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January 2021 -
Volume 20, Issue 1


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From the Editor

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Awareness and Knowledge about Childhood Autism among Family Medicine Residents in Al Madinah Region in Saudi Arabia, 2020
[pdf]
[Abstract]

Ahmad Mohammed Masarit,Maher Alhafithi, Haytham Alsanna,
Sokinh Almaghaslah
DOI: 10.5742/MEWFM.2022.95201

Exploring the Treatment Types and Challenges in Patients with Chronic Obstructive Pulmonary Disease: A Qualitative Study
[pdf]
[Abstract]

Mian Ali Kamran Baba, Shaheer Ellahi Khan, Fatima Hasnain, Rabab Sakina, Afsheen Talat, Afifa Binte Irfan
DOI: 10.5742/MEWFM.2022.95202

Prevalence and associated factors of burnout among nurses in a general hospital in Yanbu, Saudi Arabia
[pdf]
[Abstract]

Maher Alhafithi, Sami A Al-Dubai, Saleh S Alalwani,
Ahmad M Masarit
DOI: 10.5742/MEWFM.2022.95204

Prevalence of overt and subclinical hypothyroidism during pregnancy in antenatal care - cross-sectional study, Jeddah, Saudi Arabia
[pdf]
[Abstract]

Lubna M. Zahrani, Mada I. Abdulhaq, Taghreed M. Shams, Fayssal M. Farahat
DOI: 10.5742/MEWFM.2022.95206

Prevalence of iron supplementation among pregnant woman in Taif, Saudi Arabia: a cross sectional study
[pdf]
[Abstract]

Amena Ali, Setah J. Aladwani, Awatef M. Alotibi, Ibtihal M. Althumali, Marwah O. Alafghani, Mona S. Alzahrani
10.5742/MEWFM.2022.95209

Why patients go to private health care facilities? Perspectives from Qassim, Saudi Arabia
[pdf]
[Abstract]

Amel A Sulaiman, Unaib Rabbani,, Sultan Alshaya, Marwan Alyahya, Saleh A Al-Gabbany, Chandra S Kalevaru, Saulat Jahan, Raed A Aljubeilan, Ahmed A AlMeman, Bader A AlAhajji
DOI: 10.5742/MEWFM.2022.95212

Population and Community studies

Documentation of paediatric observations in an urgent care setting; a Quality Improvement Project
[pdf]
[Abstract]

Rahma Yusuf Ali
DOI: 10.5742/MEWFM.2022.95210

Public Awareness, and Perception towards Chronic Kidney Disease and its Risk Factors in Southern Region, Saudi Arabia
[pdf]
[Abstract]

Mona Mohammed Alshahrani, Haifa' Hisham A. Alwabel, Hassan Dhafer Hassan Alabisi, Mohammed Abdullah Alshehri, Abdulaziz Mari Alqahtani, Anas Ali Asiri, Manar saeed Alqahtani
DOI: 10.5742/MEWFM.2022.95211

Quality of life for Cardiovascular Patients in Saudi Arabia
[pdf]
[Abstract]

Mohammed M.Mougrabi, Nouran K.Althumali, Raghad S.AL-juaid, Thekra M.Alsalmi, Ohoud D.Alotaibi, Waad S.Alzahrani, Najla J.Alkhaldi
DOI: 10.5742/MEWFM.2022.95214

Stress and a sedentary lifestyle are associated with irritable bowel syndrome in medical students from Saudi Arabia
[pdf]
[Abstract]

Amna Fadl Bashir Fadl, Asrar Mohammed Al-Towerqi, Arwa Abdullah Alharbi,
Danah kamal kabrah, Amwaj Abdulmohsen Almalki, Bashayer Nawar Algethami, Amal Mohammed Albogami
DOI: 10.5742/MEWFM.2022.95216

Physicians' Perceptions and Attitudes toward Use of Electronic Medical Record Systems in Riyadh
[pdf]
[Abstract]

Yasser H. Al Otaib,vMoteb M. AlSaedi
DOI: 10.5742/MEWFM.2022.95218

Job Related Burnout among Emergency Physicians and Nurses
in Dammam City, Saudi Arabia

[pdf]
[Abstract]

Abdulaziz F. Alshahrani, Abdullah M. Alhotheyfa, Salman Z. Alkhiraisy,
Hassan A. Abugad, Bander F. Alshahrani
DOI: 10.5742/MEWFM.2022.95219

Sleep Patterns and Academic Performance among Medicine and Pharm D students in Almaarefa University 2018-2019
[pdf]
[Abstract]

Mashel A. Alzunidi, Jawaher A. Alowayyid, Rabab A.Benhadi, Habiba H. Farouk, Malak H. Alshammari, Asmaa S.Sultan, Rana A.Almojil, Alanoud A.Alshathri, Noor N.Alsalman, Shahad S. Alshaya, Mona M. Alfadeel
DOI: 10.5742/MEWFM.2022.95223

Reviews

Nutrition and puberty
[pdf]
[Abstract]

Dima Naddeh, Alaa Salah AG AlSharei
DOI: 10.5742/MEWFM.2022.95221

Alzheimer's Dementia - A Narrative Review
[pdf]
[Abstract]

Nasir Alzbeidi, Hem Phaterpekar, Hamed Al-Sinawi
DOI: 10.5742/MEWFM.2022.95221

Clinical Research and Audits

Clinical Audit Report on Adherence to Imaging Guidelines for Patients with Acute Low Back Pain in Airport Health Centre
[pdf]
[Abstract]

Hanan Al-shamery, Wesam Abouamer, Neelufur Sulaiman
DOI: 10.5742/MEWFM.2022.95229

Case Report

A case of Erythroderma following Terbinafine therapy
[pdf]
[Abstract]

Rahma Yusuf Ali, Fatima Ali
DOI: 10.5742/MEWFM.2022.95230

Rare presentation of lower limb weakness, a case report
[pdf]
[Abstract]

Hamzeh Yousef khmour, Salma el Nour, Mansour Elmahdi
DOI: 10.5742/MEWFM.2022.95231

Original Clinical Research

Type 2 Diabetes Mellitus Control during COVID 19 Pandemic in Qatar 2020: A Retrospective Data Analysis
[pdf]
[Abstract]

Hamzeh Yousef Khmour, Yosaf Al-Rabeei, Nashwan Zainal Deen, Salma Elnour, Khalid Al-Karbi, Mostafa Hamdy Rashed, Muneera Al-Muhannadi, Mansour El-Mahdi, Hanan Al Shamari, Mustfa Abdelhamied abugesiesa, Ahmed Mahmoud Amer, Prem Chandra, Mohamed H. Mahmoud
DOI: 10.5742/MEWFM.2022.95233

Prevalence of Generalized Anxiety Disorder among Medical Residents in Hamad Medical Corporation in 2020
[pdf]
[Abstract]

Mohamed Hnish, Nashwan Zainal Deen, Salma Snoussi, Hind Mohamad, Mohamed Abdalla, Issameldin Abdelbagi
DOI: 10.5742/MEWFM.2022.95234

Contrast-Induced Nephropathy among adults after administration of intravenous material in the Emergency department at King Abdul-Aziz university hospital
[pdf]
[Abstract]

Abdullah Bakhsh, Samiyah Alsaedi, Afaf Alsaiari, Esraa Alzahrani, Latifah Kutbi, Bothainah Abed A Alsahafi, Ghoson ghonem alharbi, Mostafa Abdelsalam
DOI: 10.5742/MEWFM.2022.95235

Insulin Resistance Related to Metabolic Syndrome
[pdf]
[Abstract]

Hanan Taha AlShamery, Neelufur Sulaiman Sait
DOI: 10.5742/MEWFM.2022.95237

Middle East Quality Improvement Program
(MEQUIP QI&CPD)


Chief Editor -
Abdulrazak Abyad MD, MPH, MBA, AGSF, AFCHSE

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Publisher -
Lesley Pocock
medi+WORLD International
AUSTRALIA
Email
: lesleypocock@mediworld.com.au
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January 2022 - Volume 20, Issue 1

Rare presentation of lower limb weakness, a case report

Specialist Family Medicine, Qatar

Correspondence:
Dr. Hamzeh Yousef khmour, LPI
Specialist Family medicine,
Qatar
Tel: +974 33304316
Email: hkhmour@phcc.gov.qa, hkhmour@gmail.com

Received: November 2021; Accepted: December 2021; Published: January 1, 2022. Citation: Hamzeh Yousef khmour, Salma el Nour, Mansour Elmahdi. Rare presentation of lower limb weakness, a case report. World Family Medicine. 2022; 20(1): 173-175 DOI: 10.5742/MEWFM.2022.95231

Abstract

SUMMARY
This is a 53 year old male, who was previously healthy, and who presented to a primary care physician, complaining of from chronic back pain. He was seen multiple times with the same problem, which was treated as Myalgia with pain killers only. After a proper approach and investigation he was found to have ALS Amyotrophic lateral sclerosis.

BACKGROUND:
Lower limb weakness is a common problem in the primary care setting, with a multiple differential diagnosis. It is defined as loss of muscle strength[1]. The physician should firstly isolate and be sure that the complaint of patient is weakness of the muscle , mainly by investigating other causes that may mimic and overlap with the presentation; the famous and most common cause being fatigue[2]. History and physical examination in addition to investigation will assure that the physician will reach the proper diagnosis and management plan but before that knowing the mechanisms of weakness is the corner stone in approach[3,5], which includes[3,4]:

Upper motor neurons, Lower motor neurons, Neuromuscular junction, Muscle.

In the primary care setting and because of patient flow, usually common is common, which is exactly what happened to the patient, as he visited the center multiple time because of weakness and mild pain which did not attract the attention of the treating physicians to more serious and complicated disease[6,7].

Amyotrophic lateral sclerosis (ALS), commonly called Lou Gehrig’s disease, is a progressive neurodegenerative disease affecting both upper and lower motor neurons. ALS is a condition characterized by weakness, muscle wasting, fasciculations and increased reflexes[1,2]. The annual incidence rate is one to three cases per 100,000. The disease is mostly diagnosed in middle age and affects more men than women [5].

Over a period of months or years, patients with ALS develop severe, progressive muscular weakness and other symptoms caused by loss of function in both upper and lower motor neurons.

Mainly it presents with 2 major categories of symptoms: Upper motor neuron, Lower motor neuron [2].
In the patient’s case it was mainly lower motor neuron symptoms without any symptoms of upper motor which makes the presentation unique and confusing with other differential diagnoses.

ALS has a bad prognosis and limited options of treatment. Respiratory failure limits survival to 2-5 years after disease onset. RILUZOLE is the only drug that can affect prognosis [1,7,8,9].

Being rare, difficult to treat and with a bad prognosis, makes us want to share this case with our colleagues as the learning opportunity in this case makes it a valuable one for a case report.

Key words: lower limb weakness, case report







 


 

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