71yr old man with cough 4_6 month

Name- xxxx
Age/sex- 71/male
Occupation- farming
Add- ....xxx
Religion- Hindu

Present complain - mild fever since 4-6 days and cough with expectoration since 4-6 years continously and difficulty in breathing since 2-3 months ..chest pain on coughing ..slight loss of hearing since 3 years ago ..swelling on any part of the body since 3 years ago ...severe cough...

Tongue - white coated
Skin- normal but trimmers in both hands
Thrist-⬇
Apetetite- low apetetite
Urine - pale/yellow/ white sometime
Stool- dry stool
Smoke - bidi left since 20 years ago ..
BP- 144/81 mg/hg
Pulse- 82/min
RR- 22/min
Spo2- 94%

Past history - before 3 years patient have all the complains ..swelling on any part of body and relief by mdcn ..breathlessness and difficulty in breath and severe cough with expectoration since 3 years ago ..fever with weakness ..patient was treated in TB hospital since 1 year ago but no any relief ..patient have slight loss of hearing since 3 years ..

Investigation-  CBC....
                      LFT/RFT
                RBS
            CXR ..PA VIEW
          SPUTUM AFB
        ECG
        URINE RM
        USG(abdomen).

Treatment- tab. PCM 500
            Tab. BC
         Tab. Rantac 100
      Tab- deriphylin 100
  Nebulization ..