54 geetha

19/01/2023 Chief Complaints:         69year old female resident of Nalgonda, shopkeeper by occupation presented to casuality with chief Complaints of Hoarseness of voice since 10 days. cough since 1 week breathlessness since 3 days   fever (high grade) since 1 day, relieved on medication. History of Present Illness:          She was apparently asymptomatic 10 days ago, started complaining of noticeable change in her voice , horseness of voice which Started gradually, not associated with foreign body sensation, Difficulty in swallowing or any neck swelling. Cough since 1 week, dry in nature ( not associated with any expectoration), not associated with cold, sore throat, Hemoptysis, loss of weight or appetite  Shortness of breath since 3 days of grade 1- MMRC which was aggravated on walking And relieved on Taking rest, it was not associated with wheeze,  pedal oedema, orthopnoea and PND.  Fever high grade associated with chills since 1 day, with no diurnal variation   no h/o chest pain o

 19/01/2023 Chief complaint : A 62 year old male patient of resident battugudem, farmer by occupation  came to opd with a complaint of decreased appetite, vomiting, nausea, facial puffiness, pedal edema, distension of abdomen and decreased urine output from 15 days.  History of present illnesses:  patient was apparently Asymptomatic 10 years back then he had fever, difficulty in having food and was taken to hospital and incidentally found to have diabetes mellitus and started on conservative management Patient was asymptomatic 3 years back and he noticed pedal edema, facial puffiness and was not treated for it  And later 2 years back the patient was Unconscious and unable to talk and was presented to local RMP doctor and was diagnosed the condition as renal failure. And conservative treatment but was not controlled. Then he went to government hospital nalgonda. 2years back he was diagnosed as hypertension 15 days back he was suffering from vomitings, nausea, facial puffiness, pedal ede