Case of hypoglycaemia

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65 year old male patient, farmer by occupation lives in ramannapet came to casualty with the 

C/O - loss of consciousness 

HOPI-

He was apparently asymptomatic 2 days back and then he went to field after consumption of alcohol.He fainted at around 9am and admitted to hospital.

Patient was unconscious when he was brought to hospital.He doesn’t remember any of the incident since he lost his consciousness.

Patient also experienced giddiness.

Daily routine- patient generally wakes up at 6:00am every morning and goes to field after having breakfast .Generally he takes tea and bread .

And takes rice for lunch at 1pm and leaves home at 2 pm

He returns home at 5pm .

HISTORY OF PAST ILLNESS-

H/o DM and HTN since 20years

No h/o

Asthma 

TB

Cardiac problems

Epilepsy

PERSONAL HISTORY-

Marital status- married

Diet:- mixed

Appetite-  normal appetite 

Bowel and bladder movements - Regular

Micturition- normal

Sleep :- adequate 

Addictions:-patient has a habit of chewing gutka since 3years

Smoking -patient doesn’t smoke

H/o Alcohol - since 20 yrs

Patient drinks daily 90ml

Drug addiction:- no

Allergies :- no h/o allergies

FAMILY HISTORY-

No relevent family history..

GENERAL EXAMINATION -

Patient was conscious, non coherent,moderately fit, moderately nourished and Cooperative, and examined in a well lit room.

No Pallor, 

No Icterus,

No Cyanosis,

No Clubbing,

No oedema (pedal)

No Lymphadenopathy

Vitals

Temp :- 98.1F

PR:- 120bpm

BP: 90/70mmHg

SpO2: 98% at RA

RR:- 20 cpm

GRBS -497mg%

SYSTEMIC EXAMINATION-

CVS - no thrills 

           No murmurs

           S1 S2 +

Respiratory- breath sounds - vesicular

                      No dyspnea

                      No wheeze

Position of trachea- central

Chest - bilaterally symmetrical

Vocal fremitus- present

No scars are seen

Abdomen - shape - scaphoid

                 No tenderness

                 No palpable mass

                 No free fluid

Liver and spleen - not palpable

 On percussion 

Resonant sounds are heard at supra clavicular 

Clavicular

Infra clavicular regions