PARDHU ROLL NO 79

 History  An 80 year old male, a resident of Chityal was brought   to the casualty in an unresponsive state at around 6:00am.  The patient was apparently alright few hours back. The day before he ate at 5 pm and went to sleep.He woke up and then couldn't sleep again at night. He tried sleeping but suddenly got up and then experienced a fall. Went to sleep again without eating anything. He woke up at around 1:00am to have some food (a glass of milk and rice). He then slept back. At around 4:00 am he felt uneasy and tried to wake up his wife by tapping her. She didn't respond initially. Later, she saw that he was sweating profusely, had raised body temperature and was unable to see or unable to talk even though there was movement of the neck muscles.  He was taken to the nearby hospital in Ramanapet where they noticed that his pupils are asymmetric and non- reactive to light.There was increased effort of breathing and fall in BP. He was treated with IV DNS and O2 supplementation.

  A 47 year old patient,House wife by Occupation,Resident of Nalgonda,Came to OPD with cheif complaints of Generalized itching since 1 month. Difficulty in breathing since 7 days. Back pain since 7 days. HOPI: Patient was apparently asymptomatic 6 years back then she developed giddiness for which  she went to Hospital and diagnosed as diabetes and she was on regular medication. In March 2022 there is a history of edema in both lower limbs up to thighs ? for which she went to hospital in Nalgonda and was discharged after resolving edema? also in her tests she was  found to be having Hypothyroidism and Hypertension and she was started on regular medication. In April 2022 she was having Abdominal Distension,She diagnosed as Ascitics for which ascitic tap was done .At that time on further examination she was found to be have cervival lymphadenopathy. In June,FNAC was done? and found to be have extra pulmonary tuberculosis. She is on ATT from 21 july. H/o generalized itching  since 1 month?