80yr male hypoglycaemia
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.