70/F RECENT HYPOGLYCEMIA 2°TO ? CKD WITH TYPE 2 DM SINCE 10 YEARS.

May 03, 2023

May 3, 2023

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CHEIF COMPLAINTS AND HOPI:

A 70 year old female who is a home maker by occupation who is a resident of chityala was brought to the casualty in altered sensorium.

Patient was apparently asymptomatic 10 years back then while doing some work she suddenly lost her consciousness with loss of speech and uprolling of eyes and weakness numbness tingling sensation in right hand and right leg for which they took her to hospital and found having right sided hemiparesis. And after 1 year she had another episode of loss of consciousness and they took her to hospital and got conservative management(like iv fluids) and got discharged.

And now since 3 days she is having 3 episodes of loss of consciousness (one episode per day in the morning) with uprolling of eyes ,protruding of tongue,dribbling of saliva ,and no involuntary movements,no involuntary defecation and micturition,no nausea and vomitings. Patient beacame normal after intake of food and some sugar.

And today morning a similar episode of loss of consciousness at 5:30 they gave sugar to her but her altered sensorium has not resolved and her grbs at home showed to be 7mg/dl (as told by attenders)and was brought to causality in altered sensorium.

she is also having osteoarthritis since 6 years. And she uses volini spray when ever her pain is aggravated.

She got operated for piles 15 years back.

Past history:

Known case of DM2 Since 10years on tablet GLICLAZIDE 30MG AND METFORMIN 500MG PO/OD

K/C/O CVA SINCE 10 years .on RIVOTRIL 0.5 mg PO/OD.

Personal history:

Diet:mixed

Appetite :normal

Bowel and baldder:Regular

Sleep:adequate.

No addictions.

DAILY ROUTINE:

THE PATEINT IS A HOME MAKER BY OCCUPATION SHE DAILY WAKES AT 6AM AND FRESHUP AND DRINKS MILK AND EATS BREAKFAST AND THEN SHE SITS AND CHITCHATS WITH NEIGHBORS WASHES HER CLOTHES AND IN THE AFTER NOON AT 1PM SHE TAKES HER LUNCH WHICH CONSISTING OF RICE AND A VEGETABLE CURRY AND AFTER EATING SHE LIES DOWN FOR SOME TOME AMD WATCHE TV AND DOES SOME HOUSE HOLD WORKS LIKE SWEEPING AND CLEANING HER UTENSILS AND AT 7PM SHE TAKES HER DINNER WHICH CONSISTING OF RICE AND VEGETABLE CURRY. AND SHE WATCH TV FOR SOME TIME AND THEN SLEEPS AT 9PM.

Family history:No similar complaints in the family

She has 2 childern on son and one daughter

Her psychosocial relation ship with her family and neighbors and friends is good.

ON EXAMINATION

PATIENT IS CONSCIOUS

BP:140/70mmhg

PR:84BPM

RR:21CPM

TEMP:AFEBRILE ON TOUCH

GRBS:43mg/DL@ ADMISSION

SYSTEMIC EXAMINATION:

CVS:S1,S2 HEARD,NO MURMURS