50years female with pedal edhema short case

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Daily routine: 

He is a farmer by occupation.

Wakes up at around 7:00 am in the morning. Eats breakfast by 8:00 am. Goes to his farm and monitors work. Then comes back to his house in the afternoon and has lunch by 1:00 pm. Sleeps for a while in the afternoon 

He has a cup of tea in the evening at around 5:00 pm , watches TV for a while and has dinner at around 8:00 pm and goes to bed at around 9:30 pm. 

Chief complaints:

 Patient c/o  bilateral swelling in the legs since3 months 

Hopi: 

Patient was apparently asymptomatic 3 months ago then she developed bilateral swelling  lower limbs

which was low grade intermittent and incidious in onset and was gradually progressing.

Patient gives a history of blurring of vision since 2 months.

HISTORY OF PAST ILLNESS:

No relevant past history.

PERSONAL HISTORY: 

Diet : Mixed

Appetite: Normal

Bowel movements: Normal

Bladder movments: Normal

Habits: Patient has a habit of consuming toddy occasionally

FAMILIAL HISTORY: 

No relevant familial history.

General examination: 

Patient is conscious, coherent and cooperative and we'll oriented to time and place.

No pallor /icterus/cyanosis/clubbing/Generalized lymphadenopathy

VITALS ON ADMISSION -

BP : 120/80 mm hg

 PR : 90bpm

temparature: 98 .6f 

RR :30 cpm 

GRBS: 125mg

SYSTEMIC EXAMINATION:

Cvs : S1 s2 heard no murmurs 

RS : BAE+ 

Vesicular breath sounds 

Abdomen : 

 Soft and non tender

CNS examination: 

Concious

Speech:normal

Gait: normal 

Sensory system :normal

Motor system: normal 

Treatment: 

 Tab.Shelcal PO/ OD

Tab.ultracet PO/ OD

Tab.Pan 40 mg PO/ OD

Provisional diagnosis: 

Bilateral  knee osteoarthritis