Language, culture and mental health

The increase in cultural and linguistic diversity of contemporary societies poses major challenges to mental health services across the world. Is it possible to work in ways that respect cultural and linguistic difference in multicultural societies? In this paper we focus on the difficulties raised by the use of interpreters in the diagnosis of depression. We use a simple thought experiment in the form of two fictitious vignettes to highlight important features of language-games, an idea introduced by Ludwig Wittgenstein in his late work, Philosophical investigations. The thought experiment draws attention to the importance of culture and contexts in understanding the meaning of what people say when they feel sad. This is even more important in understanding the help that people expect under these circumstances. This has implications not only for how we understand the role of interpreters in clinical settings, but more generally it draws attention to the importance of respecting the many different understandings of sadness and unhappiness that are a prominent feature of non-Western cultures. We conclude attempts to impose Western biomedical interpretations of sadness and suffering on people from non-Western societies has no ethical basis, and is to be avoided

Frequency of antiphospholipid syndrome in deep vein thrombosis

To determine the frequency of antiphospholipid syndrome in patients of DVT. Single center descriptive study. It was carried out at Military Hospital Rawalpindi, from May to Oct 2003. Fifty patients of either sex with Deep vein thrombosis [DVT] legs, who were diagnosed clinically and later on confirmed on doppler ultrasound, were selected through non-probability convenience sampling. doppler ultrasound was done to diagnose DVT and antiphospholipid antibodies tested namely lupus anticoagulant and anticardiolipin antibodies. Other associated risk factors were also documented. Data collected and organised, descriptive statistics were applied to calculate the frequencies. The results were organised in graphs and tables. Out of 50 patients of DVT 38 [76%] were males and 12 [24%] were females. Mean age for males was 44.94 +/- 14.92 years whereas for females it was 27.66 +/- 5.97 years. Antiphospholipid syndrome was detected in 13[26%] patients; 11 [22%] were males and 2 [4%] females. Only lupus anticoagulant was detected in 9 [18%] patients. Anticardiolipin antibodies were detected in 3 [6%] patients. In 1 [2%] both lupus anticoagulant and anticardiolipin antibodies were detected. There is an association between antiphospholipid syndrome and DVT. Association of lupus anticoagulant is more, as compared to anticardiolipin antibodies with DVT. Additional risk factors make a person further susceptible to DVT

Antimicrobial prophylaxis in acute appendicitis

It is a case series of 100 [100%] cases of acute appendicitis comprising 52 [52%] males and 48 [48%] females without any antibiotics administration. Median age was noted as 29.5 [std +/- 13.5]. 83% patients belonged to urban and remaining rural areas. 81% were discharged within 72 hours. 93% of the patients recovered uneventfully. In 2 [2%] patients wound infection were seen and in 5 [5%] stitch abscesses were noticed. We observed no significant difference in terms of postoperative wound infection rate when the results were compared with the results of the studies in which routine prophylactic antibiotics were administered