93 HARIKA KUNE

75 YR OLD MALE  ICU BED 1 Came with cheif complaints of  INVOLUNTARY MOVEMENTS OF B/L UPPER AND LOWER LIMBS  ASSOCIATED WITH FROTHING AND POSTICTAL CONFUSION. NOT associated with tongue biting, aura, involuntary micturition or defecation. H/O similar complaints in the past  (Not on any medication).  NO C/O chest pain, palpitations, shortness of breath, pedal edema, orthopnea, PND. Not a k/c/o DM,HTN, ASTHMA,THYROID, TB. PAST HISTORY: Similar episode (GTCS) , associated with uprolling of eyes and frothing, happened one yr back, during sleep in the night , lasted for 2-3 min, followed by 5minutes postictal confusion , and later on he doesn't remember whatever happened. They took to near by hospital , gave undocumented medication. No any imaging was done . Got relieved. After 6months ,  same episode was repeated. They Came to our MEDICINE OP, advised few tests, after results ,  he was given unknown medication and used for 1week. No any imaging was done . And now again similar episod

23/11/21 58 YR OLD FEMALE , SSW came with c/o  Slurring of speech since 3days Deviation of mouth to left side  since 2days Weakness of Right UL,LL since 2days. Patient was apparently asymptomatic 3days ago, then she developed sudden onset of slurring of speech, observes by her daughter, when they checked her BP: 220/100mmhg. She was taken to a near by hospital, and was given medication TAB . CILIDIN - T. Patient's daughter observed weakness of Right UL initially, followed by right LL. K/C/O DM since 10yrs , on TAB. GLIMI -M  NOT a k/c/o HTN, ASTHMA,TB, EPILEPSY, THYROID. No similar complaints in the past. No significant family history. No known allergic history. Occupation: House wife Takes mixed diet Sleep is decreased Appetite is normal Bowel and bladder movements are normal. No any addictions O/E pt is C/C/C NO pallor, icterus, cyanosis,clubbing, lymphadenopathy, edema. No malnutrition No dehydration. VITALS: TEMP: 98.5F BP: 110/80mmhg PR: 84BPM RR: 18CPM GRBS: 251mg/dl SPO2: 99

Amc bed 1 24 yr old male pt presented to op with  c/o fever since 4 days  Generalised weakness since 3 days  Pt was appently asymptomatic 4 days back , then developed fever a/w chills and rigors ,  not a/w nausea , vomiting  C/o generalised weakness since 3 days  H/o similar complaints in the past ( 1 and half yr ago) was told he had low platelet count  Not a k/c/o DM /htn / tb / asthma / epilepsy  O/E :  PR 99 bpm BP 110/80 mmHg  RR 18 cpm Temp 98 .5 F  Grbs 115 mg/dl  Spo2 99% room air  CVS :  S1 S2 heard , no murmurs  RS :  VBS +  BAE +  P/A :  Shape : scaphoid  Soft , non tender  Bowel sounds +  CNS : NAD ,HMF INTACT  Investigations :  APTT 32 sec Pt 16 INR 1.11 Bgt : o positive  Blood urea : 20  CUE :  Alb + Sugar + Pus cells 3-4  Uric acid serum 3.3  S .electrolytes :  Na 137 , K 4.4 , Cl 98  S creat : 0 .8  LFT :  TB 2.08  DB 0.86  Ast 98 , ALT 79  Alp 281  TP 6.4  Alb 4.3  A/G ratio 2.06  Hemogram :  HB : 16.3  TC : 5000 N : 76  L : 18  PCV : 45.6  PLT : 50,000 

AMC BED 7   YESTERDAY'S ADMISSION 60yr old , daily wage labourer by occupation earning around Rs.400-500/day, presented to casualty with inability to move his right upper and lower limb with deviation of mouth to left side , with slurring of speech. His daily routine includes, waking up, attending nature's call, having a cup of tea, rice for breakfast,going to work , coming for lunch , returning back home indulging himself in alcohol, around 90ml whiskey daily since 20-30 yrs and smoker around a pack of beedies  daily , (18 beedies /1pack). HOPI: He was apparently asymptomatic till yesterday afternoon 3-4 pm , he experienced sudden onset of deviation of mouth to left side with slurring of speech while having food and was encouraged to drink ( as it was the solution)., with no apparent weakness. Today mrng following his daily routine around 7:30am , after having cup of tea, he suddenly fell from chair and was unable to lift his right upper and lower limbs. PAST HISTORY: No signi