Manishgoud103

A 45 old male who was has been having a diabetic foot (necrotising fascitis on the plantar aspect of left foot)since 3 months since then he has been undergoing debridement procedure and then and had SSG 10 days ago.He was a diabetic patient since 10 yrs. He is a farmer by occupation. He had h/o toe amputation 3 yrs ago. The patient had seizure like activity yesterday night ( tonic clonic type) with loc. GCS - 6/15 O/E  Pt is drowsy but responding to commands Bp - 110/70 mmHg Pr - 84 /min CVS - s1 s2 + R/S - BAE+ P/A- soft , non tender  CNS - E 4 V 2 M 4 Both UL and both LL tone normal  Power - Moving upper limbs and rt. Lower limb. Reflexs- B ++ T ++ S ++ K ++ A ++ Pupils -Rt - reactive to light, Lt - mild dilated unresponsive. Diagnosis - SEIZURE LIKE ACTIVITY DUE TO HYPONATREMIA. ?SIADH ?ATN ?Chronic hyperglycemia.

A 45 yr old male patient who was a constable by occupation (but he left the job one and half yr ago because of his chronic alcoholism, Irregular schedules and disturbed mind ) came to the opd on his own intention of quiting the habits of drinking alcohol and chewing tobacco, by getting admitted in the de-addiction centre here. He has grade -2 SOB. He has cough  associated with sputum since 10 days  HOPI-Patient started consuming alcohol 22 yrs ago, back then he used to consume alcohol only occasionally and of a quantity of around 3 units of alcohol (once a week) and occasional chewing of tobaco.Then he along with his childhood friends started increasing the frequency of consuming alcohol from past 15 yrs and got habituated to consume alcohol daily from past 10 yrs(25 units/day) and regularly chew tobacco (10 packets/day). Then as this routine is going on,he had conflicts with his wife 8 yrs ago and so they started living seperately (daughter staying with her mom).Since then he got addi