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      A 43 old male patient  resident of nalgonda ,farmer by occupation ,presented to casualty with complaints of : Low grade Fever since 1 year  . Cough with sputum since 1 year   Complaints of neck pain since 6 months  Weakness of  all both lower limbs since 6 months . HOPI : Patient was married at age of 25 and have 3 children , one son and two daughters . He is farmer by occupation . He is occasional alcoholic and chronic smoker (1-2 packs/day) since 20 years . He was apparently alright till 33 years of age , then in view of generalised weakness pt went for routine evaluation and got diagnosed with diabetes mellites- type 2 and is using OHA since 10 years . He takes his medication regularly . Patient  had history of fever since 1 year which was low grade not associated with chills and rigors, intermittent, associated with diurnal variation and  night sweats. He also complains of cough with scanty white color ,mucoid expectorant since 1 year, non foul smelling, non blood tinged . No

 A 70 years old female patient residing in Nalgonda, is a homemaker, presented to OPD with  complaints of- loss of appetite since one week,  - generalised weakness since one week  - fever since 5 days  -burning micturation since 5days  History of present illness- patient was apparently asymptomatic one week back then she gradually developed loss of appetite since one week which was not associated with nausea, vomiting, associated with generalised weakness fever since 5 days which was high grade associated with chills and rigors, no diurnal variation, relived on taking medication, not associated with headache, cold , cough she also started experiencing burning micturation since 5 days associated with low backache , no history of dark coloured urine or blood in urine no h/o cold, cough, chest pain, palpitations, shortness of breath, pedal edema , reduction in urine output, diarrhoea, constipation, vomiting, nausea, pain abdomen Past history: she has been having similar episodes since 201