Does 6 hours of exercise a day lead to doms and fever?

New Case 7 yr old Female child , well immunized, developed fever with cough 3 weeks ago which was controlled by supportive measures and got resolved by 4 days.Following that the child was active and asymptomatic for the next 4 days.Later on while child was sleeping the mother noted to have deviation of angle of mouth to left side and was consulted in the hospital and was admitted for 14 days.During the hospital days she developed weakness of the limbs, difficulty in walking with difficulty in swallowing.During the hospital stay no bowel or bladder symptoms, no alteration in sensorium, no seizures, no blurring of vision Child was given antibiotics ceftriaxone, discharge on 28th April and suggested to consult higher centre for furtger management. On exam fully concious, slurring of speech ,normal optic fundi and pupils. left LMN facial weakness .Gaze evoked nystagmus on horizontal gaze, bilateral cerebellar signs with gait ataxia Diagnosis

### 13 years old girl... Can't walk...since 2 years... Has to be lifted for toilet...Growth is also not at par with her peers... Before 2 years she was absolutely fine...she used to go to school even... seems to be a case of poliomyelitis or GBS...how to approach this case ??? How to rule out poliomyelitis ??? What are the necessary investigations required in this case ???

12 yr old boy with progressive weakness in all four limb and dysarthia.

A 39 years old female had a history of slipped disc took physiotherapy for 10 days but then after that pain didint improve and went for surgery . after surgery came for rehabilitation program and did well for 1.5 months . suddenly she started having same pain again. on examination SLR is ok. There is tightness of hamstring and quads muscle. but pain is radiating down to the leg . Attached is the MRI report . what should be the treatment line ? @Dr_anuraag Jaiswal

Male/45 yr Came with complains of : 1. Cough with sputum - 2 months 2. Fever - 1 month 3. Chest pain - 1 month 4. Breathlessness- 1 month On examination : # a swelling is found on right lateral side of neck. 4-5 cm Which was hard , non tender , above the muscles , non pulsating and dont move with swallowing. Similar swelling is seen on left side of neck but 1-1.5 cm near angle of mandible. #The trache is deviated to left side. On percussion :- stony Dull notes are found in infrascapular and interscapular region. #Liver dullness is on 5th ICS There is h/o wt loss ,loss of appetite , muscle weakness. Pt is smoker ( 30 packs/yr) What can be Differential diagnosis..? How to manage ?