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Showing posts from July, 2022

36yr old female with raise of body temp

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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.  HISTORY : A 36yr old female came to OPD with complaints of raise in body temperature, headche and neckpain. HOPI:  Pateint was asymptomatic before one day and pt told that she did household chores after that she observed raise of temp along with headache and neckpain from Tuesday afternoon .she took a tablet without eatg and had an episode of vomting.and at night she took another tablet without eatg had another episode of vomiting ,at 11 pm  patient felt that high raise of body temperature .At night aftr raise of temp she was taken to a RMP doctor and given Dolo 650 and an injection..next day mng p

73yr old male

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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.  Case Scenario A 73 yr old male came to medical OPD with chief complaints of fall ( slipped) when he went for urination . HISTORY OF PRESENT ILLNESS Yesterday morning at around 5:00 Am pt went for urination at outside and fainted and fell on ground and no post fall Loss of consciousness, seizures, vomitings pt walked and slept. At around 8:00 Am pt couldn't walk and was taken to pvt hospital  Investigations were done showing Hyponatremia, low serum osmolarity with high spot sodium Euvolumic state  CT brain shows diffuse cerebral atrophy with small vessel ischemia   2D Echo shows WNL Na+ 206,K+

52yr old female with loin pain

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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.  History: A 52 yr old  female with loin pain came to opd on 13/07/2022. Before that she felt that pain for three days and went to local hsptl and in the scanning she came to know that she has kidney problem. 18yrs back she is diagnosed with diabetes mellitus type 2 ( on oral medications for 12 yrs and after shifted to  insulin injection) 10yrs back diagnosed with HTN ( occasional consumption of medications). 3months back she went to general checkup and diagnosed with UTI . 9days back she felt loin pain bilaterally and went to local hsptl there she diagnosed with some kidney prblm. 6dys back (on 13/09

60 yr old male with stroke

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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.  A 60year old male patient Presented to casualty(29-06-22)with the chief complaint of giddiness and weakness in both lower limbs since afternoon.               HOPI: Patient was apparently asymptomatic 1day back then he developed headache and dizziness for 30min on and off in the early morning but still he went to perform his daily work activities (i.e.agriculture) from the afternoon then he had a deviation of mouth towards right side with giddiness and weakness in both lower limbs.  He also have pain in the right side of the face H/o of vomiting(3episodes) which non bilious and non projectile sin

CASE

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 30yr old female(k/c/o of CKD on MHD) came with the complainants of SOB ,facial puffiness and pedal edema (bilaterally) since 2days and also C/O chest pain which is nonradiating retrosternal.   Pt was asymptomatic 3months back  5yrs back pt was diagnosed with HTN. 6months back pt was diagnosed with kidney problem. 3months back hemodialysis was started to the patient. 2days back patient felt nausea , diarrhea, urination has stopped and experienced SOB. K/C/O:  HTN N/K/C/O DM,ASTHMA ,CVD,IHD,TB , EPILEPSY, THYROID DISORDERS. VITALS; Temp: 98.3 F PR :  92/min BP: 110/80 SPO2:98% GRBS:104mg % PHYSICAL EXAMINATION; CVS; S1 AND S2 are heard RESPIRATORY SYSTEM ; BAE + ABDOMEN SHAPE - SCAPHOID NO TENDERNESS NO PALPABLE MASS LIVER and SPLEEN are not palpable BOWEL SOUNDS are present CNS; pt is CONSCIOUS speech is NORMAL REFLEXES;       BICEPS TRICEPS SUPINATOR KNEE ANKLE  RT.  ++.       ++.        ++.          ++.     ++ LT.  ++.       ++.        ++.          ++.     ++ PROVISIONAL DIAGNOSIS; C