P SAI PRAKASH REDDY ROLL NO 118

  A 70 year old male patient, resident of Nalgonda came. To hospital with chief complaints of    Bilateral pedal edema since 1 week   Shortness of breath since 1 week History of  presenting illness Patient was apparently asymptomatic 1 week back, then he developed bilateral pedal edema which was on and off. Pedal edema was pitting type and was initially up to ankle but gradually progressed up to the knee when he presented to  hospital. He developed shortness of breath which was initially present on doing some work or climbing up stairs. But since last 1 week he has shortness of breath on doing daily activities . No H/O fever, cough, loss of weight. Past history No similar complaints in past No H/O diabetics, asthma, tuberculosis, coronary artery disease, epilepsy He is  known case of hypertension since 10 years Personal history Diet: mixed Appetite: decreased Sleep: adequate Bowel and bladder: decreased urine output Addictions: alcohol since 30 years                       Smoking tobac

  A 57 year old male, resident of Nakrekal, mason by occupation came to hospital with chief complaints of   shortness of breath since 1 week Decreased urine output since 1 week HISTORY OF PRESENT ILLNESS patient was apparently asymptomatic 1 week back then  he had shortness of breath while walking upstairs and walking at normal pace (grade 2) which gradually progressed to shortness of breath at rest in last 1 week ( grade 4). Shortness of breath aggravate by doing work and on lying horizontally on bed. Relieved by taking rest in reclined position There is history of gradual decreased urine output since 1 week which is not associated with increased frequency, urgency or incontinence No H/O fever, chronic cough, weight loss, hemoptysis, sputum No H/O chest pain, sweating, palpitations, syncope  No H/O burning micturition, difficulty in micturition PAST HISTORY No similar complaints in past History of pedal edema on and off since 1 year, present upto level of ankle He is a known case of h