K SRINIDHI ROLLNO 63

A 45 year old female patient resident of nakrekal agriculture worker  by occupation presented with CHIEF COMPLAINTS :- fever since 2days ,  generalised body pains since 2 days,  head ache and neck pain since 1 day and  2 episodes of vomitings  HISTORY OF PRESENTING ILLNESS:-patient was apparently asymtomatic since 2days then she developed high grade fever which is  continous and not associated with chill , rigor and any kind of rash and does not relieved on medication. Then she was taken to a local doctor  where she was given the medication for fever and body aches (medication unknown) then she had an episode of projectile vomiting non bilious . Then she developed generalised body pains and nek pain by which she could not sleep .  The next day she was taken to a bigger hopital where she was admitted and then had an episode of vomting after drinking water which is projectile and the contents are water .All the routine investigations are done to find the cause but the investigations did

 A 36yr old female patient,resident of ammanabolu   Presented to med opd with cheif complaints of  Fever since 3 days  Headache since 3 days History of presenting illness: Pt was apparently asymptomatic 3 days back  Then she developed high grade fever on 26th night which was sudden In onset,intermittent and associated with chills.  Pt had severe throbbing headache and neck pain. It was associated with 3 episodes of vomitings which was non projectile,non bilious,contained food particles. H/O generalised body pains on the first day of fever. No h/o rashes on the body,cough,pain abdomen,loose stools,intake of food from outside DAILY ROUTINE She usually wakes up at 6:00am and does her household chores,drinks tea or milk by 9:00am,then she prepares lunch for the family,she eats her lunch by 12:30pm,then she either talks to her neighbours or sleeps for sometime,in the night she eats dinner and sleeps around 10:00pm. On the first day of fever,she consulted the nearby RMP and he prescribed par

  A 29 yr old male patient jewellery maker by occupation presented to medicine OPD 4 days back with chief complaints of  Constipation since 1 month  Bleeding per rectum since 1 month HOPI:  Since 1 month pt is having difficulty in passing stools .it was associated with passing of blood in stools every time he tried to pass stools.Associated with severe pain and itching around Anus and a feeling of incomplete evacuation of bowel . No abdominal pain.  Patient had 2 episodes of vomitings 10 days nd 3 days prior coming to Hyderabad which were associated with retrosternal pain,burning sensation in epigastrium and few drops of blood. Past history: not a known case of diabetes,HTN,asthma,epilepsy,thyroid disorders,ckd,cad  PERSONAL HISTORY: Diet- mixed  Appetite-normal Bowel and bladder- regular  Sleep-adequate  Addictions- smoking since 15 yrs  Alcohol since 10 yrs stopped 2 months back EXTENDED HISTORY: In 2006, gastric problems increased (suspected etiology new kind of food, used to eat sp