BUTUKURI ANILA REDDY ROLLNO188

  70 year old male came  to OPD with  CHEIF COMPLAINTS :   1.Chest Pain since 10 days  2.Cough since 10 days  3.Shortness of breath  since 8-10 days 4. Fever since 1 week Hopi- Patient was apparently asymptomatic 10 days back then he developed cough which  is productive with black coloured mucoid sputum , insidious in onset and gradually progressive, diurnal variations present more during night.  No seasonal variations.  No aggravating or relieving factors. Chest pain is left sided non radiating type not associated with excessive sweating, palpitations,pedal edema,giddiness Shortness of breath  since 8 days  which is. insidious in onset and gradually progressive,progressed from grade 1 to grade 3 . No orthopnea,no Paroxysmal nocturnal dyspnea  No seasonal variation,no diurnal variation. Fever since 1 week ,high grade associated with chills and rigors Evening rise of temperature present, loss of weight present loss of appetite present No h/o vomiting,loose  stools , pain abdomen. PAST H

A 45 year old female came to opd with the  Chief complaints Pain in wrists and ankles since 4 years , Neck pain since 4 years and  Headache since 2 years  History of presenting illness : Patient was apparently asymptomatic 4 years ago then she developed pain firstly in left ankle followed by left wrist ,neck , right wrist joints,PIP , metacarpophalengeal joints are also  involved in  right hand,insidious in onset gradually progressive aggrevated by work and relived on medication. Pain is confined to joint . H/O pain in neck which radiated to shoulders and relieved on medication. No h/o myalgia No h/ o trauma No h/o swelling,deformity History of morning stiffness and lasts  for 2 hours . Generalised weakness is present Headache since 2 years not associated with nausea and vomitings History of low grade fever intermittent in nature,not associated with chills and rigors  No h/o pain abdomen,loose stools,burning micturition,decreased urinary output No h/o weight loss,loss of appetite , swe