Sri Nithya

 70 year old male came with the chief complaints of chest pain ,cough,sob since 8-10 days Fever since 1 week Hopi- Patient was apparently asymptomatic 8 days back then he developed cough- Dey,insidious in onset and gradually progressive,diurnal variations present more during night. No seasonal variations. No aggravating or relieving factors. Chest pain left sided non radiating not associated with excessive sweating, palpitations,pedal edema,giddiness Sob since 8 days insidious in onset and gradually progressive,progressed from grade 1 to grade 3 . No orthopnea,no PND No seasonal variation,no diurnal variation. Fever since 1 week ,high grade associated with chills and rigors, Evening rise of temperature present, loss of weight present, loss of appetite present No h/o vomiting,losing stools,pain abdomen. Past h/o-  K/c/o HTN since 2 years K/c/o DM since 6 months Not a k/c/oNot a k/c/o asthma , tb , epilepsy and thyroid disorders  Surgical history - ?patient underwent exploratory laparoto

M. Sri Nithya Roll. No-86  Patient came with the complaints of  sob since 1 day,  Decreased urine output since 1 day Altered sensorium since 2 hrs B/l Pedal edema on and off since 1 year Hopi- Patient was apparently asymptomatic 1 yr back then he developed b/l pedal edema , on and off  and was on conservative management. Since then, he was diagnosed with hypertension using tab. Telmisartan 40 mg since 1 year. Since yesterday night patient is having is having sob grade 3 to grade 4,which is sudden in onset and gradually progressive, associated with PND, not associated with chest pain or sweating. No c/o fever, vomitings or loose motions . Past history - Not a k/c/o DM, tb , asthma , epilepsy, thyroid disorders, cad or CVD. History of alcohol and smoking present since 25 years Family History There is no significant family history On examination- There is no pallor, icterus, cyanosis, clubbing, lymphadenopathy B/l pedal edema present, pitting type extending up to the knee Temp- 98. 6F PR-