KANDRU CHERISH ROLL NO 68

A 53 year old male came to the GM OPD with  C/o  Yellowish Discolouration of eyes since 1 month Abdominal Distension since 20 days Pedal Edema since 20 days Loss of appetite since 10 days Cough, Fever since 5 days History of Present Illness Patient was apparently alright 1 month back then he had yellowish discolouration of eyes gradually progressive. Abdominal Distension since 20 days, insidious in onset, gradually progressive. Pedal edema since 20 days, pitting type upto knee Fever since 5 days, low grade, more at night and associated with dry cough. No h/o blood in stools, haemetemesis, abdominal pain No h/o SOB, chest pain, palpitations Past History: N/k/c/o DM2, HTN, TB, Epilepsy, CVA, CAD Personal History  Appetite-Normal Diet- Mixed Bowel& Bladder - Mixed Sleep- Adequate Alcoholic since 40 yrs 90ml /day stopped 2months back 10 cigarettes/day for a year and stopped smoking 1 year back On Examination  Patient C/CC No Pallor, cyanosis, clubbing, lymphadenopathy  Icterus Present

 A 45 year old female came to GM OPD with C/o -Neck Pain since 10 days -And low grade fever since 10 days.  HOPI: Patient was apparently asymptomatic 2 months back then she developed neck pain insidious in onset gradually progressive and aggravated since past 10 days.  Restriction of movements+. Neck Pain aggravates on flexion and extension of neck. No h/o trauma.  Low grade fever not associated with chills and rigors since 10 days,Intermittent in nature. No h/o sob,cough,sore throat,Abdominal pain,vomitings,loose stools, Tingling of b/l upper limbs+. Past History : K/c/o htn since 4 years and on medication T. losertan 50 mg+Hydrochlorothiazide 12.5 mg po/od  N/k/c/o DM, thyroid,CVA,epilepsy, Asthma,CAD Personal History : Appetite -Normal Diet -Mixed Sleep -Adequate  Bowel and Bladder -Normal and Regular Addictions -None Daily Routine: Patient is a Weaver by occupation. She works at her own house. She wakes up by 6 am in the morning. She has her breakfast around 8 am. Then she starts h

A 25 year old male came with   C/o  Fever since 4 days and Vomitings since 3 days Patient was apparently asymptomatic 4 days ago then he developed high grade fever with chills and rigors associated with generalised body pains not associated with cough, cold, sore throat, SOB, Palpitations. C/o Vomitings 3 days back, 3 episodes of Vomitings non bilious, non projectile, non foul smelling, contain food particles as content. Past History- N/k/c/o DM, HTN, Epilepsy, CVA, CAD, Asthma On examination  Patient is C/c/c well oriented to time place and person No signs of Pallor, Icterus, cyanosis, clubbing, lymphadenopathy, pedal edema  On Sustemic Examination: CVS: S1S2 + No murmurs heard RS: BLAE + NVBS heard CNS: NFND P/A: soft,nt  At Presentation Temperature: 98.4 F  Pulse rate: 65/min  Blood pressure: 130/80 mmhg  Respiratory Rate: 16/min  Spo2: 98% at RA Clinical Images: Investigations— Provisional Diagnosis  Viral Pyrexia with Thrombocytopenia  Dengue Fever( NS1 Positive) Treatment: 1.

 A 70 year old female presented to Casuality with C/o fever since 6 days, abdominal pain since 4 days, pain and swelling of Lt LL since 4 days.She was referred to GM I/V/o fever, nausea and B/l pitting edema. HOPI: Pt C/o fever since 6 days which is continuous associated with chills and rigors, relieved on medication, no diurnal variation, not ass with cold, cough, burning micturition. C/o pain abdomen which is insidious in onset gradually progressive with no aggravating and relieving factors, squeezing type of pain associated with nausea. No H/o vomitings. Also Pt C/o pain over Lt LL associated with Itching and swelling which is insidious in onset and gradually progressive. Past History  K/c/o HTN since 10 years( not on regular medication) K/c/o filariasis to Lt LL since 45 years N/k/c/o DM2, TB, Epilepsy,CAD,CVA, Hypothyroid. O/E Pt is oriented to person Not oriented to time and place BP: 90/60 mmhg PR: 96bpm PR: 20 cpm CVS: S1 S2 + RS: NVBS+ BLAE+ CNS: NFND P/A: Diffuse Tenderness P