Malaria related myalgia-arthralgia: an imported case report treated with anti-malarial drug

Malaria is still a major health problem in Indonesia, especially in endemic areas. We present an imported case of malaria with prominent subjective complaint of the patient is in the form of persistent muscles and joints pain. A 21 years old female with complaint of intermittent fever and persistent muscle joints paint since one week before seeing a doctor. She had history of repetitive attack of malaria tropica. Physical examination in general showed no clear derangements, but on thick and thin blood smear stained with Giemsa revealed malaria falciparum (+). Combo therapy of antimalarial drug soon be given and the patient healed with the disappearance of all previous complaint. Myalgia and arthralgia in case of malaria falciparum (+) might be the earliest subjective sign of rhabdomyolisis, a potentially fatal and lethal complication of malaria.

A Case Study of Janusandhigatavata (Osteoarthritis of knee joint)

Osteoarthritis is one of the most common disorders in joint disease. It is characterized by pain, shiftiness, decreased range of motion which is very close to Sandhigatavat. Sandhigatavat is amongst 80 Nanatmaj Vat Vyadhi. Here is a case of 57 years old male patient who was having complaints of pain, tenderness, crepitus, swelling and restricted movement of both knee joints. Based on these symptoms and clinical sign he was diagnosed as a case of Sandhigatvat. Treatment given to this patient was Snehan, Swedan, Janubasti, Yog, Basti and oral medication . Assessment of patient before and after treatment was done on the basis of pain, tenderness and physical activity to exclude the efficacy of the treatment. Based on assessment parameter, moderate improvement was seen in subjective sign & symptoms after the completion of Schedule of IPD treatment & 1 month follow up. The pain & physical activity were improved significantly.

Reading X-rays

Mata and Rosengart1 believe that interobserver variability in interpreting radiographs may play a part in the disparate incidence of necrotizing enterocolitis (NEC) reported from various centers. Underlying their contention is the implication that the diagnosis of NEC rests upon abnormal radiographic findings. I do not dispute their observations, but let us examine the underlying premise. Leonidas et al2 and Daneman et al3 analyzed the radiographic signs of NEC. Both groups found bowel dilation to correlate well with severity of the disease, but dilation is a highly subjective sign and is entirely nonspecific.4