A 64 yr old male with Renal calculi

A 64 yr old male  resident of chotuppal came with chief complaints of pain in the  loin, vomiting and burning micturition since one month
HOPI                                                                     
Patient was apparently asymptomatic 15 yrs back.Then he developed pain in the right loin and was diagnosed with renal calculi(bladder calculi)  and was operated and then 3 yrs later again he developed bilateral loin pain and was diagnosed with bilateral renal calculi (ureteric calculi) and was operated with a gap of one month .
Then 3 yrs later he developed a midline swelling approx 3 cm below umbilicus and diagnosed with  hernia and a mesh was placed.
Then 1 yr later he developed abdominal pain and endoscopy was done and diagnosed with peptic ulcer and was managed conservatively During this he was diagnosed with diabetes and hypertension
Then 2 yrs back he developed generalized weakness and went to hospital and was told that haemoglobin was low and was given iron injections.
Then since 1 month he developed loin pain , vomiting and burning micturition and decreased urine output and went to Hyderabad orange hospital and because of financial problem he came to our hospital

DAILY ROUTINE
Patient wakes up around 5 am and takes breakfast at 7 and lunch around 12 pm and dinner at 8 pm and sleep around 9 pm.Rest of the time he spend with his grand children
His daily routine wasnot  disturbed even after he developed the illness
PAST HISTORY
There were no  similar complaints in the past

PERSONAL HISTORY
Diet :mixed
Appetite: decreased
Sleep: adequate
Bowel: regular
 bladder: decreased flow and burning micturition
Addictions :occasionally alcohol

FAMILY HISTORY: No significant family history

DRUG HISTORY: No history of drug allergy



GENERAL EXAMINATION
Patient was conscious coherent and cooperative 
Well built and well nourished
No pallor
Icterus
Cyanosis
Clubbing
Generalized lymphadenopathy
Edema
Vitals
Temperature Afebrile
PR:60 bpm
BP:130/80 mm Hg
RR:16cpm

SYSTEMIC EXAMINATION
CVS :s1 S2 heard no murumurs 
RS :BAE normal vesicular breath sounds heard
GIT :soft and non tender
CNS :No focal neurological deficit































DIAGNOSIS 
 renal calculi with Renal failure

Treatment on 27/07/2022
Tab.Lasix 40 mg oral BD
Tab.Nodosis 500 mg oral BD
 Tab.Shelcal 500 mg oral BD
Tab.Orofer oral OD
Tab.nicardia 20 mg oral BD
 
He is on same treatment from 28/07/2022




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