"MY EXPERIENCES WITH GENERAL CELLULAR AND NEURAL CELLULAR PATHOLOGY IN A CASE BASED BLENDED LEARNING ECOSYSTEM'S CBBLE "

 I'm R.Manish Kumar undergraduate student of kamineni institute of medical sciences narketpally India !

With this blog I would like to share a bunch of cases that I took in my medical life guided by my seniors my professors and colleagues

Back in 2019 when I was in third semester I was exited to apply my classroom knowledge clinically on patients.First few days I was so nervous and tensed that I may make mistakes in correlating the knowledge but as days passed I learned many things from my patients .

The main thing that I learned from my mistakes is to take a detailed history which will direct us to the defective physiology and pathology and make our diagnosis easy and learned how important is the doctor and patient relationship is

   "The doctor patient relationship is critical to placebo effect" - Irving kisch

   "Doctor patient relationship is a part of healing process" - jalpa

 

 NOTE: THIS IS AN ONLINE E LOGBOOK 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 A SERIES OF INPUTS FROM THE AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS INTENDING TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE-BASED INPUT.

My first patient interaction:-

When I was posted in general medicine department .out of curiosity I went to patient and asked about what is happening for him and what is the reason of him coming to the hospital

She complained of

Bilateral joint pains in upper and lower limbs since 10 months 

Itchy lesions over face upper aspect of chest neck upper trunk over 10 months

 Generalised weakness since 10 months

On taking detailed history of the patient I got to know that she had mostly proximal muscle weakness that maked her inability to comb hair difficulty in walking and inability to sit down.She had a history weight loss of 4-5 kgs over the last 10 months and she had a sob grade 3 nyha.As a 3rd sem student i had limited knowledge and had doubts related to all the history given by him and their inter relations so i had went through some of the online sources which had given me a knowledge regarding them

Coming to past history she is not a known case of htn asthma epilepsy tuberculosis

No previous surgeries and no history of similar complaints in the past

Coming to her personal history her sleep was inadequate since 10 months and her appetite is decreased but her bowel and bladder moments are regular and she is no addictions

 On Examination:-

•Diffuse mottled erythematous hyperpigmentation (Heliotrope rash) noted on B/L cheeks, nose(bridge) involving nasolabial folds, ears, neck extending onto upper chest and back forming a ‘V’ on anterior chest (Shawl sign) and (V sign

Single erythematous macule noted over the right loin (Holseir sign).

 Pigmentation of B/L extensor surfaces of PIP and DIP noted (Gottron's papules)

 Mottled erythematous lesions on the palms

 Case link :-http://manishkumarollno129.blogspot.com/2023/03/1801006138-short-case.html

Case 2

This is another case that I came across in my final year ,34 year old who was suffering from breathlessness since 2 months and burning sensation in abdomen since 1 month .then I went near him and asked and he was not able to explain his condition so I asked his wife and she explained his condition on taking further history 2 months ago he developed high grade fever which was insidious in onset , gradually progressive in nature associated with chills and rigors .It aggravated on performing daily chores and relieved on taking medication. 

Fever is associated with severe body pains 

H/o cough Since 2 months which was insidious in onset non productive ,non blood stained,non foul smelling.no aggravating and relieving factors.

Breathlessness (SOB) started 2 months ago which was insidious in onset , relieved on sitting down position . Grade 2 acc to MMRC .

H/o burning sensation in the abdomen since 1 month which was insidious in onset , gradually progressive in nature , aggravated on intake of alcohol and spicy food , relieved on medication.It is recurrent in nature .

H/o 1 episode of vomiting which was non bilious,no projectile, contains food contents, relieved on medication.

H/o 1 episode of blood in stools .

H/o painful defecation.

On examination 

He has pigmented patches present on tongue 

Case link :-http://manishkumarollno129.blogspot.com/2023/04/34-year-old-male-with-pleural-effusion.html