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  A 56 years old male patient presented to emergency department with the following chief complaints Shortness of breath from 7 days Abdominal distension from 4 months B/L lower limb swelling from 4 months History of present illness:  Patient was apparently asymptomatic 4 months back and developed bilateral lower limb swelling, , reduced urine output, abdominal distension and scrotal swelling. Pedal edema pitting type grade 1and developed to grade 2 10 days later and to grade 3 15 days later. He first developed sweeling in the lower left limb extending upto ankle and right lower limb extending upto thigh. No complains of loose stool, burning micturition, vomiting,hematuria. History of past illness: Patient gives history of pulmonary koch 22yrs back and used ATT for 6months. Known case of hypertension since 3 months and on medication. No history of diabetes, epilepsy, surgery. Personal history: Appetite: normal Diet:mixed  Bowel and bladder movement:regular Sleep pattern:normal Occasiona

  CHEIF COMPLAINTS: A 50 year old male who is a daily wage worker came to the OPD with the cheif complaints of bilateral swelling in lower limbs which has extended till abdomen since 2 months and shortness of breathe ,decreased urine output and abdominal distension for the past 15 days . HISTORY OF PRESENT ILLNESS: Patient was apparently asymptomatic 3 years ago after which he visited a health care centre with complaints of diminished vision in his eyes where he was diagnosed with diabetes for which he is under medication with OHA's .patient does moderate work and gets adequate sleep daily .2 months ago one morning he noticed bilateral swelling in his feet which was insidious in onset and gradually progressive which he ignored and continued his routine for 5 days until he noticed the extension of swelling to his knees till the abdomen which did not subside after taking tablets for 10 days prescribed by doctor in Nakrekal .15 days ago he went to Nalgonda with same complaints of swel

  A 38yrs old male patient presented with  CHIEF COMPLIANTS of loss of appetite since 6 months decreased sleep since 6 months, easy fatiguability from 4 months loin pain since 3 months and SOB from past 20days HOPI Patient was apparently asymptomatic 6months back then he had loss of appetite and decresed sleep(used to sleep nearly 8hours per day before).Then he had sob(grade 2),loin pain(which started in lower back midline and radiated to groin) and decreased urine output(350ml per day),for which he visited kims hospital. PAST HISTORY Not a k/c/o HTN,TB,DM,EPILEPSY, ASTHMA. Previous surgeries: nephrostomy &left URSL TREATMENT HISTORY No relavent treatment history FAMILY HISTORY Not significant PERSONAL HISTORY Mixed Diet  loss of Appetite Bowel movements are once in 8-10days Decreased urine output Sleep decreased   Addictions -Alcohol occassionally and smoking No known allergies. COURSE OF STAY IN HOSPITAL 6 months back ultrasound was done and they diagnosed as RIGHT GROSS and LEFT