RANA DARSHANAM ROLL NO 35

A 39 year old male came to the casualty around 10 pm with  Chief complaints of sob since 3 days.  Fever since 10 days Cough since 10 days Chest pain since 10 days Pain abdomen since 10 days HOPI :  Patient was apparently asymptomatic 10 days back, then he developed fever associated with chills and body pains, headache, sore throat. Patient had cough which was productive with white coloured sputum. Then patient got tested positive for Widal after 4 days of onset of fever. He used symptomatic medication for a week. Then, he developed SOB since 3 days for which he got admitted in Nalgonda. SOB was insidious in onset, gradually progressed from grade 2 to grade 4 since past 10 days, SOB was more in sitting position and relieved on lying down, as his SOB aggravated, patient got shifted from that hospital and presented to our casualty. Patient also used to complain of intermittent chest pain, pain abdomen since 15 days Past History : Admitted to a hospital for pain abdomen for 4 days Not a k/

  80 years old female resident of Nalgonda,Home maker by occupation,presented to OPD with complaints of FEVER since 1week. HISTORY OF PRESENT ILLNESS: Patient was apparently asymptomatic 7 days ago later which she developed high grade fever intermittent type associated with chills with no aggrevating factors and relieved on taking medication,generalised weakness since 2 days. No history of any vomitings,cough,shortness of breath, cold,stomach pain. PAST HISTORY: No history of Hypertension,Diabetes mellitus, Asthma, Epilepsy, Tuberculosis,Coronary Artery disease. PERSONAL HISTORY: Diet: Mixed(eats meat once in a week) Appetite: decreased  Sleep: adequate Bowel and bladder movements: normal No addictions No allergy TREATMENT HISTORY: No significant treatment history FAMILY HISTORY: No significant family history GENERAL EXAMINATION: Patient is conscious, coherent, cooperative well oriented to time, place and person. Moderately built and nourished. Pallor-Present Icterus-Absent Cyanosis-Ab

 Chief complaints Right lower limb swelling since 10 days, fever since 5 days History of presenting illness Patient was apparently asymptomatic 10 years back then he developed progressive swelling of right lower limb and diagnosed with filariasis for which he was prescribed medicines by a local doctor 10 year back he was diagnosed with diabetes mellitus and hypertension and since then using antihypertensives( nifedipine) and anti diabetics( glizide) - 3 years back he developed pedal oedema and went for further evaluation and diagnosed to have chronic renal failure ? - 2 years back he suffered from COVID-19 following which he had shortness of breath at rest (grade 4) and chest pain for which he went to co-operate hospital in Hyderabad and diagnosed to have inferior wall myocardial infarction, So he was treated with streptokinase. At that time coronary angiogram was not done in the view of high serum creatinine levels - After 1 month coronary angiogram was done to recanalized the right c

 A 50 year old female from nalgonda ,farmer by occupation has come with chief complaints of • SOB since 15 days • Pedal edema  since 15 days HISTORY OF PRESENT ILLNESS Patient was apparently asymptomatic 3 years back when she developed SOB grade 2 and pedal edema which then extended to face and body causing generalised edema . She then went to nalgonda hospital and used medications prescribed and the symptoms subsided. 6 months back in jan 2022 she developed the same symptoms and again went to nalgonda hospital and took medications and symptoms subsided. She was also diagnosed with hypertension and is not on treatment. Now 15 days back she had developed the same symptoms SOB grade 3 and pedal edema ,generalised edema and went to nalgonda hospital and since the symptoms were not subsiding they came to Kims. (First she developed pedal edema which extended and caused generalised edema 7 days after this she developed SOB grade 3). She also complains of fever for 3 days and cough after trea

47 M came with chief complaints   -Fever since 2 days  -vomiting since 2 days -pain in  abdomen since  2 days  -Burning micturition since 2 days HOPI : patient was apparently asymptomatic 2 days ago, then he developed fever which is ,intermitent, associated with chills and rigor,relieved on medication, - vomiting from 2 days, food as content,non -projectile,3 episodes / day -pain in  abdomen from 2 days, pricking type,non radiating,in right hypochondrium - burning micturition from 2 days -uprolling of eyes,stiffness of both upper limbs yesterday  PAST HISTORY : K/C/O epilepsy 15 years ago, 3 episodes  N/k/C/O Diabetes mellitus,asthma,tb H/O fracture of left lower limb 15 years ago and operated  PRESENT HISTORY: Appetite -Nornal Diet-Mixed Sleep-Adequate Bladder habits-regular Bowel habits-regular Addiction:used to binge alcohol 15 years ago ,then after drinks occasionally GENERAL EXAMINATION: patient is conscious, coherent, co-operative,well oriented to time,place, person No pallor,ict