57 Vinila Bhavani Kanday

 A patient who is 45 yr old male came to OPD with chief complaints of fever since 2 days and blurring of speech since 1 day . HISTORY OF PRESENT ILLNESS  Patient is a daily wage worker by occupation  . Patient was apparently asymptomatic 2 years back then his appetite increased( about 5- 6 times a day ) for which he came to KIMS hospital and diagnosed with Diabetes.He used oral hypoglycemic drugs for first 6 months.Then from past 1.5 years he is on insulin.He was a chronic alcoholic since 25 yrs . he consumes more than 180ml / day . Urine output increased since 2 years about 10 times a day. Decreased weight about 25kg since 2 years. Then since 2 days he developed  fever which was high grade, continuos and associated with chills and rigor and also presence of neck stiffness and burning Micturition.Patient was also anemic for which he received blood transfusion He developed slurring of speech since 1 day then he came to hospital the next day     HISTORY OF PAST ILLNESS  Patient is a  K/c

 A 45 yr old male came to OPD with chief complaints of fever since 4 days associated with left sided loin pain . Patient also presented with breathlessness and abdominal fullness since 2 days . HISTORY OF PAST ILLNESS      Patient is a plumber by occupation and is apparently asymptomatic 14 yrs back later he was on medication for infertility ( he used both herbal and generic medicine ) for 6 months continuously and as a part of health check up he was diagnosed with Diabetes 10 yrs back . He received treatment for infertility irregularly for  about 7 yrs . Patient adopted a girl child 9 yrs back . Patient suffered with loin pain 6 months back for which he was treated by RMP and it was relieved , now since 4 days patient had fever associated with vomitings , chills and rigor. Fever not relived on medication. He also had left lumbar region pain and shortness of breath that relieved on sitting . HISTORY OF PAST ILLNESS Patient is a  K/c/o DM  Not a k/c/o asthma , hypertension,CAD , tubercu

 A 45 yrs old male patient presented to the casualty with chief complains of altered sensorium since 7 days  HISTORY OF PRESENT ILLNESS      Patient was apparently asymptomatic 10 yrs back  then he was diagnosed with Diabetes as a part of general check up and he is on medication since then . 6 yrs back he developed ulcerations on left feet little finger which became infectious and gangrenous and finally little finger was amputated . 8 months back he developed similar lesions on his left feet so 4 th toe was amputated . 3 months back following a thorn prick patient developed diabetic foot ulcer following which he had developed plantar abscess , necrotising fascitis and anemia for which he had undergone debriment and split skin graft under regional anaesthesia. Over a month back  he developed  an episode of GTCS with CGS of E3V1M2 and was diagnosed to have hyponatremic seizures with Na+ levels of 117meq/L and he had undergone Na+ correction. HISTORY OF PAST ILLNESS    K/c/o - hypothyroid