Rotations' Cases

Female 62yrs
Ischemic Stroke
Under Supervision (name):
Dr. Nadir Zafar Khan
Level:
Performed under direct Supervision
Outcome:
Admitted to inpatient facility
Brief Description:
Patient was in her usual state of health 2 days back when he suddenly developed right sided
weakness involving both upper and lower limbs, without any associated symptoms of facial
weakness or disturbance in consciousness or difficulty speaking. The weakness is progressing
and now she can't move her right arm or leg at all. Patient is known diabetic and hypertensive for
last 7 years but thee is history of poor control of blood sugar and BP due to poor compliance. CT
brain shows right parietal infarct. Carotid doppler and EChocardiography planned, medicines
started and counselling of the patient and family done.
26-09-2014
Gender:
Female
Age:
72 Year[s]
Diagnosis / Suspected Diagnosis / Cause:
Dementia
Level:
Assistant Status
Outcome:
Follow Up
Brief Description:
Patient is a known c/o Dementia of Alzheimer's type for the last 3 years having symptoms of
memory disturbance, gradual decline in higher mental and executive functions, irritability, social
avoidance and decreased interest in family matters and daily activities. His relatives came for a
worsening in behavioral disturbance for the last 1 month as he shouted and showed unusual
suspiciousness towards family members. No other psychotic symptoms reported as such.
Baseline labs showed no new physical derangement.
22-09-2014
Gender:
Female
Age:
20 Year[s]
Migraine
Level:
Outcome:
Follow Up
Brief Description:
Patient has history of having attacks of right sided headache for the last 1 year. The attacks have
worsened as far as frequency has concerned, one attack a week. Attacks accompany with
lacrimation, nausea and vomiting and photophobia. Patient reported having seen flashes of light
just before the start of the pain. CT brain and fundoscopy came out normal.
19-09-2014
Gender:
Male
Age:
22 Year[s]
Meninoencephalitis
Level:
Outcome:
Brief Description:
Patient was in his usual state of health 2 weeks back when he had symptoms of upper respiratory
tract infection that continued as patient only took symptomatic treatment. Later 3 days back
patient started having symptoms of episodic state of confusion and irritability, also c/o increased
muscle stiffness and pains with extreme weakness and malaise. The symptoms of confusion
worsened and patient became drowsy for 1 day with neck rigidity and fever. CSF showed
increased wbcs and decreased glucose. cbc showed increased wbcs. CT brain showed edematous
changes.
15-09-2014
Gender:
Male
Age:
34 Year[s]
Bell's Palsy
Level:
Assistant Status
Outcome:
Brief Description:
Patient was in his usual state of health 2 days ago when after getting up in the morning he noted
weakness in left side of the face including difficulty to speak properly. The symptoms kept
worsening till he presented in medical emergency and got admitted in neurology ward for
assessment and management. On exam, there is drooling of saliva on left side with inability to
close left eye and inability to winkle on left side of forehead. Other causes of unilateral facial
weakness have been ruled out and diagnosis of Bell's palsy made and treatment with anti viral
and steroid started.
08-09-2014
Gender:
Male
Age:
66 Year[s]
Transient Ischemic attack
Level:
Outcome:
Brief Description:
Patient was in his usual state of health 2 days ago when after getting up in the morning he noted
weakness in left side of the face including difficulty to speak properly. The symptoms kept
worsening till he presented in medical emergency and got admitted in neurology ward for
assessment and management. On exam, there is drooling of saliva on left side with inability to
close left eye and inability to winkle on left side of forehead. Other causes of unilateral facial
weakness have been ruled out and diagnosis of Bell's palsy made and treatment with anti viral
and steroid started.
.
02-09-2014
Gender:
Male
Age:
29 Year[s]
Gullain Barre Syndrome
Level:
Outcome:
Brief Description:
Patient presented with history of gradual and progressive muscular weakness involving lower
limbs (bilaterally) and later in the course upper limbs as well. Sensations also got reduced in
lower limbs. There is also difficulty chewing solid foods, difficulty controlling urine and stool
also reported. Pt. gave history of GI infection 1 week prior to the symptoms of weakness. Pt.
started with plasmaphresis. MRI spine came out normal.
29-08-2014
Gender:
Male
Age:
31 Year[s]
Hemorrhagic Stroke
Level:
Assistant Status
Outcome:
Brief Description:
Patient was in his usual state of health 3 days back when he c/o extreme headache with blurring
of vision and later he got unconscious. In medical emergency, when he regained consciousness
after 2 hours, he couldn't move his left leg and left upper limb. CT Brain confirmed the diagnosis
of hemorrhagic stroke, He got admitted for detailed assessment and management. Physiotherapy
started and counselling done.
25-08-2014
Gender:
Female
Age:
23 Year[s]
Migraine
Level:
Assistant Status
Outcome:
Under Treatment
Brief Description:
Patient gives history of having attacks of right sided headache for the last 6 months. The attacks
range from few hours to even whole day, associated with lacrimation, aggravate with tension and
sunlight and also by increased sound in surroundings, also experience nausea frequently. CT
brain clear and fundoscopy unremarkable. Patient being treated as opd f/u case, ruled out other
causes of headache.
21-08-2014
Gender:
Female
Age:
16 Year[s]
Epilepsy
Level:
Assistant Status
Outcome:
Under Treatment
Brief Description:
Patient had a history of having attacks of jerky movements of all the limbs since early childhood.
These attacks remain for 2-3 minutes with complete loss of consciousness and commonly
associated urinary incontinence. Patient has been under treatment of many physician with partial
control of fits, currently taking valproic acid and levitiracetam and fits are properly controlled.
Behavioral disturbance is also reported but other symptoms of depression not present.
16-08-2014
Gender:
Male
Age:
63 Year[s]
Ischemic Stroke
Level:
Outcome:
Brief Description:
Patient was in his usual state of health 4 days back when his family found him unconscious in his
room and later took him to medical emergency where he regained consciousness after 3 hours
and till then having symptoms of inability to talk, right sided facial weakness and right sided
upper and lower limb weakness as well. Patient communicates well by writing but cant move his
right side while makes incomprehensible sounds when trying to speak. CT Brain shows huge
infarct on left side of brain involving MCA territory. Carotid doppler and echocardiography
planned, physiotherapy started and counselling done of family and patient.
12-08-2014
Gender:
Male
Age:
26 Year[s]
Wilson's Disease
Level:
Observer Status
Outcome:
Brief Description:
Pt. was in his usual state of health 6 months back when he started having c/o tremors in hands
and muscular weakness in both legs associated with disturbance in balance during walking and
also difficulty writing. There is also gradual cognitive decline as noted by family for the last 2
months. Serum ceruloplasmin levels came out low and urine cu levels found out to be high.
Psychotic symptoms are denied.
06-08-2014
Gender:
Female
Age:
70 Year[s]
Dementia
Level:
Observer Status
Outcome:
Follow Up
Brief Description:
Pt. started having symptoms 2 years back which included gradual and progressive memory
disturbance with irritable and paranoid behavior, sleep disturbance, difficulty finding way back
to home and decreased socialization and decreased motivation. All these symptoms getting
worsened gradually within 2 years time till patient was investigated with neuropsychiatric
investigations and diagnosed with dementia of moderate severity.
28-07-2014
Gender:
Male
Age:
55 Year[s]
Ischemic Stroke
Level:
Observer Status
Outcome:
Brief Description:
Pt. got admitted from medical emergency 2 days back with history of having weakness of right
side of the body both upper limb and lower limb without any loss of consciousness and any other
associated symptoms. Pt. is a known chronic smoker for the last 35 years. CT brain showed left
sided parietal infarct. Pt. admitted for observation, workup and management. Physiotherapy
started and family and pt. counselled.
02-08-2014
Gender:
Male
Age:
65 Year[s]
Parkinson's Disease
Level:
Observer Status
Outcome:
Under Treatment
Brief Description:
Patient is following up in OPD for the symptoms of muscle stiffness, slow movements, short
stepping gait, tremors in hands that increase at rest. His symptoms are moderately managed with
treatment. No history of use of antipsychotic medications. Denied all psychotic symptoms (that
may be induced by dopaminergic drugs given to treat parkison's symptoms)
23-07-2014
Gender:
Male
Age:
34 Year[s]
Tuberculous Spine
Level:
Observer Status
Outcome:
Referred to other specialty unit
Brief Description:
Patient was in his usual state of health 3 months back when he started c/o pain in lower back that
aggravated with bending forward, also started having gradual weakness in both lower limbs more
on left side. Later his condition got worse and also c/o poor urinary and fecal control with
inability to walk properly (used support). on exam no sensory loss but motor weakness on both
sides more on left, knee and ankle reflexes diminished. Pt. gave history of using ATT 3 years
back for 9 months. MRI spine showed collapsed L4-5 vertebral disc and nerve compression at
that site.
19-07-2014
Gender:
Male
Age:
25 Year[s]
Gullain Barre Syndrome
Level:
Observer Status
Outcome:
Brief Description:
Patient got admitted with history of diarrhea 3 weeks back which didn't resolve in a week and
later pt. started having symptoms of weakness in both legs noted as he felt progressive difficulty
in walking, on exam knee and ankle reflexes are diminished. MRI spine shows no abnormality.
07-07-2014
Gender:
Male
Age:
68 Year[s]
Ischemic Stroke
Level:
Observer Status
Outcome:
Brief Description:
Patient presented in medical emergency 3 days back with history of having left sided weakness
of both upper and lower limbs suddenly and without any other associated symptoms. The
weakness progressed within hours to the level of making him unable to move his upper or lower
limb at all. He is a known diabetic and hypertensive for the last 10 years and also a chronic
smoker for more than 20 years. He was shifted to neurology ward for further assessment and
management. CT Brain revealed right parietal infarct, carotid doppler and echocardiography
planned, physiotherapy started, family and patient counselled accordingly.
15-07-2014
Gender:
Male
Age:
24 Year[s]
Meninoencephalitis
Level:
Observer Status
Outcome:
Brief Description:
Patient presented in medical emergency with c/o fever, cough with yellow sputum for 2 weeks
and symptoms of neck stiffness, 2 episodes of jerky movements of limbs for almost 1 minutes
with loss of consciousness, drowsiness and episodic confusional state for 2 days. CT brain
showed gen. edema, TLC showed increased wbcs, and csf showed increased wbcs and low
glucose. Pt. shifted to neurology ward for further assessment and management.
11-07-2014
Gender:
Female
Age:
60 Year[s]
Ischemic Stroke
Level:
Observer Status
Outcome:
Brief Description:
Patient presented in medical emergency 5 days back with sudden loss of consciousness that
lasted for 2 hours, later on regaining consciousness pt. remained in altered level of consciousness
for few hours and later showed inability to move her right side also right sided facial weakness
and inability to speak properly, got admitted in neurology ward for assessment and management,
CT Brain showed large infarct involving mca territory. Carotid doppler, echocardiography
planned.
MEDICINE CASES ENTERY
01-07-2014
Gender:
Male
Age:
60 Year[s]
Chronic Liver Disease
Dr. Khurshid Ahmad Khan
Level:
Observer Status
Outcome:
Brief Description:
Patient presented in medical opd with symptoms of abdominal distention, swelling over both
ankles, gen. weakness, decreased appetite, pain in right side of abdomen. All these symptoms
worsened in last 4-5 months. Investigations revealed deranged LFTs, fluid in peritoneum and
cirrhotic liver. Hepatitis-c came out positive.
25-06-2014
Gender:
Female
Age:
28 Year[s]
Pyelonephritis
Level:
Observer Status
Outcome:
Brief Description:
Patient was in her usual state of health 2 weeks back when she started c/o painful and increased
frequency of urination. Later for the last 2 days she has c/o fever with chills, nausea and
vomiting, gen. malaise and flank pain. There are increased pus cells and wbcs in urine exam.
01-07-2014
Gender:
Male
Age:
60 Year[s]
Level:
Observer Status
Outcome:
Brief Description:
Patient presented in medical opd with symptoms of abdominal distention, swelling over both
ankles, gen. weakness, decreased appetite, pain in right side of abdomen. All these symptoms
worsened in last 4-5 months. Investigations revealed deranged LFTs, fluid in peritoneum and
cirrhotic liver. Hepatitis-c came out positive.
25-06-2014
Gender:
Female
Age:
28 Year[s]
Pyelonephritis
Level:
Observer Status
Outcome:
Brief Description:
Patient was in her usual state of health 2 weeks back when she started c/o painful and increased
frequency of urination. Later for the last 2 days she has c/o fever with chills, nausea and
vomiting, gen. malaise and flank pain. There are increased pus cells and wbcs in urine exam.
21-06-2014
Gender:
Male
Age:
59 Year[s]
Diabetic Ketoacidosis
Level:
Observer Status
Outcome:
Under Treatment
Brief Description:
Patient was diagnosed with type 1 diabetes since the age of 14 years was taken to the emergency
room because of drowsiness, fever, cough, diffuse abdominal pain, and vomiting. Fever and
cough started 2 days ago and the patient could not eat or drink water. On examination he was
tachypneic, his temperature was 39° C (102.2° F), pulse rate 104 beats per minute, respiratory
rate 24 breaths per minute, supine blood pressure 100/70 mmHg; he also had dry mucous
membranes, poor skin turgor, and rales in the right lower chest. He was slightly confused.His
labs showed white blood cell count 18,000/ μ l, glucose 450 mg/dl. The result of the strip for
ketone bodies in urine was strongly positive. Urinalysis showed glucose 800 mg/dl.
18-06-2014
Gender:
Male
Age:
70 Year[s]
Exacerbation of COPD
Level:
Observer Status
Outcome:
Brief Description:
Patient was diagnosed with COPD 5 years ago. He presented with worsening dyspnoea, cough
and increasing purulent sputum production over the past 3 days. On examination, BP is 130/84
mmHg, pulse 102, respiratory rate 18 and temperature 37.8 ºC. Auscultation of the chest
revealed widespread expiratory wheeze and inspiratory coarse crackles in the left lung base. He
is dyspnoeic but able to speak in whole sentences. No cyanosis is present. He is a known chronic
smoker who kept on smoking even after the diagnosis though cut down the no. of cig. per day.
12-06-2014
Gender:
Male
Age:
27 Year[s]
Acute Renal Colic
Level:
Observer Status
Outcome:
Treated and called for follow-up
Brief Description:
Patient was in his usual state of health when 2 hours ago he started having severe pain in the
right flank that radiated towards right groin. The pain progressed and didn't respond to simple
pain killer. No associated symptoms or any other medical history reported. He was given i/v
analgesic and smooth muscle relaxant.
07-06-2014
Gender:
Male
Age:
67 Year[s]
Congestive Cardiac Failure
Level:
Observer Status
Outcome:
Brief Description:
Patient has been under medical care for a variety of medical problems during the past 5 years. He
has been treated for two myocardial infarctions, hypertension, non-insulin dependent diabetes.
He had an aorto-coronary bypass one year ago. He presented with shortness of breath which has
been progressive over the past five days. He has, however, experienced episodes of shortness of
breath during the past four months, especially when exerting himself. He fatigues easily and has
lost "all my energy to do anything." Echocardiogram Showed dilated heart and poor ejection
fraction.
02-06-2014
Gender:
Female
Age:
53 Year[s]
Acute Coronary Syndrome
Level:
Observer Status
Outcome:
Brief Description:
Patient was in her usual state of health when suddenly 2 hours back started c/o severe chest pain
with cold sweats, nausea and dizziness. Patient is known c/o diabetes mellitus and hypertension
for the last 8 years. ECG revealed ST segment elevation in anterior chest leads and reciprocal
changes in inferior chest leads. Strong family history of cardiac illness.
28-05-2014
Gender:
Female
Age:
34 Year[s]
Abdominal Tuberculosis
Level:
Observer Status
Outcome:
Brief Description:
Patient gave history of increasing abdominal distention, abdominal pain, weight loss, anorexia,
and malaise for the last 5 months. Patient was diagnosed with pulmonary Tuberculosis 2 years
ago and had treatment for 9 months.
24-05-2014
Gender:
Male
Age:
35 Year[s]
Pneumonia
Level:
Observer Status
Outcome:
Under Treatment
Brief Description:
Patient presented with fever and cough. He was well until 3 days earlier, when he suffered the
onset of nasal stuffiness, mild sore throat, and a cough productive of small amounts of clear
sputum. Today, he decided to seek physician assistance because of an increase in temperature to
38.3°C and spasms of coughing that produce purulent secretions. On one occasion, he noted a
few flecks of bright-red blood in his sputum.
20-05-2014
Gender:
Male
Age:
56 Year[s]
Level:
Observer Status
Outcome:
Brief Description:
Pt. was in his usual state of health 3 months back when he started having symptoms of fatigue,
weakness, and abdominal swelling. He has no other symptoms, and his medical history is
unremarkable. Physical examination revealed palmar erythema, 5 spider nevi on his chest wall,
moderate amount of ascites, multiple distended abdominal wall veins draining away from the
umbilicus, and peripheral edema. His labs showed decreased plts and deranged LFTs. Hepatitis
C came out positive.
15-05-2014
Gender:
Male
Age:
45 Year[s]
Hypertensive Crisis
Level:
Observer Status
Outcome:
Under Treatment
Brief Description:
Patient is known hypertensive for the last 3 years but was in his usual state of health 5 hours ago
when he started having symptoms of extreme headache with dizziness, mild drowsiness, nausea
and irritability. Later 1 hour ago he started getting aggressive and confused. When he was
brought in the medical emergency his BP was 210/130.
12-05-2014
Gender:
Female
Age:
20 Year[s]
Meningitis
Level:
Observer Status
Outcome:
Brief Description:
Patient was in her usual state of health 2 weeks back when she started having symptoms of fever
and cough with yellow sputum. She took symptomatic treatment for few days and later about 1
week ago started having symptoms of irrelevant talking and drowsiness with stiffness in neck
and persistent fever. Her conscious level fluctuated from normal to being confused at times. Base
labs showed increased TLC. CSF exam showed increased WBCs and decreased glucose.
06-05-2014
Gender:
Male
Age:
51 Year[s]
Ischemic Stroke
Level:
Observer Status
Outcome:
Brief Description:
Patient was in his usual state of health 2 hours ago when he suddenly started having c/o
weakness in left side of the body which progressed to the extent that he wasn't able to move his
let arm or left leg, no history of loss of consciousness or head injury. Pt. is known hypertensive
and diabetic for 10 years and also a chronic smoker.
03-05-2014
Gender:
Male
Age:
32 Year[s]
Acid Peptic Disease
Level:
Observer Status
Outcome:
Under Treatment
Brief Description:
Patient c/o frequent heart burn and nausea especially after having meals. Pt. is a heavy smoker
and accustomed of taking food with increased amount of spices, no history of chest pain or heart
disease, or haemetemesis.
28-04-2014
Gender:
Female
Age:
28 Year[s]
Acute exacerbation of asthma
Level:
Observer Status
Outcome:
Treated and called for follow-up
Brief Description:
Patient is a known asthmatic since adolescence and regularly used medications for that. He was
in his usual state of health when 1 week back he started having c/o fever with productive cough
that aggravated especially at night, also c/o worsening of her symptoms of shortness of breath for
last 2 days till for the last 3 hours she has been extremely short of breath with profuse
perspiration and worsened cough.
24-04-2014
Gender:
Male
Age:
26 Year[s]
Gastro Intestinal Infection
Level:
Observer Status
Outcome:
Other
Brief Description:
increased frequency, associated with preceding pain in the abdomen. Patient c/o weakness and
nausea forPatient was in his usual state of health 1 week ago when he started having c/o loose
motions with last 2 days.
19-04-2014
Gender:
Female
Age:
52 Year[s]
Chronic Kidney Failure
Level:
Observer Status
Outcome:
Brief Description:
Patient presented with a history of gen. body weakness and swelling of feet for the last 3 months,
also c/o facial swelling for 2 weeks. There is also frequent c/o nausea and vomiting and gen.
slowness and c/o irritability and fluctuating consciousness for 3 days. Pt. is a known c/o
Hypertension for the least 5 years and diagnosed with Diabetes Mellitus 2 years ago. Her
creatinine came out 5.4.
14-04-2014
Gender:
Male
Age:
55 Year[s]
Level:
Observer Status
Outcome:
Brief Description:
Patient was diagnosed with HCV 10 years back but he didn't take any treatment till for the last 6
months he has been persistently c/o gen. body weakness, wt. loss, decreased appetite, nausea and
pain in the abdomen usually right side. He also reports that he vomited blood few days ago. USG
abdomen reveals cirrhotic liver and base line labs abnormal LFTs.
10-04-2014
Gender:
Male
Age:
48 Year[s]
Acute Coronary Syndrome
Level:
Observer Status
Outcome:
Brief Description:
Patient is a known smoker for last 20 years, he was in his usual state of health 2 hours ago when
he started having pain in the chest that radiated to the jaw and left shoulder, pain was piercing in
character, and progressed with time, associated with increased perspiration and nausea and didn't
relieve with pain killers.
05-04-2014
Gender:
Male
Age:
31 Year[s]
Pneumonia
Level:
Observer Status
Outcome:
Brief Description:
Patient was in his usual state of health 2 weeks back when he started having symptoms of fever,
cough with yellow sputum, gen. body weakness. These symptoms persisted but pt. only took
symptomatic treatment till 3 days back his symptoms worsened and he developed high grade
fever, shortness of breath and ,increase in the intensity of productive cough and pain in chest
with coughing, gen. body weakness and headache.
PSYCHOLOGY CASES ENTERY
03-04-2014
Gender:
Female
Age:
25 Year[s]
Conversion Disorder
Dr. Rubina Aslam
Level:
Performed independently
Outcome:
Brief Description:
Patient was in her usual state of health 1 month back when after her engagement within her
family with one of her cousin whom she wasn't agreeing to get married, she started having
symptoms of attacks of Subjective Loss of Consciousness that happened in front of the whole
family and at day times mostly never at late hours of night also not associated with any urinary
or fecal incontinence, tongue bite or jerky movements of the body, remained for many hours.
The frequency has been increasing since last 1 week. No depressive symptoms reported as such,
no suicidal ideation or act, organic causes have already been ruled out.
31-03-2014
Gender:
Female
Age:
45 Year[s]
Hypochondriasis
Dr. Rubina Aslam
Level:
Performed under indirect supervision
Outcome:
Under Treatment
Brief Description:
Patient has a long history of c/o vague abdominal discomfort and 'gas' in stomach with
generalized weakness of subjective nature, also c/o frequent muscular spams of back and neck.
She has been to many hakeems who always convinced that she had 'garmi' in her liver and
stomach but never got fully recovered. She has also visited many physicians and has undergone
multiple investigations including gastroscopies many times but nothing except mild gastritis was
ever found but she kept changing doctors with the conviction that she had some severe disease of
stomach that no body ever found till she was referred to psychiatry. NO dep., psychotic
symptoms or anxiety symptoms were otherwise reported.
Female
Age:
38 Year[s]
Acute Stress Disorder
Dr. Rubina Aslam
Level:
Outcome:
Brief Description:
Patient was in her usual state of health 3 weeks back when while walking by the roadside she
witnessed a horrible accident in which a lady got severely injured and later died in front of her
eyes due to injuries. After that event pt. started having symptoms of repetitive flash backs of the
event even while awake and she started having symptoms of racing of heart, extreme restlessness
and sob with fear of going crazy, remained in this condition for 15 to 20 mins and then getting
normal on her own with reciting some surah of Quran. Her sleep also got disturbed, appetite
decreased and she couldn't concentrate on any thing since then. She never visited that area ever
again and avoided going there. The symptoms persisting and even getting worse with time and
affecting her life significantly.
25-03-2014
Gender:
Male
Age:
42 Year[s]
Pathological Grief
Dr. Rubina Aslam
Level:
Outcome:
Brief Description:
Patient was in his usual state of health 4 months back when his younger brother whom he was
strongly emotionally attached, was murdered by their enemies. Since then, pt. started having
symptoms of frequent crying spells, persistent low mood, hopelessness and extreme guilt, he lost
interest in life and his confidence significantly decreased, sleep also decreased and appetite too,
lost 8 kg wt. since then. Death wish is positive but denying any suicidal planning or acts. No
psychotic symptoms reported.
22-03-2014
Gender:
Male
Age:
34 Year[s]
Substance Abuse Disorder
Dr. Rubina Aslam
Level:
Outcome:
Under Treatment
Brief Description:
Patient has been using Cannabis for the last 8 years and heroin for the last 3 years. He has been
admitted in indoor facility for 1 month for the management of withdrawal and now he is being
treated on psychosocial and rehabilitation lines as opd patient. No psychotic symptoms reported,
behavioral disturbance reported with irritability in mood with c/o sexual weakness.
20-03-2014
Gender:
Female
Age:
19 Year[s]
Obsessive Compulsive Disorder
Dr. Rubina Aslam
Level:
Outcome:
Brief Description:
Patient having c/o repetitive hand washing, compulsion to do waddu repetitively many times and
repetitive intrusive thoughts that she hadn't completed prayer correctly. All these symptoms
progressed gradually and started affecting patient's academics and daily functioning till she
presented in psychiatry opd and started with anti obsessional medications and referred to
psychologist for psychotherapy to which pt. agreed.
17-03-2014
Gender:
Male
Age:
33 Year[s]
Panic Disorder
Dr. Rubina Aslam
Level:
Outcome:
Brief Description:
Patient was in his usual state of health 2 months back when he started having symptoms of
episodes of heart racing, fear of having heart attack, restlessness and agitation, dry mouth and
tremors in the whole body with fearful apprehension. These symptoms started without any
specific stressful thought and even happened at night during deep sleep. For the last 1 month, his
symptoms have worsened and frequency has increased to 2 attacks per week. No other
psychiatric symptoms reported, Thyroid function tests came out within normal limits.
14-02-2014
Gender:
Female
Age:
26 Year[s]
Conversion Disorder
Dr. Rubina Aslam
Level:
Outcome:
Brief Description:
Patient was in her usual state of health 4 months back when after a social conflict with her
husband patient started having symptoms of tremors like movement in her left arm and leg and
difficulty in walking due to weakness in left leg. These symptoms appeared all of a sudden
without any LOC or urinary or fecal incontinence, Pt. had no other associated symptoms. These
symptoms disappeared while sleeping. Patient was taken to many spiritual healers with
temporary improvement but her symptoms reappeared after few days of temporary improvement.
All relevant investigations show no underlying physical abnormality.
10-03-2014
Gender:
Male
Age:
36 Year[s]
Psycho-social Management of Treated Schizophrenia
Dr. Rubina Aslam
Level:
Outcome:
Under Treatment
Brief Description:
Pt. is a known c/o Schizophrenia for the last 3 years and under treatment of psychiatric facility.
He is referred to psychologist for psycho-social management and social rehabilitation.
FORM - F Miscellaneous
Hospt. Reg. No / Autopsy / MLC No:
63345
Date of Admission:
06-03-2014
Gender:
Male
Age:
27 Year[s]
Personality Disorder
Dr. Rubina Aslam
Level:
Outcome:
Under Treatment
Brief Description:
Pt. is reported to be very stubborn and demanding since childhood and also there is history of off
and on alcohol abuse with friends. He was in his usual state of health otherwise when after
failing his exam,he started staying at home refusing to go to college,getting short tempered and
irritable on trivial issues especially whenever his demands not fulfilled.No h/o depression self
talk,self smile, suspiciousness, hypomanic or manic symptoms.
03-03-2014
Gender:
Female
Age:
39 Year[s]
Depressive Disorder
Dr. Rubina Aslam
Level:
Outcome:
Brief Description:
Patient was in her usual state of health 8 months back when he lost his job and later remained
jobless and has been in financial crisis. He is having symptoms of low mood, hopelessness and
pessimism, decreased personal interests and daily activities, disturbed sleep and decreased
appetite, DUVM reported, decreased libido and decreased energies. He denied having suicidal
thoughts also denied drug abuse. No psychotic symptoms reported.
28-02-2014
Gender:
Male
Age:
35 Year[s]
Generalized Anxiety Disorder
Dr. Rubina Aslam
Level:
Outcome:
Brief Description:
Patient was in his usual state of health 1 year back when he started having symptoms of
irritability and restlessness that persisted most of the day, disturbance in sleep with intermittent
awakening and early morning awakening, His symptoms got worse at times with episodes of
extreme anxiety, apprehension, racing of heart that got better in 10 to 15 minutes. He has been
unable to go to his workplace for the last 2 months since when his symptoms have become
worse. No substance abuse or depressive or organic symptoms reported.
26-02-2014
Gender:
Male
Age:
34 Year[s]
Dr. Rubina Aslam
Level:
Outcome:
Under Treatment
Brief Description:
Patient is a known c/o OCD for the last 5 years and has been under psychiatric treatment for the
last 2 years, his symptoms of repetitively reciting Quranic Verses before even trivial acts and
then kept on doing that for hours. His symptoms are quite well controlled with medicines and
with therapy. His compliance of medicines and therapy sessions have been well.
24-02-2014
Gender:
Female
Age:
20 Year[s]
Conversion Disorder
Dr. Rubina Aslam
Level:
Performed independently
Outcome:
Brief Description:
Patient was in her usual state of health 2 months back when she started having episodic inability
to speak that remained for many hours during which pt. could do all her daily activities and
remained otherwise normal. No history of LOC, urinary or fecal incontinence or jerky
movements. There is history of social conflicts with her father few months back who is reported
to be very strict in nature. These episodes have become frequent for the last 2 weeks.
Neurological exam came out normal.
19-02-2014
Gender:
Female
Age:
25 Year[s]
Hospital Phobia
Dr. Rubina Aslam
Level:
Outcome:
Under Treatment
Brief Description:
Patient was in her usual state of health 1 year back when she went through a complicated c-
section surgery in spinal anesthesia. Due to the complication during the surgery and anxious and
dreadful comments of the surgeons, Pt. got frightened and later on started having symptoms of
extreme anxiety, apprehension, racing of heart and sob whenever she visited a hospital even for
someone else. Still late, she started having symptoms of extreme anxiety whenever someone
even talked about hospital, she would avoid visiting hospital even if direly needed. She denied
having flash back of the event and otherwise remained normal, had no symptoms otherwise.
15-02-2014
Gender:
Female
Age:
29 Year[s]
Panic Disorder
Dr. Rubina Aslam
Level:
Outcome:
Under Treatment
Brief Description:
Pt. was in her usual state of health 5 months back when she gradually started having episodes of
palpitations,tremors,dry mouth,headache with thoughts of having heart attack,occurring once or
twice a week and resolve on its own within half an hour, also occurred during sleep. All these
symptoms started after she witnessed an accident at road. No h/o depressive or psychotic
features.
12-02-2014
Gender:
Male
Age:
28 Year[s]
Dr Sa'ad B. Malik
Level:
Outcome:
Under Treatment
Brief Description:
Pt. has history of cannabis abuse of 5 years. He started using cannabis for recreational purpose
and later continued it, till recently he was brought by family to help him quit these substance
abuse. He was admitted for relief of withdrawals and currently been treated on opd basis with
sessions and therapy for the last 4 months. No psychotic, manic or depressive symptoms
reported.
08-02-2014
Gender:
Female
Age:
22 Year[s]
Dr. Sa'ad B. Malik
Level:
Outcome:
Brief Description:
Patient presented in medical emergency with c/o shortness of breath, extreme apprehension and
restlessness, dizziness and feeling pain in chest, with reassurance and lose dose benzodiazepines,
she got better in 10 mins. She gives history of having such attacks 2-3 times a day for the last 2
weeks since she has witnessed a neighbor who died of heart attack in front of her. Her sleep has
reduced since then with intermittent awakening and she has had flash backs of that event many
times.
05-02-2014
Gender:
Male
Age:
28 Year[s]
Depressive Disorder
Dr. Sa'ad B. Malik
Level:
Outcome:
Brief Description:
Patient was in his usual state of health 1 year back when he had a significant financial loss in
business and he started having symptoms of loss in confidence especially in taking financial
decision, still later his financial status started deteriorating even further and he started developing
symptoms of decreased interest in daily activities and personal interest, stopped going to his
work place, socialization decreased and appetite as well. DUVM was also positive, sleep got
disturbed and mood started remaining irritable most of the day. Suicidal plans positive but has
never acted upon any plans.
03-02-2014
Gender:
Female
Age:
22 Year[s]
Conversion Disorder
Dr. Sa'ad B. Malik
Level:
Outcome:
Brief Description:
Patient was in her usual state of health 4 months ago when after 2 weeks of her marriage, she
started having symptoms of jerky movements to left upper limb and lower limb in episodes
lasting upto many hours without loss of consciousness or urinary or fecal incontinence.
Organicity has already been ruled out by a neurologist and referred to psychiatric facility.
31-01-2014
Gender:
Male
Age:
35 Year[s]
Hypochondriasis
Dr. Sa'ad B. Malik
Level:
Assistant Status
Outcome:
Brief Description:
Patient was in his usual state of health 5 years back since when he started c/o headache which
was vague and gen., with no significant associated aggravating and relieving factors or any other
symptoms. He also c/o tenseness in back muscles with c/o vague gen. body weakness with
subjective decrease in appetite. Patient has been to many physicians who investigated him
completely and all gave a point of view that he has no physical abnormality but he is convinced
that he has a brain tumor till he was referred to psychiatric facility.
28-01-2014
Gender:
Male
Age:
33 Year[s]
Dr. Sa'ad B. Malik
Level:
Outcome:
Brief Description:
Patient is a known c/o OCD for the last 8 years with prominent symptoms of repeated hand
washing and counting rituals, also c/o repetitive intrusive and blasphemous thoughts regarding
religious personalities. He has been under treatment for many years with relapse of symptoms for
last 3 months after the death of his father whom he was very emotionally attached.
25-01-2014
Gender:
Female
Age:
31 Year[s]
Personality Disorder
Dr. Sa'ad B. Malik
Level:
Assistant Status
Outcome:
Under Treatment
Brief Description:
Patient's main symptoms include showing aggression whenever confronted or when her demands
not fulfilled by husband otherwise remained normal. When angry she used to inflict superficial
cuts on her arms and wrists, had many unsuccessful relationships due to her nature of being
stubborn and impulsive. There is history of having fight with her husband on some psychosocial
issue 2 months ago since when she started having c/o being agitated, being violent at times,
threatens to kill herself if her confronted and reporting c/o headache which generalized,
persistent and increased in the presence of husband. Objective acount from pt's family showed
pt. had behavioral issues since adolescence and had a disturbed family background.
23-01-2014
Gender:
Male
Age:
32 Year[s]
Dr. Sa'ad B. Malik
Level:
Outcome:
Under Treatment
Brief Description:
Patient has a history of abusing drugs including heroin and cannabis for the last 8 years. He has
been abstinent for the last 6 months and under psychosocial and rehab treatment of psychology
department.
21-01-2014
Gender:
Male
Age:
40 Year[s]
Dr. Sa'ad B. Malik
Level:
Assistant Status
Outcome:
Brief Description:
Patient was in his usual state of health 2 weeks back when after witnessing a murder in his
family, he started having symptoms of flash backs of the same event many times a day, disturbed
sleep since that day, also he started avoiding going outside the home due to fearful thoughts. He
didn't go to his work place since that day and started having panic like symptoms many times a
day.
18-01-2014
Gender:
Male
Age:
26 Year[s]
Depressive Disorder
Dr. Sa'ad B. Malik
Level:
Assistant Status
Outcome:
Brief Description:
Patient was in his usual state of health 7 months ago when after the unexpected death of his
mother with a heart attack, he started having symptoms of low mood, decreased interests in daily
activities and personal interests, his academics deteriorated and appetite decreased as well as
socialization, also c/o disturbed sleep, DUVM was also positive. Suicidal ideation and acts
denied but guilt significantly positive.
16-01-2014
Gender:
Female
Age:
18 Year[s]
Conversion Disorder
Dr. Sa'ad B. Malik
Level:
Assistant Status
Outcome:
Brief Description:
Patient was in his usual state of health 7 months ago when after the unexpected death of his
mother with a heart attack, he started having symptoms of low mood, decreased interests in daily
activities and personal interests, his academics deteriorated and appetite decreased as well as
socialization, also c/o disturbed sleep, DUVM was also positive. Suicidal ideation and acts
denied but guilt significantly positive.
13-01-2014
Gender:
Male
Age:
32 Year[s]
Schizophrenia with Residual Symptoms
Dr. Sa'ad B. Malik
Level:
Assistant Status
Outcome:
Under Treatment
Brief Description:
Patient is a known c/o Schizophrenia for the last 5 years. He has been treated with antiphychotic
medicines and his compliance has been good. For the last 6 months almost all of the active
symptoms of his psychiatric illness have been controlled well but his family has been
complaining of decreased involvement in family matters and daily activities, decreased
socialization and decreased confidence. For the psycho-social management he is referred to
psychologist.
09-01-2014
Gender:
Male
Age:
29 Year[s]
Post Traumatic Stress Disorder
Dr. Sa'ad B. Malik
Level:
Assistant Status
Outcome:
Brief Description:
Patient was in his usual state of health when 2 months back he had an accident in which his car
smashed into a truck. His car was damaged but fortunately he survived. Later after 2 weeks of
the accident he started having nightmares regarding that accident and he started having c/o
frequent awakening at night due to those dread full dreams. He also avoided driving car and had
to hire a driver. He also had symptoms of episodes in which he felt extreme apprehension, dry
mouth, cold sweats and racing of heart especially whenever the same accident's images flashed
back in his mind. His quality of life was seriously disturbed when he presented in psychiatry opd.
07-01-2014
Gender:
Male
Age:
27 Year[s]
Dr. Sa'ad B. Malik
Level:
Outcome:
Under Treatment
Brief Description:
Patient has a history of using cannabis for the last 5 years and also used to have alcohol once a
week for the similar period. He is having problem with sexual weakness and decided to get rid of
the addiction of drugs. He has been admitted for drug withdrawal and currently under treatment
for psychosocial rehab.
04-01-2014
Gender:
Female
Age:
15 Year[s]
Conversion Disorder
Dr Sa'ad B. Malik
Level:
Assistant Status
Outcome:
Brief Description:
Pt. was in her usual state of health 2 months back when after a conflict with her father who didn't
allow her to join a college for studies, she started having symptoms of Subjective loss of
consciousness that persisted for few mins. to even 2 hours, never had tongue bite, jerky
movements of limbs, urinary or fecal incontinence. Pt. said she could listen to everyone but
could respond. Frequency has increased for last 1 week. Substance abuse denied. No depressive
symptoms reported.

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