25yrs male presented with cough fever and breathlesness and chest pain. H/o visit to metallic industry 6 month back for period of 4 hrs.

70 years old female k/c/o DM HTN COPD c/o breathlessness sweating admitted in hospital o/e pt.dyspnea PR 110/min BP 160/90 RS crepts + PA soft non tender investigation done Hb 12.6 PCV 32.3 RBC 5.06 MCV 63.83 MCH 24.9 MCHC 39.01 RDW -CV 16.9 Platelet 2.2million PCT 0.210% MPV 6.8 PDW 7.7 TWBC 12600 Neutrophils 83 lympho 16 eosino 01 baso 01 ESR 48 neutrophillic leucocytosis normocytic normochromic Random Sugar 293 blood urea 16 BUN 7.48 Sr. Creat 0.5 LFT normal Na+ 127 K+ 3.7 ionised Ca++ 3.9(4.2 to 5.5) ECG sinus tachy.with non specific ST -T changes 2D echo shows IHD with LV systolic dysfunction treatment on which she was human mixtard 16------------13 glycomet 250 tds concor 5 od telsartan 40 bd CTD 6.25 od clodrel forte od X tor 10 od imdur 30 1/2 od (morning) deriphylline R 150 tds ferium xt od alternate day shelcal 500 od alternate day stiloz 50 bd neurobion forte od attaching photos of ct thorax and ECG kindly give your expert opinion and treatment

28years male patient c/o pain chest rt side,cough for 1month Associated with fever O/E creps all over the lung field He is a smoker,20 cigarette/day since last 8year Dx and rx Thank you

An otherwise healthy 50-year-old male presents to his new family physician with a rash he’s had for several years. He mentions that the skin eruption becomes erythematous and pruritic after exercising, and when he scratches it. On examination, reddish-brown freckle-like macules are seen on his upper extremities, back, and abdomen. A skin biopsy reveals an increased number of dermal mast cells. Which of the following is most commonly associated with this patient’s likely diagnosis? A) Interstitial lung disease B) Peptic ulcer disease C) Chronic pancreatitis D) Crohn disease

76yr old female diagnosed Interstitial lung disease.... Presented with fever breathlessness to casualty After careful examination Culture showed kleibshella ...pneumonia... Later patient was put on antibiotic according to culture report..... No improvent seen Patient still had wheeze and breathlessness and fever Changed the antibiotic to meropenam and colistin Still no improvement is seen Today ct showed image 1 Cavitation???? Fungal ball??? Aspergillosis?? But previous ct and X-rays in 2016 showed cavity too.... Patient is kept on ntg as Bp is 180/100 in titration dose 3ltrs of oxygen.... without tat patient not able to maintain saturation Ecg showed some irregular rhythm was taken advice from cardiologist and put on calaptin tablet 40.... Please suggest further suggestion n opinion