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Stroke is one of the most important and prevalent causes of morbidity and mortality around the world, with the most common site of vascular lesions being the frontal lobe. Usually, strokes present with motor or speech abnormalities. Depression or other psychiatric disturbances being the sole presenting feature of a stroke is a rare occurrence. Sudden onset of behavioral disturbances should alert the physician to investigate the patient for an underlying cause of his/her disorder. We present the case of a 65-year-old diabetic male who presented with sudden low mood and apathy that caused him severe socio-economic losses. He was initially diagnosed with depressive disorder but failed to respond to treatment. He was investigated, and a computed tomography (CT) scan of the brain led to the correct diagnosis, an old left frontal infarct. In patients with behavioral disorders, which are sudden in onset or not responding to treatment, secondary causes should always be considered.

Background: Dysphagia is a symptom of an underlying disease with a variety of conditions linked to it. Therefore, its early evaluation is of prime importance. The objective of this study was to present the endoscopic findings in patients presenting with dysphagia. Material and Methods: After ethical approval, a retrospective observational study using non-probability convenient sampling technique was carried out at the Department of Medicine, Hamdard University Hospital, Karachi for a period of 1 year from 01-07-2018 to 30-06-2019. From a sample of 400 patients, 232 were selected who were above 25 years of age and presented with dysphagia. Pregnant mothers, patients previously diagnosed with GI malignancy, patients with a neurological cause of dysphagia or with normal upper GI endoscopy within last 3 months were excluded. SPSS version 20.0 was used for data analysis. Frequency and percentages of the categorical variables such as gender and the common GI Endoscopic findings were reported. Results: Apart from dysphagia, 8.2% of patients complained of abdominal pain, 6.5% of dyspepsia and 4.3% of weight loss. Of all the endoscopies performed, 6.5% were normal, 65.4% revealed oesophageal pathologies, 25% gastric and 2.6% duodenal pathologies. Of those with abnormal endoscopies, the most common diseases were oesophageal mass lesion (28.4%), gastritis (22.8%), oesophagitis (12.9%), oesophageal motility disorders (8.2%) and oesophageal structural disorders (8.2%). Conclusion: Apart from normal endoscopies, oesophageal disorders were most frequently found on endoscopy of patients who presented with dysphagia. Oesophageal mass lesions were the most common finding followed by gastritis.