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Short case -2

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 28 year old married  woman, mother of two , from     nalgonda   ,who does maggam work on blouses , came for followup ,  patient was apparently asymptomatic till july  2021, when she first developed low grade fever ,which was present daily,increasing during evening time, for which she took tab dolo 650mg everday for one month, after which she started having joint pains(b/l knee, ankle, elbow, metacarpophalangeal and proximal interphalangeal joints) associated with swelling , with slight restriction of movement for one month. later she developed oral ulcers,which were painful . she also had increased hair fall,but no alopecia . h/o rash over cheeks ? photosensitive h/o pedal edema pitting type upto ankle. Her first consultation with a physician was in September 2021 ,where she was adviced to get  ana profile done, and was diagnosed with pancytopenia , and started on hcq  200 mg and prednisolone 10 mg twice  per day , azathioprin...
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Short case 1

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 58/M , welder by occupation, hailing from miriyalguda , came with chief complaints of giddiness since 3 days . h/o present illness he was apparently asymptomatic 3 days back when he developed giddiness which is gradual in onset, rotational, episodic, lasting for 30 sec to 1 min,  more on getting up from the bed or turning towards the right side, resolved spontaneously., increasing in frequency since 3 days , as he took leave from working and preferred to take more rest . not associated with syncope,headache,hearing loss, nausea,vomiting, chest pain, blurring of vision,neck pain, sweating, palpitations,weakness of limbs, swallowing difficulty, past history: no similar complaints in the past no history of diabetes , hypertension,cerebrovascular disease, coronary artery disease.  Personal history:  Drug history: intermittent use of pantoprazole  40 mg for symptoms of belching ,bloating sensation especially after alcohol Addictions: alcohol - whiskey 90 ml once or ...
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Long case

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 29/F ,homemaker  , unmarried, hailing from chityal, who completed her bsc botany came with complaints of  lethargy ,since 6 months. history of presenting illness: patient was apparently asymptomatic 6 months back , when she  started developing pedal edema on and off upto ankle, subsided on taking rest and elevating limbs, easy fatiguability on doing daily chores like cooking, cleaning the house. not associated with ,chest pain, shortness of breath, giddiness,loss of appetite,weight loss. past history: 12 years back , one afternoon during bathing she suddenly couldnt talk,or move her right upper and lowerlimb,with deviation of angle of mouth to the left ,upon which she made sounds , her mother who was nearby came to her aid ,and she was taken to hospital in nalgonda within an hour,and referred to gandhi hospital where she was admitted for 20 days,during which her speech returned and she was able to lift her right upperlimb and walk without support, but still has limp...
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Procedures

Central line -IJV https://youtu.be/EJlsjUL8nMc Lumbar puncture https://youtu.be/qaG8hs-rlhA Menze's technique for lung biopsy https://youtu.be/yIfqr9gjOps
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Prefinal

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Timeline of events 24/M - with a daily routine of getting up in the morning , bathing, eating food prepared at home reluctantly consisting of only curd and half a chapathi, refuses to take spices, meat,vegetables, followed by picking up cowdung 2-3 hours a day. After which he rests for an hour or two in the afternoons , and tends to the cows till evening, this involves taking them to a field 3kms away from home by walk and bringing them back.He interacts with his family and describes his daily events in the day followed by dinner and sleep...with intermittent 2-3 times a week , bedwetting in the night. He also has a liking for particular sweet which he buys with the exact money given to him at home, from a shop nearby. After getting discharged here, family has to take care of his dressing , and take effort to keep the central line dry, change his diaper once he informs them that he passed stool without his knowledge. General examination: Built: thin, poorly nourished Pallor+ Motor exam...
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