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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">JPSIM</journal-id>
      <journal-title-group>
        <journal-title>Journal of Pakistan Society of Internal Medicine</journal-title>
        <abbrev-title>J Pak Soc Intern Med</abbrev-title>
      </journal-title-group>
      <issn publication-format="print">2709-8729</issn>
      <issn publication-format="electronic">2710-0804</issn>
      <publisher>
        <publisher-name>Pakistan Society of Internal Medicine</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.70302/jpsim.v3i3.2250</article-id>
      <article-id pub-id-type="publisher-id">jpsim.v3i3.2250</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Case Report</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Dancing Movements Due to Endocrine Deficiencies: A Case Report</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author" corresp="yes">
          <name>
            <surname>Haroon</surname>
            <given-names>Maryam</given-names>
          </name>
          <email>ezamaryam911@gmail.com</email>
          <xref ref-type="aff" rid="aff1"/>
          <xref ref-type="corresp" rid="cor1">*</xref>
        </contrib>
      </contrib-group>
      <aff id="aff1">
        <institution>Postgraduate Resident, Services Hospital Lahore</institution>
      </aff>
      <author-notes>
        <corresp id="cor1">*Correspondence: Maryam Haroon (ezamaryam911@gmail.com)</corresp>
      </author-notes>
      <pub-date date-type="pub" publication-format="electronic" iso-8601-date="2022-09-12">
        <day>12</day>
        <month>09</month>
        <year>2022</year>
      </pub-date>
      <pub-date date-type="collection" publication-format="electronic">
        <year>2022</year>
      </pub-date>
      <volume>3</volume>
      <issue>3</issue>
      <fpage>250</fpage>
      <lpage>252</lpage>
      <history>
        <date date-type="received" iso-8601-date="2022-03-25">
          <day>25</day>
          <month>03</month>
          <year>2022</year>
        </date>
        <date date-type="accepted" iso-8601-date="2022-07-23">
          <day>23</day>
          <month>07</month>
          <year>2022</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>Copyright © 2022 The Author(s)</copyright-statement>
        <copyright-year>2022</copyright-year>
        <copyright-holder>The Author(s)</copyright-holder>
        <ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/>
        <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/">
          <ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0/</ali:license_ref>
          <license-p>This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
        </license>
      </permissions>
      <self-uri xlink:href="https://psimj.com/article/jpsim.v3i3.2250" content-type="text/html"/>
      <self-uri xlink:href="https://psimj.com/article/jpsim.v3i3.2250.pdf" content-type="application/pdf"/>
      <abstract>
        <p>Choreiform-ballistic movements have often been associated with lesions in basal ganglia and sub-thalamic nucleus. For a patient with dancing movements, hyperglycemia might be an initial presentation. We report a rare case of 19 years old Asian girl who had type I diabetes mellitus and Developed choreiform-ballistic type movements. She had ketoacidosis secondary to uncontrolled hyperglycemia along with hypocalcaemia secondary to either pseudo hypoparathyroidism??? On CT brain plain basal ganglia were heavily calcified. We optimized her diabetes management along with calcium and vitamin D analogues (calcitriol or alfacalcidol) and her symptoms got improved dramatically without using any specific antidopaminergic therapy or nerve stabilisers. Adults with mixed endocrine deficiencies can present with unique symptoms like choreiform-ballistic type movements that can be improved with exogenous administration/replacement of deficient harmones' analogues like in above mentioned case with insulin as well as calcium and vitamin D analogues supplementation.</p>
      </abstract>
      <kwd-group xml:lang="en" kwd-group-type="author-keywords">
        <title>Keywords</title>
        <kwd>Choreiform movements</kwd>
        <kwd>intact parathormone level (iPTH)</kwd>
        <kwd>ballistic movements</kwd>
        <kwd>pseudo hypopara-thyroidism</kwd>
        <kwd>type I diabetes mellitus</kwd>
        <kwd>basal ganglia</kwd>
        <kwd>sub-thalamus nuclei</kwd>
        <kwd>caudate and lenticular</kwd>
        <kwd>exogenous.</kwd>
      </kwd-group>
    </article-meta>
  </front>
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  <back>
    <ref-list>
      <title>References</title>
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</article>
