65 year old male patient came with abdominal pain since 1year

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65 yr old male agricultural labourer by occupation came to OPD with

 C/O abdominal pain, lower back pain radiating to b/l lower limbs, neck pain with stiffness since 1 year. 

History of presenting illness

 

Patient was apparently asymptomatic 1 year ago later he developed pain in abdomen which

Insidious in onset gradually progressive. It is diffuse and dull causing discomfort.It is aggravated on eating,performing daily activities and walking.

Pain in the chest is lasts for 2-5 min which is sudden in onset.It is relieved by massaging that particular area.

Since 2days ,patient complained of pricking type of headache due to dental carries on the right lower molars due to which he was unable to sleep.

 

Past History

Diabetes since 15 years.

Not a K/C/O  HTN, TB, asthma, epilepsy or any other chronic illness.

History of Trauma 4 years back, experienced severe pain in the right hip and was unable to walk. 

Right hemiarthroplasty was done .

Personal history

Diet mixed 

Sleep is adequate 

Appetite decreased

Bowel and Bladder: normal

No Allergies 

Addiction: alcohol occasionally once in few weeks

Examination

Patient is conscious, coherent and cooperative and well oriented to time place and person.

No pallor, icterus, cynosis, clubbing,edema, lymphedenopathy 

Vitals

Pulse rate-68 bpm

Blood pressure- 130/80mm Hg

Respiratory rate- 16cpm

Spo2 - 99%

Systemic examination

CVS- S1S2 +, no murmurs

RS- BLAE +, NVBS heard

Investigation

Treatment

1. Symptomatic treatment

2. Adviced for root canal treatment i/v/o dental caries