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A 48 YR OLD FEMALE FARMER BY OCCUPATION RESIDENT OF VELLEMLA  CAME WITH CHIEF COMPLAINTS: WOUND OVER THE LEFT FOOT SINCE 4 MONTHS HISTORY OF PRESENT ILLNESS: PATIENT WAS APPARENTLY ASYMPTOMATIC 4 MONTHS BACK, AFTER WHICH SHE DEVELOPED BLACKISH DISCOLORATION OF LEFT GREAT TOE WHICH WAS INSIDIOUS IN ONSET GRADUALLY PROGRESSIVE, ASSOCIATED WITH SWELLING OF THE LEFT LIMB TILL MID FOOT FOR WHICH SHE WENT TO A LOCAL PRACTITIONER AND WAS TREATED WITH DRESSING THERE WAS NO IMPROVEMENT, WITH PROGRESSION OF WOUND, ASSOCIATED WITH FOUL SMELLING DISCHARGE FOR WHICH SHE WAS TAKEN TO AN OUTSIDE HOSPITAL WHERE DIS ARTICULATON OF LEFT GREAT TOE WAS DONE ON 13/04/24 CAME ON LAMA TO OUR HOSPITAL FOR FURTHER MANAGEMENT NO H/O FEVER,COUGH,COLD. NO H/O CHEST PAIN, PALPITATIONS, BREATHLESSNESS, ORTHOPNEA, PND. NO H/O ABDOMINAL PAIN, BURNING MICTURITION, NAUSEA, VOMITING. DALIY ROUTINE : WAKES UP AT 6 AM IN THE MORNING  DRINKS TEA AND DOES HOUSEHOLD WORK  HAVE BREAKFAST FAST AT 9 AM GOES TO THE...
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CASE 1 THESIS

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C/o  Shotrness of breath 1 week Cough 1week  B/L pedal edema 1 week. History of presenting illness  49year old male works as a shop keeper in gold shop  was apparently Asymptomatic 7 days ago then he developed B/L Pedal edema pitting type insidious in onset gradually progressive  Breathlessness since 1 week grade 3 to 4 NYHA associated with cough without expectoration  initially he went to near by hospital there his GRBS is 610 mg/dl they suggested them to go to KIMS  No h/0 fever vomiting diarrhoea  No h/o chest pain palpitations 10 years back he came to hospital for Rt hypochondriac pain  initially evaluated and managed drs told them some liver problem (No previous documents available) 8 years back he started loosing weight nearly 8 to 10 kgs in 1 to 2 months duration doctors told them he was Diabetic  Past history Diabetes since 8 yr TAB METFORMIN500 mg  N/k/c/0 HTN CAD ASTHMA EPILEPSY Personal history Occupation: He works in gol...
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