11 Ankesh Sahu

A 15 year old male patient resident of poddichedu presented to the opd with chief complaints of  1) chapping of corner of lips since 3 months  2) inflammation of lower lip since 3 months HISTORY OF PRESENTING ILLNESS:- Patient was apparently asymptomatic 3 months ago and then he developed chapping of the corner of the lips which was insidious in onset and he is intolerable to spicy food and is aggravated by cold weather .  HISTORY OF PAST ILLNESS:- Not a K/C/O of DM , HTN , epilepsy , asthma .  TREATMENT HISTORY:-  PERSONAL HISTORY:-   Diet - mixed  Appetite - reduced  Sleep - normal  Bowel and bladder - regular  Patient wakes up around 7 am in the morning and has a good amount of breakfast fil FAMILY HISTORY:-    Not significant  O/E:- PT is conscious coherent co-operative  BP: 100/70 MMHg  PR :84 BPM RR: 18 CPM SPO2: 98% AT ROOM TEMP NO SIGNS OF PALLOR ICTERUS CLUBBING CYANOSIS LYMPHADENOPATHY S/E:- CVS: S12 PRESENT CNS: NAD RS: NVBS HEARD PROVISIONAL DIAGNOSIS:- Angular cheilitis PH

A 50 yr old female came to GM OPD with chief complaints of fever, vomiting, difficulty in breathing. HISTORY OF PRESENTING ILLNESS: - patient was apparently asymptomatic 2 weeks back then she developed fever of low grade with vomiting 4 episodes per day which is non-bilious, non-projectile. HISTORY OF PAST ILLNESS:- K/C/O- DM since 20yrs K/C/O- HTN since 20yrs. Not a K/C/O of TB, ASTHMA, EPILEPSY TREATMENT HISTORY:- METFORMIN since 20yrs TELMISARTAN since 20yrs PERSONAL HISTORY:- Diet- mixed Appetite- normal Bowel and bladder habits- regular Burning micturition No addiction FAMILY HISTORY:- Not significant PHYSICAL EXAMINATION:- # GENERAL :- No pallor No icterus No cyanosis No clubbing No lymphadenopathy Vitals:- B.p- 140/90mmHg Pulse-  Temp- Afebrile Respiratory rate- 18/min # Systemic examination:- CVS- S1,S2 heard           No cardiac murmurs           No thrills Respiratory system - dyspnoea present                                       No wheeze                                    

A male patient of age 77 years old resident of vangamurthy presented to the opd with chief complaints of  1) diminution of vision in both eyes since 2 years  HISTORY OF PRESENTING ILLNESS:- Patient was apparently asymptomatic 2 months ago and he developed diminution of vision which was insidious in onset and gradually progressive in nature .  It was not associated with watering , photophobia , redness or itching .  HISTORY OF PAST ILLNESS:- There was a history of surgery related to CHD 1 year ago  There was a history of auditory and visual hallucinations since 1 year and was diagnosed 1 month ago . K/C/O of DM 2 since months  Not K/C/O of asthma , epilepsy , Tb  TREATMENT HISTORY:- 1)  Metformin 500 mg  2) risperidone 2 mg  PERSONAL HISTORY:- Sleep : inadequate  Appetite : loss of appetite  Bladder and bowel : regular  Drug allergies : no  Addictions : no  FAMILY HISTORY:- Not significant PHYSICAL EXAMINATION:-   1)  general examination:  Height -  Weight -  Icterus - no  Cyanosis - no