The sociocultural factors and patterns of help-seeking among patients with mental illness in the sub-Himalayan region.

Context: Selection of first help in psychiatric illnesses depends on various sociodemographic and environmental factors. In integrated societies like India careers also contribute in deciding help-seeking behavior of psychiatric patients. In this study, we explored these factors and the role of education of decision maker, i.

Telepsychiatry clinical decision support system used by non-psychiatrists in remote areas: Validity & reliabilityof diagnostic module.

Background & Objectives: A knowledge-based, logically-linked online telepsychiatric decision support system for diagnosis and treatment of mental disorders was developed and validated. We evaluated diagnostic accuracy and reliability of the application at remote sites when used by non-psychiatrists who underwent a brief training in its use through video-conferencing.

Methods: The study was conducted at a nodal telepsychiatry centre, and three geographically remote peripheral centres.

Postpartum psychosis: risk factors identification.

Background: A better understanding of risk factors associated with postpartum psychosis may contribute to the better management.

Aims: This study was to identify the risk factors contributing to postpartum psychosis.

Materials And Methods: In this cross-sectional, case control study 100 patients of postpartum psychosis (PP) were compared with the healthy controls.

Chorea gravidarum: a rarity in West still haunts pregnant women in the East.

A pregnant woman, in her early 20s, presents with chorea following an emotional outburst. While the family members feel it to be a spirit haunting her, we try to establish the medical diagnosis of the present condition. There is a history of rheumatic fever in the past and examination reveals choreioathetoid jerky movements of her upper limbs with jerky speech, spooning of her limbs and demonstration of milkmaid's grip.

Onset of obsessive compulsive disorder in pregnancy with pica as the sole manifestation.

Pica refers to eating of non-nutritious substances, which is usually seen in childhood or pregnancy. Here we report a case of an illiterate tribal woman who developed pica as the sole manifestation of obsessive compulsive disorder, with onset during pregnancy. The patient had compulsions of eating uncooked rice or wheat, which resulted in toothache and abdominal discomfort.

Anabolic androgenic steroids in delayed diagnosis of tuberculosis.

This is the first case report depicting masking of symptoms of intestinal tuberculosis by anabolic androgenic steroids (AAS) causing delay in diagnosis which lead to a major surgery. Negative tuberculosis skin test (TST) probably due to immunomodulating effects of AAS also contributed to the delay. Patient also had early dependence on AAS and rapid growth of scrotal sebaceous cysts, findings of which have not yet been reported.

Carbamazepine-induced erythema multiforme major in an epileptic patient with bipolar affective disorder.

Carbamazepine (CBZ) is frequently used for epilepsy and various psychiatric illnesses. It is known for its dermatological side effects which may range from mild rash to life-threatening reactions as Stevens Johnson syndrome or toxic epidermal necrolysis. We hereby report a rare case of 17-year-old woman suffering from generalized tonic clonic epilepsy with comorbid bipolar affective disorder, who was initially treated with sodium valproate with partial improvement.

Multiple-etiology delirium and catatonia in an alcoholic with tubercular meningoencephalitis.

Delirium is a clinical entity with a variety of possible etiological conditions. Clinicians must be vigilant for the possibility of additional etiological factors. Secondly, catatonic patients should be carefully looked for general medical conditions.