Harshini reddy

A 65 year old female presented to Opd with chief complaints of  -Abdominal distension since 4 days  -Diffuse abdominal pain since 4 days  -decreased urinary output since 4 days  -Burning micturition since 4 days  -Constipation since 2 days HOPI Patient was apparently asymptomatic 4 days back then she developed burning micturition not associated with suprapubic tenderness, loin pain, fever and chills.  It is associated with decreased urinary output since 4 days.  Diffuse abdominal pain present since 4 days which was spasmodic type non radiating. No aggravating and relieved on medication.  There is history of fluid loss 4 days back ( vomitings 2 episodes )  Past History  She is a k/c/o DM type 2 since 6 months and is using medication for it (Metformin 500 mg OD)  She is a k/c/o HTN since 3 years and is on medication for it (T.atenolol 50mg and T.amlodipin 5mg)   Patient is not a k/c/o TB, Asthma, Epilepsy, CAD and CKD  ...

45 year old male patient,working as security came to the casuality with the chief complaints of fever and yellowish discolouration of eyes and urine since 10 days .  In 2008 , Patient got admitted in hospital for fever ,he was diagnosed of having jaundice and on medications for 3 months regularly.  Patient was apparently asymptomatic 10 days back then he developed fever after doing continuous night duties for a week . Fever ,is continuous ,associated with chills and rigors, relieved on medication( paracetamol,relieves for 1 hour and fever again progresses). No H/O headache , pedal edema , cough , cold , SOB,burning micturition , chest pain ,melena , night sweats . H/O mouth ulcers (lower lip) , since 5 days  had past h/o mouth ulcers , which got relieved by themselves without using any medications . Not a k/c/o DM,HTN,thyroid ,epilepsy.  K/c/o alcoholic and tobacco chew since 20yrs. Patient used to drink alcohol since 20yrs occasionally,but started drinking regularly...