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A 70 years old female referred from surgery to GM with the shortness of breath and b/l pedal edema

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Patient was apparently asymptomatic 2weeks back then she developed right leg swelling associated with wound on  the right ankle and right leg anterior region. Swelling extended from the right foot to the mid part of shin.debridement of infection was done four days back.she had h/o of atrial fibrillation before surgery which is controlled. After surgery due to stress  induced  factor atrial fibrillation which-eventually  lead to left heart failure and then right heart failure she developed shortness of breath and pedal edema. No h/o of fever, vomiting Past history: Not known Case of HTN,DM, asthma, qq1 Personal h/o Diet: mixed Bowel and bladder! Regular. Family ho:- No significant family history. GENERAL EXAMINATION:   pt is cc and non cooperative, moderately built and moderately nourished, well oriented with place and time, No pallor, no icterus, no cyanosis, no clubbing, no lymphadenopathy. Vitals: Pulse rate- 123 Bp - 110/80 Rr- 22 Temp- 98.4F Oxygen saturation 96% Systemic examinati
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53 Year old female patient

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A 53 year old female patient came to opd with chief complaint shortness    of breath since 3days .decreased urine output.    History of present illness:patient was apparently asymptomatic 10 months back.Then she developed SOB.She is brought to hospital found PH,raised creatine ,urea levels. which is Diagnosed as kidney failure.Then she underwent dialysis for every 2-3 times a week.she had two times blood transfusion  .Three days back she developed shortness of breath and decreased urinary output. PAST HISTORY: There was a history of HTN,NO H/O DM,ASTHMA ,TB,EPILEPSY. Personal history: Appetite normal Diet:mixed Bowel movements:regular BLADDER:Decrease urinary output No allergies No addiction Family history: No significant family history General examination Patient was consious,coherent,and cooperative,well oriented with time and place. Bp:150/90 Temperature:98F Pulse:86 Pallor:present Icterus:absent Clubbing:absent Cyanosis:absent Lymphadenopathy:absent Oedema:bilateral pedal oedema wh
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45 years old male with seizures one week back

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CHIEF COMPLAINTS  an episode of seizures 1 week back and he had bleeding from mouth    HISTORY  OF PRESENTING ILLNESS: Patient was apparently asymptomatic 20 years ago after which he started consuming alcohol ,initially he started consuming toddy when he was young then he started consuming alcohol with his friends at his work 3-6 units weekly once on Sunday.This continued for 7years back.He started consuming alcohol excess due to family problems.he had 3 years  back  ah/o of 3episodes of seizures each episode precedes consumption of alcohol is present.he decided that alcohol might be the reason and went to a local doctor who told the same reason for which he decided to stop consuming alcohol which he did.he was abstinent for one year.Again he started consuming alcohol duo to family problems. One week back then he developed an episode seizures while he was doing his work on monday .Then he went to the RMP for the treatment he had given a tablet for it and the seizures subsid
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