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Showing posts from April, 2022

68 YEAR OLD FEMALE WITH SHORTNESS OF BREATH

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65 year old female who used to work as a tailor came to casualty with complaints of shortness of breath since 6 days ,even in sitting position.She also complaints of swelling of limbs since 6 days ,pitting type of edema upto knee since 2 weeks .decreased appetite and increased thirst since 2 days  HOPI: patient was apparently asymptomatic 10 years back later she developed SOB ,swelling of whole body for which she was admitted in hospital on 1/7/2012 for which she was diagnosed having dilated cardiomyopathy and severe LV dysfunction a d she was in lasix and later got checked  every yearly on 2D echo which showed following findings  2014: LV dysfunction, moderate MR/TR,moderate  PAH ,mild AR 2015: decomponsated heart failure / NYHA CLASS III 2016 : admitted with dyspepsia ,vomiting ,cough,SO ,sleepiness and used DYTOR forvtgat and on 2016 June diagnosed to have left sciatica  2017 : went to hospital with dry cough ,sob ,chest pain and EF=20% 2018: having SOB II ,cough and syncope  2022:

60 YEAR OLD PATIENT WITH UNCONTROLLED SUGARS AND LOSS OF VISION

60 year old female with complaints of uncontrolled sugars since 3 days and decreased vision in left eye since 1 year  Patient was apparently asymptomatic 3 days  back then She is having uncontrolled sugars .she has come to hospital with loss of vision in  left eye since 1 year  Past history : H/o cataract surgery 5 years back H/o diabetes mellitus since 3 years on medication of glimiperide and metformin  No h/o hypertension , asthma ,epilepsy  Personal history : Married   Occupation farmer  Bowel and bladder regular No known allergies  No addictions  Family history: Not significant with the patient history  On examination: Patinet is conscious/coherent/ cooperative  No pallor /icterus/cyanosis/clubbing/lymphadenopathy  BP -110/70mmhg PR-78BPM RR-16CPM SPO2-98 ON RA GRBS-103 mg /dl on admission  Systemic examination: CVS - S1 S2 heard CNS- NAD RS- BAE + ,NVBS HEARD P/A - SOFT ,NON TENDER. Eye examination:                                    Right                             left  Visual

30 year old female farmer with weakness of both limbs

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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"   A 30 year old female farmer by occupation  Came to opd with complaints of weakness of bilateral lower limbs  and weakness of bilateral hands since 10 days HOPI: Patient was apparently   asymptomatic 15 days back then she had fever high grade and loose stools (4-5 episodes) , continuous associated with generalized body pains and joint pains (knee, ankle ,wrist,small joints) relieved with medication.  2 days later she had pedal edema ,facial puffiness a/w tingling and numbness