56F JOINT PAINS FOR 3 YRS

 30/10/2026

THIS IS THE CASE OF 56F, HOUSEWIFE WITH LEG PAINS 2 YRS AND JOINT PAINS SINCE 3 YRS.

Age: 56 yrs

Sex: Female

Occupation: Housewife

C/C: Leg pain since 2 yrs, Joint pains for 3 yrs

HOPI: Pt was apparently asymptomatic and comes to OPD. Joint pains since 3 yrs ago and gradually progress. 

No H/o of swelling, redness and No H/o of morning stiffness, No H/o of fever, trauma or difficulty in performing daily activities.

Past H/O: N/K/C/O HTN/DM/Epilepsy

Family H/O: No significant H/o

Here is the clean *deidentified text version* for your record — no identifiers on this page:

*Personal H/o:*

- Diet - Normal

- Appetite - Normal

- Sleep:

- Bowel & Bladder

- No Addictions: (Arthralgia)

*Family H/o:* No significance.

*General Physical Examination:*

P I C C L E

(-) (-) (-) (-) (-) (-)

*Systemic Examination:*

CVS - S1 S2 (+)

RS - NVBS B/L

CNS - No focal deficit

Per abdomen - Soft and tender.

50F CKD WITH PEDAL EDEMA

 29/10/2026

THIS IS THE CASE OF A 50F HOUSEWIFE WITH CKD, PEDAL EDEMA 1 YR, URINE OUTPUT DECREASED 5 DAYS, PITTING EDEMA.

Demography: 50 yrs / Female / Housewife

Date: 20/10/2026

Chief complaints:

- Edema (swelling of legs - 1 yr)

- Urine output decreased - 5 days

- Pitting edema

HOPI:

Pt was apparently asymptomatic 2 yrs ago then she diagnosed with hypertension and CKD. 1 yr ago she developed mild bilateral pedal edema, initially involving ankle & progressive to leg. Swelling was insidious on onset, gradually progressive, bilateral edema, non pitting, relieved by rest.

1 yr ago she noticed oliguria, progressive nature. Since 8 months ago she was diagnosed with CKD by blood test, 2 times/wk, 4 hrs per session through AV fistula.

Past H/O:

K/C/O HTN since 2 yrs, CKD for 2 yrs - on haemodialysis

N/K/C/O - TB, asthma, epilepsy

Personal H/O:

Appetite ↓, Diet - mixed, Sleep - disturbed, Bowels - normal, Bladder - oliguria - 200 ml/day, Addiction - No

*Family H/o = NO*

*General Examination : O/E*

Pt is C/C/C well oriented to T/P/P.

*P I C C I E*

(-) (-) (-) (-) (-) (+)

Pedal Edema

↓

Pitting edema

*Vitals:*

BP - 160/90 mmHg

RR - 29/min

Temp - 98F

SpO2 - 99% on RA

*Systemic Examination*

CVS - S1 S2 (+)

CNS - NFND

RS - NVBS, BAE (+)

P/A - Soft NT

*AV Fistula examination (Cephalic & Radial vein artery)*

Inspection: surgical scar

No prominent

No redness

Palpation: palpable continuous /

mild, swelling present.

Provisional: CKD Stage 5D on MHD - For AV fistula assessmen

33M ACUTE ABDOMEN-APPENDICITIS

 22/10/2026

THIS IS THE CASE OF A 33M, DRIVER BY PROFESSION WITH STOMACH PAIN 2 DAYS, VOMITING 4 TIMES A DAY AND LOOSE STOOLS

Demography: 33 yrs / Male / Driver

Date: 22/10/2026

Chief complaints:

- Stomach pain - 2 days ago

- Vomiting - 4 times a day

- Loose stools

HOPI:

Pt was apparently asymptomatic 2 days ago, later she developed stomach pain which was around umbilical area on 22nd Oct 2026 and admitted into hospital. Over several hrs, pain (dull, ache) increased in severity and migrated to right iliac fossa, become severe and well localized. Pain is aggravated by walking, coughing and movement, partially relieved by lying still.

Pt also complained vomiting - 4 times a day with food particles initially later watery fluid, non bilious.

Loose stools - watery.

Surgery done on 23rd Oct 2026.

Past H/O: N/K/C/O of DM, HTN, Epilepsy

Personal H/O: Diet - Mixed, Sleep - Adequate, Appetite - Used, Bladder - Regular, Bowel - Inward, Addiction - Alcoholic (for 10 yrs), last intake 4 days ago

Family H/O: No significant H/O

Gen examination: Pt c/c/c, PICCLE - absent

Systemic Exam:

CVS - S1S2+

RS - NVBS B/L

CNS - NFD

Per Abdomen: On Inspection - Abdomen is scaphoid, All quadrants are moving synchronously with respiration, No scars, sinuses, No swellings, pulsation

61F KNEE PAIN SINCE 5 MTHS

 

THIS IS THE CASE OF 61F WITH KNEE PAIN SINCE 5 MONTHS AND ANTALGIC GAIT

*Case Details:*

*Age/Sex:* 61/F

*C/C:* Pain in left knee since 5 months

*HOPI:*

Patient was apparently asymptomatic 5 months ago. 5 months ago she fell in the gutter due to impact of strong winds and fractured her knee.

Since the incident she had pain. It was insidious in onset, progressive in nature. It is aggravated on walking, relieved on joint relaxation. She took herbal medicine and also physiotherapy which was of no use. Pain is dull. She's experiencing pain on flexion of knee. (Antalgic gait) 👇

                     https://youtube.com/shorts/RgzeHIfJaHQ?si=f-KyPD2U_QzLx-Vi

*Past H/O:* N/K/C/O HTN, DM, Asthma, epilepsy.

*Personal H/O:*

- Attained menopause 5 years back

- Diet - Mixed

- Appetite - Normal

- B&B - Regular

- Sleep - Sound

*Family H/O:* No significance

*General Examination:* Pt is conscious, cooperative, well oriented to time/place/person

Gen Exam:

PICCLE - Absent

Temp - 98.7°F - Afebrile

BP - 120/80 mmHg

PR - 82 bpm

Sys Exam:

CVS - S1S2+

CNS - NVBS

Provisional Diagnosis: Knee OA

61M with polyphagia 6mths, generalized weakness

 30/10/2026

THIS IS THE CASE OF A 61YR OLD MALE, WHO IS A FARMER BY PROFESSION WITH INCREASE OF HUNGER SINCE 6 MONTHS, INCREASE IN URINATION 3 MONTHS AND GENERALIZED WEAKNESS.

61 years / Male / Farmer

C/O:

- Increase of hunger (polyphagia) - 6 months

- Increase in urination - 3 months

- Generalized weakness

HOPI:

Patient was asymptomatic 6 months ago, then developed weakness, polyuria and polyphagia. Duration 6 months. On treatment - Metformin.

Past History:

K/C/O - Diabetes

N/K/C/O - HTN, TB, Epilepsy

No surgeries or complications

Personal History:

Diet - Mixed, Appetite - Increased, Sleep - Adequate, B&B - Increased urination, Addictions - Nil

Family History: No family history

Provisional: Type 2 Diabetes Mellitus

46M SOB, DYSURIA SINCE 1.5YRS, APPETITE DECREASED.TELANGANA

 26/10/2026

THIS IS THE CASE OF 46M WITH SOB, 1.5YRS PAIN SWELLING OF LEG, DECREASED URINE OUTPUT(DYSURIA) 1.5YRS AND APPETITE DECREASED

46 years / Male

C/O:

- SOB - 1.5 years, pain - 1.5 years

- Swelling of leg

- Decreased urine output (Dysuria) - 1.5 years

- Appetite decreased

HOPI:

Patient was apparently asymptomatic 2 years ago, then developed SOB on exertion, gradual onset, progressive, MMRC grade III, aggravated by exercise, relieved by rest. No chest pain, wheezing. Developed pitting edema bilateral feet and hands, gradual onset, progressively increasing. Decreased urinary frequency - 4 times/day.

Past History:

AV fistula -> 1.5 years dialysis, 3 times/week for 4 hrs

Personal History:

Diet - Mixed, Appetite - Decreased, Bowel - Normal, Bladder - Oliguria - 4 times/day, Sleep - Normal

AV Fistula Examination:

Radial Artery - Cephalic Vein, Left forearm

Inspection - Scar +, Swelling +, No Redness

Palpation - Thrill +

Auscultation - Bruit +

Provisional Diagnosis: CKD

Age/Sex: 46/M

C/C:SOB - 1.5yrPain & swelling legs - 1.5yrs

↓ urine output - 1.5yrs

Dialysis schedule: Monday & Thursday

Follow up - Pt look dull & weak.

Appetite ↓Pedal edema (+) Last dialysis session - 26/10/26