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Showing posts from April, 2026

WEEKLY CASE #3

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  A 7-month-old boy is brought to the pediatric clinic by his parents for evaluation of progressive irritability, decreased spontaneous movements, and painful swelling of multiple joints over the past 3 months. The parents report that the child cries excessively when picked up or during diaper changes , and they have noticed that he has become increasingly stiff and reluctant to move his limbs. His feeding has also decreased, and he has not been gaining weight appropriately. They further mention that over the last month, they observed small, firm, painless nodules over his elbows, knees, and fingers , which have gradually increased in number. Additionally, his cry has changed it has become weak, hoarse, and rough-sounding , which they initially attributed to a recent upper respiratory infection, though it has persisted. Birth history is unremarkable. There is no history of consanguinity. Immunizations are up to date.   Examination Irritable infant with poor weight gain...

Curse!

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I suffer from an entity called Borderline Personality disorder(BPD). People living with BPD suffer from an enormous amount of pain which has been described akin to a third degree burn, and emotions feel like catastrophic madness with heavy upheavals and uncertainties. I am often numbed by the pain, even my numbness isn't the lack of emotions, its an another form of pain. I am often stormed by the sea of emotions and drowned within it. Hard Gasps of air lead me nowhere, as I struggle to keep myself afloat. I swim and swim, in search of a shore where I can keep my head above from being smothered. But all I can say that I have never reached the shore. I am never living, I am always surviving. I am not feeling things, I am numbed by the pain. I remember saying to someone, that I have been born with a curse. This curse has no fix, and it shall live with me, as long as I do. My highs are the highest, my lows are lowest. I have been the most unhinged guy to the most discreet person. I hav...

WEEKLY CASE #2

 A 52-year-old man presents to the emergency department with recurrent episodes of dizziness and near syncope for the past 2 months. These episodes are often triggered while turning his head to the right . He also reports a dull, intermittent pain in the right side of his neck which goes to his ear , and worsens if his partner touches it. On examination: Pulse: 48/min (regular) BP: 110/70 mmHg Mild tenderness over the right tonsillar fossa An ECG shows: Sinus bradycardia Occasional second-degree AV block (Mobitz type I) Cardiac enzymes are normal. Echocardiography is unremarkable. A carotid sinus massage reproduces his symptoms along with further slowing of heart rate. ❓ What INVESTIGATION would you do for the symptoms involved? What explains the symptoms?

WEEKLY CASE #1

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 A 24-year-old labourer presents to the OPD with complaints of generalized weakness, fatigue, and light-headedness for 2 days. He also reports decreased oral intake and excessive thirst. He has a history of recurrent headaches and has been on numerous medications across different physicians, after which he started on a particular drug for the past 3 months from which he says he feels better. He is unable to recall the name of the drug but brings a partially torn wrapper with him. You are unable to identify the medicine in it, as its single piece of table. On examination, he appears dehydrated. Vital signs: Blood pressure: 96/60 mmHg Heart rate: 112/min Respiratory rate: 20/min Breath sounds were vesicular, and Bilateral Air Entry was present. CVS examination showed S1 and S2 was present. Neurological examination shows mild proximal muscle weakness.  An intern was asked to perform CBC,LFT KFT analysis, Arterial blood gas analysis and Urine analysis which showed: What is the rea...