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A 45 year old male who is a chronic alcoholic came to the casualty with involuntary movements of upper and lower limbs. CHIEF COMPLAINTS: *c/o 3 episodes of GTCS i;e today morning 1-2am , each episode lasted for 2-3mins , postictal confusion for 5-10mins *Uprolling of eyeballs, tounge bite + *No involuntary micturation and no other complaints. *h/o 2-3 episodes vomiting after seizure activity HISTORY OF PRESENT ILLNESS: No h/o fever  Alcohol consumption since 20 years(daily drinking since 7 years) , increased since last 2 years , binge drinking since 4 days , last drank yesterday. Patient was apparently asymptomatic 20 years back , then he started consuming whiskey initially would drink 90ml / day in a social gatherings along with friends and relatives. OD reports that patient has been drinking daily since last 6 years , eyeopener + since 2 years , lends money from people to consume alcohol , was abstinent from alcohol during lockdown period and experienced sleep disturbances for 3 day
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INTRODUCTION A 60 year old female patient ,house wife by occupation and region of Nalgonda, presented to the casualty with chief complaints of                  ✓Grade 4 shortness of breath                 ✓ Bilateral pedal edema                  ✓Nil urine output (5 sessions HD done).     Patient was apparently asymptomatic 10 days ago , then she developed dry cough and shortness of breath (grade 2) ✓ post covid pneumonia 10 days ago       CORADS  - 5/5      CTSI - 21/25(10 days ago) HISTORY OF PRESENT ILLNESS: ✓ Fever positive  - 10 days ago later subsided. ✓ patient attenders checked her GRBS which was 800 mg/dl - 10 days ago .so they visited local hospital where she was COVID-19 positive and treated her pneumonia. HISTORY OF PAST ILLNESS: ✓In c/o nil urine output , hemodialysis was initiated on 21/03/21 and 5 sessions of HD done  ✓ patient  used to feel  better during dialysis and developed SOB next day. ✓ Bilateral pedal edema positive,pitting type extending upto skin  ✓ No c/o los
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This is a case of 60 year old female (fruit and vegetable vendor) which chief complaints of giddiness,  right upper limb and lower limb weakness and slurring of speech.  CHEIF COMPLAINTS:    Giddiness and generalised weakness around 6pm in the evening  Right upper limb & lower limb weakness and slurring of speech around 8pm in the night  HISTORY OF PRESENT ILLNESS:  Patient was apparently a symptomatic till 6pm in the evening. She suddenly started developing giddiness, after which the patient was taken to the local RMP and found BP was 160/80 mmHg  She was prescribed T.amlong 5mg and BP was lowered to (systolic 130mmHg)  Giddiness was non rotational,  no postural variation,  no change with position of the head, not associated with blurring of vision or headaches. Lasted for 30 min.  The taken to the local hospital where sublingual NTG was given. followed by sudden onset of weakness of right upper & lower limbs and slurring of speech. Not able to lift/move the limbs from the bed
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