cherukurisahiti

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. Case history:- A 55yr old male, daily labourer by occupation came with complaints of:-   Chest pain since 8 months Generalized weakness and  body pains since 8 months. He was apparently asymptomatic 8months back, then developed chest pain along wih cough associated with sputum with generalized weakness..Then patient went to local government  hospital where he was treated symptomatically and later in July he was diagnosed with TB, for which ATT has started.(2 mon...

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.  CASE PRESENTATION: A 61 year old female who is a farmer by occupation came with complaints of-  Pedal edema followed by  facial puffiness since 1 week Loss of appetite since 10 days   Shortness of breath since 2 days. Patient was apparently asymptomatic 6 months back,  then she developed per vaginal bleeding which is insidious in onset, she is bleeding continuously for 3 months, which is foul smelling , relieved on it's own. No h/o clots, dysmeno...

case I: 1) What is the reason for this patient's ascites? Ans: excessive chronic alcohol use can cause - chronic liver disease alcoholic hepatitis  alcoholic cirrhosis In cirrhosis increase in portal hypertension causes sphlancnic vasodilation results in increase portal venous flow... Both these cause increased production of splanchnic lymph.. These changes result in sodium retention by causing activation of RAAS pathway with increase in aldosterone..  Sodium retention causes fluid accumulation and expansion of ecf results in edema and ascites..  2) Why did the patient develop bipedal lymphedema? What was the reason for the recurrent blebs and ulcerations and cellulitis in his lower limbs?   Ans: Bilateral pedal oedema which is of pitting type is due to decrease in the albumin level trends due to course of the disease and long standing cirrhosis causing decrease in the production of proteins causing decrease in the oncotic pressure leading to accumulation of fluid. a...

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. Case presentation: A 50 yr old Male who owns a laundry shop was apparently asymptomatic 3 yrs back,  Then had vomitings ( episodes and character records not available )for which he went to a local hospital where the treating physician observed elevated creatinine levels. So he referred the patient to nephrologist where the repeat creatinine levels showed upto 9 and by then patient was in altered behaviour (irritable and walking here and there). The patients attenders we...

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. Case presentation: A 60 yr old female who works in heritage was apparently asymptomatic 15 days back then she developed fever which was high grade, intermittent. So she went to RMP who said her BP was low and used medications( records not available) and got relieved with medication. Then patient was afebrile upto 8 days, after which she went to work for 2 days and then she again developed fever  , intermittent type, relieving with medication. patient went to an another ...