ABSTRACT
INTRODUCTION: Venous air embolism is rarely seen, can be fatal and is associated mostly with large central venous catheters and mechanical ventilation. Some cases due to peripheral intravenous access have also been reported. CASE DESCRIPTION: We present a case of intracranial venous air embolism most likely secondary to peripheral cannulation. On admission, the patient was drowsy with a suddenly deteriorating Glasgow coma scale score. This case emphasizes cautious cannula insertion and close monitoring of the patient in the event of complications. CONCLUSION: Intravenous cannulation is common but care should be taken to avoid catastrophic complications. Consider air embolism as the differential diagnosis if a patient has a low level of consciousness after an intravenous cannula is inserted. LEARNING POINTS: A reduced level of consciousness in a patient should be quickly recognised and the differential diagnosis of air embolism considered.Peripheral vascular cannulation should be carefully monitored.High-flow oxygen and efficient monitoring of the patient are required.
ABSTRACT
INTRODUCTION: Self-stigma has a negative impact on the lives of children with mental health illnesses. It is a massive obstacle in the way of seeking professional help and poses a challenge to clinician's efforts to timely intervene and provide treatment. AIM: The aim of our study was to measure the stigma associated with mental illness in children with a variety of psychiatric diagnoses. METHODS: Following Institutional Review Board approval, an interviewer-based questionnaire was administered to children (aged 8-12â¯years), receiving treatment in Child Psychiatry Department at a tertiary care hospital in Lahore. The questionnaire comprised of Demographic Information Form and Paediatric Self-Stigmatization Scale (PaedS). In addition, parent / caregiver also completed a modified sub scale of the PaedS measuring the children's rejection by others due to their mental health difficulties. RESULTS: 110 children with various psychiatric problems, were interviewed with a mean age of 10 years + 1.7. Widespread presence of self-stigmatization was found in these children with particularly high scores for the scales of Societal Devaluation (2.6 + 0.54), Secrecy (2.85 + 0.59) and Self stigma (2.7 + 0.70). Almost two third of parents also answered in affirmative to statements about their children rejection by others due to their mental health difficulties. Children with emotional/ behavioral difficulties had statistically significant scores on secrecy and personal rejection subscales (P value<.05). CONCLUSIONS: Significant self-stigmatization amongst the children diagnosed with mental health illnesses in Lahore, Pakistan emphasize negative societal attitudes, which need to be addressed effectively in a timely manner.
