24 October 2022: Articles
Educational Purpose (only if useful for a systematic review or synthesis), Rare coexistence of disease or pathologyMohamad Faris Rusydi Rusly1ABEF, Mazapuspavina Md Yasin1AE, Khairatul Nainey Kamaruddin1CDE*, Nik Munirah Nik Mohd Nasir1E, Khariah Mat Nor2DE
Am J Case Rep 2022; 23:e937633
BACKGROUND: Charm needle, otherwise known as susuk, is a needle-shaped pin inserted subcutaneously into various body parts. It is most commonly inserted by shamans in the orofacial region to grant magical powers to the wearer, such as health, wealth, beauty, and other benefits. These talismans are prevalent among women in South-East Asia countries.
CASE REPORT: A 75-year-old woman presented with recurrent musculoskeletal symptoms over multiple sites, but physical assessment only revealed mild tenderness over the right hip joint. A plain pelvic radiograph showed incidental findings of susuk around the genital regions, with older skull and pelvic radiograph displaying similar findings. The patient had a susuk insertion more than 20 years ago for marriage stability and beauty. After this incidental discovery, the patient had repeated visits to the clinic to request more imaging to determine whether the susuk were still present after the shaman’s attempted mystical removal. She also developed persistent preoccupation, worry, and guilt related to the susuk presence and was referred to psychiatry for further assessment. She was diagnosed with generalized anxiety disorder. She was then started on psychotherapy and pharmacological treatment, with simultaneous spiritual therapy.
CONCLUSIONS: This case report describes the link between susuk implantation and psychological illness. Even though there are no reports that specifically correlate susuk with generalized anxiety disorder, it has been established that guilt and shame have a strong relationship with anxiety.
Keywords: Foreign Bodies, Needles, Physicians, Primary Care, Humans, Female, Aged, Incidental Findings, Anxiety, Radiography
Wearing a talisman is regarded to be traditionally common for a variety of reasons. Body piercing, scarification, tattooing, and implants were among the techniques. The practice of
This case report presents a case of
A 75-year-old Malay woman with underlying type 2 diabetes mellitus, hypertension, dyslipidemia, and stage 1 adenocarcinoma of the right breast had multiple visits to the primary care clinic in 2021, with somatic symptoms of recurrent right hip, buttock, and pelvic pain. Physical examination showed mild tenderness over the right hip joint, but no other remarkable findings. Plain radiographs of the right hip, pelvis, and lower lumbar spine were done (Figure 1). There was an incidental finding of 4 linear hyper-density areas projected within the anterior pelvic soft tissue region, near the genital area, suggestive of foreign bodies; the impression of the appearance was typical of charm needles or
Upon the findings of the
The needles were not visible or palpable on gross physical examination of the areas.
The patient stated she had
Since this incidental discovery, the patient has had recurrent visits to the primary care clinic with the same symptoms and asking for repeat imaging to see if the
She was referred to the psychiatry team for further psychological assessment in view of these persistent preoccupations, worry, and guilt. She was then diagnosed with generalized anxiety disorder and was started on psychotherapy, pharmacological treatment, and spiritual therapy. Her condition has now improved after treatment.
The practice of inserting foreign bodies has been established for decades.
To maintain its potency,
There is currently no report or journal that specifically links
A meta-analysis by Cândea and Szentagotai-Tătar discovered that shame and guilt were substantially related with anxiety, with shame-proneness being found to be more strongly associated with anxiety symptoms than guilt-proneness .
In terms of management options for
Unfortunately, few studies on the possible adverse consequences or complications of
This case report describes the link between
FiguresFigure 1.. Antero-posterior view of the pelvic radiograph taken in 2021 shows 4 linear hyper-density materials projected within the anterior pelvic soft tissue region (red arrow). There is also a popcorn calcification in the pelvis, characteristic of a calcified fibroid (black arrow). Figure 2.. Antero-posterior view of a pelvic radiograph taken in 2017, shows similar findings as described in Figure 1. Figure 3.. Antero-posterior view of a skull radiograph taken in 2017, shows 10 fine linear density needle-like foreign bodies over the maxillofacial area (red arrow).
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