120-S.Nikhil kumar casestudy-2
50 yr old female ,resident of farmer by occupation came to the casuality with c/o SOB( Grade II -III) since 3 days B/L pedal edema since 8 months (on &off) subsiding with medication & worsening since 1 week Past History:- Patient was her usual self 15 yrs back ; then she had c/o SOB and was taken to hospital where angiogram (coronary) was done and 7 yrs back Mitral valve replacement was done (she was on regular medications since then ) H/o B/L pedal edema ,pitting type and H/o vomitings (2/3 episodes per day ) on &off since 8 months K/c/o DM since 4 yrs H/o similar complaints in the past Blood transfusion done at the time of surgery (MVR) Dietary history:- Diet - Mixed Appetite - Normal Sleep -adequate Bowel and bladder movements - Regular No h/o burning micturition No addictions General Examination:- Patient is conscious ,coherent and cooperative Moderately built and nourished No pallor , icterus , cyanosis...