62.vennala reddy

 A 12 years old boy, studying 9 standard, from Nalgonda presented to opd 4 days back with cheif complaints of shortness of breathe and orthopnea. History of past history:    Patient was apparently asymptotically 2 month back .he developed high grade fever and referred to local hospital  Fever was subsided after 2 days.After one month he suffered with vomitings at night . They is no incident of any blood in vomitings.   He then immediately went to Hyderabad and found that his urea and creatinine levels are increased . They immediately started dialysis .five sessions of dialysis have been done. Patient suffered with chest pain only during sOB No history of pedal edema,facial puffiness ,no decreased urine output    Past history: Hypertensive since 1 month  No history of asthma,epilepsy, thyroid disorders Patient was undergone 3 transfusions 1 month back  Patient has increased sugar level which is subsided  1 week back Family history: No history of renal problem in family  Allergic history

A 45 year old male presented to opd with  Chief complaint -   fever and chills since 4 days .  HISTORY of Present illness-  Patient was apparently asymptotic well 4 days back  Patient complaints of high grade fever with mild continuous head ache He referred to local hospital 1 day later  Patient complaints of muscle cramps during initial days they is decreased platelet count.  No history of vomitings and loose stool HISTORY OF PAST ILLNESS:- Not a known case of hypertension, diabetes, asthma, epilepsy, tuberculosis. PERSONAL HISTORY:- Patient takes mixed diet, decreased appetite sleep adequate.  Bowel and bladder habits are regular. No addictions. Patient is married and has 2 children. Medical history  No drug allergies.   Family history: No similar complaints of family  GENERAL EXAMINATION:- On examination:  Patient is conscious, coherent and cooperative . He is well built and examined in well lent room Vitals- Temp: afebrile PR: 70 bpm BP: 130/90 mm hg RR: 24 cpm SPo2 - 98%  No Pallo

A 56 year male  patient workers in food center presented to opd with complain of swelling in leg and abdomen since 7 days ago. History of present illness: Patient was apparently asympmatic one month back .he then developed swelling in legs with no pain.they is gradually increase in swelling from legs to abdomen after 2 days . Patient develops pedal edema of pitting type grade -1 . After 10 days it is progressed to grade -2 Over 15 days pitting type grade 3 Patient has no complaints on fever, vomiting . Past history: 1.Patient is suffering with hypertension since 3 month .he is undergoing into medication immediately  2.no diabetes, no seizures,no epilepsy,no tuberculosis,no thyroid disorder  3.patient had not undergone any surgeries  4.patient had suffered from pulmonary koch’s 22 yrs back .patient has used ATT for 6 months. Personal history:  1.diet- mixed  2.appetite- normal  3 .bowel amd bladder movement- normal  4 . Sleep- normal  5. Addictions - no smoking and no alcohol consumptio