A 60 year old male came with chief complaint of fever and Head ache
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Chief complaint : A 60 year old male patient came to casualty with a complaint of fever with chills and head ache since 1 week
History of present illness :
A 60 year old male patient who was farmer by occupation was apparently asymptomatic 1 week back then he notice fever with chills and headache, relieved on taking medication and he visited other hospital before coming here they gave a report positive for widal test
Uncontrolled diabetes (2 days)
History of past illness :
History of diabetes (on medication since 18 years)
No history of hypertension, asthma,TB,Epilepsy, Thyroid
Personal History :
Married
Diet : vegetarian
Appetite : Normal
Sleep : Adequate
Allergies : No
Bowel movements : Regular
Micturition : Burning ( since 1 week )
Addictions : No
Family History :
No relevant family history
General Examination :
Patient is conscious, coherent cooperative to time, place and person
No H/o cyanosis ,pallor,icterus,clubbing,lymphadenopathy
Built: Moderately Bulit
Vitals :
Temp : 97.6 F
Rp : 20
PR : 90
BP : 110/ 70
Systemic Examination :
CVS : No thrills and Cardiac murmurs
Sounds : S1,S2 +
RS : No Dyspnoea, Wheeze
Abdomen - shape Scaphoid
CNS : conscious, speech normal
No neck stiff Ness
Diagnosis
Viral pyrexia and Uncontrolled diabetes
Investigations
Hemogram
Random blood sugar
Day 1
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