Case Studies

A 59-year-old man and 62-year-old woman were presented with degenerative gonarthritis. They had no issues of breathing, pulse and blood pressure. They also had no consciousness or sensory disorders.


Which of the following methods could be the suitable management option for this case?

  • NSAIDs
  • Knee Joint

  • Traction

  • Lateral knee injections

13min read    

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    

A 22-year-old woman was presented with a new onset of seizures after delivering her first child. The headache moderately intense, non-positional, bifrontal, with a throbbing quality after one day. Her pregnancy was unremarkable, and she developed a cough, fever (39.6°) and tachycardia at the time of her delivery. She was also detected with influenza B virus infection on nasopharyngeal swab consistent with respiratory influenza. After seven days, she had generalised convulsions and right elbow flexion and head version to the left.


Which of the following syndrome explains the new onset of seizures and respiratory influenza infection?

  • Eclampsia

  • Posterior reversible encephalopathy syndrome (PRES)

  • Cerebral Thrombosis

  • Influenza-associated encephalitis

22min read    

A 71-year-old female patient suffered from a chronic migraine for two decades. She never experienced insomnia problems before the first onset of a migraine. A migraine occurred 3-4 times per week, and each episode persisted around 4-8 hours. The pulsating pain was localised at right half of the head. The precipitating factors were the stress, increase in physical activities and sudden cold weather. The relieving factors included warm temperature, slower pacing of life and comfortable environment. The moderate or severe pain intensity was aggravated by or causing avoidance of increased physical activity. The residual symptom between the migraine episodes was the head tense feeling, but not achieving headache severity. The function remained well except avoiding exercise during and between the migraine episodes.


After going through the above case presentation, what do you think, could ramelteon alleviate a migraine?

  • Yes
  • No
15min read    

In the present study, a case of a 28-year-old sub-Saharan female is presented with insidious onset of painful burning sensations on the upper trunk, symmetrical numbness and tingling sensation on the hands and feet, progressing over a 5 year period. These symptoms began as intermittent burning sensations on the scapulae and pectoral regions of the upper trunk, which progressed to numbness and paraesthesia of the upper and lower limbs respectively. These were associated with mild weakness of the hands and feet, insomnia, irritability and constipation. There were no urinary symptoms, paralysis, gait disturbances, tremors, jaundice, limb swelling, changes in skin colour, or delusion.

20min read