54 year old male patients with chief complaints of hiccups since 1 week

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CHIEF COMPLAINTS: C/o of hiccups and generalized weakness since 1 week

HISTORY OF PRESENT ILLNESS: 

Patient was apparently asymptomatic and developed hiccups 7 days backs

Similar complaints 8 months and 4 months backs, 

and 1 month back H/o trauma to head

HISTORY OF PAST ILLNESS:

Patient was apparently asymptomatic 7 years back and then had a h/o trauma to foot which was not healing then went to hospital then diagnosed as diabetes mellitus since 7 years

Pt is a k/c/o HTN Since 1 month

Pt is not a k/c/o tuberculosis, asthma, CAD, CVA

PERSONAL HISTORY:

married

Diet mixed, appetite lost

Sleep disturbed

Bowel and bladder movements-regular

No other habits

GENERAL EXAMINATION

No signs of pallor, icterus, cyanosis, clubbing and pedal edema

VITALS

Temperature-afebrile

Pulse rate-80bpm

RR-18cpm

BP-130/90

GRBS-88mg%

SYSTEMIC EXAMINATION

RS- bae+ ,normal vesicular breath sounds 

Cvs-S1 S2 +, no murmurs heard

Abdomen-scaphoid

PROVISIONAL DIAGNOSIS

Dyselectroltemia

TREATMENT

*IV fluids NS@UO+30ml/hr

*Inj pan 40mg IV OD

*Inj optineuron 1 amp in 100 ml NS IV/OD

*Syp potchlor 15ml in 1 glass of water PO/TID

*Inj.kcl 3 amp (60 mea)+1 amp MGSO4 (2gm) in 500 ml NS @ 100 ml/hr

*Inj H.Mixtard Insulin SC BD 20u (8am)-x-15u (8pm) before meal

*Tab Cinod 10 mg PO/OD 8) Strict diabetic diet