Thesis

  Serum Albumin Ascites Gradient In The Etiological    Diagnosis of Ascites.

https://drive.google.com/file/d/1M4UQwNwb4e-u5DqwqP9NFtGwpAxsxtph/view?usp=drivesdk

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Ascitis

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Internal assesment 5/9/2020

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56 year old woman with chest pain since 2020 january presented with pericardial effsuion secondary to multiple myeloma

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56 year old female kTobacco leaf seller by occupation came to opd in january 2021 with chief complaints of  chest pain since 6 months , pricking type, subsiding on its own, no radiation  Shortness of breath grade 2(MMRC) since 1 month progressed to grade 4 since 1 day H/o orthopnoea and Paroxysmal dyspnoea and palpitations present  No history of cough , wheeze  Decreased appetite since 20 days,  generalised weakness since 15 days ,   Pain abdomen since 10 days. Diffuse predominantly in the epigastric region, non radiating B/L Lower limb ,upper limb edema and facial puffiness since 5 days.  Edema initially started in the lower limbs then prgressed to upper limbs and then face  Palpitations + Syncopal attacks - She is not a K/C/O DM - II , HTN , Thyroid abnormalities and any other comorbidites She is an occasional alcoholic ( beer / whiskey) since 35 years. Chews tobacco leaves daily since 6 months. O/E: Patient is C/C Pallor + No icterus, club...
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