Learning style is the composite of cognitive, affective, and physiological characteristics that serve as relatively stable indicators of how a learner perceives, interacts and responds to the learning environment. Felder – Solomon Index of Learning Style (ILS) includes Sensitive/Intuitive, Visual/Verbal and Sequential/ Global, Active/reflective. The learning strategies are a major indicator of exam performance of students.Objective:  To find the association between academiclearning strategies and annual examination results among medical students of King Edward Medical University.Study Design:  Cross – sectional study design.Study Setting and Duration:  King Edward Medical University and 3 months.Materials and Methods:  The study was conducted among the 3rd, 4th, and 5th year medical students of KEMU Lahore. Informed consent was taken. A total of 300 students, 100 each from 3rd, 4th and 5th year were taken. 132 males (44%) and 168 females (56%) were part of the study. Simple Random sampling (non-pro-bability sampling) was used.Results:  The overall dominant learning strategies among students of King Edward Medical University were sensing/SNS (64.3%), visual/VIS (80.7%), sequential/SEQ (63.7%) and Active/ACT (50.3%). Chi squared test for individual learning combinations against achiever types showed no significant association between academic learning strategies and annual exam performance (p value > 0.05). Results also showed that females performed better academically than their male counterparts.

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Ixodes scapularis is responsible for transmission of Borrelia burgdorferi, B. miyamotoi, Babesia microti, Anaplasma phagocytophilum and Powassan virus to humans. We present a case of an 87-year-old man who presented with fever and altered mental status. Initial workup revealed haemolytic anaemia, thrombocytopenia, mild hepatitis and acute kidney injury. Patient tested positive for B. burgdorferi and Babesia microti, and was started on doxycycline, atovaquone and azithromycin. He also underwent exchange transfusion twice. After some initial improvement, patient had acute deterioration of mental status and appearance of neurological findings like myoclonus and tremors. Therefore, testing for arboviruses was done and results were positive for Powassan virus. During a protracted course of hospitalisation, patient required intubation for respiratory failure and temporary pacemaker for unstable arrythmias from Lyme carditis. Patient developed permanent neurological deficits even after recovery from the acute illness.

Calciphylaxis is commonly associated with end-stage renal disease (ESRD) and renal transplant. We present a rare case of early onset calciphylaxis in a patient presenting with acute kidney injury (AKI) secondary to anti-glomerular basement membrane (anti-GBM) antibody disease. A 65-year-old obese Caucasian woman with type 2 diabetes mellitus and hypertension presented with a 1-month history of painless gross haematuria and worsening lower extremity oedema. Laboratory results indicated AKI and nephrotic-range proteinuria. Anti-glomerular antibodies were elevated. Renal biopsy revealed focal crescentic glomerulonephritis with linear capillary immunoglobulin G staining consistent with anti-GBM antibody disease. She was treated with haemodialysis, plasmapheresis, steroids, bumetanide and cyclophosphamide. Two months later, she developed necrotic lesions on bilateral thighs. Wound biopsy was consistent with calciphylaxis. This case highlights that calciphylaxis, usually seen in patients with chronic kidney disease or ESRD, can manifest in patients with AKI as well.

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