mdCurrent-India Case Studies

Introducing mdCurrent-India Case Studies! An opportunity for you to learn from the specific patient experiences of your colleagues. In the coming weeks, you will see more new case studies, including both in-depth case studies and short "quick cases."

If you are interested in contributing case studies of your own, click here to contact us.

Case Report: Buccal Lipoma, A Rare Entity

By: Dr. Dheeraj V. Mulchandani and Dr. M. M. Begani
A 40 year old fisherwoman presented to our day care surgery with her complaints of a slowly progressive swelling originating over the inside of her left cheek. It was relatively... Read more »

Case Study: Brightening Smiles with Laser

By: Dr. Sunitha Gadudasu and Dr. J. Gnanaraj
Everyone loves a smile with milk white teeth. Unfortunately our teeth do get stained and a variety of... Read more »

Quick Case: Hand Foot Mouth Disease in a Remote Area in Northeast

1 comment »
By: Dr. J. Gnanaraj and Dr. Bipin Kumar
Recently within a week 17 children presented with ulcers in the mouth, foot and hands that prevented them from eating and some had fever at presentation. All of them were from... Read more »

Quick Case: MIS for Uterine Septum in a Rural Area Using URS

By: Dr. J. Gnanaraj and Dr. Linda Sailo
The two Mullerian ducts join together to form the Uterus during embryogenesis. During the early stages there is a partition that dissolves later and sometimes the partition persist... Read more »

Quick Case: Laser Therapy for Trigeminal Neuralgia

By: Dr. J. Gnanaraj, H.Charles Richard M.P.T. and Dr. Sunitha Gadudasu
Trigeminal Neuralgia is a condition that can cause excruciating pain and could be very debilitating because of the chronic nature... Read more »

Case Study: Minimally Invasive Treatment for Complex Fistula in Ano

By: Dr. J. Gnanaraj and J. Regina Jeyaseeli, Bsc Nursing
A Fistula in Ano is a connection between peri–anal skin and anal canal through a tortuous tract lined by granulation tissue and epithelial cells... Read more »

Case Study: Progeria in a Rural Hospital

By: Dr. J. Gnanaraj and Dr. Sunitha Gadudasu
Progeria is also called HGPS syndrome [Hutchinson – Gilford Progeria syndrome]. It is an extremely rare genetic disorder which makes people age rapidly... Read more »

Case Study: Appropriate Care for an 80 Year Old Man from India with Dementia

By: Dr. P. Lal Arora
I have known of an 80 years old business man in India who started with memory loss a couple of years ago and was diagnosed with... Read more »

Quick Case: Giant Cell Tumor of Ilium in a Young Female

By: Dr. Swapan Samanta
A 24 years old female presented with inability to rise, walk or move her waist/lower body parts suddenly for just one month incidentally following... Read more »

Quick Case: Vacuum Therapy After Skin Grafting

By: Dr. J. Gnanaraj, Mr. L. R. Bravin, Mr. Wise Jacob, Regina and Tamilvannan
Negative Pressure Wound therapy [NPWT] has been in use since the early nineties for treating non healing wounds. It decreased the edema, improves circulation and neo-vascularization, granulation... Read more »

Quick Case: The Dramatic Benefit of Vacuum Therapy Treatment

By: Dr. J. Gnanaraj and Mr. W. Jacob
Mr. S is a known diabetic patient who came to the hospital with septicemia. He had a coronary artery bypass carried out in 2007 and noticed a non-healing wound in the... Read more »

Quick Case: Asymptomatic Conjunctival Cysticercosis

By: Dr. Swapan Samanta
Cysticercus cellulosae is caused by the larval form of Taenia solium, or pork tapeworm. Humans can get the adult worm in the intestine by consuming... Read more »

Quick Case: Tuberculosis of the Prostate – Is It Rare in India?

By: Dr. Swapan Samanta
In the last one year, I have done 70 Tru-Cut biopsies of prostate, all having raised PSA levels. Forty out of them were diagnosed with... Read more »

Quick Case: Kala-azar is Still Clinically Neglected in India

By: Dr. Swapan Samanta
A few months back, a 9-year-old boy presented with chronic ill-health, loss of appetite, loss of weight, severe anemia, mild thrombocytopenia and occasional fever. He also had hepatosplenomegaly. A routine hemogram reported... Read more »

Quick Case: Malignant Germ Cell Tumor Presents as Discharging Scrotal Mass

By: Dr. Swapan Samanta
A 69-year-old male presented with urinary obstruction for 6 months and bilateral testicular pain for 9 months. Gradually the severity increased so that he needed permanent supra-pubic catheterization, due to severe... Read more »

Quick Case: Rhinoscleroma Leads to Loss of Both Eyes in a 48-Year-Old Male

2 comments »
By: Dr. Swapan Samanta
A 48-year-old male presented with proptosis and ethmoid sinus mass, epistaxis and bilateral nasal block for 4 years, in 2009. Lateral rhinostomy was performed, and the biopsy report came as granulomatous inflammation, possibly fungal infection. Within one year, the patient developed loss of... Read more »

Case Study: BCG Vaccine-Induced Tuberculosis Takes Life of a 4-Month-Old Boy with Wiskott-Aldrich Syndrome

By Dr. Swapan Samanta
BCG vaccination is believed to give some protection against tuberculosis, and for this reason, the Universal Immunization Program includes this vaccine. However, recently I had a very sad experience while dealing with a case of disseminated tuberculosis; better to say that the little baby’s body was just converted into packets full of AFB! In the course of investigation, we found that... Read more »

Quick Case: Kikuchi-Fujimoto Disease (KFD) Mistaken and Treated as a Case of Tuberculosis

By: Dr. Swapan Samanta
A 21-year-old female presented with fever, bilateral cervical tender lymphadenopathy, skin rashes and headache for 7 days. High ESR and neutrophilic leucocytosis were noted. Mantoux test was negative. Chest X-ray was normal. FNAC from one of the lymph nodes yielded thick pus-like material. The smears were full of... Read more »

Quick Case: Black Cirrhosis in a Khaini Abuser

By: Dr. Swapan Samanta
A 64-year-old female presented with ascites, loss of weight, loss of appetite and severe weakness for the last 3 years. Upper and lower GI endoscopic findings were within normal limits. Macrocytic hypochromic anemia, elevated ESR, massive hepatomegaly and moderate spenomegaly were found, but no... Read more »

Quick Case: Left Retrosternal Goiter

By: Dr. Pragnesh Vachharajani
A 44-year-old male arrived for a routine office visit as part of an annual health check-up. His BMI was 26, and he had nothing particular in his history. But, on detailed questioning, he complained of chest pain on the left side of the upper chest and occasional difficulty in swallowing. Read more »

Case Study: Solitary Pulmonary Hamartoma with Complications in a 14-year-old Girl

By Dr. Swapan Samanta
Pulmonary hamartomas are rare, benign lesions of the lung and may be multiple in number. Recently, a 14-year-old girl presented with clinical symptoms of tuberculosis, and after transthoracic biopsy, the diagnosis was confirmed as... Read more »

Case Study: Faucial Diphtheria Complicated with Myocarditis and Cardiac Failure

1 comment »
By Dr. Swapan Samanta and Dr. Malay Acharyya
Due to universal immunization, cases of diphtheria are rare now-a-days. Recently a 12-year-old male with incomplete vaccination history presented with a fever, sore throat and “bull-neck.” Investigations confirmed the diagnosis of... Read more »

Case Study: Non-gestational ovarian choriocarcinoma in a young female

By: Dr. Moushumi Lodh, Dr. Abhishek Mukherjee and Dr. Ratnadeep Ganguly
Our patient, a twenty-two-year-old was brought to the emergency department of our hospital with a history of unconsciousness and sudden fall. Her pupils were responding sluggishly, and she was not able to move her right limbs when she arrived in the emergency department, although her left limbs were showing spontaneous... Read more »

Quick Case: Adenocarcinoid of Appendix in a 34-year-old Female

By: Dr. Swapan Samanta
A 34-year-old woman underwent an operation for recurrent appendicitis. She was suffering from frequent pain and a vague lump feeling in the right iliac fossa region for the last... Read more »

Quick Case: Rectal Cancer Presenting as a Perineal Abscess

By: Dr. Swapan Samanta
A 74-year-old male presented with a painful swelling for the last 3 months, along with dyschezia, dysuria and bloody stools. The lesion measured about 4 cm in diameter, and it was... Read more »

Case Study: Coexistent Vitamin D and Iron Deficiency in a Child

By: Dr. Moushumi Lodh
Iron deficiency is the most common nutritional deficiency worldwide, and vitamin D deficiency is a major global health issue. We present here the case of an 11-year-old boy with coexistent iron and vitamin D deficiency manifested as tiredness, leg cramps and a lack of visible weight gain over the last year. Read more »

Case Study: Hyperkalemia and ECG Changes

2 comments »
By: Dr. Pragnesh Vachharajani
A 70-year-old male presented to the ER with giddiness & presyncope for the past two hours. He was also having difficulty in breathing. No other history was known, except that he was diabetic. Read more »

Quick Case: Accelerated Hypertension

2 comments »
By: Dr. Pragnesh Vachharajani
Patient Profile: Age: 50, Sex: Male, History: Nothing particular, Presenting complaints: Multiple migrating joint pains, feeling tired since 1 week. Read more »

Quick Case: Pilomatric Carcinoma Presenting as Huge Scapular Swelling with Bone Destruction

By: Dr. Swapan Samanta
A 74-year-old male presented with a subcutaneous small cystic subcutaneous nodule, just medial to the right shoulder joint, measuring 2.5 cm in diameter. An attempt to excise the nodule resulted in partial removal, rupture and secondary infection, resulting in... Read more »

Case Study: Circumscribed Myositis Ossificans of Masseter Muscle Causing Trismus

1 comment »
By: Dr. Balasubramanian Thiagarajan
Myositis ossificans involving the masseter muscle is rather rare. This condition is characterized by dystrophic calcification and heterotopic ossification of intramuscular connective tissue. Masticatory muscles are... Read more »

Case Study: Swollen Leg with Anemia in an Obese Policeman Leads to Discovery of Cecal Cancer

1 comment »
By: Dr. Somprakas Basu
We report a case of cecal cancer in an obese policeman, who presented with recurrent deep venous thrombosis and unexplained anemia. The deep venous thrombosis was thought to be due to long hours of standing (professional hazard) and obesity. Investigations for thrombophilia came back ... Read more »

Quick Case: Isolated Hepatic Amyloidosis in a Young Male

By: Dr. Swapan Samanta
A 45-year-old male presented with loss of appetite and weight loss for last 6 months. He gradually developed jaundice (bilirubin 8.6 mg%; 90% unconjugated) and... Read more »

Case Study: Post Paracentesis Syndrome

2 comments »
By: Dr. Dheeraj V. Mulchandani
Many people with ascites secondary to liver disease have undergone paracentesis for symptomatic relief, for breathing difficulty due to their greatly increased abdominal girth preventing respiratory movements. A 43-year-old male, a known case of liver cirrhosis with... Read more »

Case Study: Hematologic malignancy in a patient with Klinefelter’s Syndrome: An Uncommon Association

By: Dr. Valluri Ramarao
A 30-year-old male who had diabetes for a year and a half attended my clinic and had other co-morbid conditions like hypertension, hypothyroid and hypogonadism. Clinically, his appearance fits in to... Read more »

Quick Case: Sellar tuberculoma presenting as pituitary adenoma

By: Dr. Swapan Samanta
A 43–year-old woman presented with polyuria polydipsia (PUPD), amenorrhea and galactorrhea for the last 2 years. Investigations revealed central diabetes insipidus, elevated... Read more »

Quick Case: Incidental myeloid sarcoma in a young male

By: Dr. Swapan Samanta
A 24-year–old, otherwise healthy male presented with numbness and pain in both lower limbs for the past two... Read more »

Quick Case: PEComa (perivascular epithelioid cell tumour) presenting as a nasal polyp

By: Dr. Swapan Samanta
A 38-year-old female presented with recurrent epistaxis for the last 11 months. Rhinoscopy revealed a right nasal polyp of... Read more »

Case Study: Right atrium thrombus in a female patient

By: Dr. Pragnesh Vachharajani
A 35-year-old female patient presented at the family physician’s clinic at midnight, with sudden onset dyspnoea for about the past hour. She had a ... Read more »

Quick Case: Malignant mixed Mullerian tumor presenting as pelvic tuberculosis

By: Dr. Swapan Samanta
A 50-year-old post-menopausal woman presented with post-menopausal bleeding, poor health, weight loss, fever and abdomino-pelvic discomfort for the last 6 months. Clinically, she appeared to be suffering from... Read more »

Quick Case: Diabetic foot treatment with topical vacuum therapy

4 comments »
By: Dr. J. Gnanaraj
The patient is a 54-year-old farmer from a rural area near Coimbatore in Tamil Nadu. He had a diagnosis of diabetes mellitus 3 years ago, and he is taking oral hypoglycemic agents.... Read more »

Case Study: Salmonella Typhimurium Meningitis in an infant, hitherto unreported in Eastern India

1 comment »
By: Dr. Subhranshu Mandal
The enterobacteriaceae family, especially non-typhoidal salmonella, as the etiological agent for pyogenic meningitis in infants is scarce. Most reports of S. typhimurium meningeal infection are confined to neonates. Read more »

Case Study: Complementary medicine causing severe side effects in children – An overlooked cause of weight loss?

By: Dr. Gaurav Gupta
Homeopathic medicine is traditionally considered to be one of the safest systems of medicine, as the drugs are made from the dilution of the active ingredients [1]. However, there is certain evidence available that supports the fact that homeopathic medicines can cause severe adverse drug reactions (ADRs) in children [2,3]. It is very important to... Read more »

Case Study: Exam-related stress and anxiety among adolescent students

2 comments »
By: Dr. Rajesh Sarkar
This study examined students coming out of 12th grade and entering professional college in the age range of 18 to 21 years. The transition from school to professional college in itself is a hectic process, involving the need for students to study day and night in order to perform well on the required entrance exams..... Read more »

Case Study: Assessing the relationship between depression, obesity, and HbA1c levels

1 comment »
By: Dr. Rajesh Sarkar
With careful assessment, it can be found that diabetic patients who are noncompliant with their treatment, as evident by rising HbA1c levels, are usually also depressed. Lack of energy, appetite, concentration and motivation are some of the significant factors, which can lead to missing.... Read more »

Case Study: Diagnosing pneumonia mimics

2 comments »
By: Dr. Kasim Kolakkadan
Pneumonia has been recognized by the medical profession since ancient times. It is one of the leading causes of infectious deaths in the West and cause of considerable mortality and morbidity in our part of the world. Diagnosis is mostly based on... Read more »

Quick Case: Young patient with anterior wall myocardial infarction

2 comments »
By: Dr. Pragnesh Vachharajani
A 40-year-old male patient presented with retrosternal pain and perspiration that was occurring for the past hour. He had mild chest pain a couple days prior. An ECG was done, and results were normal... Read more »

Quick Case: Asymptomatic case of hodgkin’s lymphoma

1 comment »
By: Dr. Pragnesh Vachharajani
A male patient, age 36, visited me for routine seasonal ailments. He was found to have swelling, large in size, in the submental region. Upon detailed investigations... Read more »

Case Study: Coexistence of tuberculosis and adenocarcinoma in the colon

By: Dr. Swapan Samanta
The occurrence of tuberculosis with adenocarcinoma is rare, but it has been observed by many. This association has been debated extensively in the literature [1-3]. Here I present a case with similar association, where extended right hemicolectomy was performed, and the diagnosis came only ... Read more »

Quick Case: Biphenotypic blast crisis in CML in a young female

By: Dr. Swapan Samanta
Biphenotypic blast crisis is not so common. If chronic myelomonocytic leukemia (CML) is undetected, and the patient first presents with features of acute leukemia, it is difficult to distinguish it from acute myelomonocytic leukemia. I recently dealt with ... Read more »

Case Study: Persistent infection in surgical wounds: Atypical mycobacteria and its surgical treatment

By: Dr. Swapan Samanta
The non-tuberculous mycobacteria (NTM) have become significant opportunistic pathogens recently, and occur in epidemic proportions in some centers. For example, atypical mycobacterial infections are a frequent problem found at the ... Read more »

Case Study: Intra-abdominal actinomycosis may present as a malignant tumor

1 comment »
By: Dr. Swapan Samanta
Actinomycosis is a chronic suppurative granulomatous inflammatory disease caused by different Actinomyces species, mainly Actinomyces israelii. It is an anaerobic gram-positive bacteria. The intra-abdominal location of this infection is ... Read more »

Case Study: Evidence of first nimesulide-induced hepato-renal toxicity in an Indian child

1 comment »
By: Dr. Gaurav Gupta
This is the first evidence of nimesulide toxicity in an Indian child as reported by Dr. Gaurav Gupta, working in collaboration with the National Institute of Pharmaceutical Education and Research (NIPER).... Read more »

Case Study: FNAC: A safe procedure for the diagnosis of hydatid cyst

By: Dr. Swapan Samanta
Hydatid cyst disease, also known as Echinococcosis, is a zoonotic infection that can affect any organ and tissue but is most often found in the liver or lungs. It is most common in rural areas, where patients have close contact with ... Read more »

Case Study: Inflamed foot cyst may be fungal tumor

By: Dr. Swapan Samanta
Fungal infections are very common in India, especially tenia pedis and other superficial fungal infections. Mycetoma is a chronic granulomatous infective disease of the skin and related tissues... Read more »

Case Study: Incidental low grade invasive transitional cell carcinoma of minor calyx in a hydronephrotic kidney with renal stones

By: Dr. Swapan Samanta
Incidental carcinoma of the renal pelvis is a rather common radiological finding with hydronephrotic kidneys or kidneys with renal stones; but it is extremely rare to detect carcinoma of the renal pelvis in such cases. I have recently reported one such case. So clinicians, radiologists, and pathologists should be aware of... Read more »

Case Study: Recurrent and cyclic appendicitis in females: suspect pelvic endometriosis

1 comment »
By: Dr. Swapan Samanta
Endometriosis is a well-recognized gynecological condition in the reproductive age group. Literature on appendiceal endometriosis, which is a rare condition, is inadequate. The presentation to general surgeons may be atypical and pose diagnostic difficulty. Thus, a thorough history, gynecological assessment, radiology and serology may... Read more »

Case Study: Stapler surgery for hemorrhoids or piles

By: Dr. Pravin Gore
Surgery for hemorrhoids or piles will leave a wound at each of the removed pile areas. This usually takes a few weeks to heal, thereby causing pain, bleeding and discomfort for the patient. With the advancement in technologies, stapler surgery for hemorrhoids or piles has been... Read more »

Case Study: Supraclavicular nodules in females: May be primary duct carcinoma

By: Dr. Swapan Samanta
A 47-year-old female presented with recent weight loss, loss of appetite and general weakness. Left supraclavicular nodules were palpable and aspiration smears were inconclusive. Trucut biopsy from the lesion confirmed... Read more »

Case Study: Pain management using alternative therapy with emphasis on magnetic therapy

By: Dr. Rajesh Sarkar
I was greatly touched by the sufferings of my patients from chronic pain. I believe patients get involved in a cycle: inactivity or sedentary life style leads to obesity, stiffness of joints, and some may develop osteoarthritis with aging and a progressive increase in pain with movement, then the patient tends to become... Read more »

Quick Case: Painless Haematuria

2 comments »
By: Dr. Pragnesh Vachharajani, MBBS, PGDMCH
Renal cell carcinoma is the most common type of kidney cancer in adults. Renal cell carcinoma may remain clinically occult for most of its course. Only 10% of patients present with the classic triad of flank pain, haematuria, and flank mass. The treatment options for renal cell cancer are surgery, radiation therapy, chemotherapy, hormonal therapy, immunotherapy, or... Read more »

Quick Case: B12 Deficiency

1 comment »
By: Dr. Pragnesh Vachharajani, MBBS, PGDMCH
Vitamin B12 deficiency is widely prevalent now a days. It is prevalent across gender and age, and it is also more prevalent in vegetarians. Vitamin B12 deficiency causes weakness, easy fatigability, tingling in limbs, at times impaired memory, and... Read more »

Quick Case: Intracranial Bleed

By: Dr. Pragnesh Vachharajani, MBBS, PGDMCH
Sudden increase in blood pressure at times can be dangerous. It can lead to bleeding anywhere in the body. Smooth control of blood pressure is a must for all. Regular monitoring is also mandatory. In this patient, a stable CKD patient, possible sudden increase in blood pressure lead to intracranial... Read more »

Quick Case: Carcinoma of Breast

1 comment »
By: Dr. Pragnesh Vachharajani, MBBS, PGDMCH
Any lump in the chest or axilla should be examined properly. Especially in females, breast examination is a must when an axillary lump is found. Even if tests are found negative for anything, regular screening is a must. All females above 40 years of age should be subjected to mammography at least... Read more »