Kovuri Yamini ROLL NO. 77

 A 67 yrs old male came to opd with chief complaints  of  not responding to words and commands ,unable to swallow,unable to speak since 1 day (30/8/22). History of present illness  Patient was admitted with complaints of unable to speak,swallow and altered sensorium which was sudden in onset. In 2012 he heart blocks  in two valves for which he underwent a PTCA  one Stent in one , 2 stents in other. In 2022, he developed flank pain , pedal edema for which he went local hospital and diagnosed as renal failure for which is taking dialysis since February.  Past history   K/C/O hypertension, diabetes mellitus since 1998. N/K/C/O of epilepsy, Asthma,tb  Treatment history   He had history  of PTCA surgery. Underwent surgery for hypertensive retinopathy,  glaucoma.  Family history  Not relevant  Personal history   Diet veg Appetite  decreased  B&B movements Irregular Sleep Disturbed  Addictions  he was drinker stopped drinking 3 yrs back   Smoker and stopped 15 yrs back Dinner at 7 pm  Sle

 A 16 year old male came to OPD with chief complaints of   • Fever since 7 days • Loose stools and vomiting since 6days HISTORY OF PRESENT ILLNESS  Patient was apparently asyptomatic 7 days back then he developed fever which was high grade, continuous not associated with chills and rigors,got relieved 2 days back.  He also complains  of loose stools since 6 days , 4- 5 times a day which was watery in consistency non foul smelling ,no blood is seen  He also complains of vomitings since 6 days with 2 episodes which was  watery in consistency  non bilious non foul smelling  non blood stained  On 22/8/22  he had 3 episodes of vomitings  On 23/8/22 he had one episode of vomiting  No c/o hematuria , petechiae, melena  No H/O cold,cough,burning Micturition,SOB,chest pain,orthopnea,PND PAST HISTORY  Orthostatic hypotension  N/K/C/O HTN,DM,TB,ASTHMA, CAD, EPILEPSY  PERSONAL HISTORY  Diet- mixed Appetite- normal Bowel and bladder -regular Sleep - adequate  Addictions - none DAILY ROUTINE  He  is

  A 80 year old male from lingotam  came with C/C of  • Pain in hypogastric region since 5 days • Decreased urine output since 5 days • Fever since 5 days SOB on exertion since 3days HISTORY OF PRESENT ILLNESS  Patient was apparently asyptomatic 2 months back when he developed fever which was high grade, on and off ,a/w chills and rigors. He also c/o decreased urine output since 5 days and pain in hypogastrium  He also c/o SOB on exertion since 3days  Went to nalgonda hospital but since the symptoms was not subsiding  he came here No c/o cough, cold, headache PAST HISTORY  N/K/C/O   DM, HTN, Asthma, epilepsy, tb, CAD  Treatment history  Left kidney operated for stones in kmni hospital narketpally. (Went to hospital because of flank pain.)  FAMILY HISTORY  Not relevant  PERSONAL HISTORY  Diet mixed  Appetite decreased since 5 days  B/B       Decreased urine output      Bowel movements regular  Sleep Disturbed since 5 days  Addictions : Smokes chutta DAILY ROUTINE  Farmer by occupation p

 A 28 year old male came to OPD with chief complaints of  Abdominal distention since 20 days  Shortness of breath since 15 days   History of present illness  Patient was apparently asyptomatic 4 months back then In April he had fever , yellowish discoloration of sclera for 3 days , fever is not associated with chills and rigor ,no evening rise of temperature then he went to hospital , used medication for 1week.  Symptoms subsided after a week ,then again he started to consume alcohol(180 ml) daily. In the month of June he had fever, Abdominal distension, yellowish decolorisation of sclera , went to a hospital in jangaon took ayurvedic medicine for 1 week , symptoms got subsided.  After that he again started to drink alcohol from July.  Then he presented to opd on July 28 with complains of Abdominal distension since 6days, Shortness of Breath of Grade lll ,fever was not associated with Chills and rigor without evening rise of temperature, he had altered sleep cycle, facial puffiness, pe

A 65 year old female patient resident of nalgonda came to the opd with chief complaints of • shortness of breath since 1 week • Pedal edema since 3 months  • back pain since 1 week  HISTORY OF PRESENT ILLNESS Patient was apparently asymptomatic 4 years back then she developed flank pain, leg pain and Pedal edema bilaterally for which she consulted local practictioner and then was on medication. Since it was not subsiding 5 months back she went to nalgonda hospital and was diagnosed with kidney failure . Now 1 week back she came with complaints of SOB grade 2-3 ,progressive ,aggravated on walking and relieved on rest. PAST HISTORY K/C/O hypertension since 10 years Not a K/C/O DM, TB, Asthma, epilepsy.  DAILY ROUTINE  She was a farmer ,daily wage laborer by occupation but she stopped working since 2 years because of back pain and Pedal edema.  Wakes up at 4Am Cooking and household activities  Breakfast at 9am Talking to neighbours  Lunch at 12am Sleep and wakes by 5pm Dinner at 7pm Sleep

A 28 year old male patient came to opd with chief complaint of blood in the stools since 1 1/2 year & shortness of breath on exertion since 1 year. HOPI:- Patient was apparently normal 1 1/2 year back then he noticed bleeding per rectum and it was once in every 1-2 months . It was not associated with any pain during defecation , no mass per rectum and there is  fresh drop of blood per rectum. Aggravated on straining while passing stools   1 year back he developed  sob on exertion which was  not associated with chest pain , no palpitations, no giddiness. He c/o fever since 1 week which is of low grade,associated with chills and dry cough  First he went to local practitioner,  but fever did not subsided then he was refereed to local hospital in Miryalaguda where he underwent for cbp examination:   Hemoglobin- 2.1%   RBC     - 1.5 millions/ mm3   Platelets- 1 lakh  Then he was  referred here for gastroenterologist  HISTORY OF PAST ILLNESS:-  He had  h/o  polio at  the  age of  5 years