Dr Raga Deepika Chakravarthula

 PAPAIAH 70/M  C/O DIFFICULTY IN WALKING SINCE 3 WEEKS POOR STREAM OF URINE SINCE 3 WEEKS BURNING MICTURITION AND FEVER SINCE 2 WEEKS HISTORY OF PRESENTING ILLNESS PATIENT WAS APPARENTLY ASYMPTOMATIC 1 YEAR BACK AFTER WHICH HE HAD DEVELOPED SUDDEN ONSET WEAKNESS OF LEFT HAND AND LEG WITH UNCONTROLLED BLOOD PRESSURE AND WAS DIAGNOSED WITH CVA AND TREATED. FROM THE HE GRADUALLY STARTED WALKING WITH THE HELP OF A WALKER .NOW SINCE 2 WEEKS PATIENT AGAIN STARTED DEVELOPING LEFT SIDED WEAKNESS WITH DIFFICULTY IN GETTING UP AND WALKING HE ALSO HAD DECREASED URINE OUTPUT , RIGHT LOIN PAIN WITH BURNING MICTURITION FOR WHICH HE WAS INVESTIGATED AND FOUND TO HAVE RIGHT URETERIC CALICULI CAUSING SEVERE HYDROURETRONEPHROSIS HISTORY OF FEVER ON AND OFF FOR WHICH HE IS ON IREEGULAR MEDICATION SINCE 2 MONTHS PAST HISTORY - K/C/O HTN SINCE 1 YEAR( ON IRREGULAR MEDICATION) N/K/C/O DM, SEIZURE DISORDER ,TB,ASTHMA, PERSONAL- DIET MIXED DECREASED APPETITE CHRONIC SMOKER AND  OCCASIONAL ALCOHO...

N ANJAIAH Case History and Clinical Findings C/O WEAKNESS OF LEFT UPPER AND LOWER LIMB , DEVIATION OF MOUTH TO RIGHT SIDE SINCE MORNING SLURRING OF SPEECH PRESENT SINCE MORNING HOPI: PATIENT WAS APPARENTLY ALRIGHT TILL TODATY MORNING ,THEN HE DEVOLOPED WEAKNESS OF LEFT UPPER AND LOWER LIMB,INSIDIOUS IN ONSET ,GRADUALLY PROGRESSIVE ASSOCIATED WITH DEVIATION OF MOUTH TO RIGHT SIDE,SLURRING OF SPEECH PRESENT SINCE MORNING NO H/O TRAUMA HEAD ,NAUSEA ,VOMITING , SCIZURES ,GIDDINESS NO H/O FEVER,COLD ,COUGH NO H/O CHEST PAIN,PALPITATIONS ,PND,ORTHOPNEA,BREATHLESSNESS NO H/O ABDOMINAL PAIN,BURNING MICTURITION , PAST H/O : K/C/O HTN ON T METXL 75MG PO.OD SINCE 3 YRS K/C/O CVA LEFT HEMIPARESIS 10 YRS BACK GENERAL EXAMINATION : PT IS CONCIOUS , COHERENT AND COOPERATIVE , MODERATLY BUILT AND NOURISHED . NO PALLOR, ICTERUS , CYANOSIS, CLUBBING ,LYMPHADENOPATHY, EDEMA TEMP - AFEBRILE PR- 60 BPM RR-19 CPM BP- 130/80 MMHG GRBS -123MG /DL SYSTEMIC EXAMINATION : CVS - S1,S2 HEARD , NO MURMURS RS - VESI...

 NAGENDRAMMA CHIEF COMPLAINTS :  PATIENT CAME WITH CHIEF COMPLAINTS OF LOSS OF SPEECH SINCE 3 DAYS. HISTORY OF PRESENTING ILLNESS :  PATIENT WAS APPARENTLY ASYMPTOMATIC 3 DAYS THEN SHE DEVELOPED LOSS OF SPEECH AND DIFFICULTY IN SWALLOWING , WHILE OBEYING COMMANDS. PATIENT HAD SIMILAR COMPLAINTS IN PAST 2 MONTHS AGO WITH RIGHT UPPER LIMB PLEGIA WITH SWALLOWING DIFFICULTY AND LOSS OF SPEECH FOR WHICH SHE WAS TAKEN TO LOCAL HOSPITAL AND WAS DIAGNOSED AS ISCHEMIC CVA (CHRONIC INFARCTION IN RIGHT HIGH FRONTOTEMPORAL REGION). NO C/O FEVER, VOMITIMG, HEADACHE, LOOSE STOOLS, BURNING MICTURITION. NO C/O CHEST PAIN,PALPITATIONS,SOB. PAST HISTORY: K/C/O HYPERTENSION SINCE 4YEARS (ON TAB TELMA 40 MG PO/OD). NOT A K/C/O DM,CAD,CVA,EPILEPSY,TB,ASTHMA. PERSONAL HISTORY: DIET: MIXED  SLEEP: ADEQUATE BOWEL AND BLADDER MOVEMENTS: NORMAL ALCOHOL: NO SMOKING: REGULAR SMOKER SINCE 35 YEARS AROUND 1 CHUTTA PACKET/DAY. LAST SMOKE WAS 1 WEEK AGO GENERAL EXAMINATION: THE PATIENT IS CONSCIOUS...

  chief complaints- C/O RIGHT UPPER AND LOWER WEAKNESS SINCE MORNING ON 16/04/24 AND SLURRING OF SPEECH SINCE MORNING ON 16/04/24 HOPI: PT WAS APPARENTLY ASYMPTOMATIC 1 DAY BACK THEN HE DEVELOPED RIGHT UPPER LIMB AND L0WER LIMB WEAKNESS SINCE MORNING ON 16/04/24 . SUDDEN ONSET NOT A/W INVOLUNTARY MOVEMENTS ,NO FROTHING FROM MOUTH, INVOLUNTARY MICTURITION,INVOLUNTARY DEFECATION C/O, SLURRING OF SPEECH SINCE MORNING ON 16/04/24 AND DEVIATION OF MOUTH TO LEFT SIDE NO H/O FEVER COUGH,COLD, ALLERGIES NO H/O ABDOMINAL PAIN, NAUSEA, VOMITING,LOOSE STOOLS. NO H/O CHEST PAIN PALPITATIONS,SOB,SWEATING NO H/O PEDAL EDEMA,DECREASED URINE OUTPUT K/C/O HTN SINCE 25 YRS AND IS ON TAB.AMLODIPINE 5 MG+TAB.TELMISARTAN 40 MG+TAB.HYDROCHLORTHIAZIDE 12.5MG OD K/C/O BRONCHIAL ASTHMA SINCE 25 YRS AND IS ON INHALER FORMONIDE 1 PUFF [SOS] PAST HISTORY N/K/C/O TB,DM2,EPILEPSY,CVD,CAD ON EXAMINATION: PT IS CONSCIOUS,COHERENT,COOPERATIVE NO PALLOR ,ICTERUS,CYANOSIS,CLUBBING,LYMPHADENOPATHY,PEDAL EDEMA TEMP: A...

57 year old female gardener resides near Sanghi ( hayathnagar) Presented with C/o fever since 3 days, high grade, continuous, with chills, relieved with medication,  pain in epigastrium since 3days, non radiating, not associated with burning, belching, associated with  one episode of vomiting, with food content, non bilious, non projectile, non blood stain No h/o chest pain, breathlessness, giddiness, palpitations, orthopnea,pnd,cough, cold, burning micturition, loose stools She's second born child ,whose father was toddy tree climber and has daily habit of consumption of toddy. She was made to start toddy consumption at very young age of 4-5years considering it to be good for health And consumes daily 1glass of toddy thrice everyday for 15 years  Works as farmer from age of 22 years at chittaluru near chitiyal ,Married and moved to hyderabad near seethaphalmandi. Stopped consuming toddy after marriage  And stopped working for some time after her marriage. At age of...

 LAKYA Case History and Clinical Findings C/O SLURRING OF SPEECH SINCE 10 DAYS DIMINISION OF VISION VISION SINCE 10 DAYS HOPI: PT WAS APPARENTLY ASYMPTOMATIC 10 DAYS BACK THEN HE DEVELOPED SUDDEN ONSET OF SLURRING OF SPEECH, NO H/O DEVIATION OF MOUTH H/O DIMINISION OF VISION , SUDDEN IN ONSET NO H/O WEAKNESS OF LIMBS, INVOLUNTARY MOVEMENTS H/O 1 EPISODE OF GIDDINESS 10 DAYS BACK AFTER WHICH THESE SYMPTOMS STARTED. NO H/O LOC, BITING OF TONGUE, INVOLUNTARY PASSAGE OF STOOLS, URINE NO H/O NAUSEA, VOMITING, HEADACHE. PAST HISTORY: K/C/O CVA 6 YEARS BACK, USED MEDICATION FOR 2 MONTHS(ECOSPRIN AV) N/K/C/O HTN DM CAD SEIZURES THYROID DISORDERS. SURGERIES- NEPHROLITHIASIS 20 YEARS BACK ON EXAMINATION: PATIENT IS CONSCIOUS COHERENT AND COOPERATIVE CLUBBING + NO PALLOR, CYANOSIS, ICTERUS, LYMPHADENOPATHY, PEDAL EDEMA TEMP 100.8F PR 90BPM RR 18CPM SPO2 96% BP 110/70MM HG CNS- GCS:E4V4M6 HMF -COULDNT BE ELICITED SPEECH - PUPILS: ANISOCORIA RT LT POWER : UL 5/5 5/5 LL 5/5 5/5 TONE: UL N N LL: ...

 SOKKAM CHIEF COMPLAINTS: PATIENT WAS BROUGHT WITH COMPLAINTS OF FEVER SINCE 3 DAYS AND WEAKNESS OF RIGHT UPPER LIMB AND LOWER LIMB SINCE 31/08/23 AFTERNOON 3PM. HOPI: PATIENT WAS APPARENTLY ASYMPTOMATIC 3 DAYS AGO.HE THEN DEVELOPED FEVER OF HIGH GRADE WITH CHILLS AND RIGOR ,RELIEVED WITH MEDICATION.NO DIURNAL OR SEASONAL VARIATION.HE THEN DEVELOPED WEAKNESS AND UNABLE TO MOVE RIGHT UPPER LIMB AND LOWER LIMB SINCE 6 HOURS SUDDEN ONSET,WHILE TAKING BATH,N/H/O FALL,H/O ?LOSS OF CONSCIOUSNESS FOR 5 MINUTES N/H/O INVOLUNTARY MOVEMENTS IN BILATERAL UPPER AND LOWER LIMB,UPROLLING OF EYEBALL,TONGUE BITE N/H/O BLURRING OF VISION DEVIATION OF ANGLE OF MOUTH TO HIS LEFT SIDE SLURRING OF SPEECH PRESENT LAST BINGE OF ALCOHOL 2 DAYS AGO PAST HISTORY: N/H/O COUGH,BURNING MICTURITION,SOB,PALPITATIONS,PEDAL EDEMA N/K/C/O HTN/DM/CAD N/H/O VOMITINGS,LOOSE STOOLS,PAIN ABDOMEN PERSONAL HISTORY: DIET: MIXED  SLEEP: ADEQUATE BOWEL AND BLADDER MOVEMENTS: NORMAL ALCOHOL: REGULAR DRINKER SINCE 25 YEAR...

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE - IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS / HER /GUARDIAN'S SIGNED INFORMED CONSENT .HERE WE DISCUSS OUR INDIVIDUAL PATIENT'S PROBLEMS THROUGH SERIES OF INPUTS FROM AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS WITH AN AIM TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUT  Blog of her previous admission-  https://venkata-phaneendra.blogspot.com/2022/02/13-yr-f-with-sickle-cell-crisis.html History - patient was apparently asymptomatic until 4 years of age  Then she developed fever, pain abdomen and was taken to nilofur hospital where patient was investigated and was diagnosed to have sickle cell anemia  Since then she's been up for the Followup  Her admissions previously for bronchopneumonia in the initial years with frequency of 2-3 times per year  Patient was taken to the thalassemia and sickle cell anaemia society and was having blood transfusions s...

It's our day 1 in the residency programme to attend the district residency in nagarjunasagar It started with zero expectation towards it With the questions popping my head , How will I matter? Will I be able to make difference to the people here? Will I change ? With no answers to these questions the journey of residency begun! Hoping the journey unveils it's own beauty and answers to these questions! This blog is journey dwelling these questions ! Day1 As the day begun started our journey to the nagarjuna sagar  Lovely weather and people with warm welcoming hearts showered us purest forms of love  Innocence and warmth of the people made me realise the value of communication  As the day passed with few opd  Cases dealt with no boundaries to the subject /system but the person as a whole No limitations to the branch or system!  Evening walk on the roads of sagar dam  With beautiful panoramic view of the nature made me realise the value of peace   E...

Being a resident in a tertiary center is like a blessing in disguise with lots of learning opportunities and a wide range of patients to work with from admission until discharge. This is a compilation of a few such cases that aroused my interest in the field of neuroscience.  I've penned down a few experiences during my residency in the Department of General Medicine. One case involved a 45-year-old male in the outpatient department. He had jerking movements in his arms and legs, and his sister, who was sitting beside him, had similar movements with less intensity.  This made me wonder about the microscopic structures called neurons that control these visible movements, which are under the control of genetic material within cells.  Further investigation revealed a family history of similar complaints, suggesting an autosomal dominant mode of inheritance.  After conducting a thorough clinical examination, history, and pedigree chart, we discovered that there was a fam...

Mortality meeting lingaiah Cdm Cme Cdm prashanth Mortality meet anjiaiah Mortality meet Chandraiah Cdm nithya Shock central meet Cdm kamalamma Central meet dm+htn Mortality yadappa Mortality venkanna    Mortality seemaiah Central meet - thesis

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 diff...

55 year old male cattle rearer by occupation was brought to the casualty with complaints of Inability to move left sided upper and lower limb since 6 days Inability to speak since morning Patient was apparently asymptomatic 6 days back then he developed weakness of left upper and lowerlimb after waking up from sleep For which he was taken to hospital and diagnosed to have multiple infarcts in.......areas and was treated for the same  During the stay patient developed ? episodes of seizure Lasted for 10 min , ?focal , post ictal confusion for 15min  Later patient was discharged  Yesterday night patient had an episode of seizure , focal tonic clonic involving left upperlimb for 5minutes , gained consciousness after 10 minutes  Later patient was unable to speak Patient was brought to the hospital  Past- K/C/O Dm since 5 years (under irregular medication) Had left index finger amputated( ? Due to diabetes) Personal-

NOTE: THIS IS AN ONLINE E LOGBOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS/HER GUARDIAN'S SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR INDIVIDUAL PATIENT'S PROBLEMS THROUGH A SERIES OF INPUTS FROM THE AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS INTENDING TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE-BASED INPUT 65/m farmer Dupalli Yadadri district farmer since 45 years was brought to the casualty with complaints of vomiting since 2 months, weakness of lower limb since 1week and difficulty in walking since 1 week 2012--> pain , deformity of right knee(? Chickungunya) 2019 --> episode of giddiness while working in the farm  Went to pvt practioner and diagnosed to have HTN and started the patient on Amlodipine 5mg  ( no loc,fall, syncope, chestpain, weakness of limbs, Involuntary movements) Similar episode an year later while working in the farm  ( Which attenders attributed to patient not having e...