jyothsna 113

58 year old male, labourer by occupation, came to the OPD with the chief complaints of Shortness of breath since 15 days, worsened 3 days back, facial puffiness since 1 week History of Presenting illness -  Patient was apparently asymptomatic 4 years ago 4 years ago - pt complained of giddiness, went to a local hospital and was diagnosed as Hypertensive, on regular medication since then T. Nicardia 10mg, T. Arkamine 0.1mg sos 2 years back Pt developed B/L pedal edema, progressed gradually to knees, diagnosed with renal failure and initiated dialysis weekly twice Left upper limb swelling, gradually progressing to current size, since 4 months . Swelling in the left chest region, gradually progressing to current size, since 4 months Back pain since 2 months, subsided on medication (T. Ultracet) 7 days back - developed Facial puffiness Shortness of breath since 7days Grade II-III progressed to Grade IV since 15 days along with orthopnea  No c/o palpitations, giddiness, cold, cough, burning

A 60 year old male came to the casualty with the chief complaints of distension of abdomen since 2-3 months, bilateral lower limb swelling since 1 month and dark stools since 4 days.  Patient was apparently normal 11 years back following which he developed sudden onset of chest pain associated with sweating and diagnosed with ? CAD and had CAG + PTCA and was on regular follow up since then.  4 months later he had persistent headache and neck pain for which he was taken to the hospital nearby where he was diagnosed with HTN and Diabetes and treated accordingly.  3 months back patient noticed progressive abdominal distension associated with SOB grade 3 for which he consulted the local RMP and got treated but refused to get admitted in hospital as he had to attend his daughter’s marriage in the coming week. Exactly one day after his daughter’s wedding patient had a bout of vomiting with fresh blood as content. On Tuesday patient came to KIMS - NKP Gastro OPD, endoscopy was done which reve

A 35 year old man, works at a wedding card printing store, presented to the casualty at 8pm with the  complaints of Fever since 2 months Generalized weakness since 2 months  Dyspnea on exertion since 2 months  Pain abdomen since 20 days Right sided chest pain since 20 days Vomiting since 20 days  Dark coloured stools since 20 days Personal history He works at a store that prints wedding cards at Suryapet. He has 2 daughters. Since the past 15 years he has been consuming alcohol everyday, he consumes around 360ml of whiskey per day and his last alcohol intake was yesterday. Since 15 years he has been smoking, he says he only smokes occasionally.  Since the past 2 years he started to experience  loss of appetite. He also tells us that he started consuming less food and started to consume larger amounts of alcohol. He also tells us that he started to experience recurrent episodes of pain abdomen along with recurrent episodes of vomiting every alternate day and he has visited hospitals 5-6