*

A MALE PATIENT NAMED MR SIVAJI AGED 33 YEARS

BELONGING TO CHRISTIAN COMMUNITY, CAME FROM
MUDINEPALLI COMPLAINING ABOUT LOSING HIS ABILITY
TO WALK SINCE BIRTH AND NOT HAVING ABILITY TO BE
IN A NORMAL POSTURE
SYMPTOM LOCATION SENSATION MODALITIES CONCOMIT
ANTS/ASS
OCIATIVE

UNABLE TO LOCOMOTOR STIFFNESS BETTER BY SUPPORT,

WALK SYSTEM ON LONG WALKING,
SITTING WARM WEATHER; ……….
WORSE BY COLD WEATHER
, LOUD SOUNDS
 *

COMPLAINS ABOUT HIS DIFFERENTLY ABLED CONDITION

I.E
• LOSING HIS WALKING ABILITY
• CANNOT STAY IN NORMAL POSTURE
*

* CANT ABLE TO WALK SINCE BIRTH

* CANNOT STAY IN NORMAL POSTURE
* HE UNDERWENT SURGERY FOR BOTH LEGS
* HE USE TO CRAWL BEFORE SURGERY
* AFTER THAT HE TRIED WALKING WITH THE SUPPORT OF STAND
WITHOUT WHICH HE CANNOT DO SO.
* HE GETS STIFFNESS IF HE SITS FOR LONG TIME . SO TO GET
RELIEF OF THIS .HE WALKS FOR SOME TIME HERE AND THERE
WITH SUPPORT OF STAND
PAST HISTORY:

USED ALLOPATHIC MEDICATION FOR PRESENTING COMPLAINT

HAD UNDERGONE SURGERY FOR BOTH LEGS AT THE AGE OF 8
FAMILY HISTORY:

oFATHER : ALIVE AND APPARANTLY HEALTHY

oMOTHER : ALIVE AND APPARENTLY HEALTHY
oSIBLINGS : ELDER SISTER ; ALIVE AND APPARANTLY HEALTHY
 *
* APPETITE : MODERATE
* DESIRES : MEAT
* AVERSION : EGG PLANT
* INTOLERANCE : NOT SPECIFIC
* THIRST : SMLL QUANTITIES AT LONG INTERVALS
* STOOL : SOFT
* BOWELS : REGULAR
* PERSPIRATION : PROFUSE , ALL OVER
* SLEEP : REFRESHED
* DREAMS : UNREMEMBERED
* SLEEP POSITION : TOSSES IN
* HABITS : MILK ONCE A DAY
*
* FANNING : IF NECESORY
* COVERING : IF NECESSORY
* BATHING : DEPENDING ON SEASON
 *
* CONJUCTIVE : NON PALLOR
* TONGUE : WHITE COATED
* NAILS : NORMALLS
* SKIN : FAIR
* ICTERUS : ABSENT
* CYANOSIS : ABSENT
* LYMPH NODES : NO ENLARGEMENT
* OEDEMA : ABSENT
VITALS:

* PULSE- 82 BPM
* HEART RATE- 75 BPM
* RESPIRATORY RATE- 26 TIMES/ MIN
DIFFERENTIAL DIAGNOSIS:
CEREBRAL PALSY
SPINAL MUSCULAR ATROPHY
MYELODYSPLASIA
MUSCULAR DYSTROPHY

PROBABLE DIAGNOSIS:
*?CEREBRAL PALSY
SYSTEMIC EXAMINATION:
*
* BORN IN 7TH MONTH OF GESTATION, NORMALLY DELIVERED CHILD.2ND CHILD
TO HIS PARENTS.
* HE DIDN’T CRY AFTER BIRTH, STARTED CRY AFTER A WHILE.
* DELAYED MILESTONES(TEETHING, WALKING, SPEECH).
* UNABLE TO HOLD HIS HEAD UP UPTO 4YEARS,HE SUFFERED FROM FEVER
RECURRENTLY IN HIS CHILDHOOD.
* HE STARTED SPEECH AND TEETHING AFTER 4 YEARS OF AGE.
* HE CANT STRETCH HIS HANDS TOTALLY, AND ALWAYS SITS WITH HIS LEGS
CROSSED.
* HE DOES SIMPLE WORKS VERY SLOWLY, HIS PARENTS SCOLDS HIM TO DO THEM
QUICKY FOR WHICH HE GETS ANGER AND IRRITATION ON HIS PATIENTS OFTEN
SHOUTS ON THEM.
* SOMETIMES HE FEELS BAD AND OFTEN GETS ANGER ON HIMSELF FOR DOING
WORKS SLOWLY.
* TILL THE AGE OF 8YEARS,HE HAD WEAK DIGESTION, VOMITS EVERYTHING
WHATEVER IS TAKEN
* DURING SCHOOLING HE USED TO SIT ON THE FLOOR AS HE CANNOT SIT ON THE
BENCH.
* HE IS UNABLE TO UNDERSTANF MATHS AND SCIENCE, BUT COULD
UNDERSTAND TELUGU AND SOCIAL.
• HE HAD WEAK MEMORY, BECAUSE OF HIS DISABILITY HIS EXAMS WERE
WRITTEN BY ANOTHER PERSON.
 HE CANT APPLY LOGIC TO ANYTHING.
 HE SUPPRESSES HIS SORROWS AND ANGER.
 HE THINKS MOSTLY OF HIS COMPLAINT BUT DOESN’T SHARE THEM WITH
ANYONE.
 HE USED MANY ALLOPATHIC MEDICATIONS FOR PRESENT ILLNESS AND AT THE
AGE OF 8 , HE UNDERWENT SURGERY FOR BOTH LEGS.
 AFTER THAT SURGERY HE IS ABLE TO GET UP AND WALK WITH HELP OF
SUPPORT LIKE CRUTCHES
 IF HE SITS FOR A LONG TIME HIS JOINTS(LOWER LIMB) GETS STIFFENED.
 TO GET RELIEF HE WALKS WITH THE USE OF CRUTCHES.
 ONCE HE TRIED FOR A JOB BUT DIDN’T GET ONE BECAUSE OF HIS DISABILITY.
 HE WANTS TO BE ALONE BECAUSE HE FEELS SAD AS EVERYONE CAN WALK ,
STAND AND DO WORKS.
 HE SUPRESSES HIS EMOTIONS BECAUSE THERE IS NO USE AND NOTHING CAN
BE DONE FOR HIS PROBLEM.
 HE PRAYS EVERYDAY, SPENDS HIS TIME BY READING BIBLE AND WATCHING TV.
 HE HAS DESIRE TO TRAVEL TO DIFFERENT PLACES BUT FEELS SAD AS HE
CANNOT WALK.
 INVOLUANTARY MOVEMENT OF HEAD WHILE TALKING AND FROWNING OF
FOREHEAD.
 HE HAS FEAR OF LOUD SOUNDS (LOUD HORNS, LOUD SCREAMS, THUNDERS)
 IN EARLIER DAYS HE IS SO ACTIVE AND TALKS EFFICIENTLY, BUT NOW HE
BECAME DULL
*MOTHER’S HISTORY:
* ANTENATAL CHECKUP DONE ONLY ONCE IN 3RD AND 5TH MONTH.
* SHE USED TO LIFT HEAVY WEIGHTS(BUCKETS OF WATER) FOR THEIR
POULTRY FARM.
* SHE WAS OF 18 YEARS OF AGE WHILE CARRYING HIM. ON A DAY IN 7TH
MONTH SHE FELT A SENSATION OF FALL OF MASS IN ABDOMEN.
* SHE CONSULTED A DOCTOR, WHERE THE DOCTOR SAID TO ADMIT IN
HOSPITAL AS SHE MAY GET DELIVERED WITHIN A WEEK.
* SHE GOT FEAR THAT IT WAS NOT THE TIME OF DELIVERY, AS THE TERM
IS NOT COMPLETED YET.
* AFTER A WEEK WHILE TRAVELLING IN A BUS SHE SAW AMNIOTIC FLUID
DISCHARGE FROM VAGINA.
* SHE WENT TO AMERICAN HOSPITAL IN GUDIVADA WITH THE HELP OF A
WOMEN TRAVELLING ALONG WITH HER
* SHE FELT INSECURE WHILE DELIVERY, DUE TO ABSENCE OF HER
FAMILY MEMBERS.
 RUBRIC COMMON/RUPS MIASM

MIND, COMPANY, AVERSION TO W/E/RUPS SYPHILIS

MIND, THUNDERSTORM, DURING E/RUPS SYCOTIC
MIND, TRAVEL, DESIRE TO E/RUPS PSORA
MIND, STARTLING, NOISE FROM E/RUPS PSORA
MIND, ANSWERS, DIFFICULTY M/RUPS PSORA
STOMACH, DESIRES, MEAT P.G/RUPS PSORA
STOMACH, THIRST, SMALL P.G/RUPS PSORA
KWANTITIES FOR
FACE, WRINKLED,FOREHEAD,BRAIN PART/RUPS SYPHILIS
SYMPTOMS IN
HEAD,HOLD UP, STEADY, UNABLE TO PART/RUPS PSORA
TEETH, DENTITION, SLOW PART/COMMON PSORA
BACK, CURVATURE OF SPINE PATH PSORA,SYPH
PART/COMMON