Roshini bala

 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 also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome.  Case presentation: 35 year old male  labourer  by occupation who is the resident of  nalgonda    presented with pedal edema since 1 month and sob since yesterday Patient was apparently asymptomatic 1 month back later he developed pedal edema Which was gradual in onset  progressed to knee , associated with facial puffiness then he went to chityala and he has taken the medications which was prescribed by local doctor ,symptoms got relieved.  Then yesterday night he deve

  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 also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome.  Case presentation: 51 year old  male who works at petrol station, resident of  Narketpally Presented with fever since 1 week ( lasted for 2 hrs)  yellowish discoloration of eyes and urine since 4 days  Patient was apparently asymptomatic 2yrs back later he developed swelling of both sided small and large joints ( multiple joints) for which he was diagnosed with rheumatoid arthritis and diabetes ,for which he prescribed prednisolone 10 mg , HCQ - 200mg , lefloreamide

October 8th  Case 1  1)Reason for this patient ascites      A : The common cause of Ascites is       Cirrhosis of liver bcz patient having truncal obesity and he's a chronic alcoholic Altered echo texture of liver due to Cirrhosis causes portal hypertension leading to increased hydrostatic pressure causing fluid accumulation hence Ascites  Q2 Bilateral pedal oedema which is of pitting type is due to decrease in the albumin level trends due to course of the disease and long standing cirrhosis causing decrease in the production of proteins causing decrease in the oncotic pressure leading to accumulation of fluid ulcerations are due his limited self practising manoeuvres done in inappropriate conditions such as  improper dressing of the wound, not maintaining aseptic conditions , indescriminate use of steroids . Q3 Reason for Asterexis and constructional apraxia  A: In hepatic encephalopathy (due to cirrhosis of liver ) damage occurs to brain cells due to the impaired metabolism of am

 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 also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome.  Case presentation: A 65 year old male Pt with k/c/o Lt sided hemiparesis of 2 attacks presented with C/O some one going to hit him (according to Pt) and seeing familiar faces (even though no one is there) and increased appetite and urinary incontinence since 2 months Patient presented with chief compliants of some one going to hit him and seeing familiar faces since 2 days . Sudden onset associated with ringing sensation in ears and hearing voices from surroundings. U