management of this case

58 yrs male pt goes into the gov.OPD with the Complain of cough, cold, fever headache,occ.constipation, burning in throat , n in stomach ,ithiching on the whole body , severe Breathlessness since 4 to 5 days... VITALS P- 138/min RR-28 ,b/min BP-132/86mmHg Spo2-89% without O2 support was given T-101ંF CVS- S1S2(+) RS-BLAE(+) CVS- conscious,oriented Due to severe Breathlessness and O2 Detoriation pt was admitted into the COVID-19 SUSPECTED WARD... In covid-19 suspected ward , pt was puted on NRBM with 15%lit/min O2 support was given... RT-PCR was done on 14/2/21 which was (+Ve) CT score -30 Consultant started a treatment... Inj. Remdesivir 100 mg in 100 ml NS OD (on the 1st day 2 dose than 1+1+1+1 upto 5 days.. Inj.piptaz 40mg in 100 ml NS iv 8 hrly + fluconazole 150 mg once / week Inj.Rantak 2cc iv 12 hrly Inj Heparin drip 25000 IU/in 50 cc NS iv 5 ml/hr Tab-pantoxyphylline 1-0-1 Tab-Aspirin 75mg 0-2-0 Tab-pcm- sos Tab-vit-C 1-0-1 Tab -zinc 1-0-1 Tab-MVBC 1-0-1 Tab-cal+2 ,0-0-1 Tab- Vt D3 sachet once/week DMR syrup 1 table spoon tds Lactulose syrup 2 table spoon ,sos * On second day of Admission Treatment was given... same VITALS P-108/min BP- 128/86mmHg Spo2- 95% with NRBM-7%lit/ min O2 suppprt was given T-98્F CVS-S1S2(+) RS-BLAE (+) In evening Vitals P- 102/min BP-124/82mmHg Sop2-94%,95%, and 96% Fluctuate NRBM 5%lit/min O2 support was given T-(N) CVS-S1S2 (+) RS-BLAE (+) *On the Third day of Admission Vitals P- 104/min BP-126/84mmHg Spo2 -95% ,NP-4%lit/min (O2 support )trial was given T-(N) CVS-S1S2 (+) RS-BLAE (+) In Evening Vitals P-102/min BP-128/78mmHg Spo2-98% Without O2 support was given (pt was on Room air ) T-(N) CVS-S1S2 (+) RS-BLAE (+) Pt Maintaing O2 bt on the third day pt start to Complaining about severe burning pain into the both feet , knee fold krke beth gya pair ko apne hatho se pkd liya n he said bhut jalan ho rhi hai, bhut hi dard ho rha hai.kuchh kijiye aap doctor hoo aap pde likhe hoo muje to isme kuchh smj nhi aata pr kuchh to kro meri or dhyan do...me chal bhi nhi pa rha hu...muje nind bhi nhi aati iski vjah se bas ye thik krdo fir me thik hi hu Completely... O/E :blackish discolouration can seen in both feet, coldness can feel , sensation decrease in both lower limb as compare to upper limb.... Same treatment was given accept inj remdesivir , inj piptaz upto 22/2/21 pt was Discharged after RT -PCR -ve Bt still pt have severe burning pain which is going day by day worse...n blackish discouration still present in both feet .pt told me koi nhi sun rha mujse ab nhi rha jata bhut jalan ho rhi hai, kuchh to kro....he was literally crying during narrating this symptoms Whenver i hv been seen him he was start crying loudly...else Continuesly crying Slowly slowly... Modalities < walking ,pressure ,touch slight feels better by rest I have attached reports, Kindly give ur views Regarding this case ...what can we help to this pt...

Male patient 52 yrs old comes with c/o of mouth ulcers since 3_4years then t/t is done subsequently but the mouth ulcers reoccurs after some months With mild constipation..then from a week there is black and whitish spots after getting relief from mouth ulcers which are painfull and sensitive to touch..and neuropathic pain in both lower limbs(legs) especially at the thigh region only in the evening and night time.. K/C/O--Diabetes mellitus since 3 years(pt is on glimpride and metformin) Vitamin b12 is high and CBC report shows high pdw and mpv levels....reports attached with the case please give your valuable opinion and DX,Rx on the case. Thank you.. Dr. Prashant Mishra Dr. Dineshchandra Sharma Dr. Kute Ankush Dr. Ashok Leel Dr. Shivraj Agarwal Dr. D K Gupta

Patient aged 46yrs c/o dry skin,mild itching ,since 1 year ,flatulance, constipation occasionally.. kindly suggest Dx and rx

A 81 yr old female patient H/o HTN on medication Telgo C OD C/o pain in both lower and upper joint, pain in back resion, severe pain in both lower knee joint, genu veram formation last 10 year ago no conginatial , mobilisation with waker, diet soft, urine/motion pass good no constipation no urine retention O/E Bp 130/90mmhg, Spo2 99%, HR 85/min, RR 20/min, RS AEBE clear, CNS concious oriented, CVS S1S2 present, P/A Soft NT.

Gasess around stomach as balloon(glass)u, upper bleeching, abdominal pain *Chief Complaints* Heptomagally, problem of taking food,indication, obstipation, acidity etc complicated case