M60. General body ache,pain &swelling lt.clavicle.

New Case 81 yr , M, Diabetic 6 yrs, on single oral med , well under control , developed back pain 3 months, progressive difficulty in walking 3 weeks . Denied having any sensory / bowel/ bladder symptoms. No fever / loos of weight Or appetite.No symptons suggestive of upper limbs / bulbar involvement/ head ache / vertigo. Examination : general - normal.Intact peripheral pulses. Higher function , cranial nerves & upper limbs - normal. positive beevors sign.Lower limb power gr 3/ 5 with spsticity , hyper-reflexes with extensor plantars . Intact sensations. possible diagnosis ?

58 female right pleural effusion mild. Protein 6.2 g/dL, sugar 78, ADA 48, pale yellow clear fluid. No history available . Cytology field stain

65 yr female came with c/o fever and breathlessness On usg gross ascitis is present mild hepatomegaly and gall bladder wall thickness is present On ascitic fluid r/m these plasma cells and multinucleated cells are present

58 years old female, a known case of T2DM on regular treatment with glycemic control. hypertensive on telmisartan + metaprolol and controlled with slowly developing general debility on investigations is having chronic diffuse hepatic parenchymal disease with moderately large Ascitis and small right sided pleural effusion Also a known case of hyperuricemia on febuxostat 40 mg . Now , anaemia, bilirubin raised. echo- Tricuspid stenosis . Management and Valuable opinion