CASE PRESENTATION

1
CASE PRESENTATION

• Dr. Bipin Jain
  MD(HOM)
• Director PG Centre (Malad)
• Asst. Prof. HMM Dept.

OCT 20-25O8 ROTP MATERIA MEDICA MLDMHI PALGHAR
2
Preliminary Data

• Name Mr H. V. T
• Occupation service
• Age 39yrs Education B.Com
• Sex male Address
• Married since 1994
• Son one

OCT 20-25O8 ROTP MATERIA MEDICA MLDMHI PALGHAR
3
Chief complaint
OCT 20-25O8 ROTP MATERIA MEDICA MLDMHI PALGHAR
4
OCT 20-25O8 ROTP MATERIA MEDICA MLDMHI PALGHAR
5
Physical Generals

• Appearance well groomed, moles on right side
  of face
• Perspiration profuse staining yellow
• Cravings apples3, chocolate, sweets

OCT 20-25O8 ROTP MATERIA MEDICA MLDMHI PALGHAR
6
Physical Generals

• Elimination dissatisfied
• Frequency polyuria 2001
• Sexual function decreased during attack by the
  goons, also wifes desire is less as she is more
  religious and he practices masturbation since
  2000.
• Thermal state Ambithermal

OCT 20-25O8 ROTP MATERIA MEDICA MLDMHI PALGHAR
7

• Past history
• Fissure- in- ano in 2003
• Sinusitis in 2005
• Treatment history
• H/o thioril, valium, restyl, spectra,
  flucanzole, alprax, esparizone, serlift , zapiz.

OCT 20-25O8 ROTP MATERIA MEDICA MLDMHI PALGHAR
8
Life-Space

• Father Patient Relationship.
• The feelings for father available
• Father would always DISCOURAGE not encourage.
• ( e.g. maths doubts that the patient had,
  instead of solving it would tell him he is poor
  at maths)

OCT 20-25O8 ROTP MATERIA MEDICA MLDMHI PALGHAR
9

• Would give him errands of paying bills.
• (Though the patient DISLIKED doing these jobs,
  he obeyed his father)
• COMPARISON with the cousins who were better off.
• ( It would hurt the patient a lot and further
  discourage him.)

OCT 20-25O8 ROTP MATERIA MEDICA MLDMHI PALGHAR
10

• Picnic to Madh Island
• Friend drowned
• Involvement of Police
• INTERROGATION by the Police, asked the
  patient a lot of questions.
• Patient was SCARED that he will be WRONGLY
  ACCUSED for the friends death.

OCT 20-25O8 ROTP MATERIA MEDICA MLDMHI PALGHAR
11

• JOB OPPURTUNITIES
• MISSED A LOT OF OFFERS
• INDESICIVENESS
• AND
• LOW SELF -CONFIDENCE

OCT 20-25O8 ROTP MATERIA MEDICA MLDMHI PALGHAR
12
INCIDENT IN THE OFFICE

• WAS ON STAR CRUISE AND RESTLESS
• TO MAKE HIM COMFORTABLE HIS BOSS
• ASKED HIM TO CRACK A JOKE
• HE WAS UNABLE TO SAY ANYTHING
• WAS SPEECHLESS AND DUMB

OCT 20-25O8 ROTP MATERIA MEDICA MLDMHI PALGHAR
13

• FEAR AND SENSITIVITY TO CRITICISM
• DURING CHILDHOOD ALSO,
• FEAR TO ANSWER QUESTIONS
• AS HE WOULD FEAR TO APPEAR SILLY.

OCT 20-25O8 ROTP MATERIA MEDICA MLDMHI PALGHAR
14
CURRENT JOB

• ANGER
• WHEN HE IS TAKEN FOR GRANTED
• WHEN ANGRY SHOUTS
• BUT CANNOT IN
• FRONT OF
• HIS BOSS OR SUPERIORS

OCT 20-25O8 ROTP MATERIA MEDICA MLDMHI PALGHAR
15
ATTACK BY THE GOONS

• EXTREMELY SCARED AND FRIGHTENED
• COULD NOT APPEAR FOR EXAMS,
• CONSTANT FEAR
• AND
• LOW SELF- CONFIDENCE
• DEPRESSIVE THOUGHTS

OCT 20-25O8 ROTP MATERIA MEDICA MLDMHI PALGHAR
16
ANGER
SUPPRESSED ANGER

FRIGHT

• FAILURE IN EXAMS
• FEAR OFANSWERING TEACHERS
• UNABLE TO CRACK A JOKE IN A MEETING
• LACK OF CONFIDENCE

INTERROGATION BY POLICE ATTACK BY THE
GOONS DROWNING OF THE FRIEND
DEPRESSION AND NEGATIVE THOUGHTS
Decreased sexual desire of wife MASTURBATION
SENSITIVE TO HURT AND CRITICISM
OCT 20-25O8 ROTP MATERIA
MEDICA MLDMHI PALGHAR
17
Totality

• Suppressed anger
• Sensitive to hurt, slightest remark(criticism)
• Easily offended
• Sensitive about his image in the society.
• Fear of being laughed at, wrongly accused.
• Unable to convey his emotions.
• Masturbation
• Craving apples, chocolate
• Perspiration profuse staining yellow.

OCT 20-25O8 ROTP MATERIA MEDICA MLDMHI PALGHAR
18
THANK YOU
OCT 20-25O8 ROTP MATERIA MEDICA MLDMHI PALGHAR