86 year male born in a middle class family of 7 children, was an elder son, did not go to school and took upon family responsibility at a very young age and started fish business. He used to travel often inter country for his business. Can speak Hindi and Telugu. Childhood was pleasant, married at young age and had five sons. His parents expired due to old age. Patient started consuming alcohol (beer) during travelling occasionally and also started smoking. 16 years ago patient had complains of lower back pain and decreased urine output, went to Kamineni Hyderabad and was diagnosed as renal calculi and operated for same. Two years later he returned home from work, had dinner and went to bed. Early in the morning he felt tiredness and struggled to wake up, later he observed he had right upper and lower limb weakness and slurring of speech. Patient went to local hospital and was diagnosed as right hemiparesis . At the same time he was also diagnosed with hypertension and diabetes. A
Case 1 https://himajav.blogspot.com/2023/08/53f-metabolic-syndrome.html 53 year old female housewife by occupation resident of coochbihar admitted with complains of generalised weakness since 6 years The patient's medical history reveals that she was asymptomatic until six years ago when she presented with weight loss, xerostomia, and anorexia. She sought medical attention at a local medical facility, where she was diagnosed with Diabetes mellitus and subsequently initiated on oral hypoglycemic agents. Around four years ago, the patient began experiencing generalized asthenia and easy fatigability, leading to the diagnosis of both Hypertension and hypothyroidism. Approximately four years ago, the patient complained of cervical discomfort, prompting a diagnostic consideration of cervical spondylosis. This condition was managed with a course of physiotherapy. Currently, the patient reports intermittent occurrences of generalized asthenia, easy fatigability, and xerostomia. She also