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24 YEAR OLD AND EXTENSIVE GASTRIC ULCERATIONS

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Mr. ABC, 24 year old work IT Professional hailing from Odisha walks into the Med Gastro OPD with dyspeptic symptoms and says he has been having heartburn, vomiting and regurgitation since 1-2 months. He initially had heartburn and regurgitation in the last 3 months followed by mutiple episodes of non bilious non projectile vomiting, more after taking meals, not a/w coffee ground vomitus. He says he is on a strict diet and exercise training as a part of weight loss programme and has been taking home made Menthi water for the same. He doesn't give history of fever, loss of appetite, altered bowel habits, postprandial fullness, yellowish discolouration of eyes and skin, black colored stools, headache, neck rigidity. He has no comorbidities. He consumes alcohol once in a while and doesn't smoke. His parents and siblings are absolutely fine and he doesn't give any significant family history as such. He is a non vegetarian. His bowel and bladder habits are regular. His appetite i

ACUTE PRESENTATION OF CHRONIC DIARRHOEA

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 Mr XYZ , a 20 year old lean Hindu boy, native of kerala, staying at chennai for his studies has been for a 1 week joyous trip with his friends somewhere in the mid february only to visit us in 1st week of March with complaints of 3-4 episodes of small volume , semisolid , bloody mucus stools. He also gives history of dyspeptic symptoms intermittently when he has oily or spicy food. He has loss of appetite, flatulence and feels tired easily these days. He completed a 5 day course of antibiotics which are supposedly Ciprofloxacin and ornidazole. He was on probiotics for 10 days before he came to us. He says he finds no improvement in his symptoms after all the above treatment. He says he doesn't have any abdominal pain, vomiting, nausea, black colored stools, pain while defecation, weight loss, fever, nocturnal symptoms, yellowish discolouration of skin or eyes, clay colored stools, evening rise of temperature, cough. PAST HISTORY: No known comorbidities. FAMILY HISTORY:   No histor

SPASTIC PARAPARESIS_HYPERTHYROIDISM A MIMICKER OF MOTOR NEURON DISEASE?

A 50 year old female patient, agricultural labourer by occupation presented to the General Medicine OPD with the complaints of weakness of lower limbs, insidious in onset, gradually progressive type since 2 years. She was apparently asymptomatic 2 years back then she developed  proximal muscle weakness in the lower limbs ,initially in the right lower limb followed by left lower limb. She had  difficulty in getting up from sitting posture. Sh doesnt give any history of loss of consciousness, seizures, giddiness, bowel/bladder incontinence,cranial nerve anbormalities,paresthesias in the limbs. H/o Weight loss present. Past history : Not a k/c/o Hypertension,Diabetes mellitus,Thyroid disorders,pulmonary kochs,epilepsy,asthma. Family history : No history of similar complaints in the family. Not a k/c/o Hypertension,Diabetes mellitus,Thyroid disorders,pulmonary kochs,epilepsy,asthma. Personal history: Mixed diet Appetite adequate. Bowel and bladder regular No sleep di

RECURRENT STROKE IN A 69 YEAR CHRONIC ALCOHOLIC

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69 year old male patient presented to our OPD with complaints of WEAKNESS OF RIGHT LOWER LIMB FOR 4 DAYS SLURRING OF SPEECH FOR 4 DAYS Patient was apparently asymptomatic 3yrs back then all of a sudden developed Loss of speech  following binge of alcohol without any limb weakness , had a Seizure episode, then he consulted a doctor where Neuroimaging was done(CT scan), He was given Treatment accordingly. He improved and was discharged. After discharge he took medicine for 5 months. An year he had similar complaints of loss of speech following binge of alcohol , was taken to the hospital improved with glucose drip( according to the patient ). Six months back patient he developed Weakness of all four limbs  associated with Loss of speech. He was admitted in our hospital this time.He also had Seizure episodes,irritable behaviour and recovered within 5 days and got discharged , was put on medication. The evaluation included following- He used the medication for a while and t

FEVER WITH ABDOMINAL LYMPHADENOPATHY IN A MALE

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A 48 yrs old male patient by occupation carpenter belongs to lower middle socioeconomic status came to the hospital on 16/4/19 with chief complaints of HIGH GRADE FEVER FOR 3 MONTHS, DECREASED APPETITE FOR 3 MONTHS, WEIGHT LOSS FOR 3 MONTHS Patient was apparently asymptomatic 3 months back, then in February he developed fever which was of high grade , intermittent in nature , associated with chills and rigors , relieved on medication. This continued for 2 days after which he went to a quack who treated him as having Typhoid fever with medications for 1 week. This fever was not a/w Burning micturition, ear pain, headache, rashes, generalised body pains, cough, cold, sorethroat,chest pain,palpitations,swelling of both lower limbs. With this the patient didnt have any fever episodes for the next 15 days. During this period the patient continued to have alcohol daily. After 15 days he had another episode of High grade fever. The patient was sent to a doctor this time in