Pranati V (roll no. 129)

 This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box A 57 year old male patient with bilateral pedal edema 57 year old male farmer by occupation Came with complaints of fever since 3 days Patient was apparently asymptomatic 4 months back then he developed:  Bilateral pedal edema, pitting type, insidious in onset, gradually progressive from ankle to below knee H/o dcreased urine output No h/o palpitations or burning micturition or chest pain. C/o B/L knee pain since 4 months Patient went to the outside hospital were renal function test

29 year old male came to casualty with complaints of fever and lower backache since 2 days. Fever low grade, a/w chills and rigors, subsided on medication. Pain was dragging type, in lower back radiating to front. Pt was apparently asymptomatic 1 year back, then presented to casualty with similar complaints along with decreased urine output hicupps and vomiting from 2 days, then developed involuntary movements of right lower limb for which he visited local hospital and on routine investigations was found to be hypokalemic, took some medication and the situation resolved. 6 months later he developed lower backache and investigations revealed renal calculi for which conservative management was done and complaints got resolved. then pt developed right sided involuntary movements again, went to local RMP, had 2 episodes of GTCS and referred to KIMS, NKP for further evaluation. Was diagnosed as ACUTE KIDNEY INJURY/NCC/TUBERCULOMA (2° seizures) and (in March of 2021) pt underwear 4 session

55 year old house wife came to casualty with complaints of: Sweating and seizure like activity since 1½ hr, after insulin injection Pt was apparently asymptomatic 10 years back then on routine checkup was told to have Diabetes Mellitus type 2 and advised to use Inj. Human Mixtard 15 units, twice a day. Dosage increased to 20 units one month back. Pt had C/O polyuria, polydypsia and loose stools 1 month back. stools were watery consistency, non blood stained, 10 episodes per day for 3 days. Watery stools subsided on medication. Last night pt consumed her meal, followed by s/c insulin injection. ½ hr later pt developed profuse sweating, cold to touch, clenching of fists, uprolling of eyes, frothing at mouth and loss of consciousness.  Seizure like activity lasted ½ hr Post ictal confusion (+) Non responsive to verbal commands or touch stimulus No H/O fever, burning micturition, cold Pt was administered 2 IVF- 25 D, after that pt regained consciousness and no seizure episodes after that. 

This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here, we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs 61 year old farmer by occupation came with chief complaints of chest tightness Pt was apparently asymptomatic 10 months back and had developed sudden onset dizziness and chest tightness. Whenever he consumes spicy or heavy foods, he experiences dragging type of pain in the left infra-axillary area of chest  When he applies pressure on left side of chest(infra axillary area for pain relief), there is relief, belching(+) Difficulty in passing stools, no blood or mucus in stools Right thigh- c/o sensation of insect crawling over thigh followed by burning sensation K/c/o HTN since 2 years, on T.Amlodipine

LThis is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here, we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs 26 Year old, P3L3, last child birth 5 years back, a homemaker came to OPD with chief complaints of multiple joint pains, and backache since 3 years Pt was apparently asymptomatic 3 years back, then developed multiple joint pains, involving small and large joints (B/L DIP, PIP, MCP, wrist, elbow, knee, shoulder, ankle)  Low backache since 3 years  A/w ROM, swelling, low grade fever  Morning stiffness (+) for 10-15 min before resuming activity 20/2/21 RA- positive (February 2021) Used : T. METHOTREXATE 7.5MG PO/once weekly T. SULFAZALAZINE 500MG PO/OD T. OLFENAC-SR 200MG po/od T. METHYLPREDNISOLONE (?d

 32 year old male with fever under evaluation 32 year old male patient came to casualty with chief complaints of: Fever since 3 months Cough since 3 months Vomitings since yesterday  History of present illness : Patient was apparently asymptomatic 3 months back,then he developed fever which was of high grade associated with headache, chills,continuous,more during night time. C/O cough since 3 months,dry,no hemoptysis.  Associated with shortness of breath.  C/O vomitings since previous day, multiple episodes. Non blood stained, non bilious. H/O weight loss present.  H/O loss of appetite present.  H/O paraplegia 3 months back,admitted, recovered with in 2 months.No bladder and bowel involvement.  Past history: H/O koch's 5 years back,used ATT for 4 months and stopped. H/o paraplegia 3 months back, admitted and recovered a within 2 months, no bowel or bladder involvement. (?GBS) H/O multiple suicide attempts present.  Not a k/c/o DM,HTN,asthma,epilepsy,CAD. Personal history : Diet-mix