scholarly journals Intestinal Obstruction following Ingestion of Metallic Instruments in a Psychiatric Patient

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Oscar Kivike ◽  
Israel Soko ◽  
David Mgaya ◽  
Frank Sandi
Keyword(s):  
Physical Examination ◽  
Intestinal Obstruction ◽  
Female Patient ◽  
Psychiatric Patient ◽  
Psychiatric Patients ◽  
Abdominal Distension ◽  
History Taking ◽  
Proximal Intestine ◽  
Psychotic Features

Pica among psychiatric patients has been well documented. We report a 25-year-old female patient who presented with abdominal distension for one week. She is a known psychiatric patient for 5 years. Through history taking, physical examination, and investigations, the patient was found to have psychotic features and features of intestinal obstruction. Surgery was done by opening the abdomen and then the stomach. The stomach, together with the proximal intestine, was found to be filled with metallic instruments weighing 780 mg. The diagnosis of a metalophagia type of pica was reached. All instruments were removed and the patient did well postoperatively.

scholarly journals Congenital Descending Colonic Stenosis with Perforation of Transverse Colon in a Neonate: A Case Report

2012 ◽  
Vol 32 (1) ◽  
pp. 73-75
Author(s):  
R Hamid ◽  
AH Shera ◽  
NA Bhat ◽  
A Baba ◽  
A Rashid
Keyword(s):  
Intestinal Obstruction ◽  
Sigmoid Colon ◽  
Transverse Colon ◽  
Late Onset ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Uneventful Recovery ◽  
Colonic Stenosis ◽  
Colonic Atresia ◽  
Mucous Fistula

Colonic atresia and stenosis are rare causes of intestinal obstruction in the infant. Only 10 cases have been reported in Literature since 1966 and only one late-onset case has been reported in Literature until now. We describe the case of a 3 day old baby presenting with abdominal distension, failure to pass meconium and vomiting. X-ray of the abdomen showed dilated gut loops. Exploratory laparotomy was performed. At the junction of descending and sigmoid colon a stenosis was found, laparotomy also revealed a perforation of transverse colon. Transverse colostomy and a mucous fistula of sigmoid colon was performed after resecting stenosing segment and colon distal to perforation site upto stenosing site. Diagnosis was confirmed on histopathology. Colostomy was close after six weaks with uneventful recovery. Considering both the Literature and our case, congenital colonic stenosis should be considered one of the rare differential diagnoses in a neonate presenting as complete or partial intestinal obstruction. Key words: Colonic Stenosis; Perforation; Obstruction DOI: http://dx.doi.org/10.3126/jnps.v32i1.5446   J. Nepal Paediatr. Soc. Vol.32(1) 2012 73-75  

Physically III and Mentally III

1986 ◽  
Vol 31 (3) ◽  
pp. 197-201 ◽  
Author(s):  
Robert Johnson ◽  
Jambur Ananth
Keyword(s):  
Physical Examination ◽  
Psychiatric Patients ◽  
Case Reports ◽  
Physical Examinations ◽  
Atypical Presentations ◽  
Do So

Undetected physical illnesses in psychiatric patients are common. Why do so many physical illnesses go undetected? These disorders are difficult to detect and need an elaborate consultatory process. Some of the problems may be related to the fact that psychiatrists do not do physical examinations. Clues suggesting an organic etiology may be attributed to psychodynamic issues by many physicians. In this paper, seven case reports are presented to illustrate the following: perform your own physical examination; do not attribute physical signs to dynamic issues; all physical signs should be explained; be alert to atypical presentations; conduct relevant laboratory workup; avoid bias against unattractive patients; and pose specific questions to consultants.

scholarly journals Machine learning for psychiatric patient triaging: an investigation of cascading classifiers

2018 ◽  
Vol 25 (11) ◽  
pp. 1481-1487 ◽  
Author(s):  
Vivek Kumar Singh ◽  
Utkarsh Shrivastava ◽  
Lina Bouayad ◽  
Balaji Padmanabhan ◽  
Anna Ialynytchev ◽  
...  
Keyword(s):  
Machine Learning ◽  
Psychiatric Patient ◽  
Classification Accuracy ◽  
Psychiatric Patients ◽  
Patient Records ◽  
Classification Technique ◽  
Machine Learning Approach ◽  
The One ◽  
Unique Dataset

Abstract Objective Develop an approach, One-class-at-a-time, for triaging psychiatric patients using machine learning on textual patient records. Our approach aims to automate the triaging process and reduce expert effort while providing high classification reliability. Materials and Methods The One-class-at-a-time approach is a multistage cascading classification technique that achieves higher triage classification accuracy compared to traditional multiclass classifiers through 1) classifying one class at a time (or stage), and 2) identification and application of the highest accuracy classifier at each stage. The approach was evaluated using a unique dataset of 433 psychiatric patient records with a triage class label provided by “I2B2 challenge,” a recent competition in the medical informatics community. Results The One-class-at-a-time cascading classifier outperformed state-of-the-art classification techniques with overall classification accuracy of 77% among 4 classes, exceeding accuracies of existing multiclass classifiers. The approach also enabled highly accurate classification of individual classes—the severe and mild with 85% accuracy, moderate with 64% accuracy, and absent with 60% accuracy. Discussion The triaging of psychiatric cases is a challenging problem due to the lack of clear guidelines and protocols. Our work presents a machine learning approach using psychiatric records for triaging patients based on their severity condition. Conclusion The One-class-at-a-time cascading classifier can be used as a decision aid to reduce triaging effort of physicians and nurses, while providing a unique opportunity to involve experts at each stage to reduce false positive and further improve the system’s accuracy.

Narcolepsy: Differential Diagnosis or Etiology in Some Cases of Bipolar Disorder and Schizophrenia?

CNS Spectrums ◽  
2003 ◽  
Vol 8 (2) ◽  
pp. 120-126 ◽  
Author(s):  
Alan B. Douglass
Keyword(s):  
Bipolar Disorder ◽  
Differential Diagnosis ◽  
Psychiatric Patients ◽  
Human Leukocyte ◽  
Sleep Paralysis ◽  
Leukocyte Antigen ◽  
Psychotic Features ◽  
Hypnagogic Hallucinations ◽  
Rule Out

AbstractDoes narcolepsy, a neurological disease, need to be considered when diagnosing major mental illness? Clinicians have reported cases of narcolepsy with prominent hypnagogic hallucinations that were mistakenly diagnosed as schizophrenia. In some bipolar disorder patients with narcolepsy, the HH resulted in their receiving a more severe diagnosis (ie, bipolar disorder with psychotic features or schizoaffective disorder). The role of narcolepsy in psychiatric patients has remained obscure and problematic, and it may be more prevalent than commonly believed. Classical narcolepsy patients display the clinical “tetrad”—cataplexy, hypnagogic hallucinations, daytime sleep attacks, and sleep paralysis. Over 85% also display the human leukocyte antigen marker DQB10602 (subset of DQ6). Since 1998, discoveries in neuroanatomy and neurophysiology have greatly advanced the understanding of narcolepsy, which involves a nearly total loss of the recently discovered orexin/hypocretin (hypocretin) neurons of the hypothalamus, likely by an autoimmune mechanism. Hypocretin neurons normally supply excitatory signals to brainstem nuclei producing norepinephrine, serotonin, histamine, and dopamine, with resultant suppression of sleep. They also project to basal forebrain areas and cortex. A literature review regarding the differential diagnosis of narcolepsy, affective disorder, and schizophrenia is presented. Furthermore, it is now possible to rule out classical narcolepsy in difficult psychiatric cases. Surprisingly, psychotic patients with narcolepsy will likely require stimulants to fully recover. Many conventional antipsychotic drugs would worsen their symptoms and make them appear to become a “chronic psychotic,” while in fact they can now be properly diagnosed and treated.

scholarly journals A Rare Cause of Intestinal Obstruction in Infants: Ileum Duplication Cyst and Literature Review

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Mehmet Serif Arslan ◽  
Erol Basuguy ◽  
Hikmet Zeytun ◽  
Serkan Arslan ◽  
Bahattin Aydogdu ◽  
...  
Keyword(s):  
Literature Review ◽  
Intestinal Obstruction ◽  
Male Patient ◽  
Pediatric Surgery ◽  
Clinical Symptoms ◽  
Abdominal Distension ◽  
Duplication Cyst ◽  
Oral Feeding ◽  
Imaging Method ◽  
History Of

Cases of neonatal gastrointestinal system (GIS) obstruction are quite complex for pediatric surgery clinics. A rare cause of intestinal obstruction is the duplication cyst (DC). A three-day-old male patient presented at our clinic with a history of abdominal distension and bilious vomiting on the second day following birth. Although pathology had not yet been determined from observation and examination, surgery was performed when the patient could not tolerate oral feeding. An ileal DC forming an incomplete obstruction was observed. Ileoileal anastomosis was performed on the patient. Because DCs can present with different clinical symptoms, it is quite difficult to diagnose them in neonate patients. Lacking an imaging method that can provide an exact diagnosis, the diagnostic laparotomy is a suitable approach for both diagnosis and treatment to avoid delays in treatment.

scholarly journals Psychosexual history-taking in the 21st century: new terminology, new technology and new risks

2018 ◽  
Vol 25 (3) ◽  
pp. 166-176
Author(s):  
Lisa Gardiner
Keyword(s):  
Social Media ◽  
Sexual Offending ◽  
Psychiatric Patients ◽  
New Technology ◽  
Relationship Maintenance ◽  
The Internet ◽  
List Type ◽  
History Taking ◽  
Sexual Behaviours ◽  
Use Of Technology

SUMMARYSexual and relationships difficulties are not uncommon among psychiatric patients. A presenting complaint of anxiety or depression may relate to an underlying sexual or relationship difficulty; commonly used psychotropic medications cause sexual side-effects that can have a significant impact quality of life, relationship maintenance and treatment adherence; patients may exhibit unusual or excessive sexual behaviours when acutely unwell, including risky use of apps to meet sexual partners and accessing online pornography in unsafe ways; patients may have used technology such as the internet to harm others or they may be victims of such harm; the internet and social media might even be influencing sexual expression, for example gender identity. Therefore, psychosexual history-taking remains a key competency for psychiatrists. They must also understand the new language used to describe sexuality, sexual behaviours and the use of social media, apps and so on to form relationships. This article outlines the key areas to consider in carrying out a structured psychosexual assessment. It also gives an overview of current sexual terminology, observed influences of the internet on sexuality and sexual behaviour, and its implications for mental health and potential sexual offending.LEARNING OBJECTIVESAfter reading this article you will be able to: •outline a framework for psychosexual history-taking•recognise emerging terminology relating to sexual behaviours and identity•understand the relevance of the internet, social media and technology-based apps to human relationships, including the use of technology in sexual offendingDECLARATION OF INTERESTNone.

scholarly journals “Trividh Pariksha-Ayurvedic and Modern Perspective.”

2020 ◽  
Vol 4 (05) ◽  
Author(s):  
Dubey Shivanikumari Rajesh
Keyword(s):  
Physical Examination ◽  
Modern Medicine ◽  
History Taking ◽  
Important Place ◽  
Different Types ◽  
Factual Data ◽  
Radiological Examinations ◽  
Or History ◽  
Modern Perspective

The term Pariksha is used for the Examinations done on patient for appropriate diagnosis. The prime duty of any Physician is to diagnose the ailment of the patient. The diagnosis cannot be done just on basis of one type of examination. In Ayurveda different types of examinations have been mentioned which were and still are useful in diagnosing the various diseases in patients. Two basic processes. 1) Interrogation or history taking or anamnesis , 2)Physical examination [1]and at present time pathological and radiological examinations are the basic requirements  by which factual data of the diseases are collected. Ayurveda has mentioned in detail about the various Parikshas which have been categorized in Trividh , Panchvidh, Shadvidh , Ashtavidha Pariksha have been mentioned. Here Trividh Pariksha –Darshan, Sparshan and Prashna and its all aspects will be discussed in perspective of both Ayurveda and Modern medicine. These basic methods which are practiced today, with modern terminologies have one of the important place in Ayurvedic Nidan (diagnosis).

scholarly journals Diagnostic accuracy of history taking, physical examination and imaging for phalangeal, metacarpal and carpal fractures: a systematic review update.

2019 ◽  
Author(s):  
Patrick Krastman ◽  
Nina M. Mathijssen ◽  
Sita M.A. Bierma-Zeinstra ◽  
Gerald Kraan ◽  
Jos Runhaar
Keyword(s):  
Physical Examination ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Scaphoid Fracture ◽  
Radiological Examination ◽  
Supporting Evidence ◽  
History Taking ◽  
Wrist Fractures ◽  
Scaphoid Fractures ◽  
Work Up

Abstract Background The standard diagnostic work-up for hand and wrist fractures consists of history taking, physical examination and imaging if needed, but the supporting evidence for this work-up is limited. The purpose of this study was to systematically examine the diagnostic accuracy of tests for hand and wrist fractures. Methods A systematic search for relevant studies was performed. Methodological quality was assessed and sensitivity (Se), specificity (Sp), accuracy, positive predictive value (PPV) and negative predictive value (NPV) were extracted from the eligible studies. Results Of the 35 eligible studies, one described the diagnostic accuracy of history taking for hand and wrist fractures. Physical examination with or without radiological examination for diagnosing scaphoid fractures (five studies) showed Se, Sp, accuracy, PPV and NPV ranging from 15-100%, 13-98%, 55-73%, 14-73% and 75-100%, respectively. Physical examination with radiological examination for diagnosing other carpal bone fractures (one study) showed a Se of 100%, with the exception of the triquetrum (75%). Physical examination for diagnosing phalangeal and metacarpal fractures (one study) showed Se, Sp, accuracy, PPV and NPV ranging from 26-55%, 13-89%, 45-76%, 41-77% and 63-75%, respectively. Imaging modalities of scaphoid fractures showed predominantly low values for PPV and the highest values for Sp and NPV (24 studies). Magnetic Resonance Imaging (MRI), Computed Tomography (CT), Ultrasonography (US) and Bone Scintigraphy (BS) were comparable in diagnostic accuracy for diagnosing a scaphoid fracture, with an accuracy ranging from 85-100%, 79-100%, 49-100% and 86-97%, respectively. Imaging for metacarpal and finger fractures showed Se, Sp, accuracy, PPV and NPV ranging from 73-100%, 78-100%, 70-100%, 79-100% and 70-100%, respectively. Conclusions Only one study was found on the diagnostic accuracy of history taking for hand and wrist fractures in the current review. Physical examination was of moderate use for diagnosing a scaphoid fracture and of limited use for diagnosing phalangeal, metacarpal and remaining carpal fractures. MRI, CT and BS were found to be moderately accurate for the definitive diagnosis of clinically suspected carpal fractures.

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