65 year old male ,farmer by occupation was brought to the casuality in an altered state with a low G C S since 1 day. involuntary movements involving left UL and LL since 1day. slurred speech since 1day. In view of low gcs patient was intubated and put on ventilator (ACMV/ VC ) On history taken from the attendars ,he is a. chronic alcoholic consumes almost 90ml/day and occasional smoker ,farmer by occupation who works hard enough under scrotching sun to earn his daily bread , this man was apparently asymptomatic 4yrs back then IN 2016 was diagnosed with diabetes mellitus when he visited the hospital with complaints of low grade fever then on was on oral hypoglycemic agents for 2months later on was shifted to insulin injections as his sugars weren’t under control with OHA. IN 2017 he revisited ho...