Tuesday, 15 July 2014

Residency Blues 1.0

                      
                  Being a resident in psychiatry is  quite a mixed bag of feelings. Though, the mankind has touched most of the celestial bodies in and around our galaxy, the stigma associated with psychiatry refuses to go away easily. On the other hand, probably this is the only clinical branch which makes the patient clinician relationship more humane than just professional.
             But this is not the point I want to make. My point is about a country which claims to have rich heritage of culture, tradition and knowledge. A country, that uses camouflage of culture and heritage, when it can’t sustain the stiff challenges faced in the race of development. Yes, it is my country   India (Bharat, Hindustan or by whatever name you want to call it).
             It was one of those lethargic afternoons, when I went to medicine 303 wards, where I had few patients up for counselling for suicidal attempts. I met this guy Basappa, a small farmer from a nearby village with 1 acre of dry land. All throughout his life, he has seen his father and brothers struggle in that piece of dry land to make ends meet. Ten years ago the baton was passed on to him. He borrowed ten thousand rupees from a local money lending shark to start farming a fresh. With the help of irregular farming, cheating middlemen and irregularities by govt officials his loan had grown 5 times and so were the threats by the goons of money lending savkars. Meanwhile, a rumour of land acquisition by the govt for SEZ was also in the air. Basappa could not see any light at the end of the tunnel and only hope he saw, was in death. He tried to gulp 200 ml of monocrotophos in one go, but he was interrupted by his fellow villagers and was saved. Life post suicidal attempt was an uphill task for Basappa.  There was no meaning in going back to that dry strip of land which yielded him nothing but sorrow. Finally, he decides to take up the job of security guard in our hospital and never to go back to agriculture.  He lived happily thereafter. But we lost some one forever... “Annadaatha”
              As I write this article, hundreds of farmers would have left farming in our country. As per the recent census, there is dip of around 4% in the farmers’ population. Traditionally, our nation’s culture, economy have been woven around agriculture. But in the recent past, farmer has been ignored big time by the govt and by us (the urbanites). Blame it on our apathy or irregular monsoon or haphazardly planned industrialization or the blitz of urban life, every day we are losing around 2000 farmers. Our villages are shrinking. Meanwhile one more weapon of mass destruction (of farmers) in its modified version (land acquisition bill) is waiting to be launched!!
            Before eating food, our elders used to fold their hands and pray “Annadaata Sukhibhava”- let the one who has provided me food be happy. But at this point in time saying “Annadaata Sukhibhava” would be cruelly satirical!!
             
                                                                                                                  Santiago Maktub

Wednesday, 26 March 2014

March 26th - World Purple Day

                  World Purple Day is an international grassroots effort dedicated to increasing awareness about epilepsy worldwide. On March 26th annually, people in countries around the world are invited to wear purple and host events in support of epilepsy awareness.   
                  Cassidy Megan created the idea of Purple Day in 2008, motivated by her own struggles with epilepsy. Cassidy's goal is to get people talking about epilepsy in an effort to dispel myths and inform those with seizures that they are not alone. The Epilepsy Association of Nova Scotia came on board in 2008 to help develop Cassidy's idea which is now known as the Purple Day for epilepsy campaign.(2)

                    
"I wanted people around the world to come together and teach others about epilepsy."
                          Cassidy Megan, Founder of Purple Day
                                  Epilepsy is a global problem with developing countries suffering the most. It is estimated that the overall “incidence” of epilepsy (number of new cases observed over a fixed period of time) lies between 20 - 50 cases per year per 100,000 persons in a general population. The usual “prevalence” rate (number of persons with epilepsy during a specified time) is 500-1000 cases per 100,000 persons in the population. Going by these statistics, there will be about  200,000 to 500,000 new cases in the whole of India (for population about 120 crores). Similarly at the present time there may be approximately about 50-100 lakhs in whole of India (2)
The following practical points need to be remembered:
  1. One in 20 people will have an epileptic seizure at some point in their lives.
  2. One in 100-200 people in a general population has epilepsy at any given time.
  3. About 50–70% patients will develop epilepsy (have their first seizure) before the age of 18 years .                                                                             Epilepsy is a major public health issue which requires lot of awareness to be created among people.
   Sources:
1. http://www.purpleday.org
2. http://www.indianepilepsycentre.com/faqs-incidence.html


Questions contd....

Q 26. A 57 year old male, banker presents to emergency room with difficulty in speaking since 2 days. He was admitted and on examination , there was no speech output, but the patient could understand the commands and followed them. He expressed himself in sign language. The most probable lesion would be located at?
A. Location 1
B. Location 2
C. Location 3
D.Location 4
















Q 27. Identify the personality





Q 28. Name the great mathematician who was suffering from schizophrenia and this movie was based
on his life?





Q 29. The pt was in this posture for a long time.. The condition in which it Is seen is?
A.OCD
B.Catatonia
C.Mania
D.Hebephrenic schizophrenia


 

Q30. A psychological phenomenon in which hostages express empathy and sympathy and have positive feelings toward their captors, sometimes to the point of defending and identifying with them is known as?




  

Psychiatry Quiz 2014 Prelims Questions


  1.      Department of Psychiatry
    Prelims of Psychiatry Quiz-2014

    1. Which among the following is not a common feature of Anorexia Nervosa?
    A.      Binge Eating   
    B.      Amenorrhea
    C.      Self perception of being fat
    D.      Under weight

    2.        Which of the following is a Cluster A personality disorder?
    A. Antisocial
    B. Paranoid PD
    C. Narcissistic
    D. None of the above

    3.       Carbamazepine may be used in all of the following except?
    A.      Mania
    B.      Schizophrenia
    C.      Epilepsy
    D.      Trigeminal Neuralgia

    4.        Algophobia is fear of
    A.      Logarithm
    B.      Algae
    C.      Pain
    D.      High Temperature

    5.        Russel’s sign is typically seen in
    A.      Major depression with suicidal tendency
    B.      Bulimia  nervosa
    C.      Cocaine abuse
    D.      Hebephrenic  schizophrenia

    6.       Dopamine theory of schizophrenia was proposed by
    A.      Sigmund Freud
    B.      Emil Kraeplin
    C.      Arvid Carlson
    D.      John Parkin

    7.        Magnan sign is seen in
    A.      Alcohol intoxication
    B.      Cocaine abuse
    C.      Cannabis abuse
    D.      Opioid abuse

    8.        Which of the following is an atypical antipsycotic
    A.      Risperidone
    B.      Haloperidol
    C.      Chlorpromazine
    D.      Flupenthixole

    9.        Which of the following is an SNRI (Selective Norepinephrine reuptake inhibitor)?
    A.      Sertraline
    B.      Citalopram
    C.      Venlafaxine
    D.      Paroxetine

    10.    Donepezil acts by inhibiting the enzyme?
    A.      Dopamine beta hydroxylase
    B.      Acetylcholineesterase
    C.      Aldehyde dehydrogenase
    D.      Tyrosine hydroxylase

    11.    Which of the following is a negative symptom of schizophrenia
    A.      Hallucinations
    B.      Delusions
    C.      Alogia
    D.      Cognitive dysfunction

    12.     Melancholia is seen in?
    A.      Endogenous depression
    B.      Anxiety disorder
    C.      Schizophrenia
    D.      OCD

    13.    Kleptomania is?
    A.      Pathological  jealousy
    B.      Pathological  fire-setting
    C.      Pathological  gambling
    D.      Pathological  stealing

    14.    Disulfuram acts by inhibiting?
    A.      Alcohol dehydrogenase
    B.      Acid dehydrogenase
    C.      Aldehyde dehydrogenase
    D.      Pyruvate dehydrogenase

            
    15.    Flashbacks are seen in?
    A.      Alcohol abuse
    B.      Cannabis abuse
    C.      Cocaine abuse
    D.      Opioid abuse

    16.    Somnambulism means?
    A.      Night terrors
    B.      Sleep walking
    C.      Nocturnal enuresis
    D.      Nightmares

    17.   All are pervasive developmental disorders except? 
    A.      Conduct disorder
    B.      Autism
    C.      Rett’s syndrome
    D.      Asperger’s disease


    18.    Progressive deceleration of head circumference is seen in?
    A.      Autism
    B.      Rett’s syndrome
    C.      Asperger’s disease
    D.      Hydrocephalous 


    19.    Treatment of choice for severe depression with suicidal tendency?
    A.       SSRI
    B.      ECT(electro convulsive therapy)
    C.      Anti psychotics
    D.      Tricyclic antidepressants

    20.    Black tongue and ulceration of nasal septum is seen in?
    A.      Opioid abuse
    B.      Cocaine abuse
    C.      Cannabis abuse
    D.      Alcohol abuse

    21.    Extra-pyramidal symptoms secondary to antipsychotics are due to  D2 receptor blocking in
    A.      Tuberoinfundibular system
    B.      Mesolimbic system
    C.      Mesocortical system
    D.      Nigrostriatal system

    22.    ECT (Electro Convulsive Therapy) was invented by?
    A.      Banting & Best
    B.      Ronald Ross
    C.      Cerletti & Bini
    D.      Hounsfield 

    23.    Patient presents with waxy flexibility, negativism & rigidity. Diagnosis is:
    A.      Paranoid schizophrenia
    B.      Hebephrenic schizophrenia
    C.      Catatonic schizophrenia
    D.      Simple schizophrenia

    24.    The term Psychiatry is coined by?
    A.      Tony Cooper
    B.      Johann Christian Reil
    C.      Sigmund Freud
    D.      Aron T Beck

    25.    All are parts of Papez circuit except
    A.      Posterior  thalamic nucleus
    B.      Mammilary bodies
    C.      Cingulate gyrus
    D.      Hippocampus






Monday, 24 March 2014

Annual CME of KLE's JN medical college Belgaum, Dept of Psychiatry

      6th Annual CME of Dept of psychiatry, KLE's JN medical college Belagum was held on 16th march 2013 at Medical education dept hall JN medical College.
        

 The CME began with study group on DSM-5 by Dr Vihang Vahia Prof emeritus and Dr Vidyadhar Watve.Presedent elect , IPS.
         











 Followed by inauguration of the  CME by Dr Godhi , Principal, KLE's JN Medical college & other dignitories by watering the sapling.






     







 


2nd talk was on "Acts,laws relevant to Psychiatrists" by Dr Chandrashekhar    Prof and Head , Dept of psychiatry, BMC &RI. Bengaluru.















3rd talk was on " Legal issues important to mental health professionals" by Dr Ravish  , Prof and Head , Dept of Psychiatry, MMC &RI, Mysore.








   



   Panel dicussion on Mental Health Care Bill 2013 by Dr Abhay Matkar,Prof & HoD psychiatry, SDMMC, Dharwad. Dr Chandrashekhar, Dr Ravish  Dr Mahesh Desai, Prof &HOD psychiatry, KIMS, Hubli. Dr Shivashankar Pol, Medical Supdt, DIMHANS, Dharwad.



The final session was Mock Post graduate clinical examination. One Long case and one short case were presented. The examiners were Dr Bhogle, Dr Harshe, Dr N M patil, Dr Abhay Matkar.
               The cme was attended by many Post graduate students from KIMS Hubli, SDMMC Dharwad, JNMC Belgaum, Kolhapur, RRMC Bengaluru.




International Sleep Day 2014

                                    



                                     Dept of Psychiatry, KIMS, Hubli , celebrated 'International sleep day' on 14th March 2014.  A short film on importance of sleep in healthy lifestyle was screened.  A talk on "Sleep disturbances" and its management was given by Dr Mahesh Desai Prof and Head , Dept of Psychiatry. The programme was attended by over 100 people including in patients, their family memebers, out pateints and medical and paramedical students. After the talk interactive session was conducted in which many patients clarified their doubts. Following the interactive session , high tea was arranged.