70Kalpak mawale

A 45 year old woman, laborer by occupation, resident of Nalgonda came to medicine OPD with chief complaints of Difficulty in breathing since 2 hours Generalized edema since 3 months History of Present Illness- The patient was apparently asymptomatic 3 months ago, then she suddenly noticed edema of the feet. She continued to go to work and observed that her swelling has progressed to upper limbs and abdomen and face, Edema was sudden in onset and rapidly progressive associated with pain, started with edema The pain was dragging type, insidious in onset and was throughout the day. Aggravated on movement and supine position. Relieved on medication and sitting. Pain eventually spread to the entire body. 2 months ago she went to a hospital in Nalgonda, where she was told she had some kidney related issue. She took medicine for 1 month irregularly.  The edema didn't subside, so she decided to come to KIMS where she was told she has to undergo dialysis. The patient was apparently anxious

A 28 year old married woman, farmer by occupation, resident of kunjbihar came to medicine OPD with chief complaints of Pain and weakness in upper and lower limbs since 8 years History of Present Illness - The patient was apparently asymptomatic 8 years ago, then had a sprain with sharp pain in the right hip region while drawing water from well. It was sudden in onset and dragging type of pain. Radiating towards  lower back and slowly spread to right upper limb amd lower limb. Pain aggravated on movement i.e., after work in the nights and relieved on medication, massage and rest. In the last 3 years, weakness has increased and she was not able to perform normal household works. She went to an orthopedicean 3 years ago, pain was relieved on medication, so she discontinued taking medicine, which brought back the pain. Later, she was asked for investigation like blood and x ray. The doctor saw the result and asked her to consult a neurologist, which they didn't consult. She then came

A 36 year old woman, farmer by occupation, resident of Tirumalagiri came to medicine OPD with chief complaints of Pain abdomen since 1 month Blood in vomiting 1 episode 1 day ago History of Present illness - The patient was apparently asymptomatic 1 month ago and then she developed, pain in the epigastric region, which is of squeezing type, aggravated on consumption of spicy, sour and non-vegetarian foods, sometimes relieved after an episode of vomiting. It is non radiating and no migration of pain. There’s is no positional variation. She had had over 10 episodes of vomiting, in the last 1 month which is non projectile, non bilious and food as it’s content. Sometimes, early morning retching, induced vomiting. A day ago, she had an episode of vomiting with some blood which is dark brown in colour. No h/o fever, blotting, constipation, loose stools, cough, shortness of breath, chest pain. No retrosternal burning. Menstrual history- Menarche at the age of 13 years Marriage at the age of 1

A 73 year old man, who is a retired bank manager, resident of chityala came to the medicine OPD with chief complaints of Fever since 3days General weakness since 3days Difficulty in breathing since 2days Loss of appetite since 2days History of present illness- The patient was apparently asymptomatic 3 days ago, he then developed low grade fever, no diurnal variation, relieved with medication, not associated with chills and rigor. Generalised weakness from 3 days. Shortness of breath since 2days which is insidious in onset and gradually progressive. No h/o vomiting, loose stools, constipation, pain abdomen, cough Past illness - Known case of HTN and DM since 15 years N/k/c/o Thyroid, Asthma, CAD, Epilepsy No surgical history Family Illness- No significant history Personal history - • Married • Mixed diet • Appetite normal • Sleep adequate • Bowel and bladder movements regular • Allergies none • Addictions- alcohol 2 quarters /day General examination - Physical examination- • No

A 42year of married male, carpenter by occupation, resident of miryalaguda came to medicine OP with Chief complaints of- pain abdomen since 5days Vomiting since 1day History of present illness - The patient started experiencing pricking pain in the epigastrium since 5days, because of which he had decreased appetite He had the same symptoms 1year back for which he was told it was a pancreas related issue and got treated  No relieving or aggravating factor No radiation. He had 2episodes of vomiting on the presenting day which was watery, non projectile No fever,headache,shortness of breath, burning micturiton and constipation Past history-  No h/o  HTN, DM, Asthma, Epilepsy, CAD, TB No surgical history Family History- no significant history  Personal History- Diet mixed Appetite normal Sleep adequate Bowel and bladder movements regular Allergy fish Addiction- alcohol 90ml/day since past 15years  General examination The patient was conscious Well oriented with time, place and person Coope

A 35 year old married man, working as a tractor driver, resident of Bhongir came to medicine OPD with Chief complaints of increase in size of the discolouration of skin since 8 months History of Present Illness- The patient was apparently asymptomatic 8 months ago and suddenly noticed heat rashes over the nose area. It was not itchy. The rash persisted for 15 days. The skin started peeling off of the rashes with skin hypopigmentation and mild pain. After 10 days, he decided to consider herbal medicine and took it for 15 days which was not of any help. The patches kept spreading to his chest, upper limb and legs over the next 15days. The skin peeling continued and was associated with fever in the evenings after coming back home from work. He went to a local doctor and took medicine with saline administered for 3months. The fever subsided on medication with decrease appetite(no significant weight loss) and burning sensation and itchiness over patches and headache over the bitemporal reg