Days of life in medicine

21 year old woman, working as a nurse in an outside hospital, residing at Nalgonda presented to casualty on 26/8/2021 with the chief complaints of  Fever since 4 months  Generalized weakness since 4 months Body pains along with multiple joint pains since 4 months Cough since 1 month  Vomiting 1 day back  Unable to walk since 1 day Unable to pass urine and stool since 1 day She was born out of a non consanguinous marriage. She cried immediately after birth.  At birth - she was in the hospital for 2 - 3 days for jaundice.  Her father works as a shop keeper and her mother works at a chaat bandi. She has 2 elder sisters, both of her sisters work as the nursing staff.  At 13 years of age, she had a history of fall following which she lost all her teeth. She was apparently alright until 1 year back when she noticed swelling in her neck after she went for a checkup to a local hospital where she got diagnosed to be hypothyroid. She was started on Tab thyronorm 100mcg once daily. Few months lat

A 65 year old from ********* presented with the complaints of  Bilateral lower limb swelling since 1 month  Dyspnea on exertion since 20 days Black coloured stools since 20 days  A 65 year old man, previously used to work as a farmer 6 years back, got married to his far relative and has been happily married with 3 children.  He has been an occasional alcoholic and a beedi smoker and smokes around 3 to 4 beedis per day. He smoked last 3 months back. 25 years back, his left index finger was amputated after it got hit by a tractor. 20 years back he got into a fight with his friends following which he had a trauma to his head following which he had one episode of seizure and he was put on antiepileptics, which he used for 3 years and stopped. Since 6 years - He has been experiencing bilateral knee joint pains so much that he stopped working. He paid a visit to our hospital and was advised for a total knee replacement. However, on further investigating him  he was told that he had a heart c

A 20 year old woman presented to our opd on 19/8/2021 with the complaints  Hyperpigmentation of her lips since 1 year Hyperpigmented patches on cheeks and upper limbs since 3 months  20 year old woman, who noticed a hypopigmented patch measuring 1cm into 1cm on her forehead 10 years back after which she consulted a doctor and was diagnosed with leprosy and has been on treatment since 10 years. Since 1 year she has been having hyperpigmentation of her lips. Since the past 3 months she has also noticed hyperpigmented patches on her face following which she developed similar patches on her chest and her bilateral upper limbs. She says these are aggravated post exposure to sun light.  She says these lesions are itchy and scrap on scratching. She was advised skin biopsy on 8/8/2021 and ANA levels by our dermatology department. SKIN BIOPSY REPORT: Serum ANA turned out to be 173 (raised) Her other routine investigations were normal except for he

55 year old man, owns a restaurant at choutuppal presented with the complaints of Bilateral lower limb swelling since 1 month Reduced urine out since 20 days Abdominal distension since 7 days Scrotal swelling since 4 days Patient used to previously work as a farmer  and later in 2004 he and his wife started running their local bandi for breakfast at Choutuppal. He even serves breakfast on cycle. He is a father of 2 children.   22 years back:  He got diagnosed with pulmonary kochas for which he used ATT for 6 months   1 month back :  He first developed left lower limb swelling extending upto his ankle and he later gradually developed swelling of his right lower limb and the swelling in both his lower limbs extended upto his thighs He even had difficulty in passing stools for which he received enema outside  Since 20 days - he has been experiencing reduced urine output  10 days back - When he paid a visit to a hospital with these complaints he got diagnosed to be hypertensive and was sta

A 60 year old woman, housewife by occupation presented with the complaints of  Dyspnea on exertion since 6 months  Chest pain since 2 days   She was apparently asymptomatic 6 months back after which one day after getting up in the morning she suddenly started to experience dyspnea at rest, which progressed over the next 3 days. She says the dyspnea aggravated on walking and on laying down in supine posture, she says her dyspnea reduced in sitting posture. Because of this she started to have disturbed sleep. The following day she  experienced retrosternal chest pain radiating to her left shoulder. Over the next 3 days she had intermittent episodes of chest pain on and off along with productive cough with scanty mucoid, non foul smelling, non blood tinged sputum.  She got admitted with us 6 months back with these complaints for 1 week and was diagnosed with heart failure with reduced ejection fraction of 29%, Iron deficiency anemia  and has been on regular medications ever since. Since t