SRIVATSA GONWAR ROLL NO 48

HOPI Patient was apparently asymptomatic 20 years back years back then he developed Shortness of breath and cough with thick blood stained sputum and went to a private hospital for checkup and was diagnosed with TB and was on ATT for 6 months and then the symptoms of cough subsided. 2 years back he had Shortness of breath (Grade 2) type which is insidious in onset and relieved temporarily on medication ( drug - unknown) from then he had intermittent shortness of breath which relieved on the medication temporarily.  6 months back he met with an accident and suffered an injury to left tibia and left rib  He was taken to nearby hospital and was put on pop cast for 40 days and used NSAIDS and calcium tablets. 5 days back Pain in umbilical region  which was insidious in onset and diffuse. He also developed SOB of grade 3 type which was insidious in onset and relieved on medication. There is a history of cough which is productive with thick sputum  fatigue; sweating ;  No history of palpitat

chief complaints: A 49-yr-old patient came with OPD with chief complaints of  -bilateral knee pain and Lower bach ache since 2 months. -pedal edema since 1 week. -shortness of breath since 1week. -decreased appetite since 1 week. history of presenting illness: -Pt was apparently assymptomatic 2 months ago, then he devoleped B/L knee pain which was insidious in onset ,gradually progressive ,pain increase on work for which he used NSAID’s prescribed by local RMP for 15-30 days and stopped  -he devoleped pedal edema 1 week ago which was insidious in onset and initially restricted to below ankle then progressed above ankle level which is not relieving on rest and not associaed with fever -he devoleped grade II shortness of breath 1 week ago DAILY ROUTINE: Patient used to be a farmer by occupation but he stopped 2 montgs back due to increased knee pain and was mostly confined to his home ad surroundings. He wakes up at around 5:30 AM and freshens up. He will be having breakfast at around 10