45 M with abdominal distension and b/l lower limb swelling
Unit 1 AMC bed 5 DOA:29/5/23 45 year old male ,lorry driver by occupation,resident of Nalgonda came to the opd with chief complaints of Abdominal distension since 4-5 days Abdominal bloating since 4-5 days Shortness of breath since 4-5 days Vomitings since 3 days B/L lower limb swelling since 15-20 days HOPI : he was apparently asymptomatic 15 days back then he developed swelling of both lower limbs (extending up to knee ,pitting type)insidious in onset ,gradually progressive, no aggravating and relieving factors . Abdominal distension since 5 days ,insidious in onset ,gradually progressive,no aggravating and relieving factors Associated with bloating ,SOB and vomitings No h/o chest pain ,orthopnea ,PND,palpitations No h/o deceased urine output,burning micturition ,fever Past history K/c/o DM since 4-5 years on medication Tab Metformin 500mg po BD N/k/c/o HTN CVA CAD TB EPILEPSY H/o Alcoholism since 10 years aggrevated 4 yrs back (180ml per day) Perso