40/F PTB
The patient is a 40 year old woman , resident of nalgonda,with history of autoimmune disease, CHIEF COMPLAINTS: She was brought with complaints of 2 episodes of involuntary movements of upper and lower limbs and hemoptysis in the morning. HISTORY OF PRESENT ILLNESS : She developed sudden onset movements of both upper and lower limbs at 5am in the morning which lasted for about 4-5mins , associated with confusion after the episode, without any trigger, aura . she had an other similar episode while she was brought to the hospital. She had similar episodes at the hospital. SHE WAS APPARENTLY ASYMPTOMATIC 13 YEARS AGO, Then she had low back ache and generalised weakness , for which she visited a local hospital.During the investigations, she was found to be having,?soft tissue overgrowth ,(as said by attenders ,no documentation)and need to get operated, during routine investigations creatinine was elevated, then she was started on conservative management . (Tab Sodium bicarbonate,She