38Fyoung onset HTN/DM

38 years old female housewife resident of coochbihar

Complains of both leg pain since one year

Born in Meghalaya in 1983 by normal delivery. Milestones achieved normal.

Education - 10th standard

Patient was apparently asymptomatic until 20 years ago

She complains of headache at parietal region throbbing pain insidious onset radiating to neck and hands accompanied with tingling sensation. Photophobia and phonophobia present along with lacrimation of eyes. Anger outburst at that time. No complains of nausea or vomitings, headache during sleep, diplopia . Aggreviated in summers relives on taking medication saradon.

18 years ago she had closure of ear piercings and pain on forcefully wearing ear rings.

Complains of pain in right calf since 15 years after strenuous exercise relives automatically. Did not affect her daily routine activities. Pain aggreviates in cold condition and relives after applying Ayurvedic oil locally

Complains of elbow joint pains, shoulder joint, knee joint, heel joint and distal interphalangeal joints stiffness in the early mornings during winters.

Patient had insomnia and frequent headaches, bleeding from mouth and nose 5 years ago.went to local hospital BP systolic -240 got diagnosed with hypertension. Prescribed telma am 40/5mg changed to tab telma 40mmhg since 2 years.

Complains of belchings and vomitings accompanied with headache, sweating and palpitations, feels weak and hot three years ago aggreviated at evenings and nights relives after taking eno and drinking sprite.

Patient had body pains and giddiness and increased sleepiness. Got sugar profile tested at home. Drank guava leaf juice and symptoms relived.

Left lower back pain dragging type insidious onset radiating till left foot since one year aggreviated at nights on lying supine or on standing and relives automatically by morning.

15 days ago she got her blood sugars tested FBS-242 PPBS-306mg/dl started on medications tab (metformin 1000mg Glimiperide 2mg ) BD . Tab vildagiptin at night.

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MEDIASTINAL SHIFT USING 2D ECHO PROBE

Case history 40 year male autodriver by occupation resident of Narketpally came to General medicine opd with complains of Pain abdomen since 3 days, Cough since three days and Difficulty breathing since 3 days Patient is apparently alright until 3 days ago then had complains of Epigastric pain and abdominal bloating sensation , insidious onset, intermittent , No aggravating and relieving factors. Patient consumed soda water, eno, jeera soda to alleviate symptoms Complains of Non productive cough insidious onset associated with shortness of breath progressive from grade 1 to grade 4 aggreviated on supine position and lying on right side. History of low grade fever not associated with chills and rigor, no diurnal variations relieved with Tab PCM650 mg No complains of loss of appetite, weight loss, insomnia No complains of Orthopnea, PND, Palpitations, profuse sweating No complaints of burning micturition, increased or decreased urine output No complains of nausea, vomiting, loose stoo

PROJECT

TITLE:- BIOPSYCHOSOCIAL FACTORS INFLUENCING OUTCOMES IN PATIENTS WITH ABDOMINAL OBESITY AND MULTISYSTEM COMORBIDITIES By Dr. VEMULAPALLI HIMAJA (General Medicine PG) Team Members- Dr. Rakesh Biswas(MD General Medicine), Dr.Vishwak (MD PSYCHIATRY) INTRODUCTION Abdominal obesity may be defined as excess deposits of fat in the abdominal region. It is a common health condition seen in South Asians and is positively related to non-communicable diseases (NCDs). It is independent of body mass index and measured by raised waist circumference for men≥90 cm and women≥80 cm1 Waist circumference (WC) and waist-to-hip ratio (WHR) are widely used as indirect measures of abdominal or central adiposity in epidemiological studies. Although the definition of abdominal obesity remains in dispute, the cutoffs for WC (102 cm for men, 88 cm for women) and WHR (0.95 for men, 0.88 for women) were recommended by the American Heart Association and the US Department of Agriculture2 Abdominal obesity was deter

74M CHF HTN DM PROSTATE CA

74 male from jalalpuram came with complaints of sob and chest pain since 3 days Patient was born and brought up in jalalpuram,lived along with parents and 3 siblings,studies till 9th standard,no health issues in childhood, discontinued education and entered carpenter work at 16 yrs of age. He got married at age of 21 years and had 3 sons and 1 daughter and lead a relatively healthy life, Patient remained asymptomatic till 14 years ago then he developed tingling sensation and weakness of limbs intermittently for which he went to local hospital and was diagnosed of having high blood pressures around 200/100 and was started on anti hypertensives,he was continuing medication and his bp was under control and remained asymptomatics until 7 yrs ago, At that time he had h/o burning micturition along with pain and dribbling of urine ,he went to local hospital for that and was diagnosed of having prostatic carcinoma and resection of tumor was done at that time and also used medication for 2 y

Himaja

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