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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 is welcome.  CASE PRESENTATION: A 52 year old female pt. Came to opd with 1.c/o pedal edema since 22 days  2.decreased urine output since 22 days 3.vomitings 20 days back(4-5episodes) which lasted for a day 4.sob on exertion since 20 days 5. 3 episodes of GTCS today morning  HOPI: PT was apparently asymptomatic 22 days back then she had pedal edema ,decreased urine output , and sob on exertion for which she was admitted to a local hospital (on 23/10/2020 : .urea - 120, se.creatinin

1) "55 year old male patient  came with the complaints of  Chest pain since 3 days Abdominal distension since 3 days Abdominal pain since 3 days and decreased urine output since 3days and not passed stools since 3days  https://sreejaboga.blogspot. com/2020/11/is-online-e-log- book-to-discuss-our.html?m=1 a) Where are the different anatomical locations of the patient's problems and what are the different etiologic possibilities for them? Please chart out the sequence of events timeline between the manifestations of each of these problems and current outcomes.  b) What are the pharmacological and non pharmacological interventions used in the management of this patient and what are the efficacy of each one of them?    ANSWER :   1) pain in the epigastric region differentials a.Inferior wall MI(normal ecg and echo) Acute pancreatitis(radiation to the back)-usg finding and elevated serum amylase level b.perforated peptic ulcer  This occurs at the level of the sphincter of Oddi, a r

https://swathibogari158.blogspot.com/2020/09/chronic-decompensated-liver-disease.html Q1  Reason for this patients ascites  Might be due to liver cirrhosis  1.reduced albumin synthesis causes decreased oncotic pressure and transudation of fluid 2.reduced aldosterone metabolism causing  no aldosterone in circulation activating RAAS  , salt and water retension causing ascites 2) Why did the patient develop bipedal lymphedema? What was the reason for the recurrent blebs and ulcerations and cellulitis in his lower limbs?   A) underfilling of circulation due to hypoalbuminemia and salt water retention causes splancnic vasodilation that increases splanchnic arterial pressure and increases permeabilty which increases lymph accumulation Ulcers might be due to  Lymph stasis causes thickening of skin due to protein crosslinking which might cause inadequate circulation gradually ischemia and he mighy have developed ulcers 3) What was the reason for his asterixis and constructional apraxia and wha

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 20year old male pt came with the  1.c/o difficult in walking since 1 week 2.generalised weakness since 1 week Pt was apparently asymptomatic 3 months back  then  pt presented with c/o difficulty in walking and generalized weakness  for which he went to a local hospital and was diagnosed with hypokalemia and was treated but was not completely resolved. Now pt presented with c/o weakness and difficulty in walking which were aggravated since a week wh

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 23y old female patient presented to casualty with c/o loss of consciousness  Pt was apparently asymptomatic 15 days back then she had headache and fever which was insidious in onset,high grade,intermittent type,not a/w chills and rigors ,no diurnal variation,releievd on medication. Fever was a/w neck stiffness  H/o vomiting since 10 days .it was a/w food intake.(with food particles as contents ,non bilious,non projectile,non foul smelling)  H/o bod