Mohammed Wahaaj

60 yr old male,tailor by occupation not working since 3 yrs c/o sob since 3 days,pedal edema since 3days,chest pain since 2hrs. HOPI - pt was apparently asymptomatic 30yrs ago diagnosed with dm,htn  7yrs ago c/o b/l pedal edema,decreased urine output diagnosed with heart failure  10/21 -pt came to our hospital with sob,pedal edema was diagnosed and treated as hfpef,crf,grade 2 bph. Since 3days c/o sob,pedal edema,chest pain since 2hrs  No h/o fever,cold,cough  K/c/o DM,HTN   Personal history: Diet -mixed  Appetite-normal Bowel and bladder-regular  Sleep-adequate  Alcoholic from 25yrs and he stopped 5yrs back and occasional smoker GENERAL EXAMINATION: Pallor -present  Pedal edema-present  No cyanosis,icterus,clubbing,lymphadenopathy  Vitals: Bp-130/80mmhg PR-120 Temp-afebrile  Spo2- 98% at room air  SYSTEMIC EXAMINATION: CVS - s1s2 heard  RS - BAE present  P/A - soft,non tender CNS- NAD PROVISIONAL DIAGNOSIS: Chronic renal failure  HFPEF(EF - 52%) K/c/o DM and HTN since 30yrs Grade 2 pr

  A 60 yr old male farmer by occupation, resident of narketpally came to the casuality  with chief complaints of dry cough, sob since 3 days and fever since 1 day. Hopi: patient was apparently asymtomatic 3days back then he had dry cough, progressive in nature not associated with any diurnal/ postural variation. sob initially grade -II gradually progressed to grade-IV.  not associated with any PND,orthopnea, pedal edema. from day 1 patient is having fever, low grade, intermittent, not associated with chills and rigors, relieves on taking medication. No h/o any decreased urine output. Past history:  no H/o of diabetes hypertension,asthma,TB, epilepsy Genral examination: pt is c/c/c,  afebrile. BP-140/80,  pr-104,  sats-89(at 15L of o2) Diagnosis: Viral pneumonia with type 1 respiratory failure with AKI Clinical pictures:- Treatment:- 1. O2 inhalation to maintain spO2 >92% 2. IVF NS, RL @75 mL/ hr 3. Inj. ceftriaxone 1gm iv/bd 4. Tab. AZITHROMYCIN 500 mg po/od 5. Inj. Pan 40 mg iv /od