A 45 YEAR OLD MALE WITH BOTH LOWER LIMB PAIN

CHIEF COMPLAINT:
A 45 year old male patient resident of Battugudem ,Auto driver by occupation came to casuality with a chief complaint of both lower limb pain ,Facial puffiness and back pain since 15 days

HISTORY OF PRESENT ILLNESS:
Patient was apparently asymptomatic 15 days back then he developed left foot pain and right knee pain went to miryalaguda local hospital, necessary investigations were done and as told he has kidney issue and 3 days later started having both lower limb pain associated with calf stiffness,non-radiating and back pain.

HISTORY OF PAST ILLNESS:
N/k/c/o H/O DM,BP,TB,CAD,CVD,Asthma

PERSONAL HISTORY:
Appetite-Normal
Diet-Mixed
Sleep-disturbed
Bowel and Bladder movement -Regular
No known allergies
Smoking -18 beedi per day
Alcoholic regularly-quarter/day

FAMILY HISTORY:
No known significant Family history

PHYSICAL EXAMINATION:
Patient is conscious, coherent and cooperative.
-No pallor
-No Cyanosis
-No icterus
-No lymphadenopathy
-No clubbing of fingers
-Oedema of feet-Present

Vitals:
Temperature-Afebrile
Pulse rate-98/min
Respiratory rate-22/min
BP-110/80
SPO-98 percent

SYSTEMIC EXAMINATION:
CVS 
S1 and S2 sounds are heard
No murmurs and thrills

Respiratory system
Dyspnea-no
Wheeze-no
Trachea central
No drooping of shoulder
No supraclavicular hallowing

Abdomen
Shape of abdomen-scalloped
Tenderness- no tenderness
Palpable mass-No
Hernial orifices-Normal
Free fluid-No
Bruits-No
Liver-Not palpable
Spleen-Not palpable

CNS
Speech is normal
cranial nerve:Intact

INVESTIGATIONS:

Provisonal Diagnosis:renal failure
Diagnosis:CKD

TREATMENT:
Hemodialysis
Tab. LASIC 20 mg/PO/BD
Syp ASCORIL 10 ML Po/TID
FIDOTOX POWDER TG WITH 1GLASS OF WATER ONCE DAILY
Cap LOBUN FORTE
Tab.SHELCAL PO/OD
Tab.SOBOSIS FORTE 1G/TID











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