M85. Pain left chest. Breathlessness. Bilateral leg swelling. 15 days.

50m. non healing ulcer over the rt leg gaiter area over the distal tendoachilles. venous claudication pain with pain free walking distance of 100mtrs. pedal pulses well felt with ABI of 1.1 bilateral. underwent rt gsv and ssv endovenous ablation in Jan 16. ulcer did not heal completely. what is the diagnosis. what would be the next investigation.

A 60year old female c/o multiple pustules which ruptured. Hypertensive since 4 yrs and is under control and not a diabetic. Spot diagnosis and treatment.

This is old lady 60 plus ,known diabetics on Insulin therapy twice a day .She came to me high fever toxic ,semiconscious ,right leg oedematous pus pointing on the entire skin with hyperpigmented skin.Leg swelling was there for many more years. Taking insulin for over 5 years. Second photograph after treatment of one month. Swelling has come down. pt is not regular in treatment due to poor socioeconomic reason. Discuss the case.

65 Years old women c/o fever rigor and body pain.I/E temp 102°F,Anaemic, glossitis,thin build, malnourished ,socioeconomically poor,agricultural labourer,. leg swelling both legs up to middle 1/3 of leg. fever monthly occurrence periodicity bilateral inguinal gland enlargement . Similar patients in her village more than 5 of her ages having leg swellings are living there as per history. She reported to my clinic during this summer for body pain,exhausted feeling,poor appetite, losing weight. Inguinal glands bilaterally present enlarged. Leg swelling with warmth noticed .Dehydrated. Discuss this case.