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hello alaikum this is me dr jhangir and you are watching me and my youtube channel that is uh doctor zhang kirkhand well today im going to to present a very uh interesting cdf a patient who presented with the chief complaint of epigastric pain associated with sweating for only one day uh the patient presented to the er with the shortness of breath and having a history of epigastric pain early in the morning and the same day and patients were also having a history of sweating the patient was only her potential when i escalated the patient he was having bilateral fine inspiratory crepes predominantly in the lower zones and decrease breath sounds in the lower zones as well so when i did an x-ray the x-ray shows uh unfortunately i did not take the picture of that x-ray but that shows the central haziness and bilateral effusion in this city you can see here over here you can see you can see you can see bilateral effusion you can see bilateral fusion more on the right and what is more impor