129 Chandana Tallamraj

The patient's and his attender's consent was obtained, following which detailed history was taken and examination was performed. HOPI The patient was apparently asymptomatic 20 days ago when he developed swelling in the feet which progressively extended to his knees. On 8th October, he didn't pass urine for the entire duration of the day and was brought to the OPD for the same reason. He also had weakness and shortness of breath.  At the time of examination, the patient was restless and unable to lie on his back for more than a few minutes. Productive cough was also noted. Past Illnesses Two years ago, the patient was in a road traffic accident where he fell from his bike near his village in Nalgonda. He fractured his left leg near his hip and underwent a surgical procedure where rod(s) were inserted to ensure proper healing. He has been unable to work ever since and has become bedridden. He is unable to walk or sit on his own.  He has been taking painkillers (NSAIDs) for h...

                    

    A 44 year old male came to the OPD with complaints of chest pain, breathlessness, fever and left sided back pain History of present illness The patient was asymptomatic one month ago. He was taken to a local government hospital for chest pain and left sided back pain. He was brought to this hospital 10 days ago due to complaints of fever, loss of appetite with heavy alcohol consumption.  He complained of pain and discomfort in the chest and upper abdomen which worsens on exertion (talking). He had shortness of breath and was unable to speak comfortably for more than a few minutes. There is left sided pain in his back from the thigh to the lower back. He also had high grade fever with chills and rigors. 20 days ago, he behaved irrationally and was reported to have had hallucinations.  There were a few episodes of vomiting with greenish discoloration while he was admitted in the government hospital.  Past history No history of diabetes, hypertension, TB, ...

 A 55 year old male came to the OPD due to weakness and inability to walk History of Present Illness Patient was asymptomatic a few days ago. He was brought to the OP due to extreme weakness and inability to walk. He was facing shortness of breath. On X-Ray examination, fibrotic lesions were more prominent in the left lung. Serum creatinine levels were high.  Past History He is a known case of diabetes (detected 2 years ago) and HTN (since 10 years). He is taking regular medication for these conditions.  X Ray findings indicate the possibility of Tuberculosis. H/O arthritis, gout and nephritis. High uric acid levels associated with pains were recorded during his previous hospital visits.  A month ago, he indulged in heavy alcohol consumption and reduced food intake which may have led to the current complaints. The first time he was hospitalized, it was about 10 years ago due to seizures that were not associated with any brain disease.  The second time, the patie...