Dr Raga Deepika Chakravarthula

75 year old male shopkeeper by occupation presented to the casuality with Altered sensorium History of 4 episodes of seizures since morning 4 am  Each episode lasting for a period of 5 minutes  Seizures- involving left upper limb and lower limb tonic clonic type associated with facial deviation and frothing not associated with urinary incontinence and tongue bite Patient was apparently asymptomatic 6 months back  Then patient developed tingling sensations of left upper and lower limb and was taken to local practioner and given unknown medications  Later patient was unable to move his left lowerlimb ,was Intitally able to move lt ul which then progressed to Inability to move lt ul and was taken to neurologist and was diagnosed as CVA  Ct brain done showing acute infarct in Rt frontal cortex Patient found to have GRBS 480 mg/dl and started on GlimiM2 twice daily During hospital stay patient developed frequent eye twitches  and was started on ? Anti epileptic ...

 Patient came to casuality with , c/o generalised body pains since 4 months  A/w pedal edema since 1month A/w fever ( on and off ) HOPI:  Patient was apparently asymptomatic 4 months back then she developed severe joint pains involving toes and fingers not a/w swelling , this then was slowly progressing to involve other joints , wrist, elbow, shoulder,knee, and ankle - pain a/w restriction of movement since 3 months - stiffness of joints present since 3 months , aggrevated with increased activity  -stiffness and pain are more in the morning ( after waking up ) and decreasing as the day progressed ( increased again at the night after 7.30pm ) disturbing her sleep quality  -swelling joints present at the knee and MCP joints since 4 days ( on and off) resolves spontaneously  -swelling at ankle : Non pitting type , increased when standing and working and decreased at rest - pt c/o decreased capacity to work due to pain since 4 months  -No similar complaint...

 A 45-year-old female tailor by occupation came to the hospital on 2/6/22 with C/O fever on and off, associated with generalized body pains, loss of appetite for 3 months  C/O  facial rash since 4-5 days  HISTORY OF PRESENT ILLNESS: Patient was apparently asymptomatic 10 years back then she developed joint pains, the fleeting type associated with morning stiffness for 10 min , not associated with swelling for 2 months for which she was treated at a private hospital and found to have?RA factor positive  patient was asymptomatic until 8 months back then she developed joint pains? post covid vaccination was treated at a private hospital with medications. 2 months back- c/o dryness and burning sensation of eyes Difficulty in eating solid food, decreased salivation seen 1 month back patient was having an episode of loss of consciousness with cold peripheries with sweating [grbs 7mg/dl] after taking Tab Glimi M2 prescribed by a local practitioner for high sugars?250mg...

Cheif complaints:  A 65year old man came to hospital with complaints of fever on and off , tightness of abdomen ,facial puffiness since 15 days   History of present illness:  A 65 year old male toddy tree climber by profession was apparently asymptomatic 10 years back then he was had swelling and pain abdomen for which he was diagnosed with- lt sided inguinal hernia and got operated in some private hospital. Preoperative and postoperative period was uneventful  4 years back patient had complaint of giddiness for which he approached government hospital physician and was diagnosed Hypertension[170/90] and was started on some unknown medication  6 months back patient had complaint of bilateral pedal edema for which investigations were done and found his serum creatinine elevated (4.3 ) and proteins in urine  CT scan showed unilateral (lt)staghorn renal calculi and bilateral inguinoscrotal hernia  DTPA scan was done showing radioactive uptake on left side(...