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62yr old with pedal edema and fever

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A 62 year old male came to the OPD with chief complaints of:- Pedal edema since 1 month Decreased urine output since 1 month Fever since 2 days HOPI :- Patient was apparently asymptomatic 3 years back then developed pedal edema, shortness of breath, fever, cough and was admitted in a private hospital hyd and diagnosed as renal failure. In February/march 2022 patient came to kamineni Narketpalli with chief complaints of shortness of breath and decreased appetite and undergone dialysis under 3 sessions and was on conservative management. In November 2022, patient came with similar complaints and undergone dialysis here Now he developed pedal edema since 1 month which is pitting type and complained of fever since 2 days which is continuous ,high grade and associated with chills and rigor. H/o nausea, vomiting, anorexia 04jan night. Vomiting is non projectile, non bilious, non blood tinged contained food particles associated with nausea in 2-3 episodes. No h/o burning micturition, pain abd...

2nd INTERNAL ASSESSMENT

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38 yr old with Pain Abdomen

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A 38yr old male resident of West Bengal , civil engineer by occupation came to the OPD with chief complaints of abdominal pain since 5 years HOPI :- Patient was apparently asymptomatic 5 years back then developed pain abdomen which is sudden in onset , gradual in progression , dragging type radiating to back which aggravates on intake of food, alcohol and relieved on medication.  From last 5 years he has episodes of abdominal pain occurring once in 3 months later from last 6 months pain occurs more frequently/daily? For the past 1 year patient has episodes of vomiting followed by pain in abdomen at least once in 2 months which is non bilious and water as content associated with weakness and giddiness On13th November he had multiple episodes of vomiting after lunch, initially vomiting containing food particles (yellowish)  later watery associated with weakness and giddiness and not relieved on medication. On 23rd November he had similar episode of pain and took medication He al...