Patient a 28 year old complains of involuntary movement of upper and lower limbs History of present illness Patient has a history of seizure on 21/12/2021 3 episodes around 3 am,7am,11am Each episode lasting for 3-5 min Seizure association with Up rolling of eye ball Brothing from the mouth History of fever,weak back association with chills Patient has no history of decreased urine output Patient has no history of pedal edema Patient urine has ,heamaturia, frothy urine History of shortness of breath from 10 days grade two- three History of past illness Patient is a known case of CKD who's on maintenance dailysis discontinued from 19/10/2021 Patient is a known case of hypertension Diabetes-no Hypertension present -. Asthma absent Tuberculosis absent No . exposure to radiation Personal history Occupation works in cloth store Unmarried Appetite-lost Diet-Mixed Regular bowel and bladder No allergy known Alcohol usage occasional Tobacco usage no No addictions