07 A.S.SIVARAM

Date of admission :-11-09-2023 CHIEF COMPLAINTS:- A male patient of age 77 years old resident of Nakirekal  presented to the OPD with  chief complaints of  1)diminution of vision in both eyes since 2 years  HISTORY OF PRESENTING ILLNESS:- Patient was apparently asymptomatic 2 months ago and he developed diminution of vision which was insidious in onset and gradually progressive in nature .  It was not associated with watering , photophobia , redness or itching .  HISTORY OF PAST ILLNESS:- There was a history of stent surgery related to CHD 1 year ago  There was a history of auditory and visual hallucinations since 1 year and was diagnosed 1 month ago . K/C/O of DM 2 since months  Not K/C/O of asthma , epilepsy , Tb  TREATMENT HISTORY:- 1)  Metformin 500 mg  2) risperidone 2 mg  PERSONAL HISTORY:- Sleep : inadequate  Appetite : loss of appetite  Bladder and bowel : regular  Drug allergies : no  Addictions : no  FAMILY HISTORY:- Not significant PHYSICAL EXAMINATION:-   1)  general examin

  A 70 years old male farmer by occupation presented to the casualty with complaints of weakness of right upper and lower limb with  inability  to talk since yesterday (8/9/23) Date of Admission: 08/09/23 CHIEF COMPLAINTS   Weakness of right upper and lower limb since 5 days. Inability to talk since 5 days. HISTORY OF PRESENTING ILLNESS   Patient was apparently asymptomatic since 5 days back and then speech got slurred while having lunch.He developed marked weakness in right upper and lower limbs.   Next day weakness persists and he was not able to talk so they brought to the hospital.  Weakness was sudden in onset non progressive. No aggravating or relieving factor. Slurring of speech was sudden and progressed to inability to talk.  H/o Drooling of saliva  H/o hiccups  No h/o deviation of mouth  No h/o involuntary movements, bladder and bowel incontinence  No h/o loss of consciousness  No h/o breathlessness , cough, fever, palpitation, reduced urine output and vomiting.  HISTORY OF PA

A 35 years old female , daily wage worker  by occupation came presented with chief complaints of painful skin lesions on B/L upper and lower limbs since 2 months, fever and burning micturition since 4days.  Date of admission: 12/09/23 CHIEF COMPLAINTS   ➤ Painful  skin lesions over both hands and legs since 2 months .  ➤Fever since 4 days ➤Burning micturition since 4 days HISTORY OF PRESENTING ILLNESS Patient was apparently asymptomatic 2 months back. Then she developed complaints of painful skin lesions over the arms and the legs , which was sudden in onset , progressive , no aggravating and relieving factors . Vesicles later ruptured with purulent discharge Not associated with itching , fever and redness. Fever since 4 days coming on alternate day not associated with chills and rigor, diurnal variation, relieves with medication.  Burning micturition since 4 days. Not associated with increased frequency /urgency /hesitancy/decreased urine .  H/o deformity of hands , toes and fingers s