A 65 year old female came with complaints of blurring of vision and burning sensation in feet .


General medicine 
Hi i am KUNAL MARATHE 5th sem student. This is an online E logbook to discuss our patient’s de-identified health data shared after taking his/her/guardian’s signed informed consent. Here we discuss our individual patient’s problems through a series of inputs from the available global online community of experts intending to solve those patients' clinical problems with collective current best evidence-based inputs

Chief complaints -
A 65 year old married female patient, housemaker by occupation came from Errapally to general medicine OPD with the chief complaints of burning sensation in both feet since 1 year and blurring vision since 10 days 

History of present illness -
The patient was apparently asymptomatic 1 year ago. Then she gradually developed burning sensation in both the feet while walking which was progressive over days.
10 days ago she experienced episodes of blurring of vision just after meals which subsided in the next 1-2 hrs. She complains of 2 episodes per day one in the morning and other in evening time after having lunch and dinner respectively everyday until she was admitted in the hospital 3 days ago.
She had no associated headache, nausea, vomiting, fever, tinnitus, sweating, palpitations. 
She complains of decreased appetite since 3 days due to the fear of experiencing symptoms. 

History of past illness -
5 yr ago she went to Miryalaguda hospital with complaints of body pain and was diagnosed with HTN and DM.
She was using regular medication but from 10- 15 days she missed the dose and started taking it in alternative days
No other significant past history.

Family history -
No significant family history. 

personal history -
Married housemaker
Mixed diet
Decreased appetite( since 3 days )
Regular bowel and bladder.
Adequate sleep 
No allergies 
Consumes toddy 1-2 glass per month
No history of smoking

Drug history -
since 5 years 
• Tab Amlodipine 5mg OD
• Tab Metformin 500mg OD - irregular intake(alternate days)

After admission 
• Tab Telmisartan 40 mg OD
• Inj insulin 40 units OD

GENERAL EXAMINATION -

Physical examination -

Patient was conscious coherent and cooperative 
Moderately built and Moderately nourished 
No pallor 
No icterus 
No cyanosis 
No clubbing of fingers 
No lymphadenopathy 
No pedal edema 

Vitals -
Heart rate - 96 bpm
Blood pressure- 150/80 mmHg

Provisional diagnosis -
Hypertensive urgency

Treatment -
After admission 
• Tab Telmisartan 40 mg OD
• Inj insulin 40 units OD


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