Vaishnavi kedari roll no 164

30 years old male occupation Working as farmer came to our casualty at 9:15 AM on 13/2/2022 with the chief complaint of dyspnoea since 2 hours and and nausea since 2 hours HOPI : Patient is a resident of iskilla , farmer by occupation he mainly does sowing rice and labourer work . patient was apparently asymptomatic on Saturday (12-2-2022) when he came home after consuming toddy from a place different from  his usual seller  around 2 bottles(360ml) (more than his usual consumption )and complained of back ache to his mother later few hours in he had 5-6 episodes of loose stools which were watery. Later he felt hungry and asked his mother for some food . He ate some rice and curry and asked for some milk.  His mother gave him few drops of milk while he layed in supine position, later at around 3am he had two episodes of vomiting, vomitus was milk like in colour and non projectile, later developed bilateral limb weakness and sob,became deliriant .Seeing his condition his family members ca

 A 40 yr old female came to hospital with chief complaint of Menorrhagia past 6months HISTORY OF PRESENT ILLNESS: A 40yr old female who was born out of consaginous marriage grade III through a normal vaginal delivery at her mother's sister house. She immediately cried and was breast  fed for 1year. Her immunization is not known . Since childhood she used to eat only one meal per day though she had a good appetite because of weakness.  She used to sway side by side while walking,sometimes fell down and again she used to get up on her own. She used to get ready to school by herself.(wearing uniform,combing hair) She used to repeat her standard almost 2-3 times. She attained menarche at the age of 14yrs with normal flow 4-5 days/month with no clots. LMP- 5/2/2022 Once she complained of heavy bleeding for a month for which they went to local mbbs doctor  who provided medications and her bleeding was relieved. Now since 6 months ,she is having heavy bleeding per vagina during her cycles

pain abdomen secondary to uncontrolled sugars with DKA with ? pancreatitis with AKI on CKD. (CKD secondary to metabolic acidosis ) with HFPEF( EF- 58%) with metabolic acidosis secondary to DKA & CKD with H/o DM-2 , hypothyroidism , CKD 43 year female came with complaints of pain abdomen & vomitings since 1 day HOPI :  Patient was apparently asymptomatic 6 yrs back, then had anasarca , went to hospital in hyderabad & diagnosed to have  hypothyroidism ( started on tab.THYRONORM 50 micrograms)  & also diagnosed as  renal failure & was on TAB.TORSEMIDE 20MG+ SPIRONOLACTONE 50MG & also DM 2 ( started on inj.MIXTARD 6U....X.. .10U & increased doses of MIXTARD to 20U...X...25U since 1 1/2 yr.  Currently patient complaining of pain abdomen which is diffuse , intermittent, dull aching pain associated with vomitings, 2 episodes non bilious , non projectile , food as content .  No H/O fever, cold, cough, loose stools, constipation , malena, haematuria No H/O pedal edem