This document presents two case studies. Case 1 is a 70-year-old male farmer with an 8-month history of cough, appetite loss, and weight loss. Examination found diminished breath sounds in the right lung. Imaging and biopsy revealed squamous cell carcinoma involving the right middle and lower lobes. Case 2 is a 75-year-old female housewife with 5 months of cough and progressive breathlessness, exacerbated for 10 days with leg swelling. Examination found elevated jugular venous pressure, leg swelling, and heart murmur. Investigations supported a diagnosis of pulmonary hypertension due to chronic obstructive airway disease.

1. DR Awadhesh kr sharma,SR DEPTT OF MEDICINE MLB MEDICAL COLLEGE JHANSI(UP) Two Case studies

2. TWO CASE STUDIES

3. CASE - I

6. Past history – no h/o DM, HTN & TB. Personnel history – Patient is chronic bidi smoker for 48 years, he used to smoke 30 bidi per day. Smoking index = 48 x 30 = 1440 i.e. > 300

7. General examination – Built – Average PR – 82/min BP- 110/80 mm of Hg RR – 16 / min Temp – afebrile Pallar--- ++ Cyanosis – absent Clubbing – absent Icterus – absent Lymph node enlargement – absent JVP – not raised

9. INVESTIGATIONS

13. On the basis of above history, examination and investigations the presumptive diagnosis is------ Right middle and lower lobe consolidation with cavitation

17. So we think in terms of lung malignancy, & go for HRCT which shows –

19. Then we done USG guided FNAC of the lesion which confirms it to be squamous cell carcinoma involving rt middle & lower lobe of lung.

26. CASE – II

29. Past history – no h/o DM, HTN, TB Personnel history – Non bidi smoker Family history – not significant On Examination PR – 100/min, regular, normovolumic, normal in character without any radiofemoral and radioradial delay. BP – 90/60 mmHg in right arm in supine position. RR – 22/min, regular, thoracoabdominal Temp – N SpO2 – 86% without O2 Pallar-absent Cyanosis-absent Clubbing-absent Icterus-absent Lymphadenopathy-absent JVP – raised, cv wave present Pedal edema--- +

38. So, final diagnosis is pulmonary hypertension associated with lung disease and or hypoxemia cause COAD.