A Case Report on Gender Identity Disorder with Recurrent Depressive Disorder is presented. Individuals having this disorder often exhibit discomfort about their actual anatomic gender, and they may have wished to alter their bodies. Sex role-stereotypes adopted during childhood are the beliefs, characteristics and behaviors of individual cultures that are considered normal and appropriate for boys and girls to possess. These "norms" are influenced by one's family and friends, the mass-media, and their community. Since some cultures disapprove of cross-gender behavior, it often results in significant problems for affected individuals and those in close relationships with them. The importance of treatment is not only because of the high rate of mental-health problems, including Depression but with higher suicide rate among untreated transsexual people than in the general population. These problems are not usually related to the gender identity issues themselves, but the social and cultural responses to gender-deviated individuals. An example which classically illustrates Gender Identity Disorder is the case of a young man from Brunei Darussalam, who was seen and treated. This contribution will highlight the cultural and religious perspective of this Disorder.

To determine the current practices of private practitioners for the management of STIs in Pulau Pinang, Malaysia, evaluation of pharmacotherapy for STIs in private clinics and to ascertain the management of STIs compared to standard guidelines. Methods: Data was collected by self-administered questionnaire for private practitioners, which gathered information on their socio-demographic as well as practice characteristics. Descriptive statistical analysis was performed by using SPSS for Windows version 13.0. Results: Data was collected from 78 practitioners. Most of the treatment choices mentioned for the treatment of gonorrhea were inconsistent with the guidelines. About 51.2% of practitioners did not screen their patients for HIV/AIDS. Majority of private practitioners counseled their patients about HIV/AIDS on an irregular basis. A high percentage of 59% did not inform health authorities about STI cases and 32.1% mentioned that they did not use any guidelines. Conclusions: Management of STIs by private practitioners with respect to selection of antibiotics, patient counseling and case notification leaves a lot to be desired. Current management practices can adversely impact on HIV/AIDS transmission in the country. Interventions are needed to improve the management practices of private practitioners.

Objective: This study intended to investigate the relationship between Emotional Intelligence (EI) and Organizational Citizenship Behaviour (OCB) with moderating role of Islamic Work Ethics (IWE). Methods: A sample of 123 students of Islamabad were surveyed on EI, OCB and IWE and data from this survey were entered into a linear regression model to study the links between these variables. Thirty-four (27.6%), 45 (36.6%), 9 (7.3%), 27 (21.9%) and 8 (6.5%) of the respondents were in the age range of 20 - 25, 25 - 30, 30 - 35, 35 and above, respectively. Furthermore, 7 (5.7%), 23 (18.7%), 43 (34.9%), 31 (25.2%) and 19 (15.4%) had qualifications of Graduate, Masters, MS, PhD and Post Doc, respectively. Eighty-two (66.67%) were male and 41 (33.33%) female. Results: There was a statistically significant linear relation between EI and OCB (Beta = 0.292) whereas IWE also had a notable link with OCB (Beta =0.559). IWE had no significant impact on the relationship between EI and OCB. Conclusion: The interaction effect of EI and IWE did not cause the target sample of the study to exhibit OCB to a significant level.

HIV/AIDS and Mental Health are two chronic diseases with huge economic burden in developing countries. For HIV/AIDS, this year marked three decades since HIV/AIDs first identified with more than 34 million people in the world are living with this chronic condition with 2.6 million new cases. More than 90% of cases are adult in their economically productive life and nearly half are women. Even though HIV/AIDs incidence fell by more than 25% in 33 countries for the last ten years, the existing burden is still huge. Africa, the least resource continent in the world bears most of the brunt of this chronic condition housing nearly two thirds of global HIV positive cases. It is estimated that the available resources for HIV/AIDs in 2009 is USD 15.9 billion, there is a shortage of nearly USD10 billion. Only one third of these countries make HIV/AIDs a high budgetary priority. Mental illness is a chronic non-communicable disease responsible for 37% of global healthy life years lost. It was also estimated that in 25% of the patients visiting any health facilities, at least one suffer from undiagnosed mental health, neurological or behavioural disorder. The current global cost of mental health is estimated at USD 2.5 trillion. This will increase to USD 6.1 trillion in 2030. More than two thirds of this cost is indirect cost mostly due to loss in productivity. Managing these two conditions posed great challenges to low and middle income countries. Huge economic burden means that additional source of funding should be sought with full participation of all stakeholders. Mobilizing resources at the community level should be seriously considered. Support for community to provide long term care for HIV/Aids and mental health patients should be adequately supported by governments through properly targeted and well organized programme. Incentives and disincentives to influence efficient and effective performance should be put in place with innovative financing approach. Vertical programme should be avoided while more integrated approach with significant task shifting should be given a priority to ensure success and sustainability. In conclusion, policy makers in low and middle income countries should take positive measures to ensure that HIV/Aids and mental health is properly addressed by mobilising efforts from all stakeholders.

This study investigated the relationship between Social Distrust (SD) with Personal Suffering (PS). This paper considered Excessive Reassurance Seeking (ERS) as a social method of expressing one’s lack of trust on others. Methods: Analytical technique of linear regression was used to test the relations statistically. A sampling method of convenient and referral selection was applied to select 85 respondents from the city of Faisalabad, Pakistan. Results: Analysis showed that only ERS predicted PS significantly (B = 0.623, p < 0.001). Age also decreased ERS in the sample (B = -0.208, p < 0.01). Conclusion: Age reduced ERS because elders became more focused on their personal objectives and therefore, they did not feel the need to confirm loyal attachment of others. Additionally, ERS contributes to increase PS as people confirm sincerity of their social circle regularly. Friends and family do not withstand constant scrutiny of their motives and individuals who use ERS intensively experience depressing loneliness in the society. ASEAN Journal of Psychiatry, Vol. 18 (1): January – June 2017: XX XX.

Mucoepidermoid carcinoma is a malignant epithelial tumour of glandular tissue, usually of the major salivary glands. However it can present in the minor salivary glands, especially in the soft palate. We report the case of a 72-year-old Malay female after presentation with sore throat, fever and odynophagia, was diagnosed with mucoepidermoid carcinoma of the soft palate.
Mucoepidermoid Tumor ; Salivary Gland Neoplasms ; Salivary Glands, Minor

Isolated internal iliac aneurysms are rare. We report a case of an uncommon presentation of perineal pain and tenesmus in a man caused by the pressure effects of the aneurysm. He had a successful endovascular exclusion and thrombosis of his aneurysm. On follow up of more than 3 years he remains free of all symptoms and no recurrence of the aneurysm.
Aneurysm

Back ground: Immune thrombocytopenic purpura (ITP) is a hemorrhagic diathesis, characterized by platelets destruction alongside impaired production. Patients from Asian regions often exhibit distinctive characteristics in comparison to the western patients. We accomplished this study to evaluate the prevalence of primary versus secondary ITP along with the comparative analysis between them. The secondary objective was to determine the etiological spectrum of secondary ITP. Methods: We illustrate the results of a large cohort of newly diagnosed adults ITP from southern Pakistan. The study extended from January 2009-December 2013. Complete blood counts, HbsAg, Anti-HCV, ANA, stool for Helicobacterpylori were done on all. HIV, TSH, anti-dsDNA, RA factor, APLA and direct coombs test were evaluated in cases where indicated. Results: A total of 417 patients were included with a mean age of 40.95±14.82 years. Primarily disease was observed in the 3rd decade of life. Male to female ratio was 1:1.5. Mean platelets count was 46.21±27.45x109 /l. At diagnosis 43.16% (n=180) patients had hemorrhagic manifestations whilst 56.8% (n=237) were asymptomatic. None of the patient presented with visceral, retropharyngeal or intracranial bleed. The prevalence of secondary ITP was substantially higher (64.8%) as compared to primary ITP (35.2%). Secondary ITP was predominantly seen in HCV reactive patients (24.4%) followed by helicobacter-pylori infection (11%). Nevertheless 16.4% patients had underlying autoimmune disorders. Providentially no study subject was found to be HIV reactive. Conclusions: Our study revealed predominance of secondary ITP. However bleeding manifestations and degree of thrombocytopenia were high in primary-ITP. Infectious etiology followed by autoimmune disorders is mainly implicated for secondary ITP in our setting.

Haemodialysis is a continuous treatment provided to patients with chronic kidney disease as a replacement for renal function. It is important to assess the quality of life among these patients. The aim of this study was to evaluate quality of life among patients on haemodialysis using an Indonesian version of the KDQoL-SF24 questionnaire. This is a cohort observational study that included 145 haemodialysis patients in a haemodialysis centre in Jakarta, Indonesia. A translated and validated version of the KDQoL-SF24 was used in this survey. The participants in this study had lower mean scores than the standard form in the following 6 components: burden of kidney disease (44.22±33.23), cognitive function (74.94±20.32), sleep (57.07±24.15), patient satisfaction (60.11±18.56), role-physical (26.21±44.01), emotional well-being (69.19±24.25) and role-emotional (40.69±49.18). A significant relationship was found between sexual function, physical functioning, role emotional and age among haemodialysis patients (P <0.05). Based on the overall health rating from the KDQoL-SF24, the mean and standard deviation for the 21- to 30-year-old age group was lower than the standard form. The burden of kidney disease, cognitive function, sleep, patient satisfaction, role-physical, emotional well-being and role-emotional component scores were low for haemodialysis patients in Indonesia compared to the standard form. Additionally, age significantly affected sexual function, physical functioning and role-emotional.

Female ; Humans ; Lipoma ; diagnosis ; surgery ; Omentum ; surgery ; Peritoneal Neoplasms ; surgery