1st Internal Examination

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45 M with Abdominal distension and b/l lower limb swelling

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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     ...
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76 Female with hemiballismus secondary to uncontrolled sugars

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 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  Bow...
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A 38 yr old female came to OPD with fever, vomiting and not able to walk..

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  A 38 yr old female patient sweeper in a fertiliser company by occupation brought to casualilty with fever and vomitings and hypersalivation. She had low grade, intermittent fever which relieves on medication not associated with chills and rigors. HOPI: She had 5 episodes of vomitings for 2 days which contained food particles, non projectile and non foul smelling. She needed support for walking. Fever since 3 days, vomitings 5 episodes(12th & 13th June 2022), unable to walk since 2 days Negative history: no history of shortness of breath, cough, loose stools Past illness- known hypertensive since 2 years (using medication) NOT a known case of DM, asthma, tuberculosis, diabetes, asthma, epilepsy, CAD Personal History: Mixed diet Bowel And Bladder-Regular   Sleep Adequate  No Allergies And Addictions. Family History: not significant  General Examination:  Patient is Conscious,  Moderately Built and Nourished. Pallor Absent Icterus Absent Clubbing Ab...
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