Dr Keerthi Sree Reddy Endoori_KIMS

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...

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 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...

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...

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/oHyper...

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...

A 45 year old male patient,agricultural labourer by occupation presented to the KIMS General Medicine OPD with the complaints of difficulty in standing up from sitting position since 6 months and history of weakness in the upper limbs hindering his daily activities since 5 months. He was apparently asymptomatic 6 months back then he developed proximal muscle weakness in the lower limbs ,initially in the right lower limb followed by left lower limb. He had difficulty in getting up from sitting posture and he also complained of tightness initially in the right lower limb followed by the left. After a month, he had difficulty in performing his daily activities with both his hands such as holding the instruments for work on the field. He says this was followed by his inability to lift his left hand above his head initially followed by weakness even in the right hand. He gives history of slippage of footwear since 3-4months and also He is unable to button and unbutton his sh...