Days of life in medicine

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...

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 ...

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 me...

A double-blind, randomized, placebo-controlled trial within 96 hours of their subarachnoid hemorrhage, to determine whether treatment with the calcium blocker nimodipine would prevent or reduce the severity of ischemic neurologic deficits from arterial spasm.  P - 125 neurologically normal  patients with intracranial aneurysms I -  8 of 60 patients given placebo  C - 1 of 56 given nimodipine O - Analysis of the amount of basal subarachnoid blood on pre-entry CAT scans in patients with deficits from spasm showed that an increase in subarachnoid blood was not associated with a worse neurologic outcome among patients who received nimodipine, unlike the situation in patients given a placebo. There were no side effects from nimodipine. It was concluded that nimodipine should be given to patients who are neurologically normal after subarachnoid hemorrhage in order to reduce the occurrence of severe neurologic deficits due to cerebral arterial spasm.  Results:  Ra...

A 60 year old woman presented with the complaints of  Dyspnea at rest since 15 days Left lower limb swelling upto knee since 10 days Reduced urine output since 10 days A 60 year old woman who used to work as a farmer 3 years back, mother of 5 children (3 daughters and 2 sons - 1 son expired, patients attendant reluctant to discuss the cause) presented to the casualty with the complains of dyspnea on exertion since 1 year. 1 year back she visited Osmania hospital for these complaints after which she has been put on medications which she has been using on and off (not documented). Since the past 4 months she has been experiencing dyspnea at rest on and off, whenever she experiences dyspnea she visits a hospital, takes medication and then stops taking them. Since the past 15 days she has been experiencing dyspnea at rest and 10 days back she has had a trauma to her right 2nd toe after which she developed left lower limb swelling along with reduced urine output. She was taken to a loca...

 Marchiafava- Bignami Disease: A 32 year old man with a history of consuming large amounts of alcohol since the past 3 years presented with an acute onset dementia, cognitive impairment. His last alcohol intake was 3 months back, His MRI brain revealed diffusely thinned out corpus callosum.  A 32 year old man who used to work at the Finance department at Kothagudem presented to our OPD today at 4pm with the complaints of: Forgetfulness since 3 months Irrelevant talk since 3 months Lack of self care since 3 months  He studied MBA and works as an accountant. He was an occasional alcoholic for 7 years but since the past 3 years, according to his wife, he has  been consuming more amount of alcohol. Initially he used to consume 180ml of whiskey per day 2 years back which increased to 360 ml of whiskey per day over the past 1 year.  Over the past 3 years, his wife also tells us that he had recurrent episodes of pain abdomen and was admitted with acute pancreatitis 5 t...

 A 50 year old housewife from Valligonda presented to our opd  with the complaints of  1 episode of loss of consciousness 3 days back  She studied till her 4th grade and got married to a farmer at the age of 17 years. She gave birth to 4 children via normal vagina delivery and got operated for hysterectomy around 25 years back. Her elder son is unemployed and is an alcoholic where as the younger son is a daily wage laborer. Both of her daughters are married.   On further questioning her brother revealed that the patients behavior has changed ever since she got married. Her brother reveales his brother in law to be an abusive husband. He says his brother in law often beats her so much to an extent that she would often have nose bleeds. She  covers her bruises and takes pain killers frequently for the pain.  On a daily basis, both the husband and wife quarrel alot. She has become an aggressive individual herself and often bears her children. She sho...