Fact of the day: Psychosomatic symptoms love to travel

Hey Awesomites

Yes, you read it right. The symptoms of psychosomatic disorders flit from one body part to another, and just too easily and quickly ( they love to travel a lot ;p ) . Just as one symptom is discovered, it disappears and another one emerges in some other part of the body.

The psychosomatic symptoms have been linked to a chameleon. Every time a medicine tries to pin them down,  they become something different.

That's all
- Jaskunwar Singh

The colours of a chameleon are not more numerous and inconstant than the varieties of the hypochondriac and hysteric disease.
 - Robert Whytt

Munchausen's syndrome

Hello

"Psychosomatic disorders are conditions in which a person suffers from significant physical symptoms (causing real distress and disability), that is out of proportion to that which can be explained by medical tests and physical examinations."

Karl Friedrich Von Munchausen, the "Baron of Lies" gave his name to the syndrome. Munchausen's syndrome (now more correctly called factitious disorder in DSM- 5 classification of somatic symptom and related disorders ) refers to patients who imitate illness (may be in an exaggerated form ) for medical attention and care and may even expose themselves to life- threatening operations, amputations, unnecessary medications and toxic treatments.

Lets take an example: A woman presents to hospital with a headache and a dilated pupil. On investigations, scans were normal and no other systemic abnormality seen. Then, a nurse walks into her room and finds the patient self- administering dilating eye drops into the affected eye.

The person has an awareness of the lies they are telling but they surely do it to seek medical care and attention, being unaware of their own motivation and uncontrolled behavior.

Upto one- third of patients in neurology ward suffer from psychosomatic illness and most often, an emotional cause is suspected.


Thats all
- Jaskunwar Singh

Fact of the day: Multi- vitamin supplements beneficial for schizophrenics

Hello

Recent studies suggest that high- doses of vitamin B help in reducing the symptoms of schizophrenic patients and those with other neuropsychological disorders, when added to the normal treatment in early stages. (Source)


- Jaskunwar Singh

Delirium and Dementia mnemonics

Hello

Delirium- "It is a transient, usually reversible cause of mental dysfunction that results in a wide range of neuropsychiatric abnormalities, mostly presented by elderly as
- waxing and waning type of acute- confusional state
- fall in attention- span
- decreased awareness of surroundings
- low cognition levels."

Causes of Delirium- (mnemonic: DELIRIUM)
D- Drugs (anti- cholinergics, antipsychotics etc)
E- Encephalopathy (Wernicke's)
L-  LSD intoxication
I- Infections
R- Respiratory failure
I- Insomnia
U- (v) visual sphere hallucinations
M- Metabolic disorders


Dementia- "A group of neuropsychiatric disorders characterised by chronic and gradual decrease in the ability of person to think, create memories, express emotions and other mental symptoms that affect the general well being."

Causes of Dementia (mnemonic: DEMENTIA)-
D- Degeneration (Primary cerebral)
E- Endocrinal dysfunction
M- Multiple sclerosis
E- Embolisation (vascular pathology)
N- Normal tension hydrocephalus
T- Tumors
I- Infections
A- Alcohol intoxication


That's all
- Jaskunwar Singh

Fact of the day: Cocaine addiction and iron concentration in brain

Do you know? Cocaine addiction leads to increased concentration of iron in globus pallidus. The more one takes this drug, more amounts of iron get accumulated in this region of brain, which normally acts as a 'brake' for inhibiting behaviour.

Also, the increased concentration of iron in brain is accompanied by iron deficiency in rest of the body.

This is possibly attained by decreasing absorption of iron from food and increasing permeability of blood- brain barrier.


- Jaskunwar Singh

Fact of the day: Talking to yourself is a sign of smartness

"Look at that guy, roaming around here and there in the marketplace, muttering words and talking to himself. He seems totally insane. Doesn't he?"

Fact of the day: Tugging on heart strings

Hey Awesomites

Since its Valentine's day, here is a love fact you need to know:

Emotional instability and stress associated with constant anxiety (in case you are suffering from I-love-you-penia or broken-heart syndrome) may actually lead to acute emotional trauma to the heart and result in rupture of heart strings, the "chordae tendineae".

The chronic negative effects on heart are associated with Takotsubo cardiomyopathy, aka broken heart syndrome which involves weakening of myocardial muscles and rupture of chordae tendineae leading to right sided heart failure, ventricular arrhythmias and rupture.

So ease your suffering by talking to the love of your life on this special day and confess about your feelings today. <3

Source- Tumblr

Ps- Medicine loves you and cares for you <3
- Jaskunwar Singh

Fact of the day: 'Experience- taking' from books

Today's fact is relatable for all medicos and books lovers <3

Yes, you can subconsciously take on the attributes of your favourite fictional characters when reading a story- not just the thoughts and beliefs of the character, but the whole state of being itself.

Well, it is more often seen in those who are depressed or who don't have much life experiences of their own.

Also, if the reader is able to relate experiences in the life of character of the story, he might take it to his own life and adopt the mindset and perspective of the character. This may lead to temporary or permanent changes in his real life.

Excessive openness to experiences may lead to schizotypal, narcissistic or paranoid personality disorders among others.


Happy reading :D

- Jaskunwar Singh

Fact of the day: Most efficient sleep position to clear the brain of waste

Your sleep position at night matters a lot. Not head-up, nor head-down, but sleeping on your side is the most efficient position to clear waste materials from the brain.

This is because the glymphatic system (exchange of CSF with the interstitial fluid to get rid of damaging brain proteins) of our brain works most efficiently in lateral position compared to supine or prone position.

Lateral position and right posture while sleeping is considered advantageous for those suffering from neurologic and psychiatric disorders due to this reason.

That's all

- Jaskunwar Singh

Neurodevelopmental maturity and adulthood

Hey Awesomites!

When do you really attain adulthood?
18. That's when you are legally declared an adult. Right? Oh so you already got the answer. Hey no wait.. we are medical professionals and students of science. So talking in a legal way doesn't always seem right, because from a scientific perspective, adulthood is still an unsolved mystery. Let me tell you about it here..

Mental distractions

Hey Awesomites!

Let me ask you a question.. how much focused you are during your study time? Well, as a medical student you try your best to focus on what is written in the book and in making your own notes. You are not aware of your surroundings anymore. Someone comes nearby and calls you or sits just beside you but still your eyes are on those words and difficult medical terms of the diseases and syndromes and the drugs used to treat them. This is called Change blindness, a perceptual phenomenon that occurs when you don't notice a major change in the environment because you are too focused on one particular thing.

Let me give you another example. A young guy is standing in a long queue at a place while some people arrive from the opposite side. He starts staring on a cute little child who was looking at him too. They share smiles, and eye contact for several minutes while the mother carrying the child moves on. The guy just stands still there and is not aware of the surroundings when other people behind shout at him because he is not moving forward or letting them go. All of a sudden he realizes where he is and so walks ahead. This transient moment is the change blindness. :D
Note: Even maintaining an eye- contact with someone, even a child in this case may prove strenuous for the brain especially during reasoning and verbal processing and so is itself a distraction (distracting the young guy from the queue and instead focusing on that child). That is why we periodically avert our eyes during conversations.

During this particular moment this guy activated his visual association area (visual cortex) while looking at that child which meant he was just paying attention to the perceptual details (the depth of eyes of that child, cuteness, innocence, love).

On the other hand, the older adults may notice changes and patterns happening around while doing a particular task as well. Reduced focus (mental distractions) in the aging brain is responsible for the abstract thinking in them that is needed for problem solving and creative work.

In other words, the healthy aging people show thinking patterns that allow them to make connections among pieces of information that are right in front of them as well as information they have have encountered in the past. For example, an older adult involved in a conversation might pick up information on current road conditions from a television nearby, whereas a younger adult might be paying a closer attention to the conversation itself. Later on, the older adult might make use of the information from the TV broadcast while planning a route home. 

The study suggests that older adults tend to have more focused attention in the morning and more of the abstract thinking later in the day. College students on the other hand tend to have their peak attention in the afternoon or evening and are less focused in mornings.

Inability to remember details of major events or just the location of objects begins in early midlife (the 40s) which does not mean the brain function is deteriorating, instead it may be the result of the changing focus of brain on the particular information during the process of memory formation and its retrieval. The experiments on this study have concluded that the middle- aged and older adults don't really show the same level of visual cortex activation as the young do when they recall the information. Instead, their medial prefrontal cortex is activated, a part of the brain that is involved in learning associations between events and the corresponding adaptive responses. The mPFC likely relies on the hippocampus to support rapid learning and memory consolidation.


Thats all
- Jaskunwar Singh

Mnemonic for personality disorders

Hello!

Soo here's a nice memory aid I came across...
A: Mad
B: Bad
C: Sad

If you write two A's (AA) It does look like an M!
B for cluster B, B for Bad!
C and Sea sounds similar for Sad xD

Mnemonic for personality disorders

"SPAS BAN His ACD"

Seasonal affective disorder

Hey awesomites

Seasonal affective disorder  (SAD) is common in winters months when days are short and nights are long. It is caused by abnormal melatonin metabolism and the patient presents with acute depressive and atypical symptoms.

Here's a mnemonic for atypical symptoms of Seasonal affective disorder.
SAD
S- Sleepiness
A- Appetite increase
D- Decreased energy

Note: Treatment of this disorder includes exposure to bright light therapy. Melatonin tablets should not be prescribed in such cases.


That's all
- Jaskunwar Singh

Neurotransmitters associated with sleep mnemonic

Neurotransmitters associated with sleep mnemonic
SAND

S- Serotonin: helps initiate sleep cycle and promotes wakefulness.
A- Acetylcholine: levels are higher during REM sleep.
N- Norepinephrine: levels are lower during REM sleep.
D- Dopamine: high levels responsible for arousal and wakefulness.

Note:
- The regulation of levels of Acetylcholine and Norepinephrine is an important biochemical trigger for REM sleep. Higher levels of Ach and lower levels of NE means there is increase in the time period of Rapid eye movement phase of sleep cycle.

- Serotoninergic neurons are present in Distal Raphe nuclei which enhances wakefulness. Thats why the 5-HT activity decreases during NREM sleep and becomes silent during REM phase.

- Dopamine agonists, such as  bromocriptine, pramipexole and others are used to treat parkinson's disease which work by acting on dopamine receptors and compensate for the lack of dopamine which the brain cells no longer produce. They are used together with levodopa. By increasing dopamine levels they restore the balance of Acetylcholine and dopamine thus increasing wakefulness.

- Antipsychotic drugs are dopamine antagonists. So they decrease wakefulness and increase sleep time of a person.

- Higher levels of Ach during REM sleep is associated with erections in men.


Thats all
- Jaskunwar Singh

Night terrors vs Nightmares

Hey awesomites!

People who have night terrors are often misdiagnosed, nightmares being the most common. Post traumatic stress disorder is another common misdiagnosis (in adults).

Here's the difference between night tremors and nightmares both of these are classified under a group of disorders, the Parasomnias!

Recent research suggests that getting an extra sleep for 30- 40 minutes a night reduces both nightmares and night terrors to a great extent.

Scheduled awakening therapy-
Another treatment strategy (for night terror) is "Scheduled awakening therapy". It involves waking the person from sleep 15- 30 minutes before the episodes typically occur so that the cycle is interrupted and prevent the onset of the night terror. But the child is not to be fully awaken in the middle of the night.
Thats where the idea of sleep guardian came from. The sleep guardian plans smartly and finds a right time to partially wake up the child and vibrate each night (for less than 3 minutes). This prevents the episode of night terrors and sleep is not actually totally disturbed.
This method of prevention of night terrors has shown 90% positive results within first week with 80% fewer night terrors after four weeks of use.

Thats all
- Jaskunwar Singh

Marijuana and cannabinoids intoxication mnemonic

Hey!

So in this post, imma gonna talk about what happens when you smoke weed yo.

The symptoms of marijuana intoxication are:

Munchies (Polyphagia)
Autonomic hyperactivity (Mild hypertension, dry mouth)
Racing heart (Tachycardia)
Injection (Scleral, conjunctival injection)
Judgement impaired
Uphoria (Euphoria)
Anxiety
Nystagmus
Ataxia

Treatment? Intoxication is self-limited to several hours. Interestingly, the treatment for marijuana intoxication and withdrawal are exactly the same: supportive care only.

That's all!

Don't do pot, you dope, you :P

-IkaN

Narcolepsy mnemonic

Hello!

This post is on narcolepsy.

For those who don't know, narcolepsy is characterized by:

Treatment of post traumatic stress disorder (PTSD) mnemonic

Hello!

Here's a short post on the treatment of PTSD. It comes with a mnemonic!

Schizophrenia subtypes mnemonic

Schizophrenia types mnemonic: CURDP

Order of decision making

Ideally, a doctor discusses the available options of treatment with the patient, the patient makes a decision and informed consent is obtained.

However, this may not be possible on every occasion and it is the physician's responsibility to ensure that a decision is made that would be what the patient would have wanted (if the patient does not have the capacity to make the decision himself/herself).