (BRMC).
11. Past Psychiatric History
• Admission March 2014 attributed to continued refusal
of medical treatment, decompensation, SI.
• Per collaterals.
– Rapid and progressive decline.
– Disheveled, unclean living conditions.
– Driving unsafe car in unsafe manner with children in car.
– Violent language toward sister, (-)HI.
– Increasing non-specific SI’s.
– Stated to sister and brother-in-law she believed they are
not who they say they are.
– “You are no more what you used to be before”.
12. Past Psychiatric History
• Per legal documents obtained.
– NJ dental license suspended due to patient
complaints of bizarre behavior and conversations.
– Claimed to NJ dental board patients were
imposters and not her patients (Variations in
dental impressions and dental bridges ordered did
not fit patients).
– Insurance fraud investigation (Excessive and
unnecessary dental impressions of patients then
billing insurance).
13. Past Medical History
• Brain Meningioma (2001).
• Resection (2002).
• No previous or current medications.
• NKDA/NKA.
14. Social & Family History
• Divorced x2 to same individual.
• 3 children (13F, 10M, 7M)
– Father/ex-husband with full custody.
– Weekend supervised visitation.
• Dentist in NJ/NY with private practice.
– 2013 NJ dental license suspended. Currently petitioning board.’
– NY dental license current.
• Lives alone in private home.
– Foreclosure proceedings pending due to lack of income.
• No history of substance abuse or dependence.
• Court appointed legal guardian (2013).
• Current litigation (NJ).
16. Biopsychosocial Formulation
• This is a 50yo Hispanic female, divorced, living
in Englewood, NJ. H/o brain meningioma with
resection (2002), psychotic d/o NOS
(2002), Capgras Syndrome (2009). Non-
compliant and refusal of medical treatment.
History of three in-patient psychiatric
admissions (2006, 2013, 2014). PESP outreach
(2014) for inability to care for self and
unspecified SI.
17. Biopsychosocial Formulation
• Predisposing Factors
– Brain Meningioma & Resection.
– Non-compliance to medical treatment.
• Precipitating Factors
– Non-compliance to medical treatment.
• Perpetuating Factors
– Lost custody of children.
– Suspension of dental license, unemployment.
– Insurance litigation.
– Financial struggles/Foreclosure.
• Protective Factors
– Access to healthcare/health insurance.
– Px now appears willing to accept help/compliance.
– Family support.
• Prognostic Factors
– Guarded due to history of poor compliance and medical predisposition.
18. Diagnostic Impression
• AXIS I
– Medical/Surgical induced psychotic d/o (Capgras).
• AXIS II
– Deferred.
• AXIS III
– Brain Meningioma with resection (2002).
• AXIS IV
– Loss of child custody, perceived lack of social
support, unemployment, litigation, financial
struggles, foreclosure and possible homelessness.
• AXIS V
– GAF 25
19. Treatment Plan
• Restart/Trial Olanzepine (Zyprexa) 20mg
– 1 Tab PO QD
• Family Therapy
• Group Therapy
• Individual Therapy
• Milieu Therapy
20. Research
Fennig S, Naisberg-Fennig S, Bromet E. [Capgras' syndrome with right frontal
meningioma]. Harefuah. 1994 Mar 15;126(6):320-1, 367. Hebrew. PubMed
PMID: 8194787.
We present a 43-year-old woman with a right frontal parasagittal meningioma
of the brain who developed the delusion that her husband and children had
been replaced by doubles (look-alikes). This type of delusion is typical for
Capgras' syndrome. After removal of the tumor the delusion disappeared. The
majority of such patients are diagnosed as paranoid schizophrenia.
However, in the past decade there has been an increasing number of cases in
which the etiology is suspected of being organic, involving mainly the right
hemisphere. The case presented is unique because it is the first with
meningioma as a possible pathogenic factor in the syndrome, as evidenced
by the cessation of the delusion when the tumor was removed.
21. Research
Madoz-Gúrpide A, Hillers-Rodríguez R. [Capgras delusion: a review of
aetiological theories]. Rev Neurol. 2010 Apr 1;50(7):420-30. Review. Spanish.
PubMed PMID: 20387212.
According to cognitive models, Capgras syndrome cannot be exclusively
conceived as a dysfunction in facial recognition but in recognizing a person
globally considered. Feeling of familiarity is absent due to the inability to
integrate successive memories about a person along episodic
experiences, thus generating delusional doubles in accordance to the
patient's needs or drives. From the neuropsychiatry point of view Capgras
delusion arises from the failure in reconciling information about identification
of the person and its associated emotions by the disconnection between
frontal lobes and right temporo-limbic regions (hippocampus), in addition to
bilateral frontal damage. Delusions are more commonly associated with right
hemisphere lesions because of the impairment of several functions such as
self monitoring, reality monitoring, memory and feelings of familiarity as well
as the necessary preservation of the left hemisphere.
22. Research
Olanzapine in the treatment of Capgras Syndrome: A case report
Julio Torales, Hugo Rodríguez, Andrés Arce, Martín Moreno, Viviana Riego, Emilia
Chávez, Marcos Capurro International Journal of Culture and Mental Health Vol. 7,
Iss. 2, 2014
•Capgras Syndrome is a delusion characterized by the patient's belief that his or her
relatives (or close friends) have been replaced by impostors who have a close
resemblance to the originals. Here we describe the clinical picture and the therapeutic
approach to a 41-year-old, divorced, Caucasian female with acute delusions and
problematic behavior. Treatment with olanzapine was initiated, based on its reported
efficacy in the treatment of monosymptomatic hypochondriacal psychosis. Our case
shows that treatment with olanzapine can lead to a good clinical outcome with a
remission of the psychotic symptoms. In our experience, the starting dose should be
as low as possible in order to avoid the occurrence of adverse effects (which are often
responsible for the dropout). According to the severity of symptoms and the risk to
the patient and family, the patient's admission to an inpatient unit should be
considered.