DEPRESSION UNFOLDING GENDER DYSPHORIA: AN UNUSUAL CASE OF RURAL INDIA.

2021 ◽  
pp. 59-60
Author(s):  
Prabhmeet Singh ◽  
Purushottam Jangir ◽  
Priti Singh
Keyword(s):  
Rural Areas ◽  
Gender Dysphoria ◽  
Rating Scale ◽  
Treatment Options ◽  
Rare Condition ◽  
Supportive Psychotherapy ◽  
Adolescents And Adults ◽  
History Of ◽  
The Individual ◽  
Structural Levels

BACKGROUND: Gender dysphoria is a rare condition, rarer in females and rarest in rural areas of India. From the surface case presented with depressive features, but inside the core diagnosis of gender dysphoria was met. The objective of index case is highlighting presentation of a female with stigmatizing condition and role of various available treatment options and utilization of services. Case presentation: A 20-year-old female from rural background demonstrating symptoms of low mood, easy fatiguability and ideas of selfharm from past few months with a long -standing history of distress and incongruence between experienced and assigned gender. According to DSM-5, diagnosis of gender dysphoria was made and further evaluated on Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults (GIDYQ-AA) and Hamilton depression rating scale. SSRI was started along with supportive psychotherapy sessions and various treatment options for gender dysphoria discussed. DISCUSSION: This case illustrates importance of history taking which becomes paramount in case of rare disorders like gender dysphoria. Multi-level interventions at the individual, interpersonal, and structural levels to reduce stigma toward transgenders, better acceptability would lead to further clarify hypothesis and early diagnosis of the disorder.

A Synchronous Ipsilateral True Superficial Femoral Artery and Profunda Femoris Artery Aneurysm With Rupture: A Case Report and Review of the Literature

2020 ◽  
Vol 54 (7) ◽  
pp. 650-655
Author(s):  
Ali Ahmet Arıkan ◽  
Fatih Avni Bayraktar ◽  
Emre Selçuk
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Treatment Options ◽  
Artery Aneurysm ◽  
Rare Condition ◽  
Review Of The Literature ◽  
Profunda Femoris Artery ◽  
Elderly Males ◽  
History Of ◽  
Profunda Femoris

Atherosclerotic true aneurysms of the superficial femoral artery (SFA) and profunda femoris artery (PFA) are rare and difficult to detect. The synchronous presence of SFA and PFA aneurysms is even rarer. Herein, we present a case with ipsilateral true SFA and PFA aneurysms diagnosed with rupture. A review of the international literature is made, and the diagnosis and treatment options of this rare condition are discussed. A 75-year-old male was admitted to our hospital with an aneurysm on the distal SFA and the ipsilateral PFA, as well as a hematoma around the PFA. It was difficult to determine the source of the rupture before surgery, even with proper imaging. Successful ligation of the PFA and an aneurysmectomy followed by a bypass grafting for the SFA were performed. An intraoperative examination revealed that the SFA aneurysm had ruptured. In elderly males with a history of ectasia or aneurysm on the aorta or peripheral arteries, a synchronous aneurysm on the SFA or the PFA should be suspected.

scholarly journals Infratentorial subdural empyemas mimicking pyogenic meningitis

2013 ◽  
Vol 04 (02) ◽  
pp. 213-215 ◽  
Author(s):  
Anurag Gupta ◽  
Suman S Karanth ◽  
A Raja
Keyword(s):  
Surgical Intervention ◽  
Treatment Options ◽  
Rare Condition ◽  
Pyogenic Meningitis ◽  
Suppurative Otitis Media ◽  
Life Threatening ◽  
History Of ◽  
Associated Risk Factors ◽  
High Degree ◽  
Delay In Treatment

ABSTRACTInfratentorial subdural empyema is an extremely rare condition which unfortunately mimics pyogenic meningitis in 75% of cases. While an ill‑planned lumbar puncture in these cases may be fatal, an inadvertent delay in treatment may be detrimental to the outcome for the patient. We present a case of a young boy with long standing history of chronic suppurative otitis media (CSOM) presenting with an infratentorial empyema with features suggestive of pyogenic meningitis. We also review the available literature to further define the condition in terms of clinical features, treatment options, and outcome. A misdiagnosis of this condition with failure to institute appropriate surgical intervention and antibiotic therapy is potentially life threatening. We highlight this rare condition which requires a high degree of suspicion especially in the presence of associated risk factors.

The Social Ecology of Power in Participatory Health Research

2020 ◽  
pp. 104973232097918
Author(s):  
Maria Roura
Keyword(s):  
Health Research ◽  
Power Dynamics ◽  
Participatory Health Research ◽  
The Social ◽  
History Of ◽  
Practical Tool ◽  
Democratic Principles ◽  
The Individual ◽  
Structural Levels ◽  
Promising Avenue

As increasing value is placed on community engagement, co-creation, and transdisciplinarity as essential ingredients to improve policies; participatory health research has gained popularity as a promising avenue for stakeholders to collaborate and solve problems in innovative ways. Participatory research has a history of success but important caveats caution against romanticizing the approach. The assumption that participation will empower participants overlooks potential feelings of disappointment or exploitation amid power imbalances, vested interest, and representativeness issues. This article outlines a multilevel conceptual framework that explicitly situates power dynamics within a wider system of bidirectional interconnections operating at the individual, interpersonal, and structural levels. It then provides a practical tool to examine and address these dynamics in a comprehensive and systematic way. This can be helpful for researchers and community practitioners working in contexts where democratic principles are not broadly endorsed and where power dynamics operate in subtle ways.

scholarly journals Bilateral Congenital Absence of the Stapes Superstructure in Two Siblings

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Jose Ignacio Undabeitia ◽  
José Undabeitia ◽  
Laura Cianci ◽  
Luis Padilla ◽  
Eduardo Petreñas ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Hearing Aid ◽  
Treatment Options ◽  
Rare Condition ◽  
Functional Results ◽  
Congenital Absence ◽  
Abnormal Development ◽  
Nerve Lesion ◽  
History Of ◽  
Facial Nerve Lesion

Middle ear ossicle malformations are an uncommon event. Among them, the congenital absence of the stapes is a very rare condition that is seldom described in the literature. We report the cases of two women, aged 19 and 22 , who presented with a long history of conductive deafness. An exploratory tympanotomy was performed and the absence of the stapes superstructure and an abnormal position of the facial nerve could be observed. A bone anchored hearing aid (BAHA) was implanted in both patients with good results. It is believed that stapes agenesis is related to an abnormal development of the facial nerve, which by the 5th to 6th week of gestation would interpose between the otic capsule and the stapes blastema, preventing these structures from contacting. A long history of nonprogressive hearing loss from birth or early childhood is the key to reach a diagnosis. Several treatment options have been described. The authors opted for a hearing aid due to the high risk of facial nerve lesion, with good functional results.

scholarly journals New Treatment Options for Pituitary Granulomatosis With Polyangiitis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A594-A594
Author(s):  
Hessa Boharoon ◽  
Majid AlAmeri ◽  
Abdulla Mohamed Alnuaimi ◽  
Nigel Mendoza ◽  
Stephen McAdoo ◽  
...  
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Treatment Guidelines ◽  
Dynamic Assessment ◽  
Treatment Options ◽  
Case Series ◽  
Rare Condition ◽  
High Dose ◽  
Pituitary Mass ◽  
Remission Maintenance ◽  
History Of

Abstract Background: Granulomatosis with polyangiitis (GPA) rarely involves the pituitary gland and has been reported in 1% of all cases of GPA. Most frequently, it presents with pituitary mass effect and diabetes insipidus (DI). To date, there are no treatment guidelines for this rare condition. Case Presentation: Case 1: A 55 year old female with a history of ANCA-positive pulmonary GPA, previously treated with glucocorticoids and immunosuppressants, presented two years later with cranial DI and bitemporal hemianopia. MRI showed a large sellar mass with suprasellar extension. High dose glucocorticoids resulted in good clinical and radiological response. Further treatment consisted in a combination of Cyclophosphamide and Rituximab (RTX). Further doses of RTX are planned aiming for a period of B-cell depletion. Case 2: A 38 year old female, presented with polyuria, recurrent nosebleeds, headaches and a left visual field defect. Pituitary profile revealed ACTH deficiency and MRI showed a heterogenous cystic lesion with peripheral enhancement and stalk thickening. Steroid replacement led to immediate improvement in her symptoms. Cranial DI was confirmed and raised Proteinase 3 (PR3) antibody suggested GPA. A combination of prednisolone and Methotrexate led to significant improvement of MRI appearances and declining PR3 antibody levels. For remission maintenance, two cycles of RTX were given with further radiological and biochemical improvement, and, following dynamic assessment of her HPA axis, she could be fully weaned off steroids. Case 3 is a 47 year old female with a history of childhood asthma. She was found to have cavitating lung lesions. ANCA positivity confirmed GPA and she was commenced on high-dose steroids. During follow-up, she developed headache, polyuria and polydipsia. MRI pituitary showed a suprasellar lesion and pituitary biopsy revealed inflammatory hypophysitis. Cranial DI was confirmed by water deprivation testing. Previous allergic reactions to both RTX and Ofatumumab precluded anti-CD40 monoclonal antibodies and she was commenced on Azathioprine. A further recurrence of pituitary GPA necessitated escalation of the steroid dose and switch of azathioprine to mycophenolate mofetil. She remains in remission and her steroids reduced to a maintenance dose. Conclusion: GPA pituitary has been observed to occur at variable time after diagnosis often in the absence of any other systemic features. A combination of glucocorticoids and RTX has been approved for severe relapsing pulmonary GPA, however, limited data is available for pituitary GPA. In this case series, the response to high dose steroids and RTX for remission maintenance has been encouraging. Experience with ‘conventional’ immunosuppresants remains limited and therapeutic responses remain variable. Further clinical studies are required to establish effective treatment for pituitary GPA.

scholarly journals Successful Use of the 308-nm Excimer Laser in Early Patch Stage Mycosis Fungoides

2019 ◽  
Vol 10 (3) ◽  
pp. 251-253
Author(s):  
Andrew M. Armenta ◽  
Krystal M. Jones ◽  
Jason S. Reichenberg
Keyword(s):  
Case Report ◽  
Skin Cancer ◽  
Mycosis Fungoides ◽  
Excimer Laser ◽  
Early Stage ◽  
Treatment Options ◽  
Rare Condition ◽  
Dysplastic Nevi ◽  
Increased Risk ◽  
History Of

Introduction: Mycosis fungoides (MF), a type of cutaneous T-cell lymphoma, is a rare condition with a variety of treatment options. A frequently utilized method in the treatment of early-stage MF is phototherapy. Full body phototherapy can be associated with photoaging of the skin and an increased risk of developing skin cancer. Targeted phototherapy, with a 308-nm excimer laser, may be just as effective and of a lower risk. This makes it especially useful in the treatment of patients with dysplastic nevi (DN) or other conditions which can put them at a higher risk of developing skin cancer. There are currently limited data on the treatment of early-stage MF with an excimer laser. Case Report: This study reports on a 43-year-old female patient presented to the clinic with early-stage (Ia) MF. Given her history of DN, she wished to pursue targeted phototherapy with an excimer laser. Localized light treatment was performed via a 308-nm excimer laser, 3 times weekly, for a total of 17 treatments to affected lesions. Following excimer laser treatment, she had a clinical resolution of her patches. On the follow-up clinic visits, she maintained her excellent response 12 months out. Conclusion: Targeted phototherapy with a 308-nm excimer laser may be a safer and equally effective alternative to generalized phototherapy in the treatment of early-stage MF. This case report demonstrates its efficacy and advantages over traditional generalized phototherapy.

Spinal Deformity and Scoliosis

2018 ◽  
Author(s):  
Daraspreet Singh Kainth ◽  
Karanpal Singh Dhaliwal ◽  
David W. Polly
Keyword(s):  
Spinal Deformity ◽  
Congenital Abnormalities ◽  
Treatment Options ◽  
Classification Systems ◽  
Spine Deformity ◽  
Treatment Needs ◽  
Adult Deformity ◽  
Risks And Benefits ◽  
Adolescents And Adults ◽  
The Individual

Spinal deformity can be present in children, adolescents, and adults. Early-onset scoliosis, which affects children less than 10 years of age, can be the result of congenital abnormalities or neuromuscular disease or can be idiopathic. Adolescents most commonly develop scoliosis as the result of adolescent idiopathic scoliosis. Adult deformity can be the result of progression of conditions present in childhood or adolescence, or from degenerative changes. Many conditions can lead to spine deformity, including congenital causes, trauma, cancer, osteoporosis, postsurgical, and idiopathic causes. Though deformity treatment needs to be tailored to the individual, there are many guiding principles and concepts that apply when treating patients with scoliosis and spinal deformity. This chapter reviews important concepts such the deformity classification systems, deformity parameters, treatment options, and associated risks and benefits.

scholarly journals Sudden Unexpected Death in a Patient with Tumour Associated Pulmonary Embolism

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
D. Laohachewin ◽  
F. André ◽  
D. Tschaharganeh ◽  
H. A. Katus ◽  
G. Korosoglou
Keyword(s):  
Causes Of Death ◽  
Invasive Coronary Angiography ◽  
Treatment Options ◽  
Previous History ◽  
Rare Condition ◽  
Suspected Coronary Artery Disease ◽  
Tumour Burden ◽  
Unexpected Death ◽  
History Of ◽  
Artery Disease

Tumour embolisms are rare and in most cases sudden causes of death. Diagnosing this rare condition is still very challenging in the daily clinical routine. In this report we present a case of a lethal sudden pulmonary tumour embolism in a 71-year-old male patient, who was admitted for elective invasive coronary angiography due to suspected coronary artery disease. The patient had suspected Ormond’s disease and no previous history of tumour burden. Possible diagnostic and treatment options are discussed herein and an overview of the current literature is also presented.

scholarly journals Juvenile Myasthenia Gravis: A Paediatric Perspective

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Maria F. Finnis ◽  
Sandeep Jayawant
Keyword(s):  
Myasthenia Gravis ◽  
Treatment Options ◽  
Rare Condition ◽  
Postsynaptic Membrane ◽  
Myasthenic Crisis ◽  
Developmental Needs ◽  
Ocular Symptoms ◽  
History Of ◽  
Receptor Antibodies ◽  
Juvenile Myasthenia Gravis

Myasthenia gravis (MG) is an autoimmune disease in which antibodies are directed against the postsynaptic membrane of the neuromuscular junction, resulting in muscle weakness and fatigability. Juvenile myasthenia gravis (JMG) is a rare condition of childhood and has many clinical features that are distinct from adult MG. Prepubertal children in particular have a higher prevalence of isolated ocular symptoms, lower frequency of acetylcholine receptor antibodies, and a higher probability of achieving remission. Diagnosis in young children can be complicated by the need to differentiate from congenital myasthenic syndromes, which do not have an autoimmune basis. Treatment commonly includes anticholinesterases, corticosteroids with or without steroid-sparing agents, and newer immune modulating agents. Plasma exchange and intravenous immunoglobulin (IVIG) are effective in preparation for surgery and in treatment of myasthenic crisis. Thymectomy increases remission rates. Diagnosis and management of children with JMG should take account of their developmental needs, natural history of the condition, and side-effect profiles of treatment options.

Erotomania – A Review of De CléRambault's Syndrome

2016 ◽  
Vol 33 (S1) ◽  
pp. S533-S533
Author(s):  
C. Oliveira ◽  
S. Alves ◽  
C. Ferreira ◽  
C. Agostinho ◽  
M.J. Avelino
Keyword(s):  
Social Economic ◽  
Case Reports ◽  
Treatment Options ◽  
Dsm 5 ◽  
Political Status ◽  
History Of ◽  
Competing Interest ◽  
New Treatment ◽  
The Individual ◽  
Clinical Cases

IntroductionErotomania (also known as De Clerambault's syndrome) is usually described as a rare delusional syndrome characteristically involving an individual who believes that another person, typically of higher social, economic or political status, is in love with the individual. De Clerambault's syndrome remains a ubiquitous nosological psychiatric entity with uncertain prognosis that remains recognised as a subtype of delusional disorder in DSM 5.Objectives and aimsTo review the history of Erotomania as a nosological psychiatric entity, its clinical characteristics and course. Also to report some selected clinical cases.MethodsThe authors have conducted an online search on PubMed with MeSH words“erotomania”, “erotomaniac delusion” and “Clerambault” and systematically reviewed some case reports.ResultsErotomania is a relatively uncommon and misunderstood disorder characterised by the presence of a persistent erotic delusion. The individual (usually described as a woman) has had little or no contact with the other person who is perceived as watching over, protecting or following the individual. Despite various authors have described and named this syndrome, it was Clérambault who first classed the symptoms into the disorder he referred to as “psychose Passionelli” (1942). There are numerous theories as to the aetiology of this illness that is not uniquely associated with any specific disorder. We reviewed some clinical cases.ConclusionsErotomania is a relatively uncommon psychiatric disorder. An increased awareness and understanding of this illness will assist in the recognition of patients affected, opening doors for future progress on its aetiology and, therefore, the development of new treatment options.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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