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60 year old male with loss of consciousness

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 A 60 years old male patient came to casuality with loss of consciousness at 2 Am  HOPI :  Patient was apparently alright and asymptomatic 12 days and then he experienced slip and fall on 15/4/24 and was taken to government hospital there he was diagnosed as intertrochanteric hip fracture and then shifted to ot there they have undergone surgery . On 17/4/24 patient developed altered sensorium and is so irritable and for further four days he is under observation of doctors and the concerned doctors did not inform the accurate cause to the patient attenders and then he was discharged  After discharge patient was at home with same irritable condition and altered sensorium for four days and again on 24/4/24 he suddenly developed SOB and then the patient attenders  admitted him to hospital there he had undergone CT brain suggested age related changes and for SOB they followed conservative treatment and altered sensorium is present And on Saturday at 2 Am patient loss...
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65F Heart failure with preserved ejection fraction , ITP

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 A 65 years old female came to opd with c/o breathlessness since one week, insidious onset gradually progressive, grade 2-3 nyha, aggrevated on exertion, relieved with rest HOPI:  Patient was apparently asymptomatic 10 days back then developed shortness of breath. H/o generalized weakness and easy fatiguability  No h/o chest pain, palpitations, syncope, orthopnea, pnd No h/o cough, cold, fever, abdominal distension, facial puffiness, pedal edema, decreased urine output Past history:  h/o similar complaints in 2010, got 3prbc transfusions for Anemia, normal bone marrow biopsy, negative direct indirect coombs, in 2011 treated with steroids K/C/O: 2mnths back got dental procedure done, associated with blood loss, and started on steroids N/K/C/O : DM/ HTN /CAD / CVA / ASTHMA / THYROID /SEIZURE DISORDERS Personal history :  _ occupation : homemaker Patient is married  Patient takes mixed diet appetite is lost  Bowel and bladder movements are regular Micturi...
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IMMEDIATE CAUSE TYPE 1 RESPIRATORY FAILURE ANTECEDANT CAUSE ALTERED SENSORIUM SECONDARY TO METABOLIC ENCEPHALOPATHY [RECURRENT HYPOGLYCEMIA / HYPOXIA ] IMPENDING DESCENDING HERNIATION

 Case History and Clinical Findings CHIEF COMPLAINTS ; PATIENT CAME WITH COMPLAINTS OF BEING UNRESPONSIVE SINCE 2 HOURS [6.00 AM] HOPI ; PATIENT WAS APPARENTLY ALRIGHT AT 6.00 AM WAS ABLE TO DO HER ROUTINE DAILY ACTIVITIES FOLLOWING WHICH SHE WAS FOUND UNRESPONSIVE AND NO C/O INVOLUNTARY MOVEMENTS ,INVOLUNTARY MICTURITION ,DEFECATION,UPROLLING OF EYES , TONGUE BITE PATIENT WAS TAKEN TO AREA HOSPITAL .GRBS WAS 32MG/DL SPO2 80% ON KA CONSERVATIVE WAS GIVEN [BLOOD GLUCOSE LEVELS WERE CORRECTED ,O2 INHALATION SUPPLEMENTATION INJ DERIPHYLLINE WAS GIVEN AND WAS SENT TO OUR HOSPITAL FOR FURTHER MANAGEMENT HISORY OF PAST ILLNESS ; NO H/O SIMILAR COMPLAINTS IN THE PAST NO C/O FEVER ,VOMITING,LOOSE STOOLS,PAIN ABDOMEN ,SOB ,CHESTPAIN , PALIPITATIONS PATIENT ATTENDARS GAVE HISTORY THAT PATIENT CONSUMED 6-8 TABLETS OF GLIMPIRIDE N/K/C/O HTN ,DM , CVA ,CAD ,TB, ASTHMA GENERAL EXAMINATION; GENERAL EXAMINATION PATIENT IS CONSCIOUS NO PALLOR ,ICTERUS, CYANOSIS ,CLUBBING ,LYMPHADENOPATHY ,OEDEMA OF...
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