INTERNSHIP MEDICINE POSTING

A 56 years old female, resident of Narketpalle a house wife came to the hospital with chief complaints of weakness of right upper and right lower limbs along with slurring of speech since 2 hrs.             The patient was apparently asymptomatic 2 hrs back. Then she suddenly fell down from chair on to right side followed by which patient attenders noticed and got her up  during which they noticed weakness of right upper limb and right lower limb. Slurring of speech with deviation of mouth to left side is present. This event was not preceded by dizziness palpitations or any syncopal attack.There is no history of involuntary movements, loss of consiousness, tongue bite, chest pain, SOB, orthopnea, PND, vomitings, loose stools, fever. Past history: 
 No h/o similar complaints in past Not a known case of DM/HTN/EPILEPSY/CVA/CAD 
 Personal history: 
 Mixed diet with normal appetite and normal bowel/bladder movements  No h/o alcohol intake No h/o smoking No significant family history. 
 Gen

            Hello everyone, I'm a medicine intern and recently started my medical posting.This is a blog to share my experience and cases I came across during this period.         70 year old woman from Chityal, a daily wage worker presented with the complains of Bilateral pedal edema since Abdominal distension since 4 days Facial puffiness since 4 days Dyspnea since 3 days  She got married to a daily laborer who passed away few years back from a road traffic accident. She has 2 sons, the elder is a tailor and the younger son is a laborer.  She was apparently alright 2 years back when she starting noticing purulent discharge from her left ear for which she visited an RMP who put her on eardrops. She has been experiencing left ear purulent discharge on and off for which she has been using ear drops. During her visit to the RMP she got diagnosed with type 2 diabetes for which she was put on tab Glimiperide and metformin 500mgs OD. She after an year started to experience body pains fo