Mrs. J. 45 years old woman with the diagnosis of M.D.P, was receiving Lithium and Haloperidol regularly and hipremine occasionally for the past 10 years. With regular follow up she used to get occasional relapse of mania as well as depressive episodes of short duration. The patient in last April suddenly presented with acute confusion, .disorientation to time, place, and person, short term memory disturbance and frequent spells of crying. The problems encountered in the diagnosis regarding the cause of delirium and the management are discussed with relevant biochemical parameters.
SUMMARY The recent availability of portable ion selective electrodes (ISE) for clinical applications has enabled lithium estimations to be performed instantly and at close proximity to patients. The significance of this is, not in the accuracy of the determination, but in the speed of the feedback provided to doctor and patient, and hence the promotion of compliance. The impact of this on lithium therapy can only be described as a clinical revolution in the making.
The domains of Psychiatry and Neurosciences have progressed from being poor cousins of Medicine to becoming one of the frontier fields in modern medicine, incorporating cutting edge science and research initiatives and influencing diverse areas like management, humanities, conflict resolution, development, organisational systems, astronomy, sports etc. After the decade of the brain, it seems the field has taken off to hitherto unimagined heights. Needless to say, we are in exciting times.
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