A 28 year old married IT professional presented with intermittent rt sided headaches since one year , noted especially after her varicalla pox attack one year back , taking treatments for vascular headaches on analgesics and gabapentin. Considering her peculiar headache with same distribution along the trigeminal nerve distribution, we evaluated on lines of TRIGEMINAL NEURALGIA. MRI Brain surprised us with a VASCULAR LOOP around the Trigeminal nerve at the CP ANGLE ! The family was explained of possibility of worsening in the case of an aneurysm in future ! Managed conservatively on follow up
30 year old man came with halitosis × 2 months with heaviness in chest. Nose, throat and oral cavity - normal. I personally couldn't pick the smell as I had a bad cold, but when my OPD nurse entered the room she gave a very bad face reaction and opened the windows which made me ask about the nature of the smell to the patient, revealed to be pungent, resembling urine. His creatine was 5.6 mg/dl and urea 243 mg/dl, BP 260/140 mm/hg and ECG showed features of LV failure. Diagnosed as CKD.
43 year old male patient presented in opd with severe (L)ear pain of sudden onset. Examination revealed no local pathology. Patient was anxious and sweating . But had no other pain during presentation. He was referred to physician to rule out MI. ECG was taken and was suggestive of inferior wall infarction. Primary angioplasty with stenting of (R)coronary artery was done. Ear pain comes as a result of auricular branch of vagus supplying the inner portion of external ear.