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Short case

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45 year  old male came to the OPD with Chief complaints   of: Bilateral pedal edema since 12days Shortness of breath since 5days  HOPI : Patient was apparently asymptomatic 12days back then he developed bilateral pedal edema which was gradual in progression, extended upto knee and is of pitting type. He also developed Shortness of breath which was initially grade 1 and progressed to grade 2 (nyha) Associated with orthopnea H/o loss of appetite since one week and nausea and vomitings three days back (3 episodes) non billious No H/o- fever,burning micturation, diarrhoea decreased urine output  No H/o cough, hemoptysis,fever, No h/o chest pain,giddiness , palpitations, decreased urine output, syncopal attacks, No h/o abdominal distension, jaundice  vomitings Past history: Not a K/C/o Diabetes Mellitus,Asthma,TB,epilepsy,leprosy,CAD Treatment history  Not significant  Personal history: Diet:Mixed  Appetite:Decreased  Sleep-adequate Bowel movements-regular Bladder movements- normal urinary
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Long case

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COMPLAINTS AND DURATION: A 77 y/o male was brought with c/o cough since 1 & half month ,  difficulty in swallowing  since one month Fever since 10 days C/o altered sensorium since 3 days HOPI  Patient is a known case of cva with left hemiplegia, DM type 2 , Hypertension, hypothyroidism   Patient was apparently asymptomatic one and half month back when he developed cough insidious in onset and gradually progressive. PRODUCTIVE but patient is not able to spit it out. Difficulty in swallowing.  H/o cough on intake of liquids.  H/o change of voice since 20 days, insidious, hoarse in character and   SLURRING OF SPEECH +present  Fever since 10 days -high grade associated with Chills and rigors  H/O WEAKNESS in LEFT upper and lower limb since 7 years aggrevated since 4 days. No history head trauma  No history of loss of consciousness No history of transient loss of vision No history of involuntary movements No history of pain in calf muscles No history of chest pain and loose stools PAST
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35 year old female

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35 year old female patient ,resident of Nakrekal came to OPD with Chief complaints of Fever since 1 week  Left sided headache since 7 days History of burning micturation since 5 days History of presenting illness:  Patient was apparently asymtomatic 10 year back then she developed  unexplained weight gain and fatigue for which she went to local hospital where she found to be Hypothyroidism and she was on thyroxine medication since then. Two years back her Thyroxine dose is increased to 75mcg daily.  One week back she developed Fever which used to start raise in  evening and the peak at mid night and  intermittent in nature relieved on medication. Associated with chills and headache Not associated with nausea, vomiting,rashes,bodypain. History of Unliateral left sided headache since 7 days .It was severe headache,Throbbing type of painin left fronto , parieto and occipital region, which is radiating to neck. Associated with phonphobia and decrease in regular physical activity. Not assoc
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second internal examination

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65 year old male

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Chief complaints :  65 year old male with chief complaints with unable to walk since 3 months , muscle stiffness since 20 days , decreased appetite since 15 days . Unresponsiveness since 3 days.  History of presenting illnesses: Patient is apparently asymptomatic 1 year back then developed unbalanced gait,insidious in onset and visited a hospital ,6 months ago and was said to be having a neurological disease (no documents available) and have been using medication since then(not known)and was having generalised weakness on and off since 6 months and due to fear of falling and as he is feeling pricking sensation over the sole,and due to decreased power in his limbs and generalised weakness he completely stopped walking  and was bed ridden since 2 months(he didn’t tried walking even with support)visited a hospital again 1 month back,MRi brain was done,showing hydrocephalus and early parkinsons changes,and advised for surgery (?Ventriculoperitoneal shunting,not done)and during hospital sta
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A 32 year ald male

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 complaints: Patient complaining of decreased appetite since 10 days , fever since 10 days Vomiting since 7 days associated with pain in abdomen, History excessive alcohol intake since 1 month , aggrevated since last 7 days Loss of weight since 10 days  No H/O fever and lose stools History of presenting illness :  Patient is asymptomatic 10 days back then he had loss of appetite and took no food since then and had excess of alcohol . He developed low grade fever 10 days back , sudden in onset , low grade , intermittent , relieved on medication, associated with rigors , no sweating and no evening rise of temperature. Vomiting since 7 days back , multiple episodes in a day like every 1 hour , bilious, Foul smelling, non projectile , not associated with abdominal pain , no headache, no diminision or blurring of vision . Past history:  No history of Diabetes mellitus, Hypertension, TB , Asthma and No history of any cardiovascular disease History of 2 episodes of admission in hospital in vi
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