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61 year old with Sob ,pedal oedema

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  C/o SOB since 1 month  Pedal oedema since 15 days  HOPI   PATIENT was apparently asymptomatic 1 month ago then he developed  sob and  pedal oedema  No h/o of burning micturition,decreased urine output  H/o of  facial puffiness  present  Patient who is a farmer by occupation stopped going to work after their family insisted he stopped the work due to his irregular sugar trends ,presented as  headache ,syncopal attacks                                              1 year back he had an ulcer to his left foot probably due to his poor foot hygiene   For 10 days he neglected his foot ,developed maggot infestation in his foot  Visited miriyalaguda local hospital   Aseptic dressing done for 4 days  Then he was referred to miriyalaguda doctor ,routine investigations were done ,deranged RFT and symptoms of SOB (grade 2 to 4 ) ,orthopnea +     on MARCH 20 2021 ( Creat - 3.8 ) as of that day of admision in prvt hospital  Amputation of left great toe was done , patient also had a history of plant
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30 year old RENAL TRANSPLANT RECIPIENT with deranged RFT

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 Chief complaints  Renal transplant recipient came with deranged RFT values on routine investigation done for his renal transplant came to kamineni on 7/2/22 No c/o pedal odema  No c/o SOB ,facial puffiness  HOPI  Patient was apparently asymptomatic then on routine investigation done for renal transplantation revealed elevated creat levels  Sr creat - 3.5mg/dl  Urea - 85 mg/dl  No h/o decreased urine output ,urinary retention Past history  H/o previous admissions for dialysis for 2 years (CRF)  K/c/o HTN on tab amlong 10 mg - 5 mg - 10 mg  Tab.arkamime 0.2 mg po/tid  H/o 2 times intubation and extubation i/v/o pulmonary oedema , hypertensive emergency and resistant hypertension 2 years back  H/o loculated pleural effusion and icd drainage 2 years back  Treatment history  K/c/o htn on tab amlong and arkamine  Surgical history  K/c/o renal transplant recipient  Personal history  Single  Appetite - normal  Bowel and bladder movement - normal  No known addictions  Family history - not sign
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44 year old with ALD

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  CHIEF COMPLAINTS   44 year old male came to casualty with chief complaints of fever with chills on and off high grade associated with chills and rigor  HOPI  patient was apparently asymptomatic 12 years back had history of intake of alcohol initially 90 ml   gradually progress to amount of 200 ml  since 2 years patient was on alcohol 200 ml , quantity increased to daily intake  of with no  or minimal food intake H/O agressive behaviour  tremors +  decreased appetite  yellowish discoloration of sclera present  vomiting of 1 episode , patient was admitted in outside hospital and treated as alcoholic liver disease With TB - 23.7 gradually reduced to 2.5   pain abdomen +  passing stools (1-2 ) episodes/day  No loose stools , vomitings,malena ,blood in stools  Past history  N/K/C/O - DM, ASTHMA,TB , EPILEPSY Personal history  married  appetite - lost  bowel - regular  micturition - normal  known alcoholic since 12 years  GENERAL EXAMINATION  no pallor,icterus,cyano
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80 year old male with SOB,PAST CAD AND ?CAP

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80 yr old came to casualty with chief complaints of SOB since 4 days  HOPI  PATIENT WAS APPARENTLY ASYMPTOMATIC 4 YEARS BACK THEN HE HAD CHEST PAIN  ECG FINDINGS SHOW ANTERIOR WALL MI AND RIGHT BUNDLE BRANCH BLOCK  CABG AND STUNTING WAS DONE IN 2017  H/O WEIGHT LOSS SINCE 4 MONTHS  H/O LOSS OF APPETITE SINCE 4 MONTHS  NO H/O RENAL CALCULI  SINCE THEN PATIENT WAS ON TAB .ECOSPORIN AV 70/20 PO/OD  TAB.MET XL 25 MG PO/OD  SINCE 3 MONTHS BURNING MICTURITION , POLYURIA, INCREASED URINARY FREQUENCY  ?BOWEL AND BLADDER INCONTINENCE  GENERALIZED WEAKNESS SINCE 3 MONTHS  SOB SINCE 4 DAYS  INITIALLY GRADE 3 PROGRESSED TO GRADE 4  SINCE LAST NIGHT ASSOCIATED WITH ORTHOPNEA  COUGH ASSOCIATED WITH SPUTUM ,CHILLS AND RIGOR  NO CHEST PAIN, SWEATING,SYNCOPAL ATTACK , PALPITATIONS,GIDDINESS  H/O SIMILAR COMPLAINTS IN THE PAST  H/O BURNING MICTURITION 4 MONTHS BACK  TREATED CONSERVATIVELY  TREATMENT HISTORY  DENOVO DM  H/O CATARACT SURGERY B/L 6 MONTHS BACK  CAD IN 2017  PHYSIC
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