1601006048

   A 29 yr old female patient name  resident of narketpally came to the opd with  cheif complaints   of  Pain abdomen  since 20 days associated with nausea H/0 of fever 1 month back - for 10-15 days which subsided after medication  HOPI Patient is apparently asymptomatic 13 yrs back then she gave birth to a baby with c section after few months pt developed fearfullness, palpitations, which she underwent many hospital  visits ,took medication.  6yrs back patient developed generalized body itching to  which she went to dermatologist  ,took medication  5ys back she had h/o of excessive menstrual bleeding  for which she was told she had infection (cervicitis) , took medication.  1-2 yrs back h/o of fever ,decreased  platelets (dengue) treated conservatively 1 month -  low grade fever loss of Apetite, palpitations,  chest discomfort.  PAST H/O Not a k/c/o diabetes ,HTN, TB,asthama,cvd , epilepsy. PERSONAL H/o diet - mixed Apetite - normal Bowel , - regular Burning  micturition present  Sle

Case of Heart Failure  70 yrs old male patient came to the opd with the   chief complaints of  Sob since 6 days which was severe pedal edema since 5 days  generalized weakness since 5 days   History Of Present Illness Patient was apparently asymptomatic 7 months back then developed generalized weakness  following which he developed sob which was mild 2 days following sob he developed pedal edema pitting type then  contipation for which he went to local doctor and was treated 6 days back he developed sob which was insidious in onset abd progressed to interfere his daily activities  and sleep   Patient has history of PND  7 months back Reports  2 D echo Ecg   Treatment given during last episode Past History Nog history of DM HTN CAD ASTHMA  TB Personal History married normal appetite mixed diet bowels regular micturation normal no allergies  habits  alcohol from past 50 years occasional consumer  Stopped 4 years back Smoking BD from past 50 years 1 or 2 per day  On Examination Pallor No

A 29 yr old male patient named lingaiah came to the opd with cheif complaints  of  Pain abdomen since 3 days associated  with tightness of abdomen Vomitings since 3 days .   HOPI Patient is apparently asymptomatic  3 days back then he developed  pain abdome associated  with tightness of abdomen   Vomitings  which is non projectile and non bilious.  No H/o of fever, body pains , headache ,diarrhea H/o of outside consumption of food 2 days back PAST H/O K/c/o pancreatitis  2018,2020 -2 episodes  Not a k/c/o diabetes ,HTN, TB,asthama,cvd , epilepsy. PERSONAL H/o diet - mixed Apetite - normal Bowel ,bladder movements - regular Sleep - adequate  Addictions - h/o of smoking stopped 2 yrs back. FAMILY  H/O No significant  family h/o GENERAL  EXAMINATION   patient is conscious, Cooperative, coherent, oriented to time,  place, person  Vitals   Bp 130 /70  , HR 86 ,PR 22, GRBS 125, spo2 98% No pallor  No cyanosis No clubbing No icterus , No edema No Lymphadenopathy  SYSTEMIC EXAMINATION   Cvs S1

 A 48yr old male patient ,resident  of chityala came to the opd with cheif complaints    C/C  of Fever since 10 days Altered sensorium  since 5 days Weakness of bilateral lower limbs - 3days  H/o of oliguria - 3days HOPI Patient was apparently  asymptomatic 1yr back then he developed decreased urine output for which they admitted in hospital and foleys was placed , then he was diagnosed with prostatomegaly with Rt renal calculi.  since 10 days patient have high grade fever on and off  not associated with vomitigs/loose stools/cough Altered sensorium since 5days Since 3 days patient had bilateral lowerlimb  weakness ,difficulty to move  B/L lower limbs associated with decreased urine output since 3 days.  PAST H/O  No H/o of hypertension , diabetes , asthma, TB , epilepsy . H/o HIV  10 YRS back PERSONAL H/O Diet - mixed Appetite  - normal Bowel ,bladder movement- regular Sleep - adequate Regular smoker , alcoholic(occasionally 250ml) FAMILY H/O no relevant family  h/o GENERAL EXAMINATI