S.Rakesh kumar roll.no.153

A 35 year old female,resident of miryalguda,worker in steel shop,came  with chief complaints of  •Fever since 12 days •Shortness of breath since 10 days •Cough since 8 days ●HISTORY OF PRESENTING ILLNESS:- She was apparently asymptomatic 12 days back,and then she developed fever which was insidious in onset,continuous,high grade and not associated with chills and rigors,for which she went near local RMP and took some medications and temperature decreased. And then she developed breathlessness 10 days back,which was insidious in onset,gradually progressive,SOB is of grade 1 i.e when climbing stairs.SOB aggravated on  exposure to dust and cool air,seasonal variation is present. History of cough since 8days,which is productive,mucopurulent,non foul smelling, and subsided on medication.Cough aggravated on lying in supine position and relieved gradually on sleeping to one side. No h/o tightness in chest,No H/0 palpitations ,sweatings,syncopal attacks,b/l pedal edema. No h/o wheeze,hemoptysi

A 57 years old male resident of palem  who used to work as a construction worker came to opd 8 days back with chief complaints of  shortness of breath,pedal edema,decreased urine output and abdominal distension. HISTORY OF PRESENTING ILLNESSES :  patience was apparently asymptomatic 1yr ago then he developed shortness of breath after walking and climbing of stairs and relieved on taking rest  He also developed pedal edema 1yr ago  They refered a local hospital in suryapet where he was diagnosed with hypertension and is on medication since then  He was also diagnosed with kidney disease and adviced of dialysis for which they declined and was on medications for 6 months  8 days back he developed shortness of breath at rest which relieved on reclined position and bilateral pedal edema he also observed decreased urine output and abdominal distension  NEGATIVE HISTORY : no history of fever, weight loss No history of chest pain, palpitations  No history of burning micturition and difficulty