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Showing posts from May, 2023

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      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

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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  Bowel and bladder:regular but c/o bu

76 year old female with hemiballismus secondary to uncontrolled sugars

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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 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