Medical e log book

A 60 yr old male came to OPD with c/o pedal edema since 10 days H/o poor stream urine + H/o nocturia + 5-6 times H/o increased frequency +  10-15 times H/o urgency + Patient was apparently asymptomatic 1 and half year back then he developed spontaneous pain and swelling in the right leg for which he was operated for the same ; no history of trauma to leg Patient has history of NSAID abuse for 1 year due to severe leg pain Past history :       N/k/c/o DM,HTN,ASTHMA,CAD, EPILEPSY Family history :     No significant family history General examination :    No pallor icterus cyanosis clubbing, lymphadenopathy VITALS AT ADMISSION : Temperature : AFEBRILE PR: 82 SPO2:92 RR: 16 B.P. : 110/80 C.v.s: s1 s2 heard no murmurs RS: BAE present CNS: NAD Diagnosis: NSAID induced nephropathy PLAN of treatment : 1. Fluid restriction (<2lit/day), salt restriction (<4gm/day) 2. INJ PAN 40 mg IV OD  3. INJ

44 year old Toddy climber, climbing around 40 trees per day , from the age of 20, at 23 he was diagnosed with dm2 started on oha,due to symptoms of polyuria, was on regular followup of his dm2 , had complaints of leg pain for which he used nsaid's frequently ,3-4times per week, diagnosed with renal failure with initial creatinine 2.5 in 2019, but was on same medication, followed up every 6 months ,in January 2020 ,in a follow up his creatinine was rising , which didn't subside after consulting ?physician so he was on follow up with an ayurvedic doctor,he also developed symptoms of pedal edema which reduced with that treatment,he didn't report any symptoms of decreased output ,in March 2020 he was admitted for loc in miriyalguda ,told to have high sugars with increased creatinine and was started on insulin, he lost follow up with ayurvedic doctor and pedal edema didn't subside with medication so he went to nims where biospy was done , and he was started on hd , that poin

45 year old female patient came to OPD with c/o reduced urine output since 1 week,easy fatigabiility from 1 week and sob since 3 days and facial puffiness since 1 week. She is a daily wage labourer and she stopped working 3 years back because she would easily get tired.  1 year back she experienced severe right loin pain along with reduced urine output and generalized anasarca.  She underwent right DJ stenting and also 3 sessions of hemodialysis She didn't undergo hemodialysis or wasn't on any treatment for 1 year due to the COVID pandemic.  1 week back, patient started experiencing reduced urine output and would easily get tired. She also told us that she noticed facial puffiness 1 week back. She also started feeling dyspneic after walking a few steps since 5 days, though it wasn't associated with any orthopnea, PND, chest pain, palpitations. Also no complaints of cough, wheeze. General Examination: Patient was a moderately built individual, with pallor  and facial puffine