mahesh

30 year male photographer by occupation chronic alcoholic for 10 years started drinking alcohol initially with friends four years later after entering into occupation started earning was habituated drinking daily 180 ml per day royal stag

 *history of present illness*

 patient was apparently asymptomatic then one year back has pain abdomen stops drinking due to pain get treatment from local RMP pain diffuse type not associated with vomiting after pain subsides he again starts drinking he had multiple episodes of pain abdomen

 *history of past illness*

 2 months back I had complaints of yellowish discoloration of eyes pain abdomen pedal edema for which he went to NIMS his symptom subsided within 2days & RT PCR for covid-19 was possible referred to Gandhi it took treatment for 10 days and came to home yellowish discoloration of eyes still present 1 week back he had non veg mutton in the night he developed the pain in abdomen when to local hospital and got treatment there is insidious onset of abdominal distention and pedal edema till knee and fever since 4 days which is intermittent low grade relieves with medication past history no diabetes, hypertension,CAD,asthma ,Tb .

He encountered RTA in 2007 head injury occured for which he is admitted in Yashoda and again had an RTA in 2014 and was admitted in NIMS  

 *personal history*

 Diet mixed

 appetite normal

 bowel and bladder movement regular 

Alcohol:180 ml per day since 10 years abstinence from alcohol since 2 months 

Smoking : cigarette1 packet per day since 10 years

 *general examination* 

 no pallor cyanosis clubbing lymphadenopathy ,icterus and edema are present 98.4 degree fahrenheit pulse rate 84 beats per minute respiratory rate 24 cycles per minute BP 80/ 60 mm Hg spo2 98% grbs 126 mg/dl

 *Provisional diagnosis*

 Alcoholic liver disease with AKI