PRASHANTH REDDY ANUGU

30 year old male patient resident of suryapet and a watchmen by occupation came to casualty with  Chief complaints: Loose stools and vomitings since yesterday morning and shortness of breath since yesterday evening.  History of presenting illness: Patient was apparently asymptomatic till yesterday morning then he developed vomitings which are non bilious, non projectile, non blood tinged filled with food particles(10 episodes since yesterday which subsided from today morning). C/o loose stools 2 episodes yesterday morning which are watery, non blood tinged,non mucopurulent,not associated with fever, pain abdomen. C/o shortness of breath (grade 3) from yesterday evening which is not associated with chest pain, palpitations, orthopnea, pnd.  Patient was admitted in Gandhi hospital yesterday evening and was given IV fluids  And Inj.HAI 40iu.  Patient then came to our hospital due to shortness of breath  Past History: He is a K/C/O DM since 4 years(was on insulin mixtard 10u-X-10u and was

  Chief complaints:     -generalised weakness since 5 months       - loss of appetite since 5 months       - hematuria since 2 days     - dizziness since 5 months       - sob ( grade 2-3) since 5 months     - fever since 1 week  History of presenting illness: Patient was apparently asymptomatic 2 years back where she developed swelling of left lower limb first as with pain and then swelling progressed to whole body where she got admitted to Osmania and treated and swelling subsided and patient is doing fine .after 1 year of that event patient gradually developed generalised weakness, easy fatiguability, loss of appetite,weight loss, sob ( grade 2-3) not with cough, cold , palpitations,  She has fever which is intermittent, low grade not associated with chills and rigors  She also has Hematuria for which she went to local hospital where she found to have Anemia for which she was transfused 5 units of blood in a span of 20 days and was discharged.  She was doing fine. Since 5 months pati