A 52 year old male farmer by occupation presented to the opd with chief complaints of  Bilateral swelling in lower limbs since 3 days The patient was apparently asymptomatic 1 week back then he developed  bilateral swelling over legs since 1 week is which started near the foot and gradually progressed to the knee. It was pitting type which resolved in between and again started 3 days back. He had similar complaints in the past for which he went to a local hospital and was advised on taking salt and water restricted diet. Patient on telmesartan for hypertension since 2 years. He is a chronic alcoholic and smoker. Examination : Bilateral pedal edema pitting type found till knee on general examination. Respiratory system: bilateral air entry present and normal vesicular breath sounds heard CVS examination : No thrills, s1 s2 heard, no murmurs. Abdomen examination : no hepatomegaly or splenomegaly. No positive findings found other than edema. Investigations : RFT Hemogram  LFT  PROVISIONAL

Long case H no 1601006033 This is an E log book to discuss our patient de identified health data shared after taking their consent.  A 51 year old male patient resident of miryalaguda occuption by farmer came to the opd with the chief complaints of  1.Fever since 10 days 2.Cough with sputum since 10 days 3.Shortness of breath since 7 days History of presenting illness: Patient was apparently asymptomatic 10 days back, then he  developed fever with chills and rigors which was insidious in onset with diurnal variation more at night which was relived on medication.He then developed expectorate cough  which was insidious in onset, gradually progressed more during the nights.It aggrevated during exposure to colder climates.The sputum was scanty and yellow  which was non foul smelling. Cough was associated with chest pain which was non radiating and aggrevated on lying down and relieved on sitting upright.He later developed Dyspnoea which was insidious in onset ,gradually progressive to an e