Undergraduate Psychiatric Training: Insights from Emergency Room.

Context: Undergraduate medical training involves a number of subjects for the trainee to go through and develop the skills necessary to mange the cases. Subjects such as psychiatry are underrepresented during this training. Aims: This study aims to assess the quality of undergraduate psychiatric training through the management of psychiatry cases by MBBS graduated in the emergency department. Settings and Design: The study was carried out in the emergency department and OPD set up. The study used the consecutive sample inclusion. Methods and Materials: The study included the consecutive initial 40 consultation from the emergency department. The analysis included the management done by the emergency department, the reasons for referral and the differences in diagnosis/ management of emergency department staff and resident doctor of psychiatry. Statistical Analysis used: The data was analysed using SPSS ver 10. Results: The diagnosis in 15 cases was revised by the psychiatry resident doctor from that made by the emergency department staff. There were certain unusual reasons for referrals to a psychiatrist. There were differences in the line of management of some of the cases as per the emergency department staff and the psychiatry resident. Conclusion: There is a need to relook into the training curriculum of the undergraduate psychiatric training programme.

Unilateral pseudohypacusis in children.

Pseudohypacusis is a condition where there is hearing loss without any organic etiology. Though this condition has been reported long before, the literature exists mainly in the form of case reports. An interesting aspect of pseudohypacusis is of patients presenting with unilateral pseudohypacusis. In children, there often exist underlying psychological factors related to the occurrence of this condition. This condition is usually suspected when there is discrepancy in audiometric testing. The authors hereby report a child of unilateral pseudohypacusis presenting with psychological stressors, along with an overview of the management of such conditions.

Chronic mania: An unexpectidly long episode?

Mood disorders (unipolar and bipolar disorders) are one of the most distressing and disabling disorders known to man kind. Mood disorders may present as either a depressive phase or manic phase. Chronic mania by definition means presence of manic symptoms in excess of 2 yrs without remission. Chronic mania differs in its psychopathological presentation from the acute mania. Chronic mania also poses a diagnostic and management challenge. Along with the poor response to the treatment these patients are also likely to suffer from severe impairment in the social, familial, interpersonal and occupational functioning. These disturbances may add to the chronicity of the condition. This case underlines the significance of keeping possibility of chronic mania which has been overlooked in the recent literature.