MED INTRODUCTION

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 is welcome.

Here is a case i have seen

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70yr F with spondyloarthropathy with oligoarthritis with hypoalbuminemia

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70yr old female, resident of ramannapet,who is a fruit seller by occupation Presented with: Fever with generalised bodypains since 15days Swelling and pain in upper limbs and lower limbs since 4 days. HOPI: Pt was apparently asymptomatic 15days back.Then while taking water from well she had pain in right hip region since 15 days. Sudden in onset,non radiating,aching type. No h/0 trauma. Next day she developed low grade fever, intermittent type ,not associated with chills and rigors,Subsided on taking medication.   The next-day she had swelling of both upper and lower limbs. Swelling gradually progressing proximally. Upperlimbs - till elbow Lower limbs- till knee,pitting type Pt had decreased urine output for one day Generalised bodypains and joint pains. C/o pains on movement of lower limbs She had hlo cannulation to both wrists by local rmp ,after that she had pain in the upper limb .  No h/o prolonged immobilisation. NO h/o loose stools,pain abdomen, burningmicturition, hematuria,
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67M with AKI ON CKD(SECONDARY TO SEPSIS)? ALCOHOLIC HEPATITIS with THROMBOCYTOPENIA with HYPOALBUMINEMIAWith? Rt LOWER LOBE CONSOLIDATION

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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 is welcome. Here is a case i have seen 67 Y M patient  who is a rikshaw driver by occupation presented with c/o fever since 3 days . History of present illness: Pt was apparently asymptomatic 3days back.Then he had fever which is high grade,intermittent, relieves on medications, associated with chills and rigors. Decreased urine output since one day.  No H/o sob , palpitations,chest pain.No h/o night sweats,weight loss,vomitings, cough,cold,dysuria,loose stools,body pains,headache,
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assessment 2

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26 year old woman with complaints of altered sensorium somce 1 day,headache since 8 days,fever and vomitings since 4 days https://harikachindam7.blogspot.com/2020/12/26-year-old-female-with-complaints-of.html a). What is the problem representation of this patient and what is the anatomical localization for her current problem based on the clinical findings? ans.)Tubercular meningitis with k/c/o SLE since 3 years Anatomical localisation: based on complaints,of head ache,neck pain and fever,it is most probably meningitis. b) What is the etiology of the current problem and how would you as a member of the treating team arrive at a diagnosis?  ans.)Mycobacterium tuberculosis H/o meningitis symptoms and also family history (Her father in law has been active pulmonary Koch’s and finished his course of medication six months ago) c) What is the efficacy of each of the drugs listed in her prior treatment plan that she was following since last two years before she stopped it two weeks back?  ans
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