Scleroderma
A localized or systemic chronic and progressive autoimmune disorder characterized by thickening of the skin and the connective tissues. Localized scleroderma affects only the skin. Systemic scleroderma affects internal organs, including the heart, lungs, gastrointestinal tract, and kidneys.

PHC Bichpuri and ESI Dispensary Chippitola Agra & SN Medical College Agra & Fatehgarh
Medical Officer Incharge
SN Medical College, Agra
DA

Siddhivinayak Clinic
Lceh Gp



Dr KUTE HOSPITAL
Dr KUTE HOSPITAL
Govt. Medical College Miraj
D M &S

JVK Hospital
M.D. DVD. LLB

Distt. Red Cross Society Bhawan
Honorary Medical Officer
SPMC, Bikaner
MBBS

Super Specialist in Reproductive Endocrinology

Phansidewa BPHC
Additional Medical Officer
Darjeeling ICMS, Calcutta National Medical College
Dip CMS, Condensed Medical Course

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In your professional opinion, which form of tobacco use currently poses the most serious health concern to the general population?
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A 50 yrs old patient (history given below) kindly suggest further management *Chief Complaints* Unresponsive/vomiting/headache/fever/seizure 2/left side weakness /episode/history of epitaxis 2 days back *History* K/c/o HTN with irregular medicine *Vitals* BP 210/120 Temp 103.f Pulse -122 Spo2 86% *Physical Examination* Left side weakness Patient is semiconscious but drowsy, moderately built, appears uncomfortable. In mild respiratory distress. Left-sided weakness noted. Vitals monitored. *Investigations* Attached *Diagnosis* Acute ischemic stroke with rt mca acute thrombosis *Management* Medical management Monocef/pantop/strocit/manitol/lobet infusion/nimodepin/Ecosprin gold/pcm/emeset/levera/deriphyllin/dexa/nebulizer/o2 inhaler
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