A 9-year-old girl with newly diagnosed Type 1 DM, DKA, brain oedema, multifocal vasogenic brain lesions and lower limb paresis was presented for treatment. She had reported polyuria and polydipsia over the past week and a weight loss of 3 kg over the previous month prior to admission. The blood glucose level initially was found to be 1136 mg/dL, and severe acidosis was also present (pH 7.1; BE-25.9). Intravenous fluid therapy and insulin therapy did not show any improvement in her medical and neurological state. Glasgow Coma Scale (GCS) scores depleted from 13 points to 7 points. She experienced agitation and motor restlessness followed by upper limb spasms. Computed tomography scan revealed brain oedema and a hypodense lesion in the left temporal region. An anti-edematous treatment helped improve her medical condition, but she had developed symmetric lower limbs paresis. Brain magnetic resonance imaging (MRI) and nerve conduction studies revealed numerous, diffuse lesions and damaged motor neurons in both lower limbs with dysfunctional both peroneal nerves and the right tibial nerve respectively. She reported improvement in her health after therapeutic regimen intensive physiotherapy.

 

What will most likely explain the pathogenesis of acute neuropathy in this case?

  • Diabetic ketoacidosis

  • Peripheral ischemia

22min read    
Key Take-Away:

Statins have significant anti-inflammatory and immune-modulating effects. The study results confirmed that the use of statins specifically atorvastatin significantly lowered the risk of developing knee pain, which could have promising future benefits for knee osteoarthritis management.

Introduction

Statins have various pleiotropic effects, but the literature concerning the possible relationship between statins use and outcomes in knee osteoarthritis (OA) is scarce. The study investigated whether statins use associated with a lower risk of radiographic (ROA), radiographic symptomatic knee OA (SxOA) and pain in North American people.

7min read    
Key Take-Away:

This study shows that the root migration was less in coronectomy with adjunctive guided bone regeneration (GBR) than to coronectomy alone. Moreover, the chance of long-term (3 years or more) root exposure and the need for a following second operation to efface the exposed root would be decreased.

Introduction

Root migration is one of the most common complications during the molar coronectomy, and a portion of the root may be exposed in the oral cavity. This study distinguished the root migration rate, surgical morbidities after third molar coronectomy with or without adjunctive GBR.

8min read    
Key Take-Away:

The study results affirm that there is a high prevalence of small fiber pathology (SFP), in fibromyalgia. The study also provides evidence about the involvement of a distinct phenotype involving SFP in fibromyalgia. Moreover, this is probably the first study to collate data on the overall prevalence of SFP in fibromyalgia.

Introduction

Fibromyalgia is a condition which exhibits widespread chronic pain with neuropathic pain features and has a significant impact on health-related quality of life. The pathophysiology of the disease remains unclear. However, there is increasing evidence for the involvement of the peripheral nervous system with a high prevalence of small fiber pathology (SFP). This systematic literature review aims to establish the incidence of SFP in fibromyalgia.

8min read    
Key Take-Away:

This cohort study describes women with rheumatoid arthritis, and juvenile idiopathic arthritis are at increased risk of PTD. It was also noted some of this risk might be due to maternal disease activity and corticosteroid.

Introduction

Very few studies have been conducted in pregnant women with inflammatory arthritis who are at high risk for preterm delivery (PTD). The pregnant women with RA, JIA, or healthier comparison women investigated the individualistic effects of maternal disease activity, medication use, and comorbid pregnancy conditions on the risk of PTD in this prospective cohort study.

7min read