Sri Nithya

 70 year old male came with the chief complaints of chest pain ,cough,sob since 8-10 days Fever since 1 week Hopi- Patient was apparently asymptomatic 8 days back then he developed cough- Dey,insidious in onset and gradually progressive,diurnal variations present more during night. No seasonal variations. No aggravating or relieving factors. Chest pain left sided non radiating not associated with excessive sweating, palpitations,pedal edema,giddiness Sob since 8 days insidious in onset and gradually progressive,progressed from grade 1 to grade 3 . No orthopnea,no PND No seasonal variation,no diurnal variation. Fever since 1 week ,high grade associated with chills and rigors, Evening rise of temperature present, loss of weight present, loss of appetite present No h/o vomiting,losing stools,pain abdomen. Past h/o-  K/c/o HTN since 2 years K/c/o DM since 6 months Not a k/c/oNot a k/c/o asthma , tb , epilepsy and thyroid disorders  Surgical history - ?patient underwent explor...

M. Sri Nithya Roll. No-86  Patient came with the complaints of  sob since 1 day,  Decreased urine output since 1 day Altered sensorium since 2 hrs B/l Pedal edema on and off since 1 year Hopi- Patient was apparently asymptomatic 1 yr back then he developed b/l pedal edema , on and off  and was on conservative management. Since then, he was diagnosed with hypertension using tab. Telmisartan 40 mg since 1 year. Since yesterday night patient is having is having sob grade 3 to grade 4,which is sudden in onset and gradually progressive, associated with PND, not associated with chest pain or sweating. No c/o fever, vomitings or loose motions . Past history - Not a k/c/o DM, tb , asthma , epilepsy, thyroid disorders, cad or CVD. History of alcohol and smoking present since 25 years Family History There is no significant family history On examination- There is no pallor, icterus, cyanosis, clubbing, lymphadenopathy B/l pedal edema present, pitting type extending up to the kn...

 M. Sri Nithya  Roll. No 86 Patient came with the complaints of shortness of breath since 15 days B/ l pedal edema  and facial puffiness since 3 days Burning micturition and decreased urine output since 2 days Patient was apparently asymptomatic  5 months ago then he developed shortness of breath and visited local doctor and took treatment and then it subsided. Now patient presented with shortness of breath since 15 days, insidious in onset and gradually progressive from grade 1 to grade 3. Orthopnea present, no PND No h/o chest pain, palpitations , excessive sweating, giddiness, vomiting. B/l pedal edema,pitting type, extending up to the knee joint present and facial puffiness present since 3 days Burning micturition and decreased urine output since 2 days No h/o fever, cough, cold, vomitings or loose motions K/c/ o type 2 diabetes mellitus since 6 years on tablet metformin 500 mg po/od K/c/o HTN since 8 years on tablet metoprolol 0.25 mg po/od H/o CVA 8 years ago ?...

  M. Sri Nithya Roll. No-86 Unit-2 70 year old female was brought to the casualty with complaints of slurring of speech in morning for 15 minutes at 8am following which patient returned to normal  No loc, seizure like activity, drooling of saliva,deviation of mouth ,no weakness of limbs, No H/O Fever; Headache; Giddiness No H/O Chest pain; orthopnea; sweating, palpitations;, PND. No H/O Burning Micturition No H/O loose stools; Nausea, Vomiting Was treated by local practioner with unknown medications Patient continued her daily routine cooking,eating At around 7pm patient developed similar episode lasting for 15 minutes Was taken to Mothkur for treatment and was given clopidogrel a ,neurobion  ( no investigations were done) On the way back to the home , patient developed deviation of mouth ,uprolling of eyeballs, dif haficulty in moving lower limbs with decreased responsiveness Brought to our hospital for further management  Daily wage labourer ( agriculture) Stopped ...

 M. Sri Nithya Roll. No -86 Unit-2 Chief compliants A 65 yr old female patient came to casualty with complaints of involuntary movements of Lt upper limb since 1 day  Cough since 4 days  HOPI  Pt was apparently asymptomatic 1 week ago then she developed generalised weakness , fell down from bed and complaints of pain in the hip  Involuntary movements of lt upper limb since 1 day to and fro  No history of speech abnormalities , weakness in the upper limb and lower limb . No H/o memory loss and abnormal posturing . Complaints of cough since 4 days ,it is productive scanty sputum - white to yellow ,non blood stained and non foul smelling  H/o inadequate controls of sugars from 4 months  N/H/o vomiting ,sob,loose stools ,pain abdomen K/c/o type 2 DM since 30 yrs on infusion since 10 yrs  ( Insulin - lispro 20-x-20 ) K/c/o HTN from 20 yrs on T prolomet - xl 50 mg  T. Atenolol 25 mg po/ od at 10 am K/c/o hypothyroidism from 15 yrs on thyr...