No abstract

This case report illustrates the case of complete androgen insensitivity syndrome (CAIS) which is a rare form of sexual development disorders (DSD). Complex critical thinking is needed for pathophysiology of primary amenorrhea causes and sex chromosomes differences of sexual development, such as primary ovarian failure, Mullerian Agenesis or disorders with abnormal androgen synthesis or response. This is a phenotypically female who presented with primary amenorrhea at the age of 19 years old. Normal levels of thyroid function test, serum prolactin and follicle stimulating hormone ruled out hypothyroidism, hyperprolactinemia, and primary ovarian failure. Magnetic resonance imaging showed absence of uterus, fallopian tubes, ovaries, but presence of proximal 1/3rd of the vagina. There is a single testis in the left inguinal region with unknown status of spermatogenesis. The chromosomal analysis revealed 46, XY karyotype conveying the patient is genotypically male. The testis-determining factor (TDF) test or sex-determining region Y (SRY) protein for male sex determination was not done. Similar presentation of primary amenorrhea diagnosis of CAIS was made to her 18-year-old sister. Women with CAIS are vulnerable to various psychological conditions caused by the appalling fact of being genotypically male when they have been raised female all their life. The gender confusion, reproductive issues and how others perceive them in the outside world require sensitive support. Hence, accentuate the need to address the emotional, psychological, and psychiatric vulnerabilities in issues pertaining to relationships, infertility and conception.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S12

Delayed neuropsychiatric sequelae is an important condition which commonly occur during recovery from acute carbon monoxide poisoning. Typical presentation would be apathy, disorientation, amnesia, hypokinesia, bizarre behavior, insomnia and neurological manifestations such as gait disturbance, hypertonia and tremor. We report here a case of a man presented with delayed neuropsychiatric sequelae one month after the carbon monoxide poisoning in his suicidal attempt. He presented with the typical presentation and diagnosis confirmed with the MRI findings. His MRI showed abnormal signal in subcortical hemisphere white matter of both temporo-fronto-parietal-occipital regions along the insula and both globus pallidus. He was treated with Olanzapine, Fluvoxamine, Chlorpromazine and Levodopa and his condition slowly improved. It is important for clinicians to recognize the symptoms and risk factors to develop delayed neuropsychiatric sequelae in patients who previously had carbon monoxide poisoning.

Patient: Female, 75-year-old Final Diagnosis: Anxiety disorder • charm needle Symptoms: Anxiety • muscular pain • pain Medication: — Clinical Procedure: — Specialty: Family Medicine • Psychiatry • Psychology • Radiology Objective: Rare coexistence of disease or pathology Background: Charm needle, otherwise known as susuk , is a needle-shaped pin inserted subcutaneously into various body parts. It is most commonly inserted by shamans in the orofacial region to grant magical powers to the wearer, such as health, wealth, beauty, and other benefits. These talismans are prevalent among women in South-East Asia countries. Case Report: A 75-year-old woman presented with recurrent musculoskeletal symptoms over multiple sites, but physical assessment only revealed mild tenderness over the right hip joint. A plain pelvic radiograph showed incidental findings of susuk around the genital regions, with older skull and pelvic radiograph displaying similar findings. The patient had a susuk insertion more than 20 years ago for marriage stability and beauty. After this incidental discovery, the patient had repeated visits to the clinic to request more imaging to determine whether the susuk were still present after the shaman’s attempted mystical removal. She also developed persistent preoccupation, worry, and guilt related to the susuk presence and was referred to psychiatry for further assessment. She was diagnosed with generalized anxiety disorder. She was then started on psychotherapy and pharmacological treatment, with simultaneous spiritual therapy. Conclusions: This case report describes the link between susuk implantation and psychological illness. Even though there are no reports that specifically correlate susuk with generalized anxiety disorder, it has been established that guilt and shame have a strong relationship with anxiety.

No abstract