What Is a Personality Disorder?

Those with psychological personality disorders have traits that cause them to feel and behave in socially distressing ways, typically resulting in discord and instability in many aspects of their lives. Depending on the specific disorder, these personalities are generally described in negative terms such as hostile, detached, needy, antisocial or obsessive.

While many other psychological disorders fluctuate in terms of symptom presence and intensity, as with normal personality, personality disorders typically remain relatively constant throughout life, although they do vary in severity from individual to individual.

Classification of Personality Disorders

According to the Diagnostic and Statistical Manual (DSM-IV-TR), the reference used to clinically define mental illnesses, there are ten different personality disorders categorized into three main groupings or clusters.

Cluster A: Odd or Eccentric Behaviors

Schizoid Personality Disorder

Individuals with schizoid personality are characteristically detached from social relationships and show a restricted range of expressed emotions. Those with SPD may be perceived by others as somber and aloof, and often are referred to as "loners."

Paranoid Personality Disorder

Those with this disorder are typically distrustful and suspicious of others. Although they are prone to unjustified angry or aggressive outbursts when they perceive others as disloyal or deceitful, those with PPD more often come across as emotionally “cold” or excessively serious.

Schizotypal Personality Disorder

This disorder is characterized both by a need for isolation as well as odd, outlandish, or paranoid beliefs. In social situations, they may show inappropriate reaction or not react at all, or they may talk to themselves.

Cluster B: Dramatic, Emotional, or Erratic Behavior

Antisocial Personality Disorder

APD is characterized by lack of empathy or conscience, a difficulty controlling impulses and manipulative behaviors. This disorder is sometimes also referred to as psychopathy or sociopathy, however, Antisocial Personality Disorder is the clinical terminology used for diagnosis.

Borderline Personality Disorder

This mental illness interferes with an individual’s ability to regulate emotion. The characteristic emotional instability results in dramatic and abrupt shifts in mood, impulsivity, poor self-image and tumultuous interpersonal relationships. Borderlines are highly sensitive to rejection, and fear of abandonment may result in frantic efforts to avoid being left alone, such a suicide threats and attempts.

Narcissistic Personality Disorder

NPD is characterized primarily by grandiosity, need for admiration, and lack of empathy. Narcissism occurs in a spectrum of severity, but the pathologically narcissistic tend to be extremely self-absorbed, intolerant of others’ perspectives, insensitive to others’ needs and indifferent to the effect of their own egocentric behavior.

Histrionic Personality Disorder

Individuals with this personality disorder exhibit a pervasive pattern of excessive emotionality and attempt to get attention in unusual ways, such as bizarre appearance or speech. With rapidly shifting, shallow emotions, histrionics can be extremely theatrical, and constantly need to be the center of attention.

Cluster C: Anxious, Fearful Behavior

Avoidant Personality Disorder

Those with avoidant personalities are often hypersensitive to rejection and unwilling to take social risks. Avoidants display a high level of social discomfort, timidity, fear of criticism, avoidance of activities that involve interpersonal contact.

Dependent Personality Disorder

People with dependent disorder typically exhibit a pattern of needy and submissive behavior, and rely on others to make decisions for them. Dependent personalities require excessive reassurance and advice, and are extremely sensitive to criticism or disapproval.

Obsessive-Compulsive Personality Disorder

Individuals with OCPD, also called Anankastic Personality Disorder, are so focused on order and perfection that their lack of flexibility interferes with productivity and efficiency. They can also be workaholics, preferring the control of working alone, as they are afraid that work completed by others will not be done correctly.

Aerosinusitis @ Barosinusitis

Aerosinusitis, also called barosinusitis, sinus squeeze or sinus barotrauma is a painful inflammation and sometimes bleeding of the membrane of the paranasal sinus cavities, normally the frontal sinus. It is caused by a difference in air pressures inside and outside the cavities. Most cases occur in Scuba divers and fliers, and are easily diagnosed when presented to physicians immediately after exposure. However, the problem may remain undiagnosed when the history fails to relate the symptoms to exposure to environmental pressure changes or if the focus is on other etiologies.

Typically, sinus barotrauma is preceded by an upper respiratory tract infection or allergy. The affected person suffers a sudden sharp facial pain or headache during descent, which increases as the aircraft approaches ground level. The pain can ultimately become disabling unless the ambient pressure is reversed.

The pressure difference causes the mucosal lining of the sinuses to become swollen and submucosal bleeding follows with further difficulties ventilating the sinus, especially if the orifices are involved. Ultimately fluid or blood will fill the space.

In most cases of sinus barotrauma, localized pain to the frontal area is the predominant symptom. This is due to pain originating from the frontal sinus, it being above the brow bones. Less common is pain referred to the temporal, occipital, or retrobulbar region. Epistaxis or serosaquineous secretion from the nose may occur. Neurological symptoms may affect the adjacent fifth cranial nerve and especially the infraorbital nerve.

Referred pain from barosinusitis to the maxilla consists about one-fifth of in-flight barodontalgia (i.e., pain in the oral cavity caused by barometric-pressure change) cases.

Although the environment of fighter pilots produces the most stressful barometric changes, commercial flying has changed the picture of the disease.

The pathology of sinus barotrauma is directly related to Boyle's law, which states that the volume of a gas is inversely proportional to the pressure on it, when temperature is constant (P1 × V1 = P2 × V2). Two types of acute barotrauma are observed: squeeze and reverse squeeze.

On ascent, the air in the paranasal sinuses will expand according to Boyle's law, contracting during descent. Normally, the sinuses drain into the nasal cavity through small ostia, which permit mucocilliary clearance and ventilation that equilibrates pressure. However, when the opening is obstructed due to inflammation, polyps, mucosal thickening, anatomical abnormalities, or other lesions, pressure equilibration is impossible. Squeeze is produced on descent when trapped air in the sinuses contracts and produces negative pressure. The pressure differentials are directed to the center of the sinuses producing mucosal edema, transudation, and mucosal-or submucosal-hematoma, leading to further occlusion of the sinus ostium. The sinus will fill with fluid or blood unless the pressure differential is neutralized.

If the outlet is blocked during ascent, the situation is reversed and "reverse squeeze" appears. Pressure inside the sinus increases, affecting the walls of the sinus and producing pain or epistaxis.

Epistaxis

Weissman defined three grades of sinus barotraumas according to symptomatology.

• Grade I includes cases with mild transient sinus discomfort without changes visible on X-ray.
• Grade II is characterized by severe pain for up to 24 h, with some mucosal thickening on X-ray.
• Patients with grade III have severe pain lasting for more than 24 h and X-ray shows severe mucosal thickening or opacification of the affected sinus; epistaxis or subsequent sinusitis may be observed.

The majority of episodes of sinus barotrauma occur in the frontal sinuses with pain localized over the frontal area. Possible explanations for this might be the relatively long and delicate nasofrontal duct that connects the narrow frontal recess with the frontal sinuses.

Barotrauma located in the maxillary, ethmoidal, or sphenoid sinuses is observed less frequently and appears when the ostia are blocked; the majority of cases are probably caused by an acute upper respiratory tract infection. The magnitude of the pressure difference needed to produce a barotrauma probably shows great individual variation and is related to the size of the sinus ostium and the rate of ambient pressure change. Due to this, even commercial flying may produce severe cases of barotraumas, although most of the cases are observed in high performance aircraft with lower pressurized cabins.

Paranasal Sinuses

Treatment:
1. Topical Decongestant
2. Pain killer
3. Surgery - Functional Endoscopic Sinus Surgery: to re-establish drainage and ventilation of the sinuses ( For Severe Cases )

Why People Smoke

Most people start smoking when they are in their teens and are addicted by the time they reach adulthood. Some have tried to quit but have returned to cigarettes because smoking is such a strong addiction. It is a habit that is very difficult to break. There are many different reasons why people smoke.

Three of the main reasons that young people smoke are to look mature, to be like their friends, and to experiment. Since teens see older people all around them smoking, especially their parents and relatives, they smoke to act older. If their friends or peers smoke, they may feel pressured into doing the same to be accepted. The last reason is the excitement of experimenting with something that is forbidden. In some countries, it is against the law for anyone under 18 years old to smoke. Usually parents do not allow their under age teens to smoke. Therefore, smoking becomes very attractive. It is exciting to get cigarettes and sneak away to smoke without being caught.

Adults smoke for other reasons. They may have a lot of stress and pressures because of economic and personal problems. They may be unemployed or working but not making enough money to take care of themselves and their families. They may be homeless, or they may be dealing with alcohol or cocaine/heroin addictions. Some may be in bad marriages or relationships in which there is physical and/or verbal abuse. All these people may smoke to feel relaxed or to give them energy while going through a hard time.

Whether young or old, some people smoke to control their weight. Smokers, on the average, weigh seven pounds less than non-smokers. Smoking reduces a person's appetite. It lessens his/her sense of taste and smell. This could be why ex-smokers gain weight after quitting cigarettes. Food tastes and smells so much better.

Finally, there are people who say they love to smoke. Smoking gives them pleasure. It just makes them feel good.

Siti Hashimah di waktu kecil...



Sarjan Kadet Siti Hashimah ( MRSM Muar 2001 )


Kesimpulan: Saya comel dan berdisiplin..hahahaha..perasan seh..

Assalamualaikum...

1. Saya berdosa kerana tidak mengupdate blog selama sebulan.. huhu.. busy ar..

2. Saya ke Padang, Indonesia pd 13th Jan 2009 hingga 21st Jan 2009, ke Fakultas Kedokteran Universitas Andalas, Rumah Sakit Selasih, Rumah Sakit Dr M. Djamil, Bukit Tinggi, Danau Di Atas, Danau Di Bawah...hmm soo best.. networking dgn ramai kawan2 baru. Siap join demo Care for Palestine kat sana..

3. Saya da mula posting baru.. skang di Specialty Posting merangkumi Anaest, Ophtal, ORL, Radiology, Forensic & Complimentary Medicine. Maka saya telah ke ICU Hosp. Serdang and harini join le CME hospital kt sana ( ENT Topic).

4. Saya juga telah membelanjakan RM 550 untuk deposit rumah baru, RM 690 untuk Diagnostic Set ( Ophtalmoscope & Otoscope) dan beberapa perbelanjaan lengai peribadi.. Maka dengan ini mengumumkan bahawa saya telah jatuh miskin dgn deficit sbyk 60% daripada pendapatan bulanan saya setiap bulan.. maka perlu rasanya menghusung tempurung untuk mendapatkan sumber kewangan baru sementara menanti Bulan Mac..huhuhuhuhuu..

5. Saya amat happy belajar Anaest & Ophtal.. sgt menarik.. dan saya juga sgt suka 4th year kerana amat relax dan byk masa study..(psst..maka mahu kawinn.. haha)

That's all.. Trimas

demo Care for Palestine in Padang..( mira curi pose kt blakang)

Hi everyone,

Happy New Year 2009...

there's a lot of things happen to me recently... mostly sad thing ended my memorable year 2008.
For this 2009 i hope that it'll bring happiness and barakah to me and our family. I'm still in radiology elective/selective. This week is spent most time for General X ray. It is very useful to learn this as it is the basic modalities of radio-imaging. They teach me on how to describe or interpret the films. Its start with describing the Patient's particular, Date the film taken, the Rotation, Penetration, Inspiration, and starts describing the findings systematically from inside-out or outer-in. I had chance to inject the contrast-media to patient who underwent IVU ( intravenous urogram )...

Radiological Modalities

Hah!.. hari yg boring.. Christmas yg boring.. already two days attached to the radiology department. Feel like been into the dungeon. I'm tagged to the Angio Room..diz room is for the angiography procedure. Among the procedures done are fistuloplasty, image-guided stenting, ultrasound guided pleural tap, ultrasound guided biopsies, radiofrequency ablation (RFA).. and a lot more.

The fistuloplasty is actually to fix or repair the arteriovenous fistula in patient who their AVF was blocked due to thrombosis. This image-guided procedure done after the patient had sedated wif midazolam and fentanyl. It requires the administration of radiocontrast medium to see the blockage and after that a stent will be inserted to dilate back the fistula. There will be certain condition that will cause failure in this procedure such as vasospasm (due to irritation by the probe), and the blockade located not in the fistula but in the main branch of the blood vessels (usually the vein). If this procedure fails to repair the AVF, surgical intervention has to be carried out to create another fistula and by the mean time, patient will undergo haemodialisis via internal jugular vein catheter until the new fistula mature.

for RFA, this procedure is carried out as intervention to treat cancer cell usually in hepatocellular carcinoma. In this procedure, a needle will be inserted to the location of tumour cell ( via image guided ultrasound ). Then the cancer cell was killed by radiofrequencies or heat. One cycle will takes about 12 minutes. The heat will killed the lesion around 2-3 cm in diameters. However, if the lesion is too big, 99.7% ethanol will be administered to kill the peripheral area around the lesion.

I can't believe it, they did it in Selayang!.. and that the advance of today's medicine!

Non-academically,... today i planned for outing to KLCC.. movies maybe.. or jalan2 cari makan.. as usual, alone... Lame!.. ajak my several colleagues from UiTM, but they have usrah in Titiwangsa.. nak join.. tp tak ngam dgn geng usrah depa lak.. and ada some of them doctors in Selayang jugak.. kang dengan kehadiran anak pengarah ini takut lak depa nak mengutarakan isu2 semasa or ketidakpuashatian... huhu.. so.. go for movie!