Shirisha

21year old Man from singaram who is an autodriver came with chiefcomplaint of Abdominal tightness since 10days and went to local hospital and was kept on T.Dytor plus 10/50mg,Abdominal tightness and edema was relieved after using medication, after 1week of hospital stay.scrotal edema is present on and off. since yesterday morning, patient observed facial puffiness from early morning and subsided as day goes on. since today morning patient observed pedal edema,pitting type grade 2(upto shin surface) No c/o sob,orthopnoea,PND,no c/o chest pain, palpitations,syncopial attack,No c/o abdominal pain,burning micturition,no c/o constipation and diarhoea. At the age of 1 year,pt had h/o sob,wheeze present, where there parents took him to local hospital for which they adviced some medication(inhalers? asthma) seasonal complaining of sob present(winter season),used medication for 3 years. No h/o HTN,DM,TB,Epilepsy,cva,CAD family h/o father had CKD diagnosed in 2014. G/E Pt is conscious, coherent ...

A 22 year old lady presented in the wee hours of Sunday with pain abdomen and vomiting.  The patient was apparently asymptomatic at 8 pm when she had her dinner as usual, a mix of rice, lentils, vegetable curry and curd and went to sleep at around 10 pm. She first developed pain at 2 am which was deep, pricking type, localising to the epigastrium. The pain then gradually worsened and she vomited all the food she had for dinner. She then had a few more episodes of greenish vomiting, which was bitter to taste. She says her vomiting mildly relieved her pain but it only came down from 8 or 9/10 to 6/10. The pain is constant and has no relieving factors. She says it is ggravted by food. She denies heartburn, hiccups, jaundice, constipation and diarrhea, malaena, or altered bowel habits in the past few weeks. She also denies any systemic symptoms in the past few weeks.  Review of systems is insignificant. However, her past history is significant for similar complaints in April when ...

A 75 year old man presented with a 10 day history of worsening breathlessness and lower extremity edema.  An elderly man, from the lower echelons of his community, the patient recalls that his current problem began about a decade ago when he felt breathlessness which was unusual to his then previous keeping, when he was employed as a shepherd, which he had been doing for a few decades now. On further questioning, the patient recalls chest heaviness and associated palpitations, which were exertional and pounding and associated with profuse sweating. He also reported that he often felt like he was blacking out during these episodes. A bit of rest under a good tree's shade usually resolved these symptoms. Over these years the patient got accustomed to these symptoms frequently citing aging as the causative factor. Then frequently incapacitated, he stopped work 6 years ago and went into a "retirement" of sorts. He denies a history of PND, Orthopnea, Bendopnea, Cough, overt Sy...

1) A 55 year old man with Recurrent Focal Seizures Detailed patient case report here:  http://ushaindurthi. blogspot.com/2020/11/55-year- old-male-with-complaints-of. html 1. What is the problem representation of this patient and what could be the anatomical site of lesion ? 55 yr old male who is k/c/o diabetic and chronic alcoholic with right upper limb weakness and involuntry movements of right upper and lower limbs, Internal capsule: pure motor strokes, ataxic hemiparesis, and clumsy hand-dysarthria.  Frontal lobe: urinary incontinence, and head and eye deviatiation Temporal lobe: It is preceeded by aura. Aura could be  sensory, emotional, cognitive, or autonomic features prior to onset of impaired awareness. Postictal confusion typically occurs. 2. Why are subcortical internal capsular infarcts more common that cortical infarcts?  Subcortical areas are supplied by penetrating branches,Occlusion of these penetrating arteries result in subcortical ...