Bangladesh Journal of Psychiatry

A case of haematohidrosis with comorbid attention-deficit hyperactivity disorder and oppositional defiant disorder: challenges to treat

Saqiba Aziz — 2020-12-31

Haematohidrosis is an uncommon disorder of unknown etiology that could be puzzling to physicians. Sufferers of this disorder were often adolescent females who were undergoing some stressful or emotional event; which might be associated with the activation of the sympathetic nervous system. These episodes involved spontaneous bleeding from skin and mucosal membranes without the involvement of trauma. An 11-years-old girl had admitted in a psychiatry hospital with recurrent episodes of bleeding from the eyes, nose and palm for one and a half years. She had been diagnosed with haematohidrosis following through clinical examination and laboratory investigations conducted a few months back prior to admission. However, the treatment appeared to be ineffective, perhaps owing to the patient’s comorbid attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). The patient was then treated with combined pharmacological and psychological interventions, thus bringing about an improvement in this challenging case.

Bang J Psychiatry 2020; 34(2): 33-34

Very low dose risperidone induced galactorrhea in a young girl: a case report

Rezwana Habiba — 2020-12-31

Risperidone, a benzisoxazole derivative atypical antipsychotic was more effective than haloperidol (typical antipsychotic) in stimulating prolactin levels. Studies showed that low[1]dose risperidone (0.75-2mg/day, mean (±SD) dose 1.26(±0.42) led to significant increase of serum prolactin levels of different age group after 4-12 weeks of treatment when no patient had other physical condition or adverse effects known to affect prolactin level. Low dose risperidone induced galactorrhea and other physical symptoms in a short period was not a very common one. A 17 years old girl suffering from obsessive compulsive disorder and major depressive disorder developed galactorrhea with breast tenderness and heaviness only 2 weeks after taking low dose risperidone (1 mg). This case report might concern for special attention for prescribing risperidone to young female patients.

Bang J Psychiatry 2020; 34(2): 35-37

Relationship between birth complications and externalizing behavioral disorders among

SM Sayful Islam — 2020-12-31

Exposure to obstetric complication was known to be associated with development of psychiatric disorders. The aim of the study was to see the association of externalizing behaviors in children and adolescents with birth complications in a tertiary care hospital in Bangladesh. It was a cross sectional study conducted among 96 cases from July, 2018 to June, 2019. Birth complications and psychosocial adversity were assessed from hospital record and from parental interviews whereas externalizing behavioral problems were assessed by psychiatrist according to diagnostic and statistical manual of mental disorders (DSM) 5. The frequency and severity of externalizing disorders were analyzed by chi-square test and paired-t test and p value d” 0.05 was significant. Data analysis was done by statistical package for social sciences (SPSS) version 26. The results showed that, among the cases 48.9% were within 10-14 years and male were 79.1%. The present study showed that attention deficit hyperactivity disorder (ADHD) was present among 54.1% of cases, oppositional defiant disorder (ODD) was present among 19.4% of cases, and conduct disorder was present among 5.1% of cases whereas 21.4% were suffering from both ADHD and ODD. Obstetric complications had no significant association with externalizing disorders. A little was known about the association between birth complications and externalizing behavior. The study revealed no significant association between birth complications and externalizing behavior. So steps were required to rule out other factors which might contribute significant role to develop externalizing disorders.

Bang J Psychiatry 2020; 34(2): 20-24

Demographic and disease patterns at a primary healthcare setting

Imdadul Magfur — 2020-12-31

Universal health coverage (UHC) implied that all people had access to quality health services they need, without financial hardship. Nandail had a population of 402,727 with high poverty and low literacy rate. The vast diversity of diseases presenting on daily basis to this facility needs to be quantified on the basis of age and gender and presenting symptoms of the diseases and organ systems involved. This study was aimed to determine the demographic characteristics and disease patterns related to different organ systems presenting at a union sub center. Proportion of smoking among these patients as well as their relation to disease patterns was also assessed. This was a cross-sectional study conducted using the union sub centers patient registry database retrospectively in order to determine the distribution and burden of various common diseases. Secondary data from patient register that presented for the first time and of those whom a specific diagnosis was possible were included into this study for a period of 21st February 2020 to 20th February 2021 were obtained. Any patient with vague symptoms, inconclusive diagnosis, repeated visits for similar symptoms/diseases were excluded from the study. The results showed that, out of total 1304 patients, 482 (37%) were males and 822 (63%) were females. Most of the patients 670 (51.3%) belonged to the age group of 15-49 years. The maximum patients 246 (18.9%) presented with symptoms involving musculoskeletal system. Certain systems like musculoskeletal system; neurology and endocrine were significantly more involved in females than males. Respiratory cases were seen more in males as compared to females. About 41% of male were smokers, highest smoking proportion was among those who aged 50 or more years. Those man who smoked had more chronic obstructive pulmonary disease (COPD), hypertension and peptic ulcer disease than those who didn’t. This study could act as landmark for future such studies which will ensure equitable distribution of limited resources and overall achieving greater efficacy.

Bang J Psychiatry 2020; 34(2): 25-29

Proportion of different anxiety disorders among outdoor patients attending a tertiary care psychiatry hospital

Muntasir Khan — 2020-12-31

As a common psychiatric disorder, anxiety disorder considerably impaired the mental wellbeing and functioning of an individual. This study aimed to estimate the proportion of different anxiety disorders among outdoor patients attending a tertiary care psychiatry hospital in Dhaka, Bangladesh. It was a descriptive cross-sectional study conducted among 150 conveniently recruited outdoor patients attending in National Institute of Mental Health (NIMH) from July 2018 to February 2023. Diagnosis of anxiety disorder was made clinically by consultant psychiatrist of NIMH outpatient department and sociodemographic data was collected by a semi-structured questionnaire through face to face interview. Data analysis was performed by statistical package for social sciences (SPSS) 23. The results showed that the most common diagnosis was generalized anxiety disorder (36.7%) followed by mixed anxiety and depressive disorder (20%) and panic disorder (15.3%). Most respondents were male (52%), urban habitants (80.7%), students (32%) and had completed honors and higher than honors education (42%) where the mean (±SD) age of the participants was 29.05 (±8.26) years. The study provided useful information regarding the proportions of different anxiety disorders and their characteristics which was expected to guide better management of this psychiatric condition as well as in-depth research in the future.

Bang J Psychiatry 2020; 34(2): 30-32