A 51 year old male with SOB since 1 month
CHIEF COMPLAINTS : A 51M farmer by occupation , resident of nalgonda came to opd with c/o shortness of breath since 2 months and bleeding per rectum since 2 months . HOPI Patient was apparently asymptomatic 2 months ago then he developed SOB of insidious onset, gradually progressive increasing in intensity since 2 months (Glade II- III) The patient had undergone surgery for Haemorrhoids 2 years ago , and then ,there was relapse of Haemorrhoids again 2 months ago and he was losing blood in an amount of 30ml/day during passing of stools No h/o constipation , nausea , vomiting ,burning micturation . PAST HISTORY : N/KC/O DM , HTN , CAD , CVA , EPILEPSY , THYROID DISORDERS FAMILY HISTORY : not significant PERSONAL HISTORY : Decreased appetite Mixed diet Decreased bowel movements Normal micturition Addictions : consumes alcohol regularly from 2 years GENERAL EXAMINATION : I have examined the patient after taking prior consent and informing the patient in the presence of a attenda