Bimonthly assessment August

This is an a online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome. The patient/ attender was informed the purpose of the information being acquired. An informed consent was taken from patient/ attender and there is omission of information that was requested to be omitted. 83yr old male came with complaints of  shortness of breath since 10 days. chief  complaints:  cough since 16 days Fever since 14 days shortness of breath since 12 days History of Presenting illness: Patient was admitted to ICU 16 days back with  breathlessness. It was insidious in onset and g

This is a case of a 35 year old female who is a wig maker and goes to part time work in paddy and cotton field’s presented to the Emergency department with acute history of:-  pain abdomen and vomiting’s since 4 days   decreased urine output since 2 days  swelling of legs since 1 day  HOPI:- Patient was apparently asymptomatic 4 days back but she developed Abdominal pain lower which is left hypochondriac and lumbar region and non-radiating with sudden in onset and gradually twisting type of pain  H/O vomiting present with 4 episodes in a day non-projectile , non-bilious , contains food particles that are aggregated on taking food H/o of Bleeding  H/o decreased urine output H/o of pedal edema which was gradual in onset nd progressive upto below knee   No H/o of Burning Micturition  No H/o PND and ORTHOPONEA  No H/o shortness of breath   No H/o chest pain  MARRIAGE & OBSTETRIC HISTORY:  Married at the age of 17 years , non-consanguineous.  FIRST child at 18 years - death of the first

This is a case of a 14 year old girl who came with chief complaints of: Shortness of breath since 2 days Fever since 1 day Abdominal pain since 1 day Vomiting 1 episode HOPI:  The patient was apparently asymptomatic  2 days ago then she developed sudden onset shortness of breath since 2 days, gradually progressive and progressed to stage 4. Shortness of breath started after patient missed taking 2 doses of insulin. No orthopnea, no PND.  Fever since 1 day, high grade associated with chills and rigors, relieved on taking medication, no diurnal variation. Abdominal pain since 1 day epigastric region alter progressed to diffuse abdominal pain. No h/o vomiting, loose stools, giddiness. Headache present, vomiting 1 episode- non projectile, not blood stained, content- food material. Past history  H/o type 1 DM since 4 years in biphasic insulin 30/70(17U-12U) h/o 2 previous admissions for fever in last 4 years Family history h/o diabetes in younger sister from 6 years of age H/o DM in her gra

CASE SCENARIO:- A 32 yr old male came to casuality with Chief complaints of   Fever since 5 days  Abdominal pain since 5 days  chest pain since 5 days   HISTORY OF PRESENTING ILLNESS:- [ ] Abdominal pain is pricking pain and continues since 1 week  [ ] High Grade fever -intermittent from 6 days associated with chills [ ] Dry cough since 1 day  [ ] Body pains present with 6 days  [ ] continues Headache since 6 days PAST ILLNESS:- No Tb,Asthma,D.M,HTN FAMILY HISTORY :- not significant PERSONAL HISTORY:- [ ] Married  [ ] occupation-Daily wage worker [ ] Appetite-Good [ ] Bowel nd Bladder-Regular [ ] Allergy-No [ ] Addiction-No cigarette smoking                             chews tobacco pan masala once after 3 days                            drinks Alchol Beer=90ml after dinner once in 3 days    GENERAL EXAMINATION:- [ ] Pallor- No [ ] Icterus-No [ ] Cyanosis-No [ ] Lymphadenopathy-No [ ] Edema-No VITALS

A  35yr old male came to causality with chief complaints of itching skin lesions all over body since 8months  𝐇𝐈𝐒𝐓𝐎𝐑𝐘 𝐎𝐅 𝐏𝐑𝐄𝐒𝐄𝐍𝐓𝐈𝐍𝐆 𝐈𝐋𝐋𝐍𝐄𝐒𝐒 :- Patient was apparently asymptomatic 8months ago the he developed small papulesbover cheek after which it transformed into erythematous scaly plaque first on nose cheek then over entire face, neck ,back ,hand and to  legs  𒊹︎︎︎ H/o itching present over plaques  𒊹︎︎︎ H/o photosensitivity  𒊹︎︎︎ Swelling restrictions of movements persistent  𒊹︎︎︎ C/o Wrist joint pain (+) 𒊹︎︎︎ C/o Metacarpo phalanges pain (+) 𒊹︎︎︎ C/o Interphalanges pain (+) 𒊹︎︎︎ C/o Tenderness present over wrist,mcp, Ip 𒊹︎︎︎ H/o fever & episode in last 8months 𒊹︎︎︎ Last episode 20days back 𒊹︎︎︎ Fever last for 1day relieved after taking medication 𒊹︎︎︎ H/o oral ulcer on hard palate since 10days  𝐇𝐈𝐒𝐓𝐎𝐑𝐘 𝐎𝐅 𝐏𝐀𝐒𝐓 𝐈𝐋𝐋𝐍𝐄𝐒𝐒 :- 𒊹︎︎︎ H/o CVA  left Up & Ll weakness &slured speech  10 years back 𒊹︎︎︎ H/o Appendectomy 8year