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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