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33 year old male patient

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33 year old male patient  GM Blog: 33 year old male patient  NOTE This is an ongoing case and will be updated  The reference link (if any) will be mentioned at the bottom. Date of admission: 29-10-2022 CHIEF COMPLAINT : patient came to the opd with complaints of burning and painful micturition since 2 years. C/o  Dyspareunia ( painful intercourse) since 2 years. C/o  Bilateral Decreased hearing since 2 years C/o indigestion and pain abdomen since 5 years HISTORY OF PRESENT ILLNESS- Patient was apparently asymptomatic 5 years back then he developed pain abdomen and epigastric burning sensation episodically for which he went to the local hospital  The pain was located in the left flank and sometimes radiating to the whole abdomen. Relieving factor - medication Aggravating factor- non vegetarian food like chicken, mutton and fish He had few episodes of vomiting during the indigestion. Vomitus mostly included food particles. following which he developed papules in the leg which lead to bli