Kovuri Yamini ROLL NO. 77

  A 32 year old male patient who is a resident of mothkur came to the OPD with chief complaints of pain abdomen since 3 days, 1 episode of vomiting 2 days back History of present illness: Patient was asymptomatic 4 years back then developed pain abdomen which was relieved by medication. Then 3 days back , he developed pain abdomen in epigastrium, left hypogastrium, and lumbar region along with 1 episode of vomiting which is green in color (bilious). He complains of loss of appetite since 2days. He complains of constipation since 2 days. History of past illness: N/K/C/O Hypertension, diabetes mellitus, epilepsy , asthma ,CAD Tuberculosis. No relevant surgical history. PERSONAL HISTORY : Married Diet - Mixed Appetite - decreased Bowel and bladder movements - Irregular Sleep - adequate Addictions - chronic alcoholic. FAMILY HISTORY : No significant family history. GENERAL PHYSICAL EXAMINATION : Patient is Conscious,Coherent, Not co operative. Moderately built, moderatel

 A 58 year old male, labourer by occupation, came to the OPD with the chief complaints of Shortness of breath since 30 days,which was worsened 1 day back(19/02/22), chest pain since 30 days ,facial puffiness since 30 days History of Presenting illness -   Patient was apparently asymptomatic 3 years ago then developed giddiness,  for which he went to a local hospital and was diagnosed as Hypertensive, for which he is taking T. Nicardia 10mg, T. Arkamine 0.1mg sos. Then 2 years back he  developed B/L pedal edema,  which progressed gradually to knees and  diagnosed with renal failure, started dialysis weekly twice. Since 4 months he developed left upper limb swelling and swelling at chest region,both of  which got  progressed to current size.  Back pain since 2 months, which got subsided on medication (T. Ultracet).  30 days back - he developed shortness of breath ,Grade II-III  which progressed to Grade IV since 30 days associated with orthopnea . Whereas from 4 days he developed right u

  A 90yr old patient who was a farmer by occupation resident of chityal was brought to casualty with chief  complaints of deviation of mouth to right since yesterday(16/02/22) morning, slurring of speech (16/02/22). HOPI:  Patient who was a farmer by occupation (staying at home since 10-15yr)  was apparently asymptomatic 1 yr back,then he developed nocturia which was10-12 times   overnight for which he went to local hospital and diagnosed with type 2 diabetes mellitus and since then he is on regular medication .Yesterday(16/02/22) when he woke up from sleep he   complains of deviation of mouth to right side and slurring of speech. No c/o involuntary micturition/defecation,involuntary movement, dysphagia  No c/o UL/LL weakness noted,fever,cold,cough,burning micturition,sob, orthopnea. Past history: k/c/o diabetes since 1 year and on regular medication since then. Not a k/c/o Htn/cad/Tb/bronchial asthma  No past surgical history Treat ment  history :On tab metformin 500 mg for d