25M muscular dystrophy
25 year Old student ,resident of annareddy gudem is brought to the opd with cheif complaints of Cough since 1 month Fever since 1 month Patient was apparently asymptomatic 1 month back then he developed Cough Duration 1month Onset insidious, Occasional - 5-6 bouts /day Non productive Non barking type Non paroxysmal cough Associated with fever No post tussive vomiting Fever- Low grade , intermittent, not associated with chills and rigors, No diurnal variation Not associated with burning micturition, loose stools,vomiting ,pain abdomen Past history- 2009-10‐-> Patient developed weakness of lower limbs, difficulty in walking Was taken to private hospital for the same Weakness of the limbs-- Insidious onset, gradually progressive, paresis Weakness begun in the lower limbs gradually progressed to upper limbs over 4- 5 months Weakness distal to proximal progression With tipping of tors, slippage of chappals Later patient developed difficulty in getting up from sqatting and diffi