general medicine
HISTORY OF PRESENT ILLNESS: A 50 year old male patient came to casualty with the complaint of tingling in both the legs as well as arms since one day, and even had the complaint of slurring of speech since 3 hrs. patient is diabetic since past 10 years and has been incidentally diagnosed. patient was asymptotic one day back but today morning he developed numbness and tingling in arms and legs for few hours which subsided. But started again at 3:00pm and also complains of slurring of speech. No H/O vomitings, headache, blurring of vision No H/O seizures, loss of consciousness. SURGICAL HISTORY: 4years back due to trauma and uncontrolled Diabetes mellitus, patient 1st thumb and little finger were removed, later all other fingers were removed. since the surgery he is on Daily mixtard 25U once a day. PAST HISTORY: DM since 10 years HTN since 6 years and on Tab Amlong 2.5 vitals: temp: 98.4 F PR: 93 BPM RR: 18 com BP: 130/90 mmHg Spo2: 98% at RA CVS: S1 S2 +, no murmurs CNS: patient is co