General medicine case 1

  CHIEF COMPLAINT:   A 27 years male patient occupation by electrician came with chief complaints of pain abdomen since 3 months  HISTORY OF PRESENT ILLNESS :-  patient was apparently asymptomatic 3 months back, then he had a trauma where his relatives have beaten him with stick at the left hypochondrium region and  then he developed mild diffuse abdominal pain associated with bilious vomiting contains food particles , then the pain subsided on taking medications . After a few days he again developed pain abdomen at the left hypochondrium region and the pain radiating to back , then he went to government hospital where he under went treatment but the symptoms didn't subsided . So he went to a private hospital we he took treatment but in the middle of treatment , he tested postive in the hospital , so he went to home isolation , were he approached a local  rmp for the pain abdomen and covid . After  5 days he tested negative in mid of January  so he went back to the same private  ho

  Feb 6,2022 A 50 year male farmer ,manual labourer,brought  to casualty with h/o altered sensorium since 1 day H/o fever since 4 days. HISTORY OF PRESENT ILLNESS - Patient was apparently asymptomatic 4 days ago,then he developed fever which is high grade,No diurnal variation, associated with chills. No h/o cough and GE symptoms.  Attenders tells h/o stoppage of  OHA for 3days, h/o decreased intake of food as he has fever. H/o altered sensorium since 1 day. Irrelevant talk,not recognising attenders since this morning . Able to move all four limbs,No h/o vomitings, head ache, seizures. Took him to nalgonda hospital SHIFTED HERE FOR FURTHUR MANAGEMENT.  PAST HISTORY -  H/o TB 2YRS back used anti tubercular therapy for 6 months. Diagnosed as Type -2 Diabetes mellitus on oral hypoglycemic medication 1 YR back. No H/O Hypertension , CVA(cerebral vascular accident) , CAD(coronary artery disease), COVID-19. PERSONAL HISTORY : DIET - MIXED, APPETITE -NORMAL , BOWEL MOVEMENT - REGULAR ,  BLADD