Vinay medicine

 CASE : 3  A 50 year old Male came with chief complaints of abdominal distension since 4 days associated with shortness of breath since 3 days.  DAILY ROUTINE AND BIOPSYCHO SOCIAL HISTORY: - He is a 50 year old gentlemen who stays with his mother, his wife and his son. he had two elder daughters who got married at age of 18 years (elder daughter) and second daughter got married at age of 20 years. - Before their marriage he used to work for annual income of around 8000-10000 at a farmer house who has many acres of land which are used for farming.  - Later after their marriage he stopped working at that farmer and started to farm his own 1 acre and also used to work in muncipal office where he used to wake up at early morning 5 am and used to clean roads ,schools , other government offices and comes to home by 9-10am and with friends of muncipal offfice he used to go near alcohol vending shop and used to buy 1 litre of sara(local alchol drink) which costs him around 150-200 rupees. - th

  This is a case of a 45 year old female,resident of Nalgonda, technician by occupation came to the op with the chief complaints of  1) C/O multiple joint pains and swellings since 15 years  2) c/o generalised weakness and easy fatiguability since 6 months History Of Presenting Illness: Patient was born out of non consanguionus marriage and had 2 siblings .  at 15 yrs of age - Got married in 10th class (Non consanguinous marriage) Her partner was a from rich family where he doesnt used to go to job and used to drink alchol through out the day . and used to come back to home by evening and started to physically and mentally abuse our patient. AT 18 YEARS - She gave birth to a healthy first male child through LSCS(No significant medical history was given for indication of LSCS) AT 20 YEARS- Gave birth to a healthy baby girl through LSCS She used to be a  homemaker initially. Due to her husband’s aggressive behaviour, she ingested pesticide which was seen by her sister. immediately She wa