Manishkumar roll no 129

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 series of inputs from an available global online community of experts to solve those patients 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 are welcome. 65year old female  came to opd with chief complaints of  -fever since 20 days  - pedal edema and facial puffiness since 20 days  History of presenting illness:- --Patients was apparently asymptomatic 20days ago then she developed fever which is insidious in onset gradually progressive ,low grade fever, intermittent, associated with body pains not associated with chills and rigors --No history of nocturnal variation in fever pattern Patient when got fever 20days back she ignored it and went on he

 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-IDENTIFI

This is an 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. 48 year old female house wife by occupation resident of west Bengal came to opd with  CC        ----Rashes on arms and legs since 6 years      ---- Back pain since 15 years    History of presenting illness:-  ----Patient was apparently asymptomatic 15 years ago then she developed backpain from cervical region extending upto lumbar region in the midline which is sudden in onset  aggravated on doing work and relieved on rest  for which she went to local hospital and was prescribed tab Fluoxetine 

This is an 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. 25 year old female student by occupation resident of westbengal came to opd with  C/c of      Swelling in both limbs since 6 years     Headache on backside since 6 years  Hopi:- Patient was apparently asymptomatic 6 years ago.On one day after she wakes up in the morning  she noticed swelling in the both limbs below knee level mainly at the level of foot which is  insidious in onset progressive with  no aggravating factors and  relieved on massage and not associated with pain. The swelling is m

48 year old male resident of Chityala Auto Driver by occupation  CHIEF COMPLAINTS  Abdominal distension since 20 days   Breathlessness since 20 days  Swelling of bilateral lower limbs since 20 days  Decreased urine output since 3 days  HISTORY OF PRESENTING ILLNESS  Patient was apparently asymptomatic 20 days back then he developed abdominal distension which was insidious in onset ,gradually progressed to present size . It is diffuse type of abdominal distension H/o Shortness of breath since 10 days initially he used to walk to his home without any problem after parking his auto at a distance from home.Now he has to take rest after walking such distance (MMRC grade 2) .Distension doesn’t change with position  No h/o orthopnea ,PND,abdominal pain ,vomitting ,obstipation . Swelling of bilateral lower limbs since 15 days insidious in onset , gradually progressive upto knee level, pitting type (grade 2) reduced on walking ,no change at rest and raising the legs No history of chest pai