Obesity has become a major public health problem over the past two decades. Non-surgical management of obesity does not often achieve its long term goals. Surgical treatment is roaring in popularity because of dramatic and durable results. However, outcomes from bariatric surgery have become a significant area of scrutiny because it is also associated with several medical and psychological complications. Out of those complications, there are descriptions of neuropsychiatric disorders and psycho-behavioral symptoms after surgery. Meanwhile, few reports of acute psychosis are described but to our knowledge, our case is the first case report of primary mania following bariatric surgery. We present an unusual and challenging case of primary mania in a 57 year old female who underwent bariatric surgery two months ago. Patient responded well initially to antipsychotic followed by mood stabilizer.
Bariatric Surgery* ; Bipolar Disorder* ; Female ; Humans ; Obesity ; Obesity, Morbid ; Psychotic Disorders ; Public Health

There was an error in name of author. Mukul Bhatarai is replaced with Mukul Bhattarai.

Cardiac tamponade due to purulent pericarditis with a characteristic greenish fluid is rare in this antibiotic era. It is highly fatal despite early diagnosis and advanced treatment. Gram-positive cocci are the leading cause of purulent pericarditis, which usually results from a direct or hematogenous spread of organisms to the pericardium from the primary foci of infection. We describe an index case of rapidly developing pericardial tamponade caused by oropharyngeal polymicrobial infection in the absence of a primary source of infection in a 62-year-old man, who was successfully managed with emergency large-volume pericardiocentesis followed by pericardiectomy.
Cardiac Tamponade* ; Coinfection* ; Early Diagnosis ; Emergencies ; Middle Aged ; Gram-Positive Cocci ; Pericardiectomy ; Pericardiocentesis ; Pericarditis* ; Pericardium