59 K. Rithika Vasantha

202410956 M Nagu CASE HISTORY AND CLINICAL FINDINGS PATIENT WAS BROUGHT TO CASUALITY WITH H/O INVOLUNTARY MOVEMENTS MULTIPLE TIMES SINCE 2 DAYS HOPI PATIENT WAS APPRENTLY ASYMPTOMATIC 2 DAYS AGO THEN HE DEVELOPED ONE EPISODE OF SEIZURE LIKE ACTIVITY AT 11 PM ON 6/3/24 .ONE EPISODE AT 9PM ON 7/3/24,4 EPISODES WITH 5 MINUTES INTERVAL AT 12 AM ON 7/3/24 EACH EPISODE LASTING FOR 5- 10 MINUTES WITH INVOLUNTARY MOVEMENTS OF ALL FOUR LIMBS.FROATHING FROM MOUTH PRESENT,UPROLLING OF EYEBALLS PRESENT TONGUE BITE ABSENT INVOLUNTARY MICTURITION,DEFEACATION ABSENT H/O VOMITING FOR 2 DAYS ,3 EPISODES PER DAY,FOOD AS CONTENT,NON BILIOUS NO H/O HEAD TRAUMA,FEVER,LOOSE STOOLS PAST HISTORY; K/C/O DM SINCE 6 YEARS ON REGULAR MEDICATION ON TAB.GLICLAZIDE 60MG PO/OD N/K/C/O HTN,EPILEPSY,CAD,CVA,ASTHAMA,THYROID GENERAL EXAMINATION PT IS C/C/C PR - 104BPM BP - 180 / 100 MMHG RR - 20 CPM TEMP - 98 F GRBS - 312 MG /DL CVS - S1 S2 PRESENT RS - BAE PRESENT , NVBS P/A - SOFT , NON TENDER PSYCHIATRY REFERRAL ON 8/

202421430 gopal CASE HISTORY AND CLINICAL FINDINGS C/O WEAKNESS OF RIGHT UPPER LIMB SINCE 3 MONTHS HOPI: PATIENT WAS APPARENTLY ASYMPTOMATIC 3 MONTHS AGO, THEN HE DEVELOPED SUUDEN ONSET WEAKNESS IN RIGHT UPPER LIMB,NOT PROGRESSIVE H/O DIFFICULTY IN MIXING FOOD,TAKING BATH,COMBING H/O TINGLING AND NUMBNESS OF BOTH RIGHT UPPER LIMB AND LOWER LIMB NO H/O DEVIATION OF ANGLE OF MOUTH NO H/O SLURRING OF SPEECH, DIFFICULTY SWALLOWING H/O COUGH WITH COPIOUS SPUTUM,WHITE COLOR, NON BLOOD TINGED, NON FOUL SMELLING PAST HISTORY: K/C/O CVA SINCE 5 YEARS, NOT ON MEDICTION HTN SINCE 5 YEARS ON MET XL 50 MG PO OD DM 5 YEARS ON INJ.MIXTARD 5U-5U N/K/C/O CAD ASTHMA TB,EPILEPSY PERSONAL HISTORY: AUTODRIVER BY OCCUPATION,MARRIED,APPETITE NORMAL,SONSUMES NON VEG, BOWEL AND BLADDER REGULAR CONSUMED 180 ML/DAY FOR 40 YEARS STOPPED 5 YEARS AGO,COSNUMED BEEDI 1 PACK/DAY, STOPPED 10 YEARS AGO GENERAL EXAMINATION: PATIENT IS CONSCIOUS,COHERENT COOPERATIV WELL ORIENTD TO TIME PLACE AND PERSON NO PALLOR,ICTERUS,C

202329331 kotaiah CASE HISTORY AND CLINICAL FINDINGS PT WAS REFERRED FROM ANOTHER HOSPITAL I/V/O HYPOTENSION BINGE ALCOHOL DRINKING SINCE 10 DAYS DEVELOPED TINGLING, NUMBNESS OF ALL LIMBS ON 2/7/23 AND ALTERED SENSORIUM ON 3/7/23 AND WAS TAKEN TO LOCAL HOSPITAL. DUE TO GRBS BEING 40MG/DL, HYPOGLYCEMIA CORRECTION WAS DONE. BP WAS ALSO NOT RECORDABLE SO IONOTROPES WERE STARTED AND HE WAS REFERRED FOR FURTHER MANAGEMENT. NOT A K/C/O HTN, DM, CAD,CVA,EPILEPSY,THYROID DISORDERS ,TB,ASTHMA DIET : MIXED APPETITE : NORMAL BOWEL AND BLADDER : REGULAR ADDICTIONS : ALCOHOL. LAST BINGE ON 30/6/23. SMOKING SLEEP: ADEQUATE ON EXAMINATION PT IS CONCSIOUS, COHERENT, COOPERATIVE ORIENTED TO TIME, PLACE, PERSON B/L PUPIL: NSRL PALLOR ABSENT NO ICTERUS,CYANOSIS,CLUBBING,LYMPHADENOPATHY,OEDEMA VITALS TEMP : AFEBRILE PR : 106 BPM RR: 16 CPM BP : NOT RECORDBLE ---> NORAD @6ML/HR---> SBP 60MMHG ---> 2 NS: BP 120/70MMHG SYSTEMIC EXAMINATION CVS : S1,S2 HEARD ,NO MURMURS RS: BLAE PRESENT, NVBS P/A : S

202403311 laxmamma Case History and Clinical Findings PATIENT CAME WITH C/O BILATERAL PEDAL EDEMA SINCE 1 MONTH ,DECREASED URINE OUTPUT SINCE 1 MONTH,FEVER SINCE 1 MONTH. DIFFICULTY IN BREATHING SINCE 1 MONTH, SWELLING OVER CHEEKS SINCE 3 MONTHS  HOPI   PATIENT WAS APPARENTLY NORMAL 3 MONTHS BACK AND THEN DEVELOPED BILATERAL PEDAL EDEMA THAT WAS INSIDIOUSON ONSET, GRADUALLY PROGRESSIVE AND ASSOCIATED WITH DECREASED URINE OUTPUT. FEVER IS LOW GRADE, GRADUAL IN ONSET, PERIODIC, NO ASSOCIATED CHILLS AND RIGORS. DIFFICULTY IN BREATHING IS ASSOCIATED WTH EXERTION. NO PND NO ORTHOPNEA , NO H/O VOMITINGS, DIARRHOEA, COUGH, COLD, BURNING MICTURITION  Past h/o NOT A K/C/O DM, HTN TB, ASTHMA , EPILEPSY, CAD  H/O HYPERTENSION SINCE 1 MONTH.  SURGERY REFERRAL DONE ON 23-1-24 I/V/O PLEOMORPHIC ADENOMA ADVICE : USG OVER SWELLING, FNAC OVER PAROTID GLAND, OPG OPHTHAL REFERRAL WAS DONE ON 24/1/24 SPECTACLE CORRECTION DONE, USAGE OF SPECTACLES ADVICED FOR LEFT EYE. Investigations USG WAS DONE ON 24/1

202400190 machu saidulu CHIEF COMPLAINTS PATIENT CAME WITH CHIEF COMPLAINTS OF SOB SIONCE 10 DAYS, GENERALISED BODY SWELLING SINCE 1 WEEK, GENERALISED WEAKNESS AND UNABLE TOP WALK HISTORY OF PRESENTING ILLNESS:- PATIENT WAS APPARENTLY ASYMPTOMATIC 10 DAYS AGO THEN HE DEVELOPED SOB SINCE 1 MONTH MMRC GRADE 3 AGGRAVATED ON EXERTION, RELIEVED ON TAKING REST, ASSOCIATED WITH WHEEZE. PATIENT DEVELOPED GENERALISED BODY SWELLING SINCE 1 WEEK WITH FACIAL PUFFINESS GRADUAL IN ONSET. H/O FEVER LOW GRADE, INTERMITTENT, NOT ASSOCIATED WITH CHILLS AND RIGORS AND RELEIVED ON MEDICATION. H/O LOSS OF APPETITE AND LOSS OF WEIGHT PRESENT H/O GENERALISED WEAKNESS AND SKIN ALLERGIES PRESENT SINCE 10 DAYS NO H/O CHEST PAIN, CHEST TIGHTNESS, PALPITATIONS PAST HISTORY:- NO H/O SIMILAR COMPLAINTS IN THE PAST K/C/O TYPE 2 DM SINCE 2 YEARS USING T.METFORMIN 500MG PO/OD ON IRREGULAR USAGE N/K/C/O HYPERTENSION, CVA, CAD, THYROID DISORDERS, EPILEPSY, TB, ASTHMA GENERAL EXAMINATION: AFEBRILE (98.7C/F) BP:80/60 MMHG

356190 p mallesh CASE HISTORY AND CLINICAL FINDINGS C/O FEVER SINCE 3 DAYS C/O VOMITINGS 2 DAYS BACK HOPI PT WAS APPARENTLY ASYMPTOMATIC 3 DAYS BACK THEN HE DEVELOPED HIGH GRADE FEVER,CONTINUOUS, NO DIURUINAL VARIATION ASS WITH CHILLS RIGORS.ASS HEADACHE , GENERALISED PAINS NO H/O COUGH,COLD,THROAT PAIN H/O EPISODES OF VOMITINGS,BIIOUS,NON PROJECTILE ON FIRST DAY FEVER NO H/O PAIN ABDOMEN,HEMATURIA,ABDOMINAL DISTENSION H/O SOB GRADE 2 H/O LOSS OF APPETITE PAST HISTORY: K/C/O DM SINCE 20 YRS ON GLYCOMET SR PO/OD K/C/O HYPOTHYROIDISM SINCE 15 YRS ON THYRONORM 50 MCG N/K/C/O CAD,CVA,ASTHMA,TB GENERAL EXAMINATION PT IS CCC NO SIGNS OF PALLOR,CYANOSIS,CLUBBING,LYMPHADENOPATHY PR 76 BPM BP 130/80 MMHG SPO2 98 RR 22 CPM SYSTEMIC EXAMINATION: CVS S1 S2 HEARD RS BAE+ GIT SOFT NT CNS NFND INVESTIGATION BLOOD UREA15-12-2023 06:13:PM3.3 mg/dl42-12 mg/dlSERUM CREATININE15-12-2023 06:13:PM1.4 mg/dl1.3-0.9 mg/dlSERUM ELECTROLYTES (Na, K, C l) AND SERUM IONIZED CALCIUM 15-12-2023 06:13:PM SODIUM135 mE

202323120 janamma CASE HISTORY AND CLINICAL FINDINGS CHIEF COMPLAINTS C/O LOWERBACKACHE SINCE 5 MONTHS C/O BURNING SENSATION OF BOTH UPPER LIMB AND LOWER LIMB SINCE 5 MONTHS C/O FEVER SINCE 10 DAYS C/O PAIN DURING DEFECATION SINCE 5 MONTHS HOPI PATIENT WAS APPRENTLY ASYMPTOMATIC 5 MONTHS BACK THEN HE DEVELOPED LOWER BACKPAIN , INSIDIOUS IN ONSET , GRADUALLY PROGRESSIVE AGREVATED ON BENDING ,RELIEVED ON MEDICATION C/O BURNING SENSATION OF BOTH UPPER LIMB AND LOWER LIMB SINCE 5 MONTHS NOT ASSOCIATED WITH ANY TINGLING AND NUMBNESS OF THE LIMBS. C/O OF FEVER LOW GRADE SINCE 10 DAYS , NOT ASSOCIATED WITH CHILLS AND RIGOR,ON AND OFF ,NO COUGH AND COLD C/O BURNING MICTURATION SINCE 5 TO 6 MONTHS ,NO INCREASED IN FREQUENCY , NO HESITANCY,NO COMPLAINTS OF DECREASED URINE OUTPUT NOCTURIA + , NO C/O OF POLYPHAGIA , NO POLYDYPSIA C/O OF PAIN DURING DEFECATION SINCE 5 MONTHS, NON BLOOD STAINED STOOLS , NO TENESMUS DECREASED APPETITE HISTORY OF WEIGHT LOSS PAST HISTORY N/K/C/O DM,HTN,EPILEPSY,CVA,CA

202416614 narasimha CASE HISTORY AND CLINICAL FINDINGS CHEIF COMPLAINTS : PATIENT PRESENTED WITH COMPLAINTS OF ABDOMINAL PAIN SINCE 1 DAY. HOPI PATIENT WAS APPARENTLY ASYMPTOMATIC 1 DAY BACK WHEN HE DEVELOPED PAIN IN THE RIGHT UPPER ABDOMEN WHICH INITALLY STARTED AFTER CONSUMPATION OF TODDY EARLY IN THE MORNING . PAIN IS SQUEEZING IN NATURE, NON RADIATING, NO AGGRAVATING AND RELIVELING FACTORS. H/O ANOREXIA SINCE 1 DAY H/O VOMITIMG 1 EPISODE TODAY NO H/O FEVER , TRAUMA , DIARRHOEA NO H/O CHEST PAIN, CHEST TIGHTNESS, PALPITATIONS NO HISTORY OF ORTHOPNEA PND NO HISTOTY OF CONSTIPATION PAST EXAMINATION: N/K/C/O DM/HTN/CAD/CVA, ASTHMA, THYROID DISORDERS H/O SIMILAR COMPLAINTS IN THE PAST RELIVED ON MEDICATION GENERAL EXAMINATION: PATIENT CONCIOUS COHERENT COOPERATIVE TEMP 97.3F PULSE 96 BPM RR 20/MIN BP 140/100mmHg SPO2 98% NO ICTERUS PALLOR CYANOSIS LYMPHADENOPATHY CLUBBING SYSTEMIC EXAMINATION: CVS:S1S2 HEARD , NO MURMURS. RS :BAE NORMAL, NVBS CNS :NO FOCAL NEUROLOGIC DEFICIT LEVEL OF CO

202307718 linga swamy CASE HISTORY AND CLINICAL FINDINGS A 35 YR OLD MALE WHO WAS ATRUCK DRIVER BY OCCUPATION WAS BROUGHT TO THE CASUALITY WITH C/O ALTERED SENSORIUM AND GENERALISED WEAKNESS SINCE 1WEEK HOPI PT. WAS APPARENTLY ASYMPTOMATIC 10YRS AGO THEN HE DEVELOPED COUGH AND GENERALISED WEAKNESS FOR WHICH HE WENT TO HOSPITAL AND DIAGNOSED WITH DM AND WAS PRESCRIBED OHAS SINCE THEN HE STARTED USING OHAS BUT WAS ON IRREGULAR MEDICATION AND HAD POOR CONTROL OF SUGARS .THEN WAS ON INSULIN SINCE 7YS,STOPPED USING INSULIN FROM 15DAYS 2 YRS BACK HE DEVELOPED BOTH LL SWELLING WHICH GRADUALLY PROGRESSED TO ANASARCA SINCE THEN HE HAD FREQUENT ATTACKS OF HYPOGLYCEMIA AND DECREASED URINE OUTPUT 3 MONTHS BACK.PT.DEVELOPED FEVER WITH ULCER OVER RIGHT GREAT TOE. LOWER LIMB AND FACIAL PUFFINESS AGGRAVATED ,BROUGHT TO OUR HOSPITAL AND WAS ADMITTED AND DISCHARGED SINCE 7DAYS,PT. HAD GENERALISED WEAKNESS , ALTERED BEHAVIOUR ,INCREASED SLEEPINESS DURING DAY TIME,ALTERED SLEEP CYCLE SINCE 1WEEK, AND WAS

202422234 CASE HISTORY AND CLINICAL FINDINGS CHIEF COMPLAINTS: C/O FACIAL PUFFINESS SINCE 5 MONTHS C/O BILATERAL SWELLING OF LOWER LIMBS SINCE 5 MONTHS. HOPI: PATIENT WAS APPARENTLY ASYMPTOMATIC 5 MONTHS AGO THEN DEVELOPED FACIAL PUFFINESS WHICH WAS INSIDIOUS , ON AND OFF .ONLY IN MORNING , GRADUALLY DECREASED BY NIGHT FOLLOWED BY PEDAL EDEMA, IN BOTH LEGS EXTENDS UPTO MIDTHIGH, PITTING TYPE, GRADUALLY PROGRESSIVE. H/O SOB CLASS 2 NYHA, ABDOMINAL DISTENSION , SWELLING OF BOTH HANDS. NO H/O DECREASED URINE OUTPUT ,FEVER NO H/O CHEST PAIN, PALPITATIONS NO H/O COUGH,COLD,CONSTIPATION NO H/O RASH,ITCHING PAST HISTORY - K/C/O NEPHROTIC SYNDROME SECONDARY TO MEMBRANOUS NEPHROPATHY (SEROLOGICAL DIAGNOSIS )SINCE 1 YEAR 3 CYCLES OF MODIFIED PONTICELLI REGIMEN WAS GIVEN AND ON REGULAR MEDICATION K/C/O HTN SINCE 2 YEARS WAS ON TAB .CLONIDINE 0.1MG PO/BD,TAB CINOD 10 MG PO/BD ,TAB METXL 25MG PO/BD K/C/O DM SINCE 2 YEARS WAS ON TAB.LINAGLLIPTIN 5MG PO/OD N/K/C/O EPILEPSY,THYROID DISORDERS,CVA,CAD,A