17 year old girl A k/c/o T1 DM and hypothyrodism Case was diagnosed as dissociative disorder by psychiatrist B/L breasts affected for almost 1 yr on n off Pain in vagina for 15 days Dx and Mx

86 years male feeling insect crawling on his head and face line of management plz

26 yrs married f suffering from pain chest,sob, restlessness since 4 yrs on & off, no dm no htn cxr,ecg,usg of w/A , NORMAL diagnosed as anxiety neurosis suggest ur opinions plz

5 yr old child brought for 2 episodes of altered sensorium Each episode associated with skipped meal in night and followed by altered sensorium in early morning around 5 am .there is documented hypoglycaemia each episode .Child improved immediately after glucose administration .Routine investigations like CBP CRP are normal.Serum Insulin is low and serum cortisol is normal.Diagnosis and further any work up ?

SHORT REVIEW OF PSYCHOBIOTICS Psychobiotics were previously defined as live bacteria (probiotics) which, when ingested, confer mental health benefits through interactions with commensal gut bacteria. Expand this definition to encompass prebiotics, which enhance the growth of beneficial gut bacteria .Review probiotic and prebiotic effects on emotional, cognitive, systemic, and neural variables relevant to health and disease. Gut–brain signalling mechanisms enabling psychobiotic effects, such as metabolite production. Overall, knowledge of how the microbiome responds to exogenous influence remains limited. exploration of which will generate both mechanistic insights and facilitate future psychobiotic development .Definition of psychobiotics be expanded beyond probiotics and prebiotics to include other means of influencing the microbiom. Enteric nervous system work as mini brain and produce more than 30 type of neurotransmitter .Healthy gut contain a ratio of 85%  good bacteria and 15% bad bacteria, when this balance disarray called as DYSBIOSIS , this has variety of symptoms. MECHANISM  of psychobiotics. Synthesis of neurotransmitter, Reduction of stress hormones, Reduction of inflammation, Promote neurotropic growth, Protect brain from free radical damage, Neuromodulation, Communication via Vagus nerve.