Case -4 RENAL FAILURE
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A 58 year old male patient who was agricultural worker by occupation ;was presented to OPD 2½yrs back with the cheif complaints of swelling of the legs and body pains.
HISTORY OF PRESENT ILLNESS:
The patient was apparently normal 4 years back ,Then the patient has suffered from fever 4 yrs back and visited the hospital.
In the general checkup he was identified with the increase in the blood pressure and was prescribed with the medicines. One tab. Daily in the morning
The fever subsided on medication.
The patient continued medicine for hypertension for 2 yrs.
After 2yrs he identified swelling in the legs and diffuse body pains and difficulty in walking due to pain.
He went to the local hospital and the swellings subsided with the medication. But he was suggested for the dialysis 2½ yrs back.
History of past illnesses:
The patient has no history of surgeries in the past;
no known allergies;or TB ,asthma,CAD.
PERSONAL HISTORY:
The patient complains of decreased appetite.
Diet changed after the problem.earlier the patient had mixed diet with non-veg; now he stopped having non veg food.
Normal bowel and bladder movements.
Decreased sleep since 2months due to pain in the back and radiating to the abdomen.
The patient used to have the habit of toddy 2bottles daily,after work in the evening.
Currently the patient has addictions.
FAMILY HISTORY:
the patient has no known family history of diabetes ,CAD,asthma.
GENERAL EXAMINATION:
The patient is conscious, coherent,co operative and well oriented to time and place.
Patient has NO signs of PALLOR, ICTERUS ,CYANOSIS and CLUBBING.
VITALS:
BP. :140/80 mm Hg
PR. :84bpm
R.R. :22 cpm
Temp. :afebrile
GRBS. :133
SPO². :98
SYSTEMIC EXAMINATION:
ABDOMEN:
No palpable mass identified.
Free fluid: no.
Liver and spleen : not palpable.
Bowel sounds :yes.
* Bilateral pitting type of pedal edema is identified
Swelling of the upper left arm is observed since 4 months. The swelling subsided by medication and re appeared.
INVESTIGATIONS:
RFT : 20/10/21
Serum iron:83ug/dl.
ECG:
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