C/o swelling in the front of the neck since 1year, The patient was apparently asymptomatic one year ago, then later noticed a swelling in front of his neck which gradually progressed to attain current size. It is not associated with pain. Patient is complaining of discomfort.No H/o Trauma, fever NO H/o swelling in the past No h/o other swelling in the body. No h/o hoarsness of voice No h/o difficulty in deglutition H/o loss of weight since 1 year On Inspection:- A visible Swelling of 5x5 cm spherical in shape is seen on the front of neck left side to trachea. The stin over the swelling appears to be normal, no visible pulsations No Scars, sinuses,engorged veins. The skin around the swelling appear to be normal The swelling moves upwards on deglutition. The swelling does not move on protrusion of the tongue. Lower border of swelling is visible. On Palpation- These is no local rise of temperature over the swelling All the Inspectory findings are confirmed on Palpation Non- tender,
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On Inspection - A Solitary ovoid shaped swelling of about 4x3 cm noted over the left anterior chest wall - Surface of the swelling appears smooth - Skin cover the swelling N - Edges (clearly) defined" - No visible pulsations and peristalsis - On palpation - No local rise in temperature. Non tender - All Inspectory findings regarding size shape and extent have been confirmed - Surface smooth well defined edges -Soft in consistency - Skin pinchable Swelling is mobile Tab AUGMENTIN 625MG PO/TID TAB FLUCANAZOLE 200MG PO/BD TAB PAN 40MG PO OD BBF TAB MVT PO OD TAB VIT C PO OD
Chief complints- A 4yrs old female child Was brought by mother with the complaints of cough :: 7days History of Presenting illness: child was apparently asymptomatic 7days back then developed cough which was Productive type, diurnal variation Present, gradually progressive more during the night time associated with post tussive vomiting. It is associated with nasal discharge noisy breathing, not associated with mouth breathing H/o fever 5 days back for 3 days which was gradual in onset, low grade, intermitta not associated with rigors; aggrevates durine night time , relieved on taking medication Past History H/o nasal discharge at 3 months of age. Shown to local RMP , where symptomatic and supportive treatment was given and symptoms subsided. No documentation available Antenatal History -conceived spontaneously after 9 months of married life Natal History Full term, LSCS BT WT 2.5kg cried immediately after birth Breast fed within 24 hours of delivery . POST NATAL HISTORY H/O NiCU
45 M with Abdominal distension and b/l lower limb swelling
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. I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings investigations and come up with diagnosis and treatment plan. Unit 1 AMC bed 5 DOA:29/5/23 45 year old male ,lorry driver by occupation,resident of Nalgonda came to the opd with chief complaints of Abdominal distension since 4-5 days Abdominal bloating since 4-
C/O VOMITINGS SINCE 3 MONTHS SWELLING OF BOTH LOWER LIMBS SINCE 1MONTH. HOPI:- PATIENT WAS APPARENTLY ASYMPTOMATIC 3 MONTHS BACK. SHE THEN HAD VOMITINGS (2-3 EPISODES/DAY) -ON AND OFF SINCE 3 MONTHS VOMITINGS - WATERY, NON-PROJECTILE, NON-BILIOUS WITH FOOD PARTICLES AS CONTENTS AND NOT BLOOD STAINED.; HEART BURN OCCASIONALLY. VOMITINGS HAPPEN AFTER TAKING FOOD (NOT DAILY),NO NAUSEA. -NO C/O PAIN ABDOMEN, LOOSE STOOLS. C/O CONSTIPATION - PASSES DAILY -HARD STOOLS OR PASSES EVERY ALTERNATE DAY C/O SWELLING OF BILATERAL LOWER LIMBS -PITTING TYPE, EXTENDING ABOVE ANKLE AND NOT EXTENDING UPTO THE KNEE. AGGREVATED ON WALKING AND RELIEVED (INCOMPLETELY) ON LYING DOWN (INCREASED BY EVENING AND DECREASED BY MORNING). DECREASED URINE OUTPUT, NO BURNING MICTURITION, NO INVOLUNTARY MICTURITION , PT IS UNABLE TO HOLD THE URINE DURING URGE TO MICTURITION. C/O SOB - AFTER EATING FOOD, AND AFTER WALKING (GRADE-II) NO C/O CHEST PAIN, PALPITATIONS, ORTHOPNEA, PND. C/O LBA-RADIATING TO B/L LOWER LIMBS
76 Female with hemiballismus secondary to uncontrolled sugars
A 66 yr old female ,residence of nalgonda came to the old with c/o Slurring of speech since 15days Involuntary movements of right upper limb since 10days And right lower limb since 5 days She was apparently asymptomatic 15days ago then she developed swelling of tongue f/b slurring of speech , insidious in onset and gradually progressive,no aggravating and relieving factors Not associated with deviation of mouth C/o involuntary movements of right upper and lower limb,insidious in onset and gradually progressive , aggravating on increasing sugars and decreasing with decrease in grbs levels She also c/o skin lesions over genital region since 15days Past history: K/c/o HTN since 2 years K/c/o DM since one week She has h/o joint pains( shoulder and elbow) since 2-3 months for which she went to a local hospital and the reports shower RA FACTOR+ and was advised tab . methotrexate (on regular medication) Personal history: Diet :mixed Appetite:normal Bowel and bladder:regular but c/o bu
76 year old female with hemiballismus secondary to uncontrolled sugars
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. I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings investigations and come up with diagnosis and treatment plan . Unit 1 Amc bed 1 DOA 22/5/23 A 66 yr old female ,residence of nalgonda came to the opd with c/o Slurring of speech since 15days Involuntary movements of right upper limb since 10days And right lower li