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30 yr male with C/O pain abdomen since 3 days  Vomiting since 3days  Fever since 2days  Decreased urine output since 2 days  Patient was apparently asymptomatic 3days back then he developed pain in epigastrium and left hemichondrium,colicky type,non radiating ,no aggravating and relieving factors Associated with vomitings since 3 days 5-6 episodes per day watery immediately after food intake non bilious nonon blood stained No h/o loose stools C/O fever since 2 days,high grade intermittent ,not associated wirh with chills and rigor No h/o cough ,cold,chest pain,sob ,pedal edema C/O decreased urine output and high coloured urine since 2 days Patient got admitted in local hospital in view of pain andomen and and vomiting and was referred here in view of decreased urine output  Not a k/c/o HTN  DM TB asthma CAD  After 2 days of admission his bp raised to 170 /90 from then he is having intermittent high bp He is chronic alcoholic since 6 yrs he has binge intake of alcohol 3 days back No sig
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psmr A case of 65 yr old came with the chief  of  Vomitings since 5 days  Altered sensorium since 4 days.  Patient was apparently asymptomatic 7 months back  when he suddenly developed pain in the low back and loin region for which he went to hospital and was diagnosed with Ckd .. but was only on maintainance medication since  7 months and  SINCE 1 month patient had history of intermittent head ache , FEVER  intermittent, which was low grade , no evening rise of temperature ,not associated  with chills rigors . Headache was not associated with blurring of vision and diplopia .No history of ,giddiness ,photophobia and phono phobia . Pt even has history of ? CAD , was on medication since 6 months . Since 10 days patient had h/o loss of appetite and generalised weakness. H/o vomittings since 5 days , 5-6 episodes/day, non bilious,non- blood stained, not associated  with pain abdomen, loose stools, immediately after food intake. So patient got admitted in local hospital on 13/06/20 where h
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