SUMANASRI KANDREGULA ROLL NO 67

  A 36 year old female, resident of Ammanabolu,housewife by occupation came to OPD with chief complaints of  Fever since 26/7 Headache since 26/7 Neck pain since 26/7 HISTORY OF PRESENTING ILLNESS Patient was apparently asymptomatic 2 days back then she developed fever which was insidious in onset,intermittent,associated with chills and relieved on taking medication. There is h/o vomitings 2 days back,no.of episodes were three and the episodes were preceded by nausea,the vomitings are non bilious,non projectile,contents are food and water. H/O headache and neck pain since 2days H/O generalised body pains on the first day of fever. No h/o rashes on the body,cough,pain abdomen,loose stools,intake of food from outside. DAILY ROUTINE She usually wakes up at 6:00am and does her household chores,drinks tea or milk by 9:00am,then she prepares lunch for the family,she eats her lunch by 12:30pm,then she either talks to her neighbours or sleeps for sometime,in the night she eats dinner and sleep

A 70 year old female patient came to general medicine OPD with chief complaints of Shortness of breath since 1 month Generalised body swelling since 10 days Chest pain and palpitations on and off since 1 month Vomitings 2 episodes, 1 month back HOPI Patient was apparently asymptomatic 1 month ago and then developed SOB grade IV for which she was taken to local hospital and got treated conservatively for raised creatinine and then SOB got relieved temporarily. Again after 10 days developed SOB and for which she was taken to hospital to see the creatinine levels raised and adviced for dialysis and they denied and was discharged after consecutive management and decreased symptomatically. After 10 days developed swelling of both lower limbs and abdominal distention and both upper limbs edema for which taken to hospital and foleys was placed as patient was bed ridden (since 1 month due to generalised weakness and decreased power in both lower limbs) And now came with chief complaints SOB gr