Three cases of manic-depressive illness in mentally retarded adults

The authors point out that manic-depressive illness is often not diagnosed in mentally retarded patients because they are already regarded as "different." They discuss the use of lithium carbonate as a prophylactic agent in the treatment of manic-depressive illness in mentally retarded patients and present three case histories illustrating some of the difficulties encountered in diagnosing mania or hypomania in such patients. They provide a number of suggestions to help physicians recognize and treat these disorders.

Psychogenic fever: entity or nonentity?

A review of the literature suggests that body temperature may rise when a person is under emotional stress. The term "psychogenic fever" has been applied to this phenomenon. A study of temperature and pulse rate of psychiatric patients diagnosed predominantly as neurotic in a university teaching hospital was undertaken. Changes in pulse rate indicated that the period before ward rounds was more stressful than other times of the day. However, psychogenic fever in these patients was not found. One case of factitious fever was uncovered during the study.

Primary anorexia nervosa (weight phobia) in males

Ten cases of primary anorexia nervosa (weight phobia) in males (as against 196 females) have been treated in the United Birmingham Hospitals over 19 years. A discrete syndromes appears to exist with much to support the view that it is the counterpart of primary anorexia nervosa in the female. Six illustrative case histories are described briefly. The heavy loading with consistent abnormalities of psychiatric interest makes it very probable that weight phobia is primarily a psychiatric disorder.

Fast-track Cardiac Surgery in Children: Feasibility in Bangladeshi Setting

Background: Fast-track recovery protocols in cardiac surgery is gaining worldwide popularity and have contributed to significant reductions in the postoperative hospital stay and cost without any increase in postoperative mortality and morbidity. The aim of this study was to find out the feasibility of fast track paediatric cardiac surgery in Bangladeshi setting. Method: It was a prospective study conducted in National Institute of Cardio-vascular Diseases, Dhaka, from July 2009 to June 2010. All patients, between 3 to 18 years, underwent surgical closure of atrial or ventricular septal defect under cardio-pulmonary bypass. 20 patients from our unit served as fast track group and 30 patients from other units of the same hospital served as conventional group. Fast track patients were extubated in less than 6 hours after surgery, shifted from ICU in less than 24 hours and geared up to discharge home within 3 days of surgery. Result: 18 (90%) of the 20 patient of the fast track group were discharged within 3 days of surgery, 2 patients cannot be discharged within this time frame. Mean post operative hospital stay for study group was 3.1 days, whereas the mean hospital stay in the control group was 7.5 days. Follow-up was 100% complete at 30 days. There was no major in-hospital or out-of-hospital complications in either group. No patient was readmitted at our centre or elsewhere for any complication arising from this process. Conclusion: Fast tracking is feasible and safe in low-risk paediatric open-heart surgery in Bangladeshi scenario. A multidisciplinary approach with a set protocol is required to achieve this goal in a safe and reproducible manner. Keywords: Cardiac surgery; Congenital heart disease; Fast track; Hospital discharge. DOI: 10.3329/cardio.v3i1.6427Cardiovasc. j. 2010; 3(1): 50-54