Anal spasm

Diagnosis please.

M.64yrs. Pain lower abdomen. Blood in urine. Frequent urge to urinate 2 months.

Complain pain and difficulty in movements of right ring finger *History* Fall on out stretched hand *Chief Complaints* Difficulty in movements of right ring fingure *Vitals* Stable *Investigations* X-ray attached *Diagnosis* Metacarpel fracture *Management* Done with orif with k wiring *History* Fall on out stretched hand *Chief Complaints* Difficulty in movements of right ring fingure *Vitals* Stable *Investigations* X-ray attached *Diagnosis* Metacarpel fracture *Management* Done with orif with k wiring

A 37yrs old female presented to casualty with fever, headache, and altered sensorium of 6 days duration. an episode of seizure At admission, She was Afebrile with a pulse rate of 110/min and a blood pressure recording of 100/70mmHg; her Glasgow Coma Scale score was 10 (E3M2V5). There were no petechiae or signs of bleeding over the skin or any mucosal surface. There was no focal neurological deficit and neurological examination was normal, including (absence of) signs of meningeal irritation. patient is on infusion Noradrenaline and vasopressin support.Kindly discuss the case and give your expert advice….

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