Dr Keerthi Sree Reddy Endoori_KIMS

A 32 year old female patient presented to the OPD with the complaints of - Pain and burning sensations over the upper back for 7 years  -Breathlessness on exertion for 7 years -Difficulty in speech for 5 years -Facial puffiness since 2 weeks She was apparently asymptomatic 7 years back, then she developed pain in the back,scapular region, dragging type a/w burning sensations . She says she started having breathlessness on exertion (even on climbing stairs/walking for a distance of 1/2-1km) since 7 years. She says all her problems started since her last childbirth 7 years ago when she had postpartum hemorrhage and hysterectomy done for it. History of bilateral swelling of both the legs since 7 years. History of Paresthesias of both upper and lower limbs since 7 years. History of muscle cramps in both the calfs since 7 years. She says she developed difficulty in speech i.e slowness in speech,exhaustion on talking for sometime, stuttering , insidious onset, gradually pro

A 47 year old male patient, shopkeeper by occupation and resident of nalgonda presented in the casuality with the chief complaints of -Fever for 2 days -Bleeding per rectum for 2 days. He was apparently asymptomatic 2 days back, then he developed fever, of high grade, a/w chills and rigors, headache and intermittent in nature. He gave history of bleeding per rectum,frank blood on the sqatting pan,not a/w any pain while defecation. He had Pain abdomen in the periumbilical region,squeezing before passing stools and subsides after thet. History of loose stools for 2 days,watery in consistency and 4-5 times per day. History of giddiness present. No history of nausea/vomitimgs/giddiness/burning micturition/cough/sore throat/generalised body pains/breathlessness. Past history- No history of similar complaints in the past. He is known case of type2 diabetes mellitus since 4 years and on regular medication(Tab.Metformin 500mg and Glimeperide 1mg once daily). Not a k/c/oHypertens

A 2o year old female patient, labourer at construction site by occupation and resident of nalgonda district camw with the chief complaints of -Difficulty in walking for 10 days -Difficulty in standing up from sitting position since 10days Patient was apparently asymptomatic 10 days back,then she developed difficulty in walking (says she has the fear of falling down while walking), insidious in onset, progressed to the present stage. She also has difficulty in standing up from sitting position since 10 days. 10 days back she consulted a doctor at local hospital for this illness and she says she got treated in v/o low potassium levels, but she couldnt find any improvement even after her potassium levels got corrected. She doesnt give any history of difficulty in combing her hair/ mixing food while eating/ slippage of footwear. There is no history of any headache/bowel and bladder incontinence/seizures/fever/ giddiness. No history. dysphagia/dysarthria/ any history suggestive of