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45years old female with bilateral swelling in lower limbs

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  45years old female came to casuality with  Chief complaints: Bilateral Swelling in lower limbs  Pain in abdomen  History of presenting illness : Patient was apparently asymptomatic 20days back later she developed swelling in limbs,right side is more compare to left side in the bilateral lower limbs it is insidious in onset gradually progressive in nature associated with pain while walking,  10 days back she developed pain in the right hypochondrium which was insidious in onset gradually progressive increase in sitting position decrease in laying position she also developed pain in right shoulder  Daily routine  :    Patient wakes around 6am and completed her daily routines completes.comoletes her tiffin and goes to work at around 9am.She returns from work  around 6 pm in evening and completed dinner by 9:30pm. Past history : Not a known case of diabetes, hypertension,asthma ,TB , epilepsy   Treatment history : No significant treatment history Personal history Diet -mixed  Bowel and b