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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. A 46yr old female, labourer by occupation resident of suryapet came to hospital with complaints of fever 20 days back- High grade, sudden in onset, intermittent type associated with nausea vomitings 1-2 episodes/day non projectile, bilious and food particles as contents. History of loose stools 2-3 episodes only on one day- foul smelling, no blood and mucus in stools.                 Patient was apparently asymptomatic 6yrs back. Later she developed generalised weakness and giddiness for which she was taken to hospital and diagnosed with diabetes mellitus and on glimi M1 initially and converted to glimi M2 3yrs later. History of one episode of asthma 3yrs back for which she used inhaler. Since 1yr she developed left knee pain for which she is using unknown medication regularly. 6 months back she had an episode of giddiness f
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Biweekly assessment

 1)Anatomical diagnosis -? Glomerulosclerosis                                                                        Etiological diagnosis -  ?? Nephrotic syndrome secondary to the diabetic nephropathy or CKD.      2)Reasons for I) Azotemia : impaired renal excretion of urea and creatinine secondary to CKD.  II) Anemia : decreased erythropoietin.  III) Hypoalbunemia: capillary basement membrane and podocytes damage.  IV)  acidosis: acidification of urine is lost.                                       3) Rationale : syp potchlor was given because of the hypokalemia.. Inj. NaHCO3 was given because of metabolic acidosis ..Insulin and antihypertensives are given because known case of DM and HTN. Orofer XT was given because of anemia.. Inj. Lasix was given to decrease her volume overload. Spironolactone was given it was a potassium sparing diuretic.Calcium was given to the patient  because of hypocalcemia secondary to CKD. Indications of NaHCO3:metabolic acidosis in cardiac arrest, Tricycli
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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
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            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
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