We describe a case of aplastic crisis caused by parvovirus B19 in an adult sickle-cell patient presenting with paleness, tiredness, fainting and dyspnea. The absence of reticulocytes lead to the diagnosis. Anti-B19 IgM and IgG were detected. Reticulocytopenia in patients with hereditary hemolytic anemia suggests B19 infection.

The drug of choice for the treatment of occasional acute symptoms of asthma is an inhaled beta adrenergic agonist, such as salbutamol. The most frequent adverse reactions to salbutamol include nervousness, headache, tremor, tiredness and light-headedness [1]. The following report describes a patient with asthma from childhood, who developed creatine phosphokinase elevation associated with sever...

ISSUE Second only to depressed mood itself tiredness, low energy, and listlessness are the most common symptoms associated with depression. Recent understanding of interactions between monoaminergic neurons may help explain why some antidepressants may be more rapidly energy restoring than others.

Case 1. Robert Davies, a 50-year-old man, presents with tiredness and lethargy. Examination demonstrates pallor and jaundice. Investigations reveal anemia that is consistent with warm autoimmune hemolytic anemia (AIHA; Figure 1). He has no evidence of any other autoimmune disease or chronic lymphocytic leukemia (CLL) and is not taking any medications; these factors suggest idiopathic AIHA. How ...

A middle aged lady presented with fever, generalized tiredness and dysphagia. Neurological evaluation revealed weakness of pharyngeal muscles, uvula,palate with absent gag reflex and a weak sternocleidomastoid muscle. Involvement of 9,10,11,12 cranial nerves in the absence of Horner’s syndrome confirmed the diagnosis of Collet-Sicardsyndome. MR imaging studies revealed a Sigmoid Sinus Thrombosi...

Case 1. Robert Davies, a 50-year-old man, presents with tiredness and lethargy. Examination demonstrates pallor and jaundice. Investigations reveal anemia that is consistent with warm autoimmune hemolytic anemia (AIHA; Figure 1). He has no evidence of any other autoimmune disease or chronic lymphocytic leukemia (CLL) and is not taking any medications; these factors suggest idiopathic AIHA. How ...

OBJECTIVE Morningness/eveningness (M/E) is a stable characteristic of individuals. Circadian rhythms are altered in episodes of mood disorder. Mood disorder patients were more evening-type than normal population. In this study, we compared the characteristics of M/E among the 257 patients with bipolar I disorder (BPD1), bipolar II disorder (BPD2) and major depressive disorder, recurrent (MDDR)....

BACKGROUND According to an old Swiss proverb, "a new mother lazing in childbed is a blessing to her family". Today mothers rarely enjoy restful days after birth, but enter directly into the challenge of combining baby- and self-care. They often face a combination of infant crying and personal tiredness. Yet, routine postnatal care often lacks effective strategies to alleviate these challenges w...

BACKGROUND Women in the menopausal transition and the postmenopausal period are affected with vasomotor symptoms, urogenital atrophy, sexual dysfunction, somatic symptoms, cognitive difficulty, sleep disturbance, and psychological problems. It is important to gain a better understanding of the complexity and diversity of climacteric disturbance in order to optimize treatments for individual pat...