A Case Report of Non-Reactive Psychosis in a COVID-19 Patient

Background: COVID-19 causes reactive psychiatric symptoms like anxiety, depression, insomnia etc besides significant inflammatory response. A number of COVID-19 patients are found to present with complex neuropsychiatric syndromes, including the first onset of psychosis, that seem to be directly related to brain damage in the context of COVID-19. Most cases of psychotic disorder in COVID-19 patients are being found in individuals with no personal or family history of mental illness. Case Description: A 33-year-old man presented with acute restlessness, agitation, wandering, vandalizing things, suspiciousness, hallucinatory behaviour, decreased sleep for 3 days duration. There was no past history or family history of any psychiatric illness. There was a history of mild grade fever 7 days before the onset of the psychotic symptoms. The patient was uncooperative, irritable, and had hallucinatory behaviour. Rapid Antigen Test (RAT) was positive. The patient responded to injectable antipsychotic haloperidol which was later changed to Tab Olanzepine 5 mg. The patient developed no COVID symptoms and no psychotic symptoms were seen further. Conclusion: There is a possibility of a psychosis break as a COVID-19 clinical presentation, suggesting potential participation of inflammatory and autoimmunologic phenomena triggered as a response to the coronavirus infection.

Tension Band Wiring for Fracture Patella Outcome with 3 K Wire versus 2 K Wire

Introduction: Fractures of the patella constitute almost 1% of all skeletal injuries, resulting from either direct or indirect trauma. Many forms of internal fixation for patellar fractures have been described in the literature but perfect anatomical reduction during surgery has an excellent outcome irrespective of the method of fixation used. The conventional method of patellar tension band wiring is always done with the help of two parallel Kirschner wires. Here, in our study, we intended to see whether the use of 3 parallel Kirschner wires in comparison to conventional one results in a superior functional outcome. Methods: A prospective observational study was carried out in ANIIMS and GB Pant hospital Port Blair from November 2016 to November 2019 on 44 patients of patellar fracture operated by tension band wiring with 22 patients in 2 parallel Kirschner wires and 3 parallel Kirschner wires groups respectively. Results: 44 patients were followed up postoperatively for 1 year and assessed by Lysholm knee score for pain status and working status and other variables. The mean age of the participants was 40.27 years (41.86 in two Kirschner wire group and 38.68 in three Kirschner wire group) in our study. Lysholm knee score, pain status, or working status was not significant throughout the mean follow-up periods for both groups. Conclusions: We found no significant difference between patellar TBW in 3 Kirschner wire and 2 Kirschner wire groups. However small sample size limits our study.

Giant Cell Reparative Granuloma Presented as Nasal Mass: A Rare Entity

Giant Cell Reparative Granuloma (GCRG) is an unusual non-neoplastic lesion which most commonly involves maxilla and mandible. We present a case of GCRG of the nasal cavity in a young female presented with the complaint of progressively nasal obstruction. Radiological findings are usually nonspecific in this entity, therefore a good clinical, radiological and pathological correlation is needed for final diagnosis and to differentiate it from other giant cell lesions. Surgical excision is the preferred treatment modality over simple curettage.

A Case Report on Mephentermine Induced Psychosis with Acute Liver & Kidney Injury

Background: Mephentermine is a sympathomimetic agent derived from methamphetamine. It is a commonly used drug for the treatment of hypotension during anaesthesia. Its abuse has markedly increased especially in the young population due to its stimulant properties and ability to boost performance in competitive sports or bodybuilding. Very few cases of Mephentermine dependence with or without psychosis have been reported from India and worldwide. Case Description: A 24-year-old male presented with a sudden onset of behavioural abnormalities a few hours following the use of Mephentermine. He was very agitated and restless. On physical examination, tachycardia, elevated BP and bilaterally dilated pupils were found. His symptoms remitted within a few hours of using Injection Haloperidol 10 mg with Lorazepam 4 mg once. He was found to have grossly deranged liver and kidney function tests. There was no past and family history of any psychiatric illness. No past history of any physical illness. Conclusion: No previous report of mephentermine induced psychosis with acute kidney and liver injury has been reported in the literature. Cases such as this may be common among the general public. Long term follow-up is required to know the course and outcome in such unusual cases.

Occult Expression of Non Syndromic Sex Cord Tumor with Annular Tubules in Ovary with Coexistent Cervical Fibroid

Sex Cord Tumor with Annular Tubules (SCTAT) is a rare ovarian tumor. It has morphological features intermediate between that of granulosa cell and sertoli cell. It is considered an estrogen and progesterone secreting tumor carrying low malignant potential. Due to its rare occurrence, its clinical recognition is difficult; hence, there are no standard treatment protocols. We present an incidentally detected SCTAT in the ovary coexisting with cervical fibroid.