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14 y female child with fever and swelling of left upper limb and right lower limb k/c/o SCA

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 25/7/2023. 14 year female child who is k/c/o sickle cell anemia came with c/o fever and swelling of left upper limb and right lower limb associated with pain since 3 days  Fever which is of high grade not associated with chills and rigors , cold ,cough, sore throat, chest pain , palpitations,sweating,abdominal pain,vomitings,diarrhoea,decreased urine output . No h/o hematuria , melena,bleeding gums,petechia,menorrhagia . HISTORY OF PRESENTING ILLNESS: Patient was apparently asymptomatic 11 years ago (1/4/2012) when she was 3 years old she was admitted in the hospital with c/o fever , cough, vomitings she was diagnosed to have sickle cell anemia (Hb electrophoresis was done) and was given blood transfusion and treated with Inj ampicillin and folic acid  2. On 23/9/14  She was taken to the hospital with complaints of fever, cough ,cold since 1 week and diagnosed with bronchopneumonia ( chest x ray showed left lower lobe consolidation). She was treated with Inj Augmentin and whole blood
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74 y male with sudden loss of speech

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  A 74 year old male who is resident of kondaram Dist- Nalgonda) ,an agricultural labourer ( cotton , paddy ) was referred to our hospital i/v/o loss of speech since 10 days  Urinary incontinence since 10 days  HISTORY OF PRESENTING ILLNESS-  Patient was apparently asymptomatic 25 years back  1.5 years back he went to Bombay at her sisters home while returning back to kondaram got fever for a 1 week which relieved with medication and on routine investigations was found to have Diabetes Mellitus for which he was started on  oral hypoglycaemic drugs  2. Patient was asymptomatic ,17 years ago he developed pedal Edema till knees, yellowish discolouration of eyes and shortness of breadth on exertion for which he got admitted to hospital for 8 days and was managed conservatively.  3. Then  10 years back he developed, history of fever which was low grade associated with evening rise of temperature and cough for 10 days  Diagnosed with ? Sputum positive Tuberculosis and was treated with ATT fo
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46 year old male with spasm of upper limbs

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  46 year old male from chityala came with   c/o spasm of fingers of upper limbs with tremors since 3 days , excessive sweating , calf muscle pain and generalised weakness since 3 days .  History of presenting illness: Patient was apparently normal 10 years ago then he had severe stomach pain and vomitings for which he was admitted to the hospital and was diagnosed to have pancreatitis, he underwent surgery For that and was discharged.After 5 years he went to hospital with complaints of weight loss and weakness,there he was diagnosed with diabetes and was put on oral hypoglycemic drugs , his sugar levels weren’t controlled so he was shifted to insulin . (Past 6 years he is on insulin ) . 4 months ago he had an episode of seizures associated with up rolling of upballs which lasted for one minute, 5 episodes occurred in 30 minutes and in between each episode he had no memory of what had happened. He was admitted in KIMS hospital and was discharged after 5 days . He also has delusional ep
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