53M - CKD

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A 53 year old male patient, resident of Pochampally, agricultural worker (toddy tree climber) by occupation came to the OPD with chief complaints of:

Chief Complaints:

Difficulty in passing urine since 10 days

Leg swelling since 5 days

Breathlessness since 4 days

History of Presenting Illness:

Patient was apparently asymptomatic 10 days back, then he developed difficulty in passing urine, associated with pricking type of pain, non blood tinged, clear in appearance.

He also developed irregular passing of stools of frequency once in 2 days after using medication.

Then he developed bilateral swelling of both lower limbs, sudden in onset and gradually progressive not associated with pain.

Later he also developed dyspnoea, insidious in onset and gradually progressive - Grade 4 (occurred even during rest) aggravated during rest and relieved on walking. (Orthopnea+)

Patient also has cough which is productive, non blood tinged, non foul smelling.

No history of palpitations/ burning micturition

Past History:

Known case of Hypertension (using medication)

Known case of Diabetes (initially used medication then stopped)

N/K/C/O Epilepsy, Thyroid.

Personal History:

Diet Mixed

Decreased Appetite

Decreased Urine Output

Decreased Bowel Moments

Consumes Alcohol - Occasionally (2 times per week)