Very good

It is very useful for me sir am from Nellore

Thanks to all the teachers! 🙏

Preface: my feedback is coming from a western[North American] pov. dr. Mahendra, good job! You took the criticism very well, and were so polite with the comments that were given to you even though some of them only reflected on the ignorance of the actual attending making the comment to see below. I was quite impressed with your review of possible medical ideologies outside of psychiatry to explain her symptoms. Such a type of “outside of the box“ view of a patient’s presentation is very atypical at least here in the United States however from personal experience thinking outside of the box often does lead to uncover ease of medical diagnoses that were missed by other specialists. hopefully some feedback was given in regards to how to present an H&P, i’m not sure how her attendings did not at any point rectify her during her training to consolidate positive/negative pmhx or ROS, that is there is no need to say “there is no history of” repeatedly 20+ times. Thus it would’ve sufficed with something like “ review of systems was negative apart for a weight loss of 30 kg, persistent Globus sensation in the throat, and depressed mood” Or some thing I can to that extent because the format used of no history, no history, no history, no history, no history sounds like a broken record and loses the attention of the audience (at least by Western standards). Likewise with the physical exam; one could truncate and only mention the pertinent positives and negatives. Rather than going down a whole entire physical exam. One of the attendings inquired about looking at the “ laryngeal recess” which I can’t imagine a psychiatrist has a flexible nasolaryngeal scope to look at that laryngeal recess so I’m not sure why he posed that question. Such scopes are really limited to specialists here in the United States and even with that they are quite costly medical equipment, so I don’t know how an average clinic would have such a medical instruments not to mention how often it would even be used in the psychiatric office. Perhaps he meant oropharynx?

Wonderful Case Discussion. It is extraordinarily helpful for every psychiatry resident.

I also wondered about ocd. The described behavior really resembled ocd. But, they said that she has no history of anxiety

Please continue the case presentation series....... Excellent platform for learning My deep regards to all of you sir....🙏🙏🙏🙏

Gud

If we ask the patient why you would save a drowning child,it will make the patient lose her remaining brains.