95 P Charitha

 A 18yr old male patient presented to the Opd with chief complaints of purple stretch marks all over abdomen, lower back, b/l lower limbs, b/l upper limbs since 2 years No itching, burning sensation, pain History of presenting illness Patient was apparently asymptomatic 2 and 1/2 years ago then he developed round annular itchy lesions on lower back which spread all over the abdomen, groin, b/l upper limbs, b/l lower limbs for which he visited local doctor where he prescribed ayurvedic medication, ointment and tablets (unknown composition).  Patient used the medication for 2 months the lesions reduced a bit Later 2 months the patient got multiple hyperpigmented plaques all over abdomen,lower back, b/l upper limbs, b/l lower limbs associated with dizziness, tiredness, inadequate sleep, increased weight of 30kgs for which he again visited the same doctor who prescribed ayurvedic oil and CLOBETASOL ointment for the lesions for 1yr History of past illness  N/c/o DM HTN CAD ASTHMA TB epileps

 A 38yr old male patient presented to the Opd with chief complaints of 2 episodes of involuntary movements since 1 week History of presenting illness  Patient was apparently asymptomatic 1 week back he developed involuntary movements during sleep lasting for 15 minutes involving whole body which resolved spontaneously which was noticed by his mother  Not associated with loss of consciousness up rolling of eyes frothing micturition defecation  History of past illness  K/c/o type 2 DM on medication insulin Cataract surgery  Personal history  Normal appetite  Mixed diet Normal bowel and bladder movements  Adequate sleep Occasional toddy drinker Family history  DM and HTN - mother  General examination  No Pallor icterus cyanosis clubbing pedal edema lympadenopathy Systemic examination  CVS system No thrills Cardiac sounds are heard No cardiac murmurs Respiratory system No dyspnoea  No wheeze Trachea is centrally positioned  Vesicular breath sounds Abdomen  Scaphoid shape abdomen  No tender

 A 50 Yr old male patient presented to the Opd with chief complaints of Bleeding from mouth since 1 day Fever Generalized weakness since 4 days Headache neck pain since 20 days History of presenting illness Patient was apparently asymptomatic 20 days back he developed headache dragging type of pain Fever and Generalized weakness since 4 days not associated with chills and rigors  Bleeding from mouth since 1 day morning History of past illness K/c/o HTN since 5 months and under medication  Not k/c/o DM ASTHMA CAD Personal history  Mixed diet Normal appetite  Adequate sleep Normal bowel and bladder movements  Chronic smoker since 15 years 2-3 cigarettes per day Vitals Pluse 84bpm Bp 140/90mmhg General examination  No Pallor icterus cyanosis lymphadenopathy Systematic examination 

 A 76 year old male farmer by occupation known case of metastatic adenocarcinoma lung stage 4 and bilateral lung nodules thymoma status post thoracotomy and excision came to Opd for blood transfusion for anemia due to chemotherapy History of presenting illness  Patient was apparently asymptomatic 9 years back he developed cough for which he went to hospital and got diagnosed with adenocarcinoma of lung for which he took 4 sessions of chemotherapy  8 months back he developed shortness of breath in view of covid he got HRCT in which the nodule was again visible following which he was put on chemotherapy  History of past illness  Know case of metastatic adenocarcinoma lung stage 4 and bilateral lung nodules thymoma Not a k/c/o DM HTN CAD ASTHMA Treatment history  Chemotherapy  Surgery - thoracotomy and excision  History of blood transfusion  Personal history  Mixed diet Normal appetite  Adequate sleep Normal bowel and bladder movements No addictions Family history  Not significant  Genera

Date of admission 07-09-2001  A 40yr old female presented to the Opd with chief complaints of Fever since Sunday  afternoon low grade intermittent not associated with chills and rigors on exertion cough Generalized weakness for a day Nausea since 3 days  Loose stools for a day Decreased food intake since 3 days History of presenting illness Patient was apparently asymptomatic 1 week back on Sunday afternoon she developed low grade fever associated with Generalized weakness went for consultation to local hospital on Monday investigation revealed hypotension and started on iv fluids and discharged She had Nausea which caused decreased food intake  History of loose stools for 4-5 episodes watery foul smelling non mucoid non bloody not associated with abdominal pain Cough since 4 days productive whitish scanty No myalgia joint pain retro orbital pain chest pain bleeding and burning micturition  Past history No DM HTN CAD ASTHMA TB  no blood transfusion  Surgery history  Total abdominal hys

Case link : https://aitharaveena.blogspot.com/2022/09/year-old-male-with-1fever-since-15-days.html A 70 year old male presented to the opd with chief complaints of fever since 15 day, generalised weakness and body pains  in bilateral lower limbs since 10  days HOPI Pt was apparently asymptomatic 15 days back then had fever which high grade more during night time associated with chills and rigors it is intermittent not associated with cold , cough, vomitings, loose motions, abdominal pain, burning micturition , no h/o rash, hematuria, bleeding from gums For which he was taken to local rmp and  got treated for the same and diagnosed typhoid fever and reports from outside showing platelets of 85,000 Then he had generalised body weakness and  pains in bilateral lower limbs and lower back ache since 3days. Pt is unable to walk or stand without support. DAILY ROUTINE He wakes up at morning 6 does his daily routine and takes rice at 8:00-9:00am goes to work ( farmer)  and takes food at 1:00pm