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Delusional parasitosis (DP) with Koro-like syndrome poses a complex clinical challenge, demanding a comprehensive and empathetic approach from healthcare professionals. This exceptional combination of fixed beliefs about infestation and experiences of genital retraction can profoundly impact patients' well-being and daily functioning. The associated stigma and misconceptions further compound the difficulties faced by individuals struggling with these co-occurring conditions. Given the rarity of encountering both conditions simultaneously, navigating the diagnosis and treatment of delusional parasitosis with Koro-like syndrome requires a thorough understanding of its multifaceted nature. Embracing a holistic strategy encompassing psychoeducation, psychotherapy, and pharmacological interventions is essential for effectively addressing these dual conditions.

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INTRODUCTION: Koro is a delusion whereby a man believes his penis is shrinking into his abdomen and this may result in his death. This socially-transmitted non-neuropsychological delusional belief occurs (in epidemic form) in South-East and South Asia. We investigated whether the two-factor theory of delusion could be applied to epidemic Koro. METHODS: We scrutinised the literature on epidemic Koro to isolate features relevant to the two questions that must be answered to provide a two-factor account: What could initially prompt the Koro delusional hypothesis? Why is this hypothesis adopted as a belief? RESULTS: We concluded that the Koro hypothesis is usually prompted by the surprising observation of actual penis shrinkage-but only if the man has access to background beliefs about Koro. Whether the hypothesis is then adopted as a belief will depend on individual factors such as prior belief in the Koro concept or limited formal education and sociocultural factors such as deference to culture, to media, or to rumours spread by word of mouth. Social transmission can influence how the first factor works and how the second factor works. CONCLUSION: The two-factor theory of delusion can be applied to a socially-transmitted delusion that occurs in epidemic form.

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Schizophyllum commune Fr. is a wild macro fungus species, which is often used as a food source by the indigenous Kaili tribe along the Palu-Koro fault, Central Sulawesi, Indonesia. This fungus has a wide variety in terms of the weathered wood substrate as a place to grow and is found in almost all types of ecosystems. Although its diversity has been investigated, there is no identification of the weathered wood type as a substrate for growth. Some communities in Indonesia have not also known its potential and benefits. Therefore, this research aims to determine the wood type that grows S. commune fungus, ethnomycology, mineral composition, proximate, and phytochemical compounds. It was carried out using the descriptive explanatory approach and the fungi location as well as wood substrate sampling, was determined through the purposive sampling technique in forest areas, agroforestry, and community gardens along the Palu-Koro fault, Central Sulawesi. The samples of unknown wood types were through the collection of tree parts, namely twigs, leaves, flowers, and fruits, which were brought to Herbarium Celebense, Tadulako University for identification. Analysis of mineral content, proximate, and fungal phytochemical compounds was carried out based on the method according to the existing protocol. The results showed that 92 types of rotted wood found where the fungus S. commune grew, belonged to 36 families. The nutritional content is also good, although it varies based on the type of wood growing media. Therefore, it can be used and processed into various health-beneficial food products. This showed that domestication of the fungus needs to be carried out to support its commercialization as food and medicine in the future.

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Koro syndrome is a multi-tiered disease presenting as an overwhelming belief that one's sex organs are shrinking into their body. Moderate to severe anxiety attacks are associated with the condition, along with a fear of imminent death. Koro is often culturally related and is most seen as an epidemic form in East and Southeast Asia, although it can present anywhere worldwide in its sporadic form. The condition typically affects young males who believe in sex-related myths, and many individuals can co-present with anxiety, depression, or even psychosis. Although most presentations of Koro are self-limiting, the condition is harmful for one's self-esteem and quality of life, and some individuals may go through extreme, physically injurious measures to prevent genital retraction. Treatments include the use of psychotherapy that has a sex education component, especially if the patient believes in culturally rooted myths. In sporadic Koro, it is believed that if the primary psychiatric disorder is treated with anxiolytics, antidepressants, sedatives, or psychotics, the secondary Koro-like symptoms will also fade. Additional investigation on the prevalence, pathogenesis, factors that correlate with treatment efficacy are needed to fully understand Koro syndrome.

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Three morbidly obese men aged 69, 49 and 45 years with respective BMIs of 46.3, 49.1 and 59.3 died suddenly from underlying cardiovascular disease. At autopsy all were found to have marked penile shortening typical of an entity known as "buried penis." This condition arises in adulthood most commonly from morbid obesity as the penile shaft becomes enveloped by encroaching suprapubic adipose tissue. It is associated with infective, obstructive and malignant complications. Histology will be required to identify less-common causative conditions or any inflammatory or premalignant/malignant changes.

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We use both Synthetic Aperture Radar (SAR) and Optical data to constrain the co-seismic ground deformation produced by the 2018 Mw 7.5 Sulawesi earthquake. We exploit data processing techniques mainly based on pixel cross-correlation approach, applied to Synthetic Aperture Radar (SAR) and optical images to estimate the North-South (NS) displacement component. This component is the most significant because of the NNW-SSE geometry of the fault responsible for the seismic event, i.e., the Palu-Koro fault, characterized by a strike-slip faulting mechanism. Our results show a good agreement between the different data allowing to clearly identify the surface rupture due to the fault slip. Moreover, we use SAR and optical intensity images to investigate several secondary phenomena generated by the seismic event such as tsunami, landslides, and coastal retreat. Finally, we discuss differences between SAR and optical outcomes showing strengths and disadvantages of each one according of the investigated phenomenon.

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PM Yap's most significant intellectual achievement was his development of the concept of the culture-bound syndrome, which synthesized years of research into transcultural psychiatry, and situated this work within this field by drawing on elaborated nosological schema that challenged some of the ethnocentric assumptions made by previous psychiatrists who had tried to understand mental illnesses that presented in non-western cultures. This introduction to Yap's 1951 paper emphasizes that Yap needs to be understood as working within the western tradition of transcultural psychiatry, and argues that his English training and his continual engagement with western psychiatric and philosophical frameworks is the best way to conceive of his contributions to this field. Yap's paper, republished below as the Classic Text, was his first foray into comparative transcultural psychiatry.

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RESUMO A síndrome de koro é uma síndrome psiquiátrica ligada à cultura, que se caracteriza por um episódio de ansiedade súbito e intenso relacionado com a crença de que o pênis (nas mulheres, mamilos e grandes lábios) estar a retrair-se para o interior do organismo, podendo conduzir à impotência, esterilidade e, eventualmente, morte. É mais frequente nos países do Sudoeste Asiático e no sexo masculino. No Ocidente é rara, embora existam descrições de koro-like secundárias a perturbações neurológicas, psiquiátricas ou orgânicas. No Diagnostic and Statistical Manual of Mental Disorders-5 é classificada como um "Transtorno Obsessivo-Compulsivo e transtornos relacionados com outra especificação". Este artigo descreve um caso raro de um doente com síndrome de koro secundária a um transtorno obsessivo-compulsivo. Neste artigo, apresenta-se a descrição de um caso clínico e revisão bibliográfica, com base na pesquisa de artigos publicados, desde 2000, no PubMed, com as palavras-chave: "koro syndrome", "obsessive-compulsive disorder" e "koro-like symptoms". Analisaram-se alguns artigos anteriores ao ano 2000 para contextualização histórica. Doente com síndrome de koro secundária a transtorno obsessivo-compulsivo, com boa resposta à terapia farmacológica associada à terapia cognitivo-comportamental. O conhecimento desse diagnóstico e da sua gestão clínica é importante para identificar as condições subjacentes e otimizar o tratamento.

ABSTRACT Koro's syndrome is a psychiatric culture-bound syndrome characterized by an episode of sudden and intense anxiety related to the belief that the penis (in women, nipples and labia majora) is retracting into the body, leading to erectile dysfunction, sterility and, eventually, death. It is more common in Southeast Asia and in males. In the West it is rare, although there are descriptions of koro-like secondary to neurological, psychiatric or organic disorders. In the Diagnostic and Statistical Manual of Mental Disorders-5 it is classified as an "Obsessive-Compulsive Disorder and disorders related to another specification". This article describes a rare case of a patient with koro's syndrome secondary to obsessive-compulsive disorder. In this article we present the description of a case report and review of the literature by searching articles published in PubMed since 2000, with the keywords: "koro syndrome", "obsessive-compulsive disorder" and "koro-like symptoms". Articles prior to 2000 were also analyzed for historical considerations. A patient with koro's syndrome secondary to obsessive-compulsive disorder with good response to pharmaceutical and cognitive behavioral therapy combination. Being aware of this diagnosis and its clinical management is essential to identify the underlying conditions and optimize treatment.

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Koro syndrome is a psychiatric disorder specific to certain Asian cultures. It is characterized by acute and intense anxiety with fear of a retraction of the penis into the body and resultant death. We report the case of a 43-year-old Moroccan male presenting with persistent anxiety associated with avoidance behaviors and a chronic belief that his genitalia may shrink or disappear and lead to his death. This impacted his professional and family functioning. The diagnosis of culture-bound syndrome was considered although the presenting syndrome was chronic and sporadic. The Moroccan culture, which attributes a great importance to the male sex, would explain this syndrome.

Le syndrome de Koro est un trouble psychiatrique spécifique à certaines cultures asiatiques. Il est caractérisé par la survenue brutale d'une anxiété intense associée à la peur d'une rétraction du pénis dans le corps qui peut mener à la mort. Nous rapportons le cas d'un patient marocain âgé de 43 ans, qui présente une anxiété persistante avec des conduites d'évitement associées à une chronique croyance que ses organes génitaux pourraient se rétrécir ou disparaître et conduire à sa mort, ce qui a impacté son fonctionnement professionnel et familial. Le diagnostic d'un trouble lié aux concepts culturels semble le plus probable, en se référant à la culture marocaine qui attribue une grande importance au sexe masculin, même s'il s'agit d'un cas chronique et sporadique.

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INTRODUCTION: Health systems are challenged by care underutilization, overutilization, disparities, and related harms. One problem is a multiyear latency between discovery of new best practice knowledge and its widespread adoption. Decreasing this latency requires new capabilities to better manage and more rapidly share biomedical knowledge in computable forms. Knowledge objects package machine-executable knowledge resources in a way that easily enables knowledge as a service. To help improve knowledge management and accelerate knowledge sharing, the Knowledge Object Reference Ontology (KORO) defines what knowledge objects are in a formal way. METHODS: Development of KORO began with identification of terms for classes of entities and for properties. Next, we established a taxonomical hierarchy of classes for knowledge objects and their parts. Development continued by relating these parts via formally defined properties. We evaluated the logical consistency of KORO and used it to answer several competency questions about parthood. We also applied it to guide knowledge object implementation. RESULTS: As a realist ontology, KORO defines what knowledge objects are and provides details about the parts they have and the roles they play. KORO provides sufficient logic to answer several basic but important questions about knowledge objects competently. KORO directly supports creators of knowledge objects by providing a formal model for these objects. CONCLUSION: KORO provides a formal, logically consistent ontology about knowledge objects and their parts. It exists to help make computable biomedical knowledge findable, accessible, interoperable, and reusable. KORO is currently being used to further develop and improve computable knowledge infrastructure for learning health systems.

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Cultural factors have influenced the presentation, diagnoses, and treatment of anxiety disorders in India for several centuries. This review covers the antecedents, prevalence, phenomenology, and treatment modalities of anxiety disorders in the Indian cultural context. It covers the history of the depiction of anxiety in India and the concept of culture in the classification of anxiety disorders, and examines the cultural factors influencing anxiety disorders in India. We review the prevalence and phenomenology of various disorders, such as generalized anxiety disorder, panic disorder, social anxiety, and phobic disorder, as well as culture-specific syndromes such as dhat and koro in India. Finally, the review examines the wide range of therapeutic modalities practiced in India, such as faith healing, psychotherapy, ayurveda, psychopharmacology, Unani medicine, homeopathy, yoga, meditation, and mindfulness. We conclude by emphasizing the significance of cultural factors in making relevant diagnoses and offering effective and holistic treatments to individuals with anxiety disorders.

Por varios siglos, Ios factores culturales han influenciado la presentación, diagnóstico y tratamiento de Ios trastornos de ansiedad. Esta revisión abarca Ios antecedentes, prevalencia, fenomenología y modalidades terapéuticas de Ios trastornos de ansiedad en el contexto cultural de India. También incluye la historia de la descripción de la ansiedad en India y el concepto de cultura en la clasificación de Ios trastornos de ansiedad, como asimismo examina Ios factores culturales que influyen en Ios trastornos de ansiedad en India. Se revisa la prevalencia y la fenomenología de varios trastornos, como el trastorno de ansiedad generalizada, el trastorno de pánico, la ansiedad social y el trastorno fóbico, como también síndromes culturales específicos en India como el dhat y el koro. Por ultimo, el artículo revisa el amplio rango de modalidades terapéuticas practicadas en India, como la curación por la fe, la psicoterapia, el ayurveda y la psicofarmacología. Se concluye enfatizando en el significado de Ios factores culturales que son relevantes para realizar diagnósticos y ofrecer tratamientos efectivos y holísticos para individuos con trastornos de ansiedad.

Depuis plusieurs siècles, des facteurs culturels influent sur la présentation, le diagnostic et le traitement des troubles anxieux en Inde. Cet article parcourt les antécédents, la prévalence, la phénoménologie et les modalités de traitement des troubles anxieux dans le contexte culturel indien. Il traite de l'histoire de la représentation de l'anxiété en Inde et du concept de culture dans la classification des troubles anxieux et analyse les facteurs culturels influant sur les troubles anxieux en Inde. Nous examinons la prévalence et la phénoménologie des différents troubles, comme les troubles anxieux généralisés, le trouble panique, l'anxiété sociale et les troubles phobiques, ainsi que les syndromes culturels spécifiques comme le syndrome du Dhat et du koro en Inde. Enfin, l'article analyse la large gamme de modalités thérapeutiques pratiquées en Inde, comme la guérison par la foi, la psychothérapie, l'ayurvéda, la psychopharmacologie, la médecine Unani, l'homéopathie, le yoga, la méditation et la pleine conscience. Nous concluons en soulignant l'importance des facteurs culturels dans l'établissement de diagnostics pertinents et en proposant des traitements efficaces et holistiques aux individus ayant des troubles anxieux.

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BACKGROUND: Koro, as a culture bound syndrome is predominantly reported from Asian countries. There is dearth of well-designed research focussing on course and outcome of Koro. METHOD: In the index study, 64 consecutive consenting patients with symptoms of Koro reported in different disciplines of a tertiary care Government Hospital of West Bengal were recruited over a period of 3 months. They were treated by standard treatment protocol and followed up for next 3 months. Data was collected on clinical course and treatment outcome by a pretested semi-structured proforma, specially developed for this study. RESULTS: A typical subject was a young single male, educated up to primary standard, agricultural worker by occupation and belonged to Hindu rural joint family. Among the whole sample 23% were female. Majority were referred from either private doctors or hospitals or government hospitals and reported first at non-psychiatric OPD. Dropout and recovery rates were 28% (male 33%, female 13%) and 89% (male 89%, female 92%) respectively. 20%, 75%, 9%, 31%, 19% of patients needed indoor admission, oral anxiolytics, injectable tranquilizers, specific pharmacological and psychosocial treatment, supportive medical treatment respectively. There was a subtle difference in course and treatment outcome noted between the genders. A new modality of psycho-sexual intervention 'sex education in vivo' was applied on patients of Koro with favourable result. CONCLUSION: Female counterpart represented a significant proportion. Overall improved trend of utilizing medical care facilities was observed. But sceptical attitude towards Psychiatric treatment is prevailing. An overall good treatment outcome was noted among the Koro victims.

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OBJECTIVE: Koro is a culture bound syndrome, endemic in South-East Asia. The present study attempts to correlate the socio-cultural and demographic variables of the patients with the occurrence of the Koro and the differences in presentation between the classical features of the Koro and the actual presentation of the disease that has been observed in the present study. METHOD: A cross-sectional observational study was performed and data collected during the period was compared, analyzed and studied. A total number of 70 patients who presented to the Department of Psychiatry with symptoms of Koro over the period of 5 days were taken into the study. RESULTS: Most of the patients were, young, unmarried males belonging to a lower socioeconomic status. Most of these patients suffered the attacks in the evening mostly while at home. It was common in migrant and migrant lineage. Media had a major role to spread this epidemic. CONCLUSIONS: Koro epidemics are considered to be the result of panic that spread following the occurrence of symptoms in one or more individuals within the same geographical zone. While the issues concerning phenomenology, diagnosis and nosology of Koro are still being discussed, it is apparent that Koro which presents as an acute anxiety state is treatment responsive and has good prognosis.

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This case report highlights Koro-like symptoms with erectile dysfunction. Methods: We report a case of a Rohingya refugee who presented with Koro-like symptoms associated with erectile dysfunction and severe religious guilt. Results: Sexual dysfunction, i.e. erectile dysfunction may be a predisposing factor for a Koro incidence. Religious issues complicated by superstitious beliefs pose a treatment challenge. Conclusion: Treating patient with sexual dysfunction should involve exploring and addressing patient’s conflicts to avoid worsening of symptoms. As this case illustrates, severe anxiety can present with Koro-like symptoms.

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Objective: Culture-bound syndrome is a term used to describe syndromes unique to certain cultures. We need to understand the origins of cognitions related to these syndromes. Methods: We present the case report of a patient with dhat syndrome and koro with no other psychiatric disorder. Results: The cognitions related to these two distinct culture-bound syndromes in our patient seem to have their origins from different sources. While those related to dhat anxiety are peer-group induced, the one related to koro-like symptoms seem to have been affirmed by an alternative medical practitioner. Conclusion: Mental health professionals dealing with patients having culture-bound syndromes need to get to the core of origin of various cognitions and beliefs that such patients bring into the consultation rooms.

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Koro is a culture-bound syndrome that is characterized by the belief of retraction of genitals into the abdomen. It was initially reported in Asian countries, as having a usual acute and brief course. Two case clusters have been described in this article. Both occurred in the same jute mill in southern West Bengal among the workers. The case clusters depict unique socioeconomic factors and interesting health-seeking behavior toward koro. All the cases had a self-limiting course and reasonably good outcome. The case cluster yet again confirms that koro is not as rare as it is thought of and social and economic factors continue to play an important role in the etiology of the disease.

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A case of koro in a white English male is described. This is followed by a brief review of other similar cases and possible psychophysiological mechanisms.

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A self—designed “Folk Belief Questionnaire”(FBQ)was administer among young men aged 18to 20 years in Taiwan,Jilin,and Guangdong provinces,to compare their attitude to and perception on sexual issues,koro syndrome,and the transcendent religion.Some responses to the FBQ differed significantly in the subjects amongthese three regions,suggesting that the occurrence of epidemic koro may be related to special local folk belief.