Manishkumar roll no 129

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

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 CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUT Chief complaints:pt came to OPD with known case of CKD for MHD HOPI:pt was apparently asymptomatic 3months back then she had history of pedal edema insidious in onset and gradually in progression upto knee And history of shortness of breath since 3months insidious in onset and gradually in progression which is grade2, associated with loss of appetite and decreased urine output she went to hospital and she found to have increased creatinine level and bilateral kidney failure  Past history: history of HTN and DM and no history of Tb,asthama, thyroid abnormality, Personal history: Diet: mixed Appetite:normal Sleep:

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. Case : 35 years old female,resident of choutuppal,works in the hotel, came with chief complains SOB since 3 months , fever and generalised weakness since 1 month. HOPI: Patient was apparently asymptomatic 3 months back then she had shortness of breath which relieved on taking rest ,No orthopnea, no PND. -C/o generalised weakness since 1month ,13 days back she went to the Suryapet hospital ,there they did haemogram and diagnosed as anemia, at that time her hb was 3 gm/dl. -C/o fever since 1 mont

This is an online E logbook to discuss our patients' 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 patients' clinical problems with the collective current best evidence-based inputs. This e-log book also reflects my patient-centred online learning portfolio and your valuable inputs on the comment box are welcome.   45 years old female came with C/O right and left wrist and ankle joint pain since 4 years C/O neck pain since 4 years C/O generalised weakness and difficulty in lifting weights since 4 years HOPI: Patient was apparently asymptomatic 4 years back and then patient developed joint pains such as wrist and ankle joint pains which is insidious in onset gradually progressive,dull aching type of a pain, associated with early morning stiffness lasts for 2 hours  Pain aggr

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 reflects my patient centered online portfolio and your valuable inputs on the comments is welcome. 30  year old female came to the op with *Chief complaints of:- •Bilateral joint pains in upper and lower limbs(knees, hip, ankle, shoulder, elbow, wrist, including small joints) since 10 months.  •Itchy lesions over the face,upper aspect of the chest, neck and back of the neck and upper trunk with dark coloured lesions over the knuckles since 10 months.  •Generalised weakness since 10 months - Inability to comb the hair, difficulty in walking and inability to sit down.  History Of present illness