jyothsna 113

48year old male resident of kottapalle, nalgonda.came to the casualty with c/o 1episode of involuntary movements -bilateral upper limbs lasted for 10mins.(sparing lower limbs) Tonic seizures associated with tongue bite, froathing,uprolling of eyes. No involuntary micturition or defecation. Post ictal confusion lasted for 10 hours. No further episodes after that . Patient was apparently asymptomatic 4years back had h/o pedal oedema,sob (on and off ), aggrevated since 15 days . SOB -GRADE III-IV,NOT ASSOCIATED WITH ORTHOPNEA,PND ,GIDDINESS,SWEATING,SYNCOPE. PEDAL OEDEMA-GRADUAL ONSET, PROGRESSIVE TO ANASARCA. NO URINE OUTPUT SINCE ONE DAY . 2YEARS BACK HAD H/O TRAUMA CAUSED LEFT FEMUR FRACTURE WHICH WAS OPERATED . Walked with support since 2years. Diagnosed with kidney disease?CKD at the time of operation 2years back, asked to followup regularly which patient did not. DENOVO HYPERTENSIVE. PERSONAL HISTORY- HE USED TO WORK AS FARMER , DUE TO TRAUMA HAPPEND 2YRS AGO, STOPED WORKING. APPETI...

32 year old male came to the casualty with clo Pain abdomen in epigastim ,left hypochondrium Since 1 day. C/o vomiting since 1day (non-billious,non projectile) 2episodes , containing food-particles Passing flatus, constipation since 1day  morning Loss of appetite+ No c/o fever HISTORY OF PAST ILLNESS not a K/c/o DM HITN, epilepsy,asthma, CVA,CAD . PERSONAL HISTORY- Loss of appetite+,takes mixed diet ,bowel and bladder movements were regular . H/o alcohol consumption(beer) since 5yrs(2times a day) stopped 1 month back.  ON EXAMINATION- Patient  is conscious ,coherent ,co-operative  Temp-98f PR-90BPM RR-20CPM BP-100/70mmhg GRBS-266MG/DL Spo2-98@RA CVS-S1S2+ RS-BAE+,NVBS P/A-SOFT,NON TENDER,B/S+ CNS-NAD INVESTIGATIONS  HIV,HCV,HBsAg -negative Hemogram on 30/10/2021 DIAGNOSIS-   ACUTE PANCTREATITIS SECONDARY TO ALC...

40 year old male came to the casualty with c/o pain abdomen since 5days,a/w vomitings ,non bilious ,non projectile. HOPI- Patient was apparently asymptomatic 5days back then she developed pain abdomen -diffuse(more in lower abdomen ),burning type ,radiating to back , aggravated with food ,relieved with medication a/w h/o vomitings since 1day ,4to5  episodes ,watery non bilious ,non projectile,a/w intake of food . No h/o fever /constipation/loose stools /burning micturition/dysuria/trauma. Last passed stools 1day before ,passing flatus. No h/o previous abdominal surgeries. PERSONAL HISTORY- Loss of appetite+,takes mixed diet ,bowel and bladder movements were regular . H/o alcohol consumption since 20 years , cigarette smoking 5to6 /day since 20years . ON EXAMINATION- Patient  is conscious ,coherent ,co operative Temp-98f PR-77BPM RR-18CPM BP- 140/100 mmhg Spo2-98@RA CVS-S1S2+ RS-BAE+,NVBS+ P/A- Shape-flat,tenderness+ (diffuse),left hydrocele +. CNS-NAD INVEST...

A 58year old female resident of bhogramguri of westbengal came to casualty with chief complaints of headache since 20yrs which is intermittent,generalised (as well as feeling of burning sensation) relieved after taking tablets (if not taken tablets,it stays for 2-3days) ,associated with nausea sensation, Not associated with giddiness.   H/o generalised weakness since 12yrs PAST HISTORY: Not a K/c/o hypertension, DM, CAD, asthma, TB, epilepsy,CVA PERSONAL HISTORY: Patient has mixed diet with normal appetite and adequate sleep.  he has normal bowel movements and bladder filling.  addictions: betel nut chewing+ No significant family history GENERAL EXAMNATION: No pallor, icterus, cyanosis, clubbing, lymphadenopathy, pedal edema.  VITALS: BP: 120/80 MMHG,  PR: 76bpm  Temp: afebrile SPO2: 98%  Rr:18/min RS: BAE+,NVBS heard CVS: S1 ans S2 heard. No murmurs.  P/A: soft and non-tender CNS: No focal deformities.  ...

  A 68 year old male, resident of bengal, farmer by occupation came to the casuality last night with complaints of burning sensation in the epigastric region since 7 years relieved after medication, associated with loose stools ( after intake of spicy food), 5-6 episodes.  Patient also complaints of lower back pain since 10 years, for which he got treated with medication from local hospital. H/ o burning sensation in the lower abdomen since 1 year. No h/ o burning micturition, decreased urine output.  Not a k/c/o diabetes, hypertension, asthma, tuberculosis, epilepsy, CAD History of jaundice 50 years back, hospitalised and treated. History of appendicetomy 32 years back.  He is a chronic alcoholic, takes 80 ml/ day since 50 years, now stopped since 6-8 months. Chronic smokers, 1 pack per day since 25 years. Chews betel nuts since 50 years  He takes mixed diet, appetite normal, sleep adequate( sleeps for 6-7 hours a day), bladder habits regular.  On examinat...