EMANY MANI CHANDANA ROLL NO. 42

 A 36 year old female, homemaker from Narketpally was presented to the hospital with C/o Shortness of breath since 4 days History of presenting illness Patient was apparently asymptomatic 7 days back then she developed fever with chills and rigor (9th August 2022) which was intermittent, subsided on taking medication but increased within 30-60 mins. Fever was associated with headache and sensation of pins and needles on the left side from head to toe.  She visited a local doctor and was diagnosed to have typhoid for which she was taking medication.  She developed shortness of breath 4 days back(12th August 2022) which was of grade 3. She had 4-5 episodes of vomiting three days back(13th August 2022) which was non projectile, non bilious and contained food particles of immediately previous meal.  Past history H/o of left mastectomy 2 years back on suspicion of malignancy.  H/o Renal calculi 7 years back No h/o Diabetes mellitus, Hypertension, Tuberculosis, Asthma, Epilepsy, CAD.  Person

Patient is referred from Dermatology department.  A 66 year old male patient from Kakkereni, AP Lingotam, Shepherd by occupation came to the OPD with C/o Multiple painful blisters all ove the body sparing palms and soles.  History of presenting illness Patient was apparently asymptomatic 5 years ago then he started developing itching all over the body suddenly which subsides temporarily on applying Vaseline.  5 days ago he developed a blister on the dorsal surface of the middle distal phalynx of his left hand following which his body started itching and blisters started appearing on his body starting from the periphery spreading to the trunk which were painful. It was associated with fever but cured immediately on taking medication. The blisters are rupturing spontaneously and serosanguinous fluid is oozing out of the ruptured blister.  Past history He had no similar complaints in the past.  K/c/o Diabetes mellitus since 5 years and Hypertension since 3 years and is on medication with

 A 65 year old male patient from Gundrampally village, Chityala who used to be a toddy climber by occupation came to the casuality with C/o Shortness of breath since 3 days Associated symptoms are  Weakness in left upper limb and lower limb since 8 days Difficulty in walking since 8 days Involuntary defecation and micturition since 5 days History of presenting illness As explained by the patients' younger son Patient was apparently asymptomatic 10 years back then one day early in the morning while waking up he noticed weakness in the left upper limb and lower limb and couldn't support himself properly.  2 days later he started using Ayurvedic medicine for the weakness, which progressively improved and he got completely alright within a month and got back to his daily routine Patient had a normal life style until 8 days back.  8 days back at 12 am patient woke up to micturate and noticed that he is having a similar weakness in the left upper and lower limb like previous and coul