Chief complain : nausea and vomiting Description : patient had nausea and vomitting 3 days ago before coming

to hospital. Patient felt nauseous and vomited almost everytime 2 hours after having meal. Patients vomit contains undigested food and fluid. This made the appetite of the patient to reduce. Besides that, patient also suffered from cough for the past one week. The cough worsens at night. The cough produces white phlegm, blood(-). Patient also complained of body weakness for the past 3 months. Patient felt increasing lethargy day by day. This was accompanied by swollen legs and hands. Patient is suffering from diabetes melitus for the past 15 years. Blood sugar level of the patient was 400 mg / dl during the diagnosis. Cheif complain during that time was frequent urination and thirst. Patient took glibenclamid and metfocmia for 3 years. She stopped the medication because blood sugar level became very low. From the year 2010, patient started using insulin but did not take it regularly because she feels weak each time after the injection. During a routine control in april 2010, patient was told that ureum and creatinin level in the blood have increased. She was prescribed furosemide, amlodipin and irtan. Patient was diagnosed as having stroke 4 years ago and was admitted in RSSA for two weeks. Patient also suffers from hypertension since 6 years ago.