36YRS MALE WITH ABDOMINALPAIN

Chief complaints:

          35 yr old male came to opd with chief complaints of abdominal pain since 1week


History of present illness:

          Patient was apparently asymptomatic 1 week back then he developed abdominal PAIN(loin).  Which is insidious in onset, gradually progressive dragging type of pain,no aggrevating or relieving factors,pain radiating to back.. associated with vomiting non biliary,non projectile 
Pain not associated with fever,
 distention of abdomen.

Past history: 
      
          Known case of hypertension since 8yrs
         Known case of ckd since 6 yrs on MHD

NO H/O DM, Epilepsy, bronchial asthma ,TB

H/o. CKD::
       patient suffered from PEDAL OEDEMA, DECREASED URINE OUTPUT,SOB.
 Previously.,,6yrs back and same symptoms 3 months back.

Personal history::

Appetite:normal
Diet :mixed
Bowel: regular
Addictions:no

Treatment history::

For HTN NICARDIA 10MG od
No food and drug allergies

General examination::

Prior consent patient examined in a weel lit room

No pallor, ICTERUS,CYANOSIS, PEDAL OEDEMA,LYMPHADENOPATHY

Vitals::

Temperature: afebrile
Bp:170/110mmhg
Pulserate:98b/min
Spo2:98%
Rr:22c/min

Local examination::

ABDOMEN:
Temperature:afebrile
Tenderness:no
Palpable mass:no
Free fluid:no
Liver:not palpable
Spleen:not palapable
Bowel sounds : present
CVS::
S1S2 HEARD
NO cardiac murmurs
CNS::
Conscious
Speech:normal
No neck stiffness
kerning sign:-ve

RESPIRATORY SYSTEM::
No dyspnoea,wheeze
Position of trachea:central
B/Lsymmetrical
Vestibular breath sounds heard

Investigations::
Provisional diagnosis:;

 CKD ON MHD 

MANAGEMENT::

Tab.nicardia.od 10mg
Hemodialysis






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