66.Sai.Aishwarya

CHIEF COMPLAINT:                      A 60 year old male patient driver by occupation came to  causality with the chief complaints of -Pedal oedema since 15 days.   -Vomitings since 1 week -SOB since 5 days.                                               -Fever,cough since 5 days. -Decreased urine output since 3 days -He is a known case of chronic renal failure and he is on hemodialysis and he underwent (4) sessions of hemodialysis. HISTORY OF PRESENT ILLNESS ; -Patient was apparently asymptomatic 15 days back and he is completely normal and he was able to do his regular routine work.   -But 15 days back he developed oedema in his lower limb which is extended up to ankle which is pitting type -fever which is continuous associated with cough and vomiting  since 5days.vomiting of one episode which is non projectile - Cough with sputum which  is red in colour and reduced after medication. -SOB of grade 4 since 5 days -Patient had underwent 7 sessions of hemodialysis till date. PAST HISTORY

 A 50 year male farmer ,manual labourer,brought  to casualty with h/o altered sensorium  H/o fever since 5 days. HISTORY OF PRESENTING ILLNESS - Patient was apparently asymptomatic 5 days ago,then he developed fever which is high grade,No diurnal variation, associated with chills. -No h/o cough and GE symptoms.  -Attenders tells h/o stoppage of  OHA for 3days, h/o decreased intake of food as he has fever. -H/o altered sensorium  -Irrelevant talk,not recognising attenders since this morning . -Able to move all four limbs,No h/o vomitings, head ache, seizures. -Took him to nalgonda hospital SHIFTED HERE FOR FURTHUR MANAGEMENT.  PAST HISTORY -  -H/o TB 2YRS back used ATT for 6 months. -Diagnosed as Type -2 Diabetes mellitus on OHA 1 YR back -No H/O HTN,CVA,CAD,COVID-19. PERSONAL HISTORY  -DIET - MIXED, -APPETITE -NORMAL , -BOWEL MOVEMENT - REGULAR ,  -BLADDER MOVEMENTS - REGULAR, -ADDICTIONS-H/O  SMOKING 30yrs ago(1 pack per day)-  -ALCOHOL-REGULAR INTAKE OF 180ML  SINCE 30YRS,STOPPED SIN