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Showing posts from August, 2021

54/M with pain in left chest

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Informant- patient  Chief complaints : A 54 year old male patient came with Pain in the left side of the chest radiating to the back side since 8 days, difficulty in breathing since two days. History of present illness : Patient was apparently asymptomatic 8 days back then he developed pain in the left side of chest all over, of stabbing type, which increased on inspiration, radiating to the left upper back. Pain associated with difficulty in breathing with pain during inspiration, progressing over time, increased with intermittent cough. Not associated with high grade fever, chills. No history of shortness of breath before 8 days. No history of palpitations orthopnoea, PND, headache, burning micturition, vomiting loose stools, cough, fever. No history of headache, tingling sensation, numbness. No history of decreased urine output. History of burning sensation of both feet since 1 year, associated with tingling sensation of both lower limbs extending till ankle, equal on both sides...

38/M with weakness

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  Informant : Patient  A 38 year old male, a resident of chandanapally, nalgonda district came to the hospital with complaints of difficulty in walking since 8 years Chief complaints : difficulty in walking since 8 years (2014 March) Feeling weak during walking since 7 years (2015 January) History of present Illness : The patient had difficulty while walking, while getting up from chair without support, but gets up from chair with support, difficulty in squatting, difficulty in sitting on floor, difficulty in getting up without support from floor. Initially he had difficulty in going uphill but since 3 years he was complaining of difficulty in walking on level ground also.        Uphill: steps are difficult        Downhill: comparatively easier steps than uphill Difficulty in running  The patient did not have any difficulty in wearing chappals, holding chappals. He did not have any problem in removing chappals. However he complained...

3 years log

 I worked in kamineni institute of medical sciences as a post graduate in general medicine for 3 years. In this span I have to say that I saw the most interesting cases especially in the first half of my post graduation before covid.  A few cases I’ve found interesting are 1. A case of 24/M who had history of red coloured urine during night came with complaints of weakness, easy fatigueability and turned out to have paroxysmal nocturnal hemoglobinuria confirmed later on flow cytometry with minimal splenic vein thrombus covering about 30% of the lumen and is on followup 2. A 22/F came with history of chronic anemia turned out to be thalassemia trait with family history 3. A 21/F came with status asthmaticus( previous history of intubation and status asthmatic is present) and status epilepticus and was intubated for 7 days and was my first case that was extubated. 4. A case of 58/M with olanzapine induced dilated cardiomyopathy on maintainance haemodialysis well maintained over ...

58/F with shortness of breath

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Informant: patient’s daughter  A 58 year old woman presented with the complaints of  Chief complaints : Shortness of breath with exertion since 1 year and at rest since 15 days Cough intermittently since 4 months Swelling of both lower limbs on and off since 2 months Swelling of right lower limb since 10 days History of present illness : the patient had complaint of shortness of breath since 1 year which was present with farm work started insidiously, progressing over time, exertional, non seasonal, reached the present state of shortness of breath at rest. Associated with increase during sleeping position and relieved during sitting or standing position. Complaint of cough with expectoration intermittently, associated with worsening of chest pain, not associated with fever, no diurnal variations. Expectorant- whitish to slightly pinkish in colour, not foul smelling, no plugs, no frank blood. Complaint of bilateral pedal edema on and off since 2 months, pitting present, extendi...