C/O lower limb weakness from 1 hr

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C/O lower limb weakness from 1 hr

-fever since 3 days

-burning micturition  since 3 days

HOPI-patient presented to casuality on 10/11/23 with complaints of lower limb weakness since 1 day. 

No h/o weakness of upper limb,loss of consciousness,deviation of mouth, involuntary urination or defecation.

H/o fever since 3 days,low grade and not associated with chills and rigor.

H/o burning micturition since 3 days.

No h/o nausea,vomitings,loose stools,pain abdomen

PAST HISTORY-

KNOWN CASE OF DM2 SINCE 8 years (Tab. GLIMIPERIDE 1MG &METFORMIN 500 MG PO OD)

N/k/c/o HTN,ASTMA,EPILEPSY,CVA,CAD.

PERSONAL HISTORY-

Sleep-adequate

Appetite-normal

Bowels-regular

Bladder movements-burning micturition since 3 days

No known food and drug allergies.

Alcohol-occasional drinker

O/E-patient was conscious, coherent, cooperative well oriented yo time place and person

He is moderately built and nourished

Pallor, Icterus,Cyanosis, clubbing, lymphadenopathy, Pedal edema absent

Vitals-

Temp: Afebrile 

PR- 58bpm    

RR- 20/Min

BP- 110/80 mmHg

SYSTEMIC EXAMINATION

P/A - Shape of abdomen- flat. No scars. No organomegaly. Bowel sounds heard.

CVS- S1 S2 heard, no murmurs

RS- NVBS.

CNS- No focal neurological deficits

Tone- RT. LT

UL. Normal. Normal

LL. Normal normal

POWER

UL. 3/5. 3/5

LL. 3/5. 3/5

Reflexes: right left  

Biceps 1+ 1+

Triceps 3+ 3+

Supinator 1+ 1+

Knee 2+ 2+

Ankle 1+ 1 +

Plantar present. Present

PROVISIONAL DIAGNOSIS- HYPOKALEMIC PERIODIC PARALYSIS WITH  UTI

TREATMENT-

INJ KCL 2 AMP IN 500 ML NS IV OVER.6 HRS

INJ PAN 40 MG IV OD

INJ OPTINEURON 1 AMP IN 100 ML NS IV OD

TAB GLIMI M1 PO OD

INJ PIPTAZ 4.5 GM IV TID