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

70M ALTERED SENSORIUM ET TUBE INSITU

70 year male was bought to Casuality in an intubated state HOPI: Pt is apparently asymptomatic until 2 days ago then he developed sudden onset of abdominal discomfort and SOB after dinner. Patient was taken to nearby hospital in altered sensorium and was found Grbs-30 mg/dl . patient was intubated i/v/o poor GCS-5/15 and was bought to our hospital for further management with ET tube in situ PAST HISTORY: H/O Right inguinal surgery on 15/09/23 K/c/o hypertension since 12 yrs( on unknown medication) K/c/o Pulmonary Tuberculosis 30 years back( used ATT for 6 months) PERSONAL HISTORY: DIET :mixed APPETITE : Normal SLEEP: adequate BOWEL AND BLADDER :Regular Addictions : Patient was an Alcoholic and smoker 30 years ; stopped after diagnosed with Tuberculosis. FAMILY HISTORY: N/K/C/O DM, Hypertension,Epilepsy, Asthma, Thyroid disorders. GENERAL EXAMINATION: Patient is on Mechanical ventilation. Dilated neck veins present. No Pallor,Icterus,clubbing,cynosis. VITALS: TEMP: 97.2 F BP: 160

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

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