G.VAMSI KRISHNA

66 years old male patient came to OPD with C/O Right sided weakness of Both UL and LL since 3 days H/o SOB on exertion since 4 months Patient was apparently normal 4 months back and then he had sob on exertion which relieved with rest. 3 days back then at morning after his work while eating breakfast he couldn't mix food, immediately they went to local RMP and took some injections and went back home in hope of recovery, next day morning he developed Right lower limb weakness No deviation of tongue No deviation of angle of mouth No drooping of eyelid Past History -  Not a k/c/o HTN,DM,TB,CAD, CVD,Asthma  Personal history - He is married and a farmer by occupation  He has a habit of drinking alcohol (180ml) daily from the past 40 years and smokes beedis(one pack-18) daily from the past 40 years Diet - mixed Appetite - Normal  Bowel & bladder movements - regular  Family history - not significant On Examination  patient is c/c/c No pallor , icterus , cyanos...

 47 yr old male came to casualty with c/o SOB , cough with sputum since 4days . HOPI- Pt was apparently asymptomatic 15yrs back had intermittent SOB (grade 2) assoc. with cough with sputum (?asthma ) for which pt was on intermittent inhalers . 3yrs back had H/o pedal oedema , SOB (grade-4) with orthopnea , abdominal distension , consulted the cardiologist , said to have CAD , patient was on TAB.frusemide , TAB PAH(20 mg) , Echo shows : RA , RV dilated with EF 50%.Patient was on irregular medication for CAD and Right heart failure with PAH. 4days back had H/o pedal oedema , abdominal distension, SOB(grade-4), decreased response , not responding to deep stimuli . Admitted in outside hospital with SpO2 :80 @ RA, RR:38/min . Patient was put on Inj.NA & dobutamine , O2 inhalation & intermittent BiPAP , Inj. Zostrutum, Inj thiamine   Past History : Not a k/c/o HTN,DM,TB, Asthma, CAD, CVD Personal history : Diet-mixed  Appetite - normal  B&B - regular ...