Psychology Case Record

ADJUSTMENT DISORDER: BORDERLINE INTELLIGENCE: Patient was apparently normal about a week prior to admission. Informants report that patient is not a good student and used to perform poorly in all his class exams. He was given pass marks by the school authorities in spite poor performance in all the exams. Once patient reached 10th standard, his school teacher apparently warned him that if he did not perform well in the forthcoming class tests, he would not be allowed to sit for his final exams. Following this, patient got very upset and was found to be sitting depressed the whole day and expressed fearfulness. He also had crying spells, decreased concentration in his studies. Patient also expressed suicidal ideas and was found to sleep very less at night. SUMMARY: Patient obtained an IQ score of 75 indicating Border line level of Intellectual functioning. SCHIZOPHRENIA: Patient was apparently alright about 4 years back. He reported that his colleagues at his work place have made a plan against him and trying to get him removed from the job. He also reported that his parents are against him and his mother does not take care of him properly. He accuses his mother of giving affection only for his elder brother and because of which he is in a very good position and become a lawyer. Patient also expressed suspiciousness that people in the neighboring streets talk about him and discuss about him. Parents report that patient would apparently pick up fights with a lot of people for this reason. He would be found smiling and muttering to himself at various times and would not have any explanation for the same. Parents also report that, patient would not take bath regularly, refuse to comb his hair, change clothes and had very poor personal hygiene. He has repeatedly changed jobs and has not held a single job for more than a month. Many times the patient was terminated from the job as he was not found to be efficient. He complained of disturbed sleep and parents reported that he would roam around in the night aimlessly. SUMMARY: Overall, testing showed the presence of formal thought disorder, possibly Schizophrenia. DISSOCIATIVE MOTOR DISORDER: Patient apparently got married about 9 months back. On the same day, she started complaining of having back pain which was of severe nature and lasting few minutes to 2 hours. She consulted many neurologists and orthopaedicians for the same. All the investigations were done and found to be normal. She was prescribed medications but she did not report any improvement in her back pain with them. Patient also had sleep disturbance for a week before coming to psychiatry OPD. She had told her family that she does to wish to live as she was unable to tolerate the pain. She was eating very little as she complained that intake of food worsened her pain. Two days before presentation to OPD, patient started having episodes of unresponsiveness for a few minutes. These episodes used to be accompanied by swirling movements of the body and patient was found lifting both her lower limbs. She reported complete amnesia for the episode. After 15 to 20 minutes patient used to become completely alright and no confusion was noticed. SUMMARY: Assessment is indicative of significant stressors in the form of unresolved conflicts. Affective symptoms are also present. Current dissociative symptoms can be possibly attributed to poor coping skills. RECURRENT DEPRESSIVE DISORDER: Patient was apparently normal about 5 days prior to admission. Her husband had been insisting that she should join for work, so she joined as a daily wager in a nearby mill. Following that, patient was found to have disturbed sleep. She was appearing sad all the time, not taking any interest in her daily routine work. She complained of feeling tired even on doing minimal work. Patient was not taking care of her children as before. She used to be preoccupied in her own thoughts and would be found sitting in the same place for long periods of time. She complained of hearing nonexistent voices which were commenting about her continuously. She expressed wishes to die on several occasions. Initially, patient was having less communication with family members but within two days she became completely mute, stopped eating food, after which she was brought to the hospital. SUMMARY: Overall, Testing is indicative of presence of Depressive features. DEMENTIA: Patient was apparently normal until 4 months back, following which, his family members noticed him to be repeating the same sentences many times. He had significant sleep disturbance and for the last two months, he stopped going for work. Family members report that many times he has failed to recognise his close friends and family members and has landed up calling them by some other name. On few occasions, he apparently forgot the way to his house and lost his way. He went on some other unfamiliar road and was brought back home by the family members. He talks irrelevantly at times saying that he is in his office when actually he would be elsewhere. At times he would apparently just sit in the same place and stare at the ground for long periods of time. Patient had to be repeatedly instructed by the family members to do his routine activities. He would ask for breakfast twice saying that he had not had it, when in fact, the family would have given the same some few minutes earlier. His sleep was found to be disturbed

The sunshine vitamin D: ubiquitous source, still so deficient in mother and baby duo

Background: Vitamin D is a fat-soluble vitamin, a sunshine vitamin. Vitamin D deficiency is now recognized as a pandemic. Fetus depends on mother for its need of vitamin D, thus there is growing concern for its impact on neonates. This study was designed to determine the correlation between 25-hydroxyvitamin D (vitamin D3) levels in maternal blood and in cord blood.Methods: A total 50 term pregnant women attending antenatal clinic at SVS medical college, Telangana and their neonates were included in the study. At term after taking written consent, maternal and cord blood vitamin D3 were measured, and values were correlated. Antenatal and neonatal complications were noted, and correlated with vitamin D3 levels.Results: In this study 80% of pregnant women and 88% of neonates were vitamin D3 deficient. Mean maternal blood vitamin D3 was 17.62±10.01 and cord blood vitamin D3 was 12.84±7.68. Maternal blood vitamin D3 correlated positively with cord blood vitamin D3 (r=0.951, p<0.001). Antenatal and neonatal complications were observed, but statistically significant association with vitamin D3 deficiency could not be established.Conclusions: This study has demonstrated a very high prevalence of vitamin D deficiency in apparently healthy, young, pregnant women despite abundant sunlight leading to deficiency in their neonates. To establish strong association between vitamin D3 deficiency and various antenatal and neonatal complications further studies with large subject groups are required

Testing the multipole structure and conservative dynamics of compact binaries using gravitational wave observations: The spinning case

In an earlier work [S. Kastha et al., PRD {\bf 98}, 124033 (2018)], we developed the {\it parametrized multipolar gravitational wave phasing formula} to test general relativity, for the non-spinning compact binaries in quasi-circular orbit. In this paper, we extend the method and include the important effect of spins in the inspiral dynamics. Furthermore, we consider parametric scaling of PN coefficients of the conserved energy for the compact binary, resulting in the parametrized phasing formula for non-precessing spinning compact binaries in quasi-circular orbit. We also compute the projected accuracies with which the second and third generation ground-based gravitational wave detector networks as well as the planned space-based detector LISA will be able to measure the multipole deformation parameters and the binding energy parameters. Based on different source configurations, we find that a network of third-generation detectors would have comparable ability to that of LISA in constraining the conservative and dissipative dynamics of the compact binary systems. This parametrized multipolar waveform would be extremely useful not only in deriving the first upper limits on any deviations of the multipole and the binding energy coefficients from general relativity using the gravitational wave detections, but also for science case studies of next generation gravitational wave detectors.Comment: 16 pages, 8 figures, Mathematica readable supplemental material file for all the inputs to calculate the parametrized waveform is with the sourc

Nuchal cord: from dread towards confident management

Background: This study was aimed at observing the outcomes of pregnancies with sonographically detected nuchal cord or cord around the neck at term. Early studies on nuchal cord showed many maternal and neonatal complications. But several recent studies have suggested that maternal and neonatal complications do not increase with nuchal cord at delivery. This ambiguity increases anxiety in treating obstetricians and relatives of pregnant women, thus leading to unnecessary caesarean sections. This study is intended to observe the maternal and neonatal outcomes of 300 pregnant women with sonographically detected nuchal cord at term.Methods: Prospective observational study where 300 term pregnant women with sonographically detected nuchal cord were observed through delivery at Shri Venkata Sai Medical College, Mahabubnagar, Telangana, during October 2016 to April 2018.Results: In this study 80.6% women had normal vaginal delivery, 8.3% had LSCS, 11% had instrumental deliveries. 54% had loose nuchal cord, 46% had tight loop of cord.60% had normal CTG, 8% had variable deceleration, 2% late deceleration. Neonatal morbidity was 9.6% and zero neonatal mortality.Conclusions: The study concluded that the presence of nuchal cord does not adversely affect the mother and the neonate. Presence of nuchal cord per se is not an indication for LSCS. Effect of nuchal cord on neonate is only transient. These women can be allowed for vaginal delivery with routine labour room protocols. Routine sonographycal detection of nuchal cord is not required and if it is reported, it should not dictate obstetric management

Multiparameter tests of general relativity using multiband gravitational-wave observations

In this Letter we show that multiband observations of stellar-mass binary black holes by the next generation of ground-based observatories (3G) and the space-based Laser Interferometer Space Antenna (LISA) would facilitate a comprehensive test of general relativity by simultaneously measuring all the post-Newtonian (PN) coefficients. Multiband observations would measure most of the known PN phasing coefficients to an accuracy below a few percent---two orders-of-magnitude better than the best bounds achievable from even `golden' binaries in the 3G or LISA bands. Such multiparameter bounds would play a pivotal role in constraining the parameter space of modified theories of gravity beyond general relativity.Comment: 7 pages, 4 figures. v3: version published in PR

Detection of Brain Tumor by Clustering Technique

It is considered that manual diagnosis of tumor detection is both expensive and time consuming and also includes a lot of human errors. Hence Requirements for robust and efficient tumor detection methodologies are necessitated. Therefore, In this paper, the development of a robust tumor detection technique by also performing denoising along with binarization and thresholding method is performed. The work was carried out by considering Noise such as Gaussian and averaging filtering method is used for denoising process. Experiment result shows the area of tumor was successfully identified and segmented for which an improved performance considering the image quality assessment such as PSNR and SNR was observed

Management of a case of thromboembolism post spine surgery: a case report

Postoperative deep vein thrombosis (DVT) of lower limbs is often asymptomatic. In many patients, fatal pulmonary embolism (PE) is the first clinical manifestation of postoperative venous thromboembolism (VTE). Routine screening for asymptomatic DVT of the lower limbs has a low sensitivity and is quite impractical. For these reasons, routine and systematic prophylaxis in patients at risk, is the strategy of choice to reduce the burden of VTE after surgery. If used appropriately such prophylaxis is cost effective since it reduces the incidence of symptomatic thromboembolic events, which require costly diagnostic procedures and prolonged anticoagulation therapy. Here we report the post-operative course of a spine surgery patient, presenting with DVT in calf veins, which lodged into pulmonary artery and was managed successfully with low molecular weight heparin (LMWH), embolectomy, inferior vena cava (IVC) filter, and dabigatran

Seasonal variation in yield and yield contributing characters of selected cocoa clones

Cocoa, the only source of chocolate, is divided into three groups viz. Forastero, Criollo and Trinitario. This study was taken up to gauge the performance of 12 years old cocoa clones of three types. Among these, Forastero was found to perform well under tropical conditions in all three seasons. The performance of Forastero was unrivaled with pod weight 429.95 g and wet bean weight 117.79 g. All three varieties performed well under post-monsoon season exploiting advantages of monsoon. When correlated with weather, it was observed that number of rainy days, rainfall and relative humidity had a negative correlation with number of pods, whereas mean sunshine hours had a positive correlation with pod weight, wet bean weight, and TSS. In order to comprehend the significance of weather parameters, canonical correlation was estimated. The high value indicated that all the weather parameters influenced the characters to a great extent. Rainfall, temperature and relative humidity were the three climatic factors influencing the yield parameters. High R2 value obtained in prediction model suggested that it could be efficiently used in the prediction of yield and yield contributing characters of cocoa. &nbsp

Comparison of serum calcium and magnesium levels between preeclamptic and normotensive healthy pregnant women

Background: Preeclampsia is idiopathic multisystem disorder specific to human pregnancy. Its incidence is 8-10% of total pregnancies in India. It is one of the leading causes of maternal and fetal morbidity and mortality worldwide. Alterations in serum calcium and magnesium levels have been suggested as effective factors in causing preeclampsia. The aim of this study was to compare serum calcium and magnesium levels in preeclamptic and normal pregnant women in third trimester of pregnancy.Methods: The study was conducted in the department of biochemistry in collaboration with department of obstetrics and gynaecology, Sri Aurobindo medical college &amp; P. G. institute, Indore during the period January 2012 to January 2013. Subjects were divided into two groups: group-I included 100 preeclamptic women group-II included 100 age matched, healthy pregnant women. Serum calcium and magnesium was estimated by Arsenazo III method and by Calmagite method in ERBA CHEM-5 respectively (Enzymatic kit method).Results: Serum levels of calcium (8.27 ± 0.37 mg/dL vs. 9.06 ± 0.27 mg/dL) and magnesium (1.99 ± 0.13 mEq/L vs. 2.03 ± 0.13 mEq/L) were significantly lower in preeclamptic women than the control group (i.e. healthy pregnant women).Conclusions: Hypocalcaemia and hypomagnesaemia are seen in the preeclamptic women may be responsible for the vascular pathology associated with onset of preeclampsia. Hence it can be concluded that adjuvant supplementation of calcium and magnesium may prevent further progression of preeclampsia.