Objectives: The concept of “Abnormal illness behavior (AIB)” has been evolved to a greater extent in the last century. Henry Sigerist introduced the concept of “illness behavior” in 1929. Mechanic & Volkart defined and further conceptualized the impression on illness behavior. Talcott Parson had given the concept of “Sick role,” and Issy Pilosky had familiarized the notion of “abnormal illness behavior.” The main objective of this article is to review the conceptual evolution on “abnormal illness behavior” and to analyze its current clinical implications. Methods: Extensive search of literature was performed regarding abnormal illness behavior, illness behavior and sick role in online web searching sites like – Google Scholar, PubMed and individual journal sites as well as google books. The literature was critically reviewed with personal inputs from authors. Results: Abnormal illness behavior ranges from denial of illness in one extreme to conscious amplification of symptoms on the other. Abnormal illness behavior is noticed in various clinical conditions like stress-related disorder, stress-related disorders, factitious disorder and malingering. Conclusions: Identifying abnormal illness behavior can prevent unnecessary and excessive utilization of medical aids for the same.

Disease Progression ; Humans ; Pharmacogenetics ; methods ; Precision Medicine ; methods ; Psoriasis ; genetics

Protein malnutrition is a major concern in Bangladesh where there is a high dependence on cereal-based diets. Use of protein-calorie sources of plants like soybean and mushroom as a dietary supplement may provide a solution. This study was designed to formulate a high protein and fibre enriched soy-mushroom health drink powder, and to compare its nutritional contents with locally available health drink powders. Methods: Soy-mushroom health drink powder was developed mainly from soy flour, mushroom, germinated wheat flour, malt extract and milk powder. Three locally available health drink powders were randomly selected. Proximate and microbiological analyses and sensory evaluation were undertaken by standard methods. Data were analysed using Statistical Package for the Social Sciences (SPSS). Results: The moisture, ash, protein, fat, fibre, carbohydrate and energy contents of the developed soy-mushroom health drink powder ranged from 3.04-3.96%, 3.23-7.4%, 8.98-21.37%, 1.10-10.13%, 0.04%-1.50%, 59.93-81.58% and 363.54-416.40 kcal/100g, respectively. The soy-mushroom product had the highest content of protein, fibre, energy and the lowest content of carbohydrate compared to the other health drink powders. Based on sensory analysis, the soy-mushroom product showed high acceptability. Microbiological assessment showed the shelf life of this product to be one year. Conclusion: The soy-mushroom health drink powder was nutritionally superior to locally available health drink powders and could serve as a nutritional supplement.

Pseudocyst of the auricle is a rare, asymptomatic, cystic, swelling of the upper portion of the auricle. It results from spontaneous collection of an oily, serous fluid within an unlined intracartilaginous cavity1. The aetiology and pathogenesis of this condition is not known. Although various medical and surgical therapeutic approaches have been described, the treatment of pseudocyst of auricle is difficult and recurrences are frequent2.

Early life adversities like parental loss during childhood, physical abuse, sexual abuse and emotional harassment may have deleterious consequences in an individual’s life, which can manifest under the form of various externalizing or internalizing behaviors. This case study aimed to highlight the impact of unusual early life adversities in a young woman’s mental health and related management issues. Methods: We reported a case of a young lady presenting with anxiety, low mood, disturbed sleep and appetite for more than six months. She also had episodes of dissociative stupor following any stressful event for approximately 13 years. She was hospitalized, evaluated clinically as well as by psychometric assessment. Relevant pharmacological and psychological interventions were performed. Results: She was diagnosed with Major depressive disorder with dissociative disorder and borderline personality disorder. The patient had multiple stressors during childhood like - loss of parents, emotional & physical abuse, which had an impact on her mental wellbeing. Conclusion: Early life adversities are detrimental to the mental health of an individual. The clinical outcome depended upon on the nature of trauma to the mental well-being, mode of intervention done and available psychosocial supports. ASEAN Journal of Psychiatry, Vol. 17 (2): July – December 2016: XX XX.

Hyperekplexia (startle disease) is a rare non-epileptic neurological entity resulting from gene mutation. The onset of this disorder is usually in infancy, but can be delayed until early adulthood. Patients with this disorder usually have normal mental development. Patients with hyperekplexia may present with symptoms ranging from sub-syndromal anxiety, to symptoms of syndromal anxiety disorder. This case report is about two siblings with hyperekplexia, in whom phobic anxiety disorder was a prominent manifestation.

In this case report, a middle aged lady presenting with persistent vomiting of 12 years duration, not responding to conventional management and showing dramatic response to combinations of low dose Imipramine and Trifluperazine is discussed. Method: In our case, a middle aged lady presenting with chronic, recurrent episodes of severe vomiting for approximately 12 years with poor treatment outcome was evaluated and treated with low dose imipramine and Trifluperazine, which was found to be highly effective. Results: Low dose Trifluperazine and imipramine is effective in the treatment of cyclic vomiting syndrome. Conclusion: Cyclic Vomiting Syndrome is often missed and appropriate psychiatric intervention gives a better outcome.

Ficus deltoidea leaves were widely used as a tea beverages in Malaysia with no information of its mineral content. Hence the mineral content of two species of Ficus deltoidea leaves were investigated. The dried leaves of F. deltoidea var. angustifolia and F. deltoidea var. deltoidea were acid digested and mineral elements of Na, Mg, K, Ca, Mn, Cr, Fe and Zn were determined using ICP–MS. Magnesium, potassium, sodium, manganese, iron and zinc were found to be present in the leaves of F. deltoidea var. angustifolia and F. deltoidea var. deltoidea. Concentration of magnesium (1934 mg/L), manganese (58.37 mg/L), iron (6.89 mg/L) and zinc (1.77 mg/L) in F. deltoidea var. deltoidea species were significantly (P < 0.05) higher than in F. deltoidea var. angustifolia species with concentration of 317 mg/L, 29.62 mg/L, 4.55 mg/L and 1.26 mg/L for magnesium, manganese, iron and zinc respectively. Meanwhile, concentration of sodium in F. deltoidea var. deltoidea species (3.13 mg/L) was found to be significantly (P < 0.05) lower than the concentration in F. deltoidea var. angustifolia species (9.11 mg/L). The finding showed that the leaves of F. deltoidea var. deltoidea has higher nutritional value than the leaves of F. deltoidea var. angustifolia. Leaves of Ficus deltoidea especially the F. deltoidea var. deltoidea species contain high amount of magnesium, manganese and potassium. Therefore, tea made of this leaves can be served as a good source of minerals for human consumption

Objective: Mental health services in Malaysia often face competition from traditional healers especially among patients with psychosis. The objective of the study is to determine whether patients who sought help earlier from traditional healers had longer duration of untreated psychosis (DUP), and more adverse experiences in pathways to psychiatric care. Methods: This is a hospital-based cross-sectional study of 50 inpatients with first-episode psychosis in Hospital Kuala Lumpur. Structured Clinical Interview for DSM-IV (Diagnostic and statistical manual, 4th edition) Clinical Version for Axis I Disorders (SCID-CV) was used for establishing diagnosis. Onset of psychosis was defined as any one positive symptom with a score of >3 on the Positive and Negative Syndrome Scale (PANSS). Socio-demographic data, information on pathways and treatment delaying factors were determined through face-to-face interview and semi-structured questionnaire. Results: Fifty-four percent of the patients had at least one contact with traditional healers prior to consulting psychiatric service, and it was the most popular first point of non-psychiatric help-seeking contact (48%). Contact with traditional healers was not associated with age, gender, ethnic, education level, longer DUP or treatment delay, and admissions with violent behaviour or police assistance. Of those who had sought help from traditional healers, one third were recommended by at least one of their traditional healers to seek medical help. Conclusion: Consultation involving traditional healers was a popular choice, and not associated with treatment delay. Traditional healers in an urban setting may be potential collaborators in managing patients with first-episode psychosis. Future research should explore the frontiers of such collaborative work.

Objective: The association between thyroid dysfunction and Type 2 Diabetes Mellitus has been reported in several studies. This study was done to explore the prevalence of thyroid dysfunction in young (<40 years) patients with type 2 Diabetes Mellitus in Eastern India. Methododology: A retrospective chart review of 120 patients with Type 2 Diabetes Mellitus was done. 120 patients (male 81, female 39) of age <40 years, who fulfilled the diagnostic criteria for Diabetes Mellitus according to ADA (American Diabetes Association) were enrolled and investigated through performance of Thyroid Function Tests (FT4,TSH). Results: Of 120 patients (of less than 40 years of age ), 65.83% of patients had the biochemical features of thyroid dysfunction. In descending order of frequency, we found subclinical hypothyroidism in 43.33% of cases (defined by no symptoms or no clinical features of hypothyroidism but with TSH level in the range of above 5 miu/ml but below 10 miu/ml with normal FT4 level), followed by 9.2% of patients with overt hypothyroidism ( either clinical features or TSH >10 miu/ml or FT4 below normal), 8.3% with subclinical hyperthyroidism (only biochemically low level of TSH <0.34 miu/ml in this study) and 5% of patients show features of clinical hyperthyroidism (clinical or FT4 level well above normal range along with low TSH). Conclusion A high prevalence of thyroid dysfunction in young type 2 DM patients suggests evaluation for thyroid disorder for proper management.
Diabetes Mellitus ; Thyrotropin