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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">JPSIM</journal-id>
      <journal-title-group>
        <journal-title>Journal of Pakistan Society of Internal Medicine</journal-title>
        <abbrev-title>J Pak Soc Intern Med</abbrev-title>
      </journal-title-group>
      <issn publication-format="print">2709-8729</issn>
      <issn publication-format="electronic">2710-0804</issn>
      <publisher>
        <publisher-name>Pakistan Society of Internal Medicine</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.70302/jpsim.v5i4.2479</article-id>
      <article-id pub-id-type="publisher-id">jpsim.v5i4.2479</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Case Report</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Unrecognized and Untreated: Refeeding Syndrome Complicating Treatment of Schizophrenia</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author" corresp="yes">
          <name>
            <surname>Hotiana</surname>
            <given-names>Usman Amin</given-names>
          </name>
          <email>molecularpsych@gmail.com</email>
          <xref ref-type="aff" rid="aff1"/>
          <xref ref-type="corresp" rid="cor1">*</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Ali</surname>
            <given-names>Shawaz</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Ahmed</surname>
            <given-names>Umair</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Sabir</surname>
            <given-names>Muzammil</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Fatima</surname>
            <given-names>Samin</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Ayub</surname>
            <given-names>Maryam Nisar</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
      </contrib-group>
      <aff id="aff1">
        <institution>Rashid Latif Medical College, Lahore</institution>
      </aff>
      <author-notes>
        <corresp id="cor1">*Correspondence: Usman Amin Hotiana (molecularpsych@gmail.com)</corresp>
      </author-notes>
      <pub-date date-type="pub" publication-format="electronic" iso-8601-date="2024-12-09">
        <day>09</day>
        <month>12</month>
        <year>2024</year>
      </pub-date>
      <pub-date date-type="collection" publication-format="electronic">
        <year>2024</year>
      </pub-date>
      <volume>5</volume>
      <issue>4</issue>
      <fpage>753</fpage>
      <lpage>755</lpage>
      <history>
        <date date-type="received" iso-8601-date="2024-09-30">
          <day>30</day>
          <month>09</month>
          <year>2024</year>
        </date>
        <date date-type="accepted" iso-8601-date="2024-11-16">
          <day>16</day>
          <month>11</month>
          <year>2024</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>Copyright © 2024 The Author(s)</copyright-statement>
        <copyright-year>2024</copyright-year>
        <copyright-holder>The Author(s)</copyright-holder>
        <ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/>
        <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/">
          <ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0/</ali:license_ref>
          <license-p>This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
        </license>
      </permissions>
      <self-uri xlink:href="https://psimj.com/article/jpsim.v5i4.2479" content-type="text/html"/>
      <self-uri xlink:href="https://psimj.com/article/jpsim.v5i4.2479.pdf" content-type="application/pdf"/>
      <abstract>
        <p>This case report was considered to present refeeding syndrome and the occurrence of schizophrenia could be due to eating disorder. It is about a 40-year-old female patient, former employee at a local bank, ex-principal at a local school, and an NGO worker with a past psychiatric history of psychotic episodes previously treated with multiple antipsychotics along with suspected non-compliance. The patient had not been eating for several weeks, and her father described her as severely malnourished. She exhibited severe paranoid delusions, including a fear that people were trying to harm her. She would particularly refuse any male who tried to approach her. She was suffering from fatigue, muscle weakness, confusion, and fluid retention. Her bloodwork revealed low serum electrolytes and slightly elevated liver function tests. Careful electrolyte repletion and slow reintroduction of nutrition were adopted to treat this patient. Chronic illnesses like schizophrenia could be a risk for eating disorders. Phenomenon like refeeding syndrome could be seen and should be diagnosed.</p>
      </abstract>
      <kwd-group xml:lang="en" kwd-group-type="author-keywords">
        <title>Keywords</title>
        <kwd>Refeeding Syndrome</kwd>
        <kwd>Schizophrenia</kwd>
        <kwd>Untreated</kwd>
        <kwd>Unrecognised</kwd>
      </kwd-group>
    </article-meta>
  </front>
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  <back>
    <ref-list>
      <title>References</title>
      <ref id="ref1">
        <label>1</label>
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      </ref>
      <ref id="ref2">
        <label>2</label>
        <mixed-citation>Boland K, Solanki D, O’Hanlon C. Prevention and treatment of refeeding syndrome in the acute care setting. Irish Society for Clinical Nutrition and Metabolism (IrSPEN); 2013. Guideline Document No. 1.</mixed-citation>
      </ref>
      <ref id="ref3">
        <label>3</label>
        <mixed-citation>Marinella MA. The refeeding syndrome and hypophosphatemia. Nutrition Reviews. 2003;61(9):320-323. <pub-id pub-id-type="doi">10.1301/nr.2003.sept.320-323</pub-id></mixed-citation>
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        <label>4</label>
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      </ref>
    </ref-list>
  </back>
</article>
